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Are you someone/do you know someone that has MS that went through puberty early?
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DoleDevotion

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MS treatments and causes
Posted: 04-20-08 22:04pm

Hi everyone. I have a friend that was very recntly diagnosed with MS based on a bout of optic neuritis and an MRI that showed a few inactive lesions and one active one. Since I heard the news, I've been doing some reading up, but there are still a lot of questions that I have.

First of all, my friend is female, 27 years old and she had some double vision about a year ago that her physician considers to be probably her first episode. Her doctor put her immediatley on betaseron injections, and from what I have heard from her, he didn't really present her with other options. I haven't really seen too many people talking about betaseron. Anybody have experience with it and how it worked for them, expecially anyone that took it newly diagnosed? Anyone have any recommendations for treatment for someone newly diagnosed that doesn't know how their MS will really be affecting them?
Does anybody have anything that they regret doing or not doing when they were first diagnosed or that they would change if they could go back and do so?

Next I have a fiarly good understanding of the theories of the processes that cause MS, but I have some questions about MS that i've been unable to find an answer to. If MS involves the eating away of the myelin sheath on nerves, then why is the damage limited to the nerves in the central nervous system? Why aren't periferal nerves affected? Or are they affected and I am mistaken?
They say that whatever immune response is triggered in MS, or whatever substance in the immune system is causing the damage is present throughout the whole body and not just in the brain and spinal column. So has there been any research as to why the damage is limited to just the central nervous system. Is there some innate difference in nerve cells in one place or the other?

Also, I've read that everyone has, in their immune system, the t-cell that have the potential to attack nerve cells, they just don't get "turned on" in most individuals. But i've also read that people with MS might have some issues with the blood brain barrier, since lymphocytes don't typically migrate into the brain. So, if you took a person that didn't have MS and stuck some of their lymphoctyes into the brain, would it activate that same immune response and do damage to the myelin in them as well? In other words, do people who do not have MS, simply don't have it because their lymphoctyes stay out of the brain? or would no immune response occur anyway, even if the lymphocytes of person without MS were introduced into the cerebrospinal fluid?

I've also read about attempts at filtering antibodies out of the blood stream, where the blood is run through a machine and back into the body, of which the results were that it seemed to help but only for a limited time. Does the body constantly produce the components of the immune system? Like T-cells, B-Cells, etc etc. Do they only live for a limited time and there is a a constant stream of new ones being made, and that is why the blood filtering only worked for a little while? What about if you replaced all of someone's blood with transfused blood from a healthy individual, would the same thing occur-- that there might be a temporary improvement but that the healthy immune components- or components that might inhibit the irregular immune response that might be present in the transfused blood-would eventually die out and the regular unhealthy parts of the immune system would continue to be reproduced?

Just out of ignorance, is there such a thing as a cerebrospinal fluid filtering? Has it ever been tried? What about a cerebrospinal fluid transfusion, like a blood transfusion?
Has there ever been an attempt to transplant brain cells, and if so, was there a similar immune response to the transplanted cells as you see in multiple sclerosis?

I was also wondering if anyone has heard anything about or has had done that new test to see how the immune system is functioning-called immuknow by cytex? It was developed for transplant patients who are on immunosuppresants to see what type of drugs would work best for them and what dosage is ideal. Do people with MS ever take a maintence of immunosuppresants as a transplant patient would?
Also I've heard that bone marrow transplants may hold some promise as a treatment for people effected with MS, but I've had trouble really finding any recent information about it. Does anyone know of results of such studies or know of anyone that's had that done?

Next, this is kind of an area that I don't think has been looked into very much lately at all but it interests me because of what i see as the coincidental timing of the development /appearance of MS most occurs most often in young adulthood, and the termination of the thymus's active role in the regulatory development of components of the immune sytem. There have been studies that environmental factors that change in the years before puberty, can have a change on a person's risk factor of developing MS. It then seems possible to me that there could be something that happens during puberty that triggers the disease, or that the ending of the period of the thymus being active, ends the period when a person still has a "chance" to develop the balance or regulatory components needed to stay healthy.

