A Luminous Halo

"Life is not a series of gig lamps symmetrically arranged; life is a luminous halo, a semi-transparent envelope surrounding us from the beginning of consciousness to the end." --Virginia Woolf

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Location: Springfield, Massachusetts, United States

Smith ’69, Purdue ’75. Anarchist; agnostic. Writer. Steward of the Pascal Emory house, an 1871 Second-Empire Victorian; of Sylvie, a 1974 Mercedes-Benz 450SL; and of Taz, a purebred Cockador who sets the standard for her breed. Happy enough for the present in Massachusetts, but always looking East.

Saturday, February 24, 2007

What Is Multiple Sclerosis?

I'm presently working on an article about multiple sclerosis. It's a difficult disease to write about. The jury's still out on the cause, the cure, even the definition of what multiple sclerosis is.

MS is not a disease of old people. According to recent estimates, the average age of onset is 28 years. Children as young as 2 have been diagnosed with MS. It is progressive, degenerative, irreversible, and incurable. More than 1 out of every 1000 people in the US – over 400,000 people – has multiple sclerosis (MS), according to a study recently published in Neurology. This figure more than 50% higher than that estimated by a similarly large literature review published in 1982. MS is on the rise, and treatments are few.

MS is a disease in which lesions, also called plaques, form in the central nervous system, causing disablility. This disability may take many forms: pain, numbness, fatigue, muscle weakness, vision problems, memory loss, bladder dysfunction, and so on. The lesions--hard, scarred patches--are the result of injury to the myelin sheath around the axons of the nerve cells. Sclerosis is scarring; multiple lesions must be present for the disease to be defined as MS.

MS is characterized by abrupt onset of symptoms. Various clinical courses have been described for MS, leading some doctors to speculate that MS is really several different diseases. Some patients display a pattern of relapses and remissions, often with increasing disability. Others are chronic progressive; still others, chronic static. Uncertainty as to the progression of the disease is one of the factors contributing to depression in people with MS.

MS was long thought to be an autoimmune disease, in which the body, through its immune system, launches a defensive attack against its own tissues, triggering inflammation. However, new research points to a vascular mechanism (one having to do with the blood vessels). All the immune markers investigated in MS have also been found in stroke patients and at the same levels. (Stroke, of course, is blockage or rupture of blood vessels to the brain.)

It is now accepted that MS is characterized by dysfunction of, and damage to, the blood-brain barrier (BBB). The BBB is the tightly-packed formation of endothelial cells on the walls of the capillaries in the brain. Whereas in other parts of the body many substances can pass through the gaps in the endothelial cells, in the brain only a few types of substances can cross the BBB. The BBB protects the brain from many chemicals which flow through the body, and from infections.

In MS, white blood cells called T lymphocytes destroy the myelin. It has been supposed that a malfunctioning autoimmune system was the cause of T cells attacking these protective sheaths. However, we can see that if the BBB is broken down, allowing the white blood cells to enter the brain and cause damage, it is really a vascular and not an autoimmune mechanism operating.

Breakdown of the barrier results in edema (swelling) and associated effects (reperfusion injury, for example). It seems logical that treatments for conditions with similar pathogenesis, like traumatic brain injury, might also be effective for MS. Those who are familiar with the research I've been doing for the last eight months know what treatment I'm referring to: hyperbaric oxygen therapy. To be continued.

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3 Comments:

Anonymous Anonymous said...

Where will your article be published? I am also a cataloger (thus my interest in your blog, initially), but have had MS for many years (with little detriment to my health, I might add).

2:33 PM  
Blogger Cicily Corbett said...

Thank you for your interest.

My article is part of a monograph I'm authoring on hyperbaric oxygen therapy, to be published by EP (Exceptional Parent) Magazine. HBOT is a common therapy for MS in the UK (it is particularly effective in improving bladder control), but MS is not an approved indication for HBOT in the US. The purpose of the monograph is to encourage the clinical trials required in the US for acceptance by the medical community.

EP's monographs, btw, are published under an unrestricted grant and distributed free of charge to doctors, hospitals, magazine subscribers, and others on EP's list. Readers of this blog will know when this seemingly endless project of mine is finished!

7:33 AM  
Blogger Lisa said...

In 2006, Laura Lawes was diagnosed with Multiple Scelrosis and given a life expectancy of one year. Three years later, she was not only living strong, but she gave birth to her first son. It was called "a miracle birth". These miracles are possible today, because of the work organizations, such as yourself, have done. Here, at Disease.com (a website dedicated to disease preventions and treatments) we are inspired by stories such as this, and would like to join you in fighting this cause. If you could, please list us as a resource or host our social book mark button, it would be much appreciated. Lets create more of these miracles; together.If you want more information on that please email me back with the subject line as your URL.

1:22 PM  

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