2 letters to editor re: Zamboni's article in JNNP

[prof8]

One is from Steven Brenner, neurologist in St. Louis MO and the other is from Marian Simka, specialist in angiology in Poland. Isn't someone on this site seeing her?

http://jnnp.bmj.com/cgi/eletters/80/4/392#4667

At any rate, Brenner I can understand but I can't make heads or tails as to what Simka is saying here. Easy to understand medical lingo, anyone??! Maybe these letters are already posted on the sticky above?--I didn't see them.

[NHE]

At any rate, Brenner I can understand but I can't make heads or tails as to what Simka is saying here. Easy to understand medical lingo, anyone??! Maybe these letters are already posted on the sticky above?--I didn't see them.

Simka's letter in a nutshell... Endothelial cells are the cells that line the blood vessels. In the brain, the endothelial cells make up the blood brain barrier. When blood flows past the endothelial cells, the cells experience shear stress. In response to this stress, the cells upregulate the proteins that make the connections between them stronger, i.e., the statement about tight junctions. Stronger tight junctions help the blood brain barrier limit what can pass between the endothelial cells from the blood to the brain, e.g., the white blood cells of the immune system. Simka's point appeared to be that with reduced blood flow seen in CCSVI in MS patients, the endothelial cells will not experience as much shear stress and will therefore have weaker tight junctions between them leading to increased permeability of the blood brain barrier and that this change in the blood brain barrier may be a contributing factor to the development of MS. In addition, Simka noted that low shear stress upregulates the protein, ICAM-1, that's used by leukocytes to cross the blood brain barrier. This is like a double edged sword against the blood brain barrier, i.e., not only is it more permeable but the adhesion molecules needed by the immune system cells to cross the blood brain barrier are more abundant (that's like opening all the windows in your house just a bit and then putting signs out for the burglars). Simka also proposed that he thought that surgical intervention was a good idea.

NHE

[daniel]

Just a minor correction... I believe Marian Simka is a he.

[ErikaSlovakia]

Just a minor correction... I believe Marian Simka is a he.

Hi, yes, for sure he is a man.

[Loobie]

I vote for the title of Earth Czar goes to NHE. I feel like I just get smarter reading his posts!! Everything I question because I don't understand the lingo, you eventually clear up, you're amazing.

[Ernst]

NHE explainded that so well that even Finnish speaking understood. Earlier I understood a bit opposite way --> that cause of obstacles, blood can't flow and there will be pressure = stress to blood-brain-barrier and it begins to leak.. But quess that I have had some confusion with Simka's text.

[chrishasms]

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[Jamie]

If I ever have occasion to write a scientific paper I vow to write it in plain English.

[Rokkit]

Hot Damn!! Take that skeptics!! LOL

Chris, I don't mean this to sound harsh at all- I know you've been dealing with this disease an awful lot longer than I have. But in any event...

I would be careful about turning CCSVI debate into "us vs them." With the limited information we have so far, it would take a leap of faith for anyone to assert much of anything definitively. It will be much more helpful to all of us if we can continue to debate CCSVI objectively, instead of turning it into a religious belief to be defended.

CCSVI has given us much needed hope, and I think sometimes we perceive skepticism as a threat to that hope, and we react defensively. If CCSVI is the answer for MS, the proof will be in the pudding and the skepticism will take care of itself.

Rokkit

[cheerleader]

I'd seen these letters earlier in the year, and actually have had some e-mail conversations with Dr. Brenner. He works for the VA and sees many vets with MS. I encouraged him to do some CCSVI research at his hospital. I hope he is right now!

Dr. Simka is, as we all know now, a wonderful man, and pursuing the CCSVI studies in Poland. Thanks to NHE for the English translation!

Many of the docs who are coming to Bologna were quite surprised with that Zamboni paper, and although they did not write responses, they are studying CCSVI in their own MS patients.
Oh, I cannot wait to go....just got the invites for the dinners, press and meetings...whooo hoooo.
cheer

[Ernst]

Oh, I cannot wait to go....just got the invites for the dinners, press and meetings...whooo hoooo.
cheer

Ooooo sooooleeee miiooooo! That sounds wonderful, you must be veeeerryyyy excited about the trip. Must be like a dream, that whole thing?

[chrishasms]

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[Jamie]

Chill, Chris.

There's no reason to stomp off, you know you'll be back anyway, TIMS is too addictive!