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Cure for Multiple Sclerosis Allegedly Found

Tellenbach

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Italian doctor may have found surprisingly simple cure for Multiple Sclerosis

In an initial study, Dr. Paolo Zamboni took 65 patients with relapsing-remitting MS, performed a simple operation to unblock restricted bloodflow out of the brain - and two years after the surgery, 73% of the patients had no symptoms.

He formed a hypothesis on how this could lead to MS: iron builds up in the brain, blocking and damaging these crucial blood vessels. As the vessels rupture, they allow both the iron itself, and immune cells from the bloodstream, to cross the blood-brain barrier into the cerebro-spinal fluid. Once the immune cells have direct access to the immune system, they begin to attack the myelin sheathing of the cerebral nerves - Multiple Sclerosis develops.

More than 90% of people with MS have some sort of malformation or blockage in the veins that drain blood from the brain. Including, as it turned out, his wife.

I'll try to dig up the actual scientific journal article, if it exists. This is huge news if true.
 

á´…eparted

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You need to read more carefully, and triage what is good/bad a lot better.

The article was posted in 2009. We have heard nothing of this since. There is no reference to publications of the findings/research, which suggests either A. there are none, or B. it's not a major journal and thus holds little to no weight. Further, if you go to the bottom of the article, it says:

Update (Feb. 10,2014): A study conducted by researchers at the University of Buffalo has cast doubt the validity of this approach.

This is just a flash in the pan, and just goes to show you digging around in the fringe yields little value the vast majority of the time.

This all took me about 2 minutes to do.
 

magpie

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This is why it's so important to make sure your doctor knows what they're doing. Or rather, you know what your doctor's doing.
 

Tellenbach

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Chronic cerebrospinal venous insufficiency in patients with multiple sclerosis - J Neurol Neurosurg Psychiatry 2009;80:392-399 doi:10.1136/jnnp.2008.157164

Subsequently, venography demonstrated in clinically defined multiple sclerosis (CDMS), and not in controls, the presence of multiple severe extracranial stenosis, affecting the principal cerebrospinal venous segments; this provides a picture of chronic cerebrospinal venous insufficiency (CCSVI) with four different patterns of distribution of stenosis and substitute circle.

Observational case-control study of the prevalence of chronic cerebrospinal venous insufficiency in multiple sclerosis: results from the CoSMo study

No significant difference in CCSVI prevalence was found amongst the three cohorts (MS versus HC, OR = 1.55, 95%CI = 0.72–3.36, p = 0.30; OND versus HC, OR = 1.47, 95%CI = 0.53–4.11, p = 0.46; MS versus OND, OR = 1.05, 95%CI = 0.47–2.39, p = 0.99).

Unfortunately, other groups can't seem to see the venous irregularities (the stenosis) that Dr. Zamboni sees; Dr. Zamboni thinks they're using different techniques.

Why not do a larger clinical study and put Dr. Zamboni in charge of the surgery? That seems to be the most logical next step. Also, let's interview the 65 patients that were treated using the technique and ask them if they had multiple sclerosis and whether or not their symptoms improved after the treatment.
 

á´…eparted

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Why not do a larger clinical study and put Dr. Zamboni in charge of the surgery? That seems to be the most logical next step. Also, let's interview the 65 patients that were treated using the technique and ask them if they had multiple sclerosis and whether or not their symptoms improved after the treatment.

A. Because in order for something to be valid, it needs to be reproduced by multiple people and multiple research groups.
B. The experts in the field have triagged this, and based off the research this does not seem like a viable method, or a hot topic. The most logical step would be for the original researcher to refine, improve, and publish new work to encourage confidance. Others failed to reproduce his work. Thus, the onus is on the original researcher.
 

Tellenbach

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Hard said:
A. Because in order for something to be valid, it needs to be reproduced by multiple people and multiple research groups.

We've gone over this, but the validity of a theory doesn't really depend on whether or not it can be reproduced by multiple people because the competence level of the researcher, the equipment, purity of samples would all be in play. It is almost impossible to exactly replicate an experiment since there are dozens, if not hundreds of variables that could affect the outcome.

If 65 patients underwent this procedure and 73% of them reported no MS symptoms after 2 years, that would warrant further investigation, preferably by investigators with the latest and greatest equipment. I'd love to see American doctors test this hypothesis.

These 65 patients should be studied further to determine if their MS markers (I'm not sure if there are any such markers.) have decreased. There has to be some sort of objective measure of improvement.
 

á´…eparted

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We've gone over this, but the validity of a theory doesn't really depend on whether or not it can be reproduced by multiple people because the competence level of the researcher, the equipment, purity of samples would all be in play. It is almost impossible to exactly replicate an experiment since there are dozens, if not hundreds of variables that could affect the outcome.

If 65 patients underwent this procedure and 73% of them reported no MS symptoms after 2 years, that would warrant further investigation, preferably by investigators with the latest and greatest equipment. I'd love to see American doctors test this hypothesis.

These 65 patients should be studied further to determine if their MS markers (I'm not sure if there are any such markers.) have decreased. There has to be some sort of objective measure of improvement.