So, I've also read that they have tried Thymus transplants, which didn't seem to have much effect. Has there ever been tried a simultaneous bone marrow and thymus transplant of a immature thymus?

Also, have there been any studies done that anyone knows of that explore commonalities in people who develop MS? Especially things that are in common that happen before or during puberty? Well I've actually heard that they think that contracting Epstein Barr may have some impact on the immune system that could trigger MS. They have also done studies about genetic components that may mean a higher risk of developing MS. I've heard they've identified at least one possible genetic contributor. Have they done any studies to see who or how many people have this genetic characteristic in common, and if so, tried to find differences between someone with that genetic characteristic that hasn't developed MS and someone that has?
I've also heard that a deficiency in Vitamin D may contribute to the risk of developing MS. I know that exposure to sun light helps the body develop vitamin D, would using a lamp that is supposed to simulate sunlight also do that?
I've also read that allergies to certain food products could inhibit the absorption of vitamin D. My friend had an allergy that she attributed to oats and oat products since she was young. I think she told me that they tested her for food allergies and didn't find any allergy to oats but everytime she ate something like oatmeal she would get sick (vomiting). Do you think this might be significant to her development about MS.
Another sort of unusual thing about my friend is that she started puberty at a fairly young age (around 9). Has this ever been linked to MS as a risk factor?

I guess i'm just looking for some answers though i know i'm unlikely to really find any. But any information that anyone has about the things i've asked would be very much appreciated. The more answers the better.

RainRabbit
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Dr. Nikola

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Posted: 04-21-08 16:59pm

1. Multiple sclerosis is treated with corticosteroids and beta-interferon. Corticosteroids are immunosupresive drugs used for treating the acute exacerbations (relapses) of the disease especially for treating the optic neuritis. Beta-interferon (Betaseron) is immunomodulating drug used for preventing the new relapses of the disease. Other medications and procedures like Glatiramer acetate, intra venous imunoglobulines, cyclophosphamide, aminopiridines, hyperbaric oxygen-therapy may have some positive effect but not that efficient and proven like corticosteroids and beta-interferon.
2. From the peripheral nerves only optic nerve is affected. Other peripheral nerves are not affected probably because antibodies can't reach them because they are produced and present only in the liquor and not in the blood. Trigger might be present all over the body but immune response is limited only in the brain and spinal tissue. Optic nerve is an exception because its coverings are in contact with the liquor from the sub-arachnoid space. Allergen that provokes the immune response is still unknown. Produced antibodies are not specific so allergen can't be identified. It is believed that allergen is some structural protein of the myelin.
3. T-lymphocytes probably have the main role in the MS pathogenesis. But macrophages, microglia and B-lymphocytes are also included in the process. T-lymphocytes can enter the brain tissue whenever there is some stimulation that will call them. But only T-lymphocytes that are specific for certain antigen will come, not all. Specific antigen activates the specific T-Lymphocyte and than this activated T-lymphocyte induces the whole inflammatory process. This is so called inductor-T-lymphocyte. In normal occasions, inductor-T-lymphocytes that are specific for host's antigens either should not exist or should be suppressed. Presence of T-lymphocytes, that are specific for some host's antigens, is genetically determined. In case of MS, people with certain genetic marks are found to be more susceptible to develop MS than people that don't have such genetic characteristics. Even if such inductor-T-lymphocytes, directed toward own body structures (some myelin component in case of MS), exist, there are another specific T-Lymphocytes that serve to block this process. These are called suppressor-T-lymphocytes. It is found that in MS there is a defect in the function of the suppressor-T-lymphocytes.
4. Blood filtering for removing the antibodies won't help because there is no antibodies in the blood. Antibodies are present only in the cerebro-spinal liquor and brain tissue. Cells that are directly involved in the abnormal immune process (T-Ly, B-Ly, plasma-cells, macrophages and microglia have limited life but new cells are created all the time. Specific T and B-Lymphocytes multiply from so called memory-cells that are placed in the bone marrow, lymph nodes and brain. Memory-Lymphocytes are not directly involved in the inflammatory process but serve as a reserve for the active cells. Whenever some specific memory-cell is stimulated by some specific antigen it starts to proliferate. Some of the new created cells will become active and some will stay calm waiting for the next stimulation. Memory-cells are long-life which means live as long as the whole body lives.
5. Liquor filtrating does not exist but even if possible the inflammatory cells and antibodies in the brain tissue will stay. There is no need of brain cell transplantation because brain cells are not killed but only their axons' myelin coverings.
6. There is a great difference in the immune response in the transplanted patients and in patients with MS. In transplanted patients the immune system fights against the foreign antigens in the transplanted organs which is completely normal reaction. Immunosupresive therapy here is used to decrease the normal immune reactivity which also has some bad consequences (vulnerability to infections. In MS, immune system fights against normal body components and immunosupresive therapy has task to calm this abnormal reaction.
7. Thymus is the place where T-lymphocytes "learn" how to recognize the antigens and also "learn" which antigens are foreign and which are not. T-lymphocytes that are specific for host's antigens are ether destroyed or suppressed. Similar process is happening in the bone marrow and refers to the B-lymphocytes. This process of lymphocyte maturation ends when thymus stops functioning (before puberty). Any damage of the thymus during lymphocyte maturation may cause severe immune deficit. Transplantation of the thymus and bone marrow won't help because after maturation all the clones of "memory" cells populate the "secondary" lymph organs: lymph nodes, lien, MALT etc.
8. People that wear these genes: HLA-A3, HLA-B7, HLA-DR2 and HLA-DQw1 are susceptible to develop MS. Viruses are blamed for provoking many auto-immune disorders including MS.
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oopoopoop

