Commentary: Structural and functional features of central nervous system lymphatic vessels

Bradstreet, James Jeffrey; Ruggiero, Marco; Pacini, Stefania

doi:10.3389/fnins.2015.00485

Cited by 19 publications

(19 citation statements)

References 15 publications

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“…However, at variance with our previous studies, at Sophia Health Institute, we do not limit our intervention to the evaluation of extra-axial fluid accumulation and how it relates to neurological symptoms, but we use that information to proceed with application of therapeutic ultrasounds to the brain and the deep cervical nodes (Fig. 2) with the intent of restoring the flow of cerebral lymph and possibly ameliorating neurologic symptoms when present (Bradstreet et al, 2015;Tarasoff-Conway et al, 2015).…”

Section: Description Of the Rk Protocolmentioning

confidence: 99%

The Ruggiero-Klinghardt (RK) Protocol for the Diagnosis and Treatment of Chronic Conditions with Particular Focus on Lyme Disease

Klinghardt¹,

Ruggiero²

2017

American Journal of Immunology

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Abstract:Here we describe the Ruggiero-Klinghardt (RK) Protocol that is based on integration of Autonomic Response Testing (ART) with diagnostic ultrasonography and on application of therapeutic ultrasounds; the latter are used as a provocation tool and as an instrument to optimize drug uptake and utilization in specific areas of the body. This protocol consists of a precise sequence of diagnostic and therapeutic procedures with the ultimate goal of improving sensitivity and specificity of diagnosis at the same time evaluating and optimizing efficacy of treatments in chronic conditions including, but not limited to, persistent Lyme disease. The RK Protocol represents a paradigm shift in diagnostics and therapeutics: Thus, compartmentalized microbes, transformed cells, toxins and metabolites could be detected using a safe and non-invasive method. In addition, the RK Protocol allows optimization of efficacy of drugs and other therapeutic interventions. Although the RK Protocol was initially developed for persistent Lyme disease, it shows significant potential in conditions ranging from cancer to neurodegenerative diseases and autism. In oncology, the RK Protocol may serve to facilitate early diagnosis and to increase sensitivity of cancer cells to the killing effects of a variety of remedies ranging from conventional radio-and chemotherapy to more recent forms of immunotherapy. Thus, the 1st goal of the RK Protocol is diagnostic: That is, to make pathogens, toxins, transformed cells and cells infected by viruses that are inaccessible to conventional diagnostic and therapeutic tools, "visible" to the therapist who can detect them with laboratory methods and deal with them with appropriate interventions; and also to make them "visible" to the immune system that can fight them in a physiological manner. The 2nd goal is to optimize drug uptake and utilization in the organs and tissues studied and targeted with these procedures.

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Section: Description Of the Rk Protocolmentioning

confidence: 99%

The Ruggiero-Klinghardt (RK) Protocol for the Diagnosis and Treatment of Chronic Conditions with Particular Focus on Lyme Disease

Klinghardt¹,

Ruggiero²

2017

American Journal of Immunology

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“…This latter observation further highlights the role of the immune system in connecting the gut microbiota with the brain microbiota [4]. We recently demonstrated that alterations of brain lymphatic drainage may be responsible for the lesions in the brains of autistic children [5,6], and it can be hypothesized that such alterations of brain lymphatic circulation affect the composition of the brain microbiota. Therefore, the concept of brain dysbiosis should be evaluated, together with the concept of gut dysbiosis, when FMT is considered for neuropsychiatric disorders.…”

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confidence: 90%

Fecal Microbiota Transplantation and the Brain Microbiota in Neurological Diseases

Ruggiero¹

2016

Clin Endosc

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“…The lymphatic nodes and vessels are the primary route for cancer metastasis, and lymphatic dysfunction has been implicated in a variety of debilitating conditions including lymphedema, hypertension, obesity, infection, and fat disorders . Most recently, lymphatics within the central nervous system (CNS) have been observed, which may have direct relevance for diseases of the CNS with unknown etiology, including multiple sclerosis and Alzheimer's disease . The relevance of improving our understanding of lymphatic functioning has been the topic of multiple recent review articles, yet one barrier to addressing this fully is the lack of imaging methods that can be applied routinely to characterize lymphatic transport.…”

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confidence: 99%

Lymphedema evaluation using noninvasive 3T MR lymphangiography

Crescenzi

Donahue

Hartley

et al. 2017

Magnetic Resonance Imaging

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Purpose To exploit the long 3.0T relaxation times and low flow velocity of lymphatic fluid to develop a noninvasive 3.0T lymphangiography sequence and evaluate its relevance in patients with lymphedema. Methods A 3.0T turbo-spin-echo (TSE) pulse train with long echo time (TEeffective=600ms; shot-duration=13.2ms) and TSE-factor (TSE-factor=90) was developed and signal evolution simulated. The method was evaluated in healthy adults (n=11) and patients with unilateral breast cancer treatment-related lymphedema (BCRL; n=25), with a subgroup (n=5) of BCRL participants scanned before and after manual lymphatic drainage (MLD) therapy. Maximal lymphatic vessel cross-sectional area, signal-to-noise-ratio (SNR), and results from a five point categorical scoring system were recorded. Nonparametric tests were applied to evaluate study parameter differences between controls and patients, as well as between affected and contralateral sides in patients (significance criteria: two-sided p<0.05). Results Patient volunteers demonstrated larger lymphatic cross-sectional areas in the affected (arm=12.9±6.3mm2; torso=17.2±15.6mm2) vs. contralateral (arm=9.4±3.9mm2; torso=9.1±4.6mm2) side; this difference was significant both for the arm (p=0.014) and torso (p=0.025). Affected (arm: p=0.010; torso: p=0.016) but not contralateral (arm: p=0.42; torso: p=0.71) vessel areas were significantly elevated compared with control values. Lymphatic cross-sectional areas reduced following MLD on the affected side (pre-MLD: arm=8.8±1.8mm2; torso=31.4±26.0mm2; post-MLD: arm=6.6±1.8mm2; torso=23.1±24.3mm2). This change was significant in the torso (p=0.036). The categorical scoring was found to be less specific for detecting lateralizing disease compared to lymphatic-vessel areas. Conclusion A 3.0T lymphangiography sequence is proposed, which allows for upper extremity lymph stasis to be detected in approximately 10 minutes without exogenous contrast agents.

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Commentary: Structural and functional features of central nervous system lymphatic vessels

Cited by 19 publications

References 15 publications

The Ruggiero-Klinghardt (RK) Protocol for the Diagnosis and Treatment of Chronic Conditions with Particular Focus on Lyme Disease

The Ruggiero-Klinghardt (RK) Protocol for the Diagnosis and Treatment of Chronic Conditions with Particular Focus on Lyme Disease

Fecal Microbiota Transplantation and the Brain Microbiota in Neurological Diseases

Lymphedema evaluation using noninvasive 3T MR lymphangiography

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