You really have absolutely no idea how science works, do you? That's rhetorical, don't answer.

Yes, they would have to be able to reproduce this. If they couldn't, it wouldn't even be a viable procedure in the first place.
 

Redbone

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/DG/

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I do recall some interesting information on treating rheumatoid arthritis (I have this myself) by hacking into the vagus nerve.

:shock: That sounds so incredibly random that I'm intrigued. Do you think you'd be able to find the paper and link me to it? I can get around journal paywalls with my university.
 
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You really have absolutely no idea how science works, do you? That's rhetorical, don't answer.

Yes, they would have to be able to reproduce this. If they couldn't, it wouldn't even be a viable procedure in the first place.

Agreed. It costs between $30-40 million to run a single clinical trial - and around the same cost to get approval assuming it passes phase 3 (most don't). Who would throw away that money on a single study? There are literally millions of non-replicable studies flying around in the literature - published in prestigious journals (e.g. Nature, Science) with impact factor several times that of J Neurol Neurosurg Psych. None of those made it to clinical, so why this one? And what you're talking about is surgery (albeit keyhole) - which carries associated risk of thrombosis/stroke. You've gotta be kidding.

*edited to add a couple of links.
To add context to what I'm saying, there's an ongoing case in Brazil where people went through the courts to get a supposed "miracle" cancer drug that had been tested in several publications but had not made it through clinical. This is Nature's editorial on the issue, which I completely agree with: Drugs on demand : Nature News & Comment

Further, when talking about autoimmune/neurological conditions like MS which we don't fully understand the cause of, separating placebo from real effects is crucial. There's a review here (behind an institutional paywall, another of my pet peeves) that has a short section on studies evaluating placebo effect in MS: Mechanisms and therapeutic implications of the placebo effect in neurological and psychiatric conditions. - PubMed - NCBI

I'll just screenshot the relevant bit here:
J-7vz7PfKUpwwyYuQXI4ThuWEERDrp1Yxdd4VO_lIDU


In short: Probably placebo, patients could be experiencing benefit just 'cause they expect one from having undergone surgery. Last line suggests that having a close doctor/patient relationship would increase expectation of benefit from the procedure, and thus lead to a larger placebo. Note that the doctor in the study linked even had his wife as a member of his cohort!

As for why I'm even bothering to explain or look up the literature, it's in the hope that people learn more about the nature of research, trials and drug development. Otherwise discussion of science will remain at a very superficial level, and people will continue to be duped by every sensationalist headline.
 

Tellenbach

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Hard said:
Yes, they would have to be able to reproduce this.

Lots of valid theories haven't been proven or reproduced. Black holes have been theorized for decades but indirect evidence surfaced only with the creation of the Hubbell telescope. Fermat's last theorem was unproven for over 3 centuries. The metabolic theory of cancer from a 2 time Nobel prize winning biochemist was largely ignored until the last 10 years. I think you should read up on the history of science; you'll find that many valid theories are dismissed for a variety of reasons.

nonsequitur said:
In short: Probably placebo, patients could be experiencing benefit just 'cause they expect one from having undergone surgery.

Highly unlikely that a placebo effect would last 2 years. Also, most placebo effects are of a much smaller magnitude, usually around a 30 to 40% improvement, not a 100% improvement.
 

/DG/

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Wildly uneducated random guess...

I wonder if it helped to relieve some symptoms because it helped reduce any possible increased intracranial pressure from inflammation, not because it is actually "curing" the disease.

I do intend to read up a bit more on this later on, but it will have to wait until after finals next week. Then I may be able to have a more educated discussion.
 

Tellenbach

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Tellenbach's theory on Multiple Sclerosis and other Autoimmune Diseases: The Adjuvant Theory of MS

I'm reading Howard Weiner's "Curing MS" and a section on the background of the disease brought to mind a series of experiments performed by the brilliant Emanuel Revici on animals.

The animal model of MS is called 'experimental allergic encephalomyelitis' or (EAE). It was discovered that certain monkeys given the rabies vaccine developed symptoms similar to humans with MS. The rabies vaccine is incubated in a brain extract. This gave Thomas Rivers (in the 1930s) the idea to use brain extracts to see if he could create an animal model of MS. It worked, but the process took a long time and only a tiny percentage of the animals developed the disease.

Fast forward a couple decades and someone finds out that if you add a chemical (Shit, I've already forgotten the specific name of it.) to the brain extract, the process becomes exponentially more efficient and all the animals develop the disease when injected with the chemical + brain extract. The chemical that amplifies the immune response is called an "adjuvant".

This is exactly what Revici did using a plant extract with bits of organ tissue. Revici found that if he mashed organ tissue and then added the plant extract to it, it would elicit a powerful immune response in the same organ of the animal that received the injection. For instance, if he ground up liver tissue and added the plant extract and then injected the solution into a rat, the rat's immune system would attack the liver, resulting in liver failure and death to the rat. Btw, that's why I'm not naming the plant; this knowledge is too dangerous to share.