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Re: MS treatments and causes
Posted: 05-04-08 08:56am

DoleDevotion wrote:

I've also heard that a deficiency in Vitamin D may contribute to the risk of developing MS. I know that exposure to sun light helps the body develop vitamin D, would using a lamp that is supposed to simulate sunlight also do that?


I can't really answer the rest of your post, but this is the one that I have been focusing on. I had a bout of optic neuritis four years ago, and with a family history of MS (my father), the doctor warned that I had a higher than average likelihood of MS. He did not, however, at this stage suggest any kind of MRI or prescribe steroids -- about 50% of optic neuritis is idiopathic.

My research into the issue ended up focusing on Vitamin D, due to the epidemiological studies linking incidence of MS and distance from the equator/altitude/consumption of oily fish: there appears to be a very strong inverse correletion between exposure to Vitamin D and incidence of MS in a population. Vitamin D regulates the immune system, i.e. it doesn't boost it or suppress it, but keeps it steady. If indeed MS is an autoimmune response, then stablising the immune system as much as possible may be a critical factor. The possibility may be that a genetic predisposition coupled with inadequate Vitamin D exposure, or perhaps an inherited inefficiency in processing Vitamin D so that a higher intake is necessary, may explain who gets MS. Incidentally, because of the assiduous use of sunblock and lack of oily fish in most people's diets, a lot of people in northern latitudes are actually deficient in Vitamin D anyway.

Short answer to your question: everyone, and particularly people who are predisposed to MS should get at least 15 minutes exposure on bare face and arms to the sun every day between 10 am and 3 pm. This only works between April and October, however. I don't think a daylight bulb would be sufficient to create the effect on the skinThe rest of the time, the easiest thing to do is to take Vitamin D supplements -- the minimum recommended daily amount is 5 micrograms = 200 IU. I take at least double that every day in the winter. I also take additional fish oil, linseed and selenium supplements. I would add that in four years I have not had any other MS symptoms -- this may be good luck, or I may be helping it along.
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