Here's my theory on what causes autoimmune diseases:

Foreign antigens enter the body through the diet or the environment. The foreign antigen resembles the antigens or protein markers of the host animal. In MS, this is a protein on the myelin sheath. If an antigen similar to the myelin sheath protein is introduced AND an adjuvant is also present, this will cause the immune system to rev up and start attacking both the foreign antigen and the host's antigen, just as with Revici's rat experiments. In the case of MS, the foreign antigen is likely nerve cell myelin proteins found in all meat products.

MS researchers have been looking for a viral or other infectious agent for 50 plus years with no success. What they should be looking for is the adjuvant and how it super-activates the immune system. We got a huge clue this week when a research group found that Type 2 diabetics are deficient in a regulatory protein that stops the immune system from attacking pancreatic cells. This is the strategy that should be employed in every autoimmune disease. Find the adjuvant, find out how it works, and find out how to neutralize it.

If my theory is correct, this is what I predict:

1) Young vegetarians (look for Hindu/buddhist children or chidren raised by vegans) will not develop MS later on because they haven't ingested any antigens similar to the myelin sheath protein;

2) People with MS might improve on a vegetarian diet (I'm assuming that not introducing more foreign myelin antigens will calm the immune system.); and

3) Using sodium thiosulfate/ butanol or glycerol/cholesterol (one or the other, not both) might calm the immune system since Revici discovered that the fatty acid/sterol ratio in the body regulates the immune response and the 2 sets of substances above tweaks that ratio.
 

tkae.

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I don't understand how this treatment would even help. Multiple Sclerosis is a condition where your immune system attacks the myelin sheath, which is basically the insulating tissue that protects the integrity of your nervous system. It causes your neural circuitry to be compromised. I have no idea what a treatment to increase blood flow would have to do with an autoimmune problem.
 
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I don't understand how this treatment would even help. Multiple Sclerosis is a condition where your immune system attacks the myelin sheath, which is basically the insulating tissue that protects the integrity of your nervous system. It causes your neural circuitry to be compromised. I have no idea what a treatment to increase blood flow would have to do with an autoimmune problem.

I'm a research fellow in the field of immunology. I wouldn't even know where to start with addressing his theory.

This turned up on my twitter feed today and I thought it was exceptionally relevant:
Zi31ogqJ-ImRuwuZp4ZVDi6HXUTFgj_ZbLKi2gjsH-U
 

tkae.

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I'm a research fellow in the field of immunology. I wouldn't even know where to start with addressing his theory.

This turned up on my twitter feed today and I thought it was exceptionally relevant:
Zi31ogqJ-ImRuwuZp4ZVDi6HXUTFgj_ZbLKi2gjsH-U

Broken link.
 

Tellenbach

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From Redbone's link:

Researchers Report Alternate Explanation Discovery Of How And Why CCSVI Treatment Works In MS Patients

They suggest that further studies should investigate TVAM in a larger MS cohort, and that the improved R-R intervals post-TVAM achieved in this study, combined the results of their recent study showing arterial blood pressure increase post venous angioplasty in MS patients with below-normal baseline pressure readings, strengthen the notion that angioplasty exerts beneficial effects by improving ANS function, and that the safety of this modified procedure, coupled with its efficacy observed in this pilot study, suggests its utility in improving symptoms of ANS dysfunction, noting that this modified technique could be further applied in other autoimmune and neurological diseases where dysautonomia plays a role in disease pathophysiology.

“The current study demonstrates the procedure’s effect on autonomic function, offering an explanation for why patients may see symptom improvement with venous ballooning even though separate studies have failed to show a relationship between venous obstruction and Multiple Sclerosis. The mechanism of symptom improvement is improved autonomic tone rather than relief of flow obstruction,” says Dr. Arata.

A graduate of UCSF School of Medicine, Dr. Arata has spent more than a decade performing angioplasty and has been at the forefront of research for CCSVI. “There is a possibility that improved autonomic function may diminish symptoms and have an impact on the course of the disease,” comments Dr. Arata, who serves as Medical Director at Synergy Health Concepts in Newport Beach. He is the most experienced CCSVI physician in the United States having performed more than 2000 procedures on patients with autonomic-associated disease, claiming a high clinical (patient response) success rate in excess of 90% in a recent study group.

So this Dr. Arata thinks that the procedure works but not for the reason that Dr. Zamboni thinks. It's not improved venous blood flow that's important but the stimulation of the nerve fibers around the veins that's important.
 

Redbone

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:shock: That sounds so incredibly random that I'm intrigued. Do you think you'd be able to find the paper and link me to it? I can get around journal paywalls with my university.

Here are several links:

Neural Stimulation for Autoimmune Diseases | MIT Technology Review

ARTICLES | Advances in Physiology Education

Can vagus nerve stimulation halt or ameliorate rheumatoid arthritis and lupus?

That should get you started. The last link has another article link to the right about vagus nerve stimulation, too. If you scroll down, there looks to be a promising article on how the vagus nerve modulates CD4+ T cell activity.
 
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