Pathology-supported genetic testing as a method for disability prevention in multiple sclerosis (MS). Part I. Targeting a metabolic model rather than autoimmunity

Disability in Multiple Sclerosis is Associated with Vascular Factors: An Ultrasound study

“…These associations confirm that increased MS disability may be related to abnormal blood flow to the brain due to cerebral hypoperfusion [2] demonstrating a reduction in cerebral blood flow in pwMS which is associated with hypoxia leading to white matter damage. Oligodendrocytes are extremely vulnerable to a hypoxic environment, resulting in demyelination and an increase in formation of white matter lesions [1,2] .…”

“…Disability may be transient due to the restoration of the myelin sheaths by stem cells, the oligodendrocyte precursor cells (OPCs) residing in the CNS, emphasizing the importance of understanding what the OPCs require to fulfil this function. Managing MS disability requires more than medicines, as outlined previously by van Rensburg et al [1,3]. People with MS (pwMS) need to be empowered to challenge the present narrative that predicts inevitable progressive disability following an MS diagnosis.…”

“…Systolic blood pressure differences of greater than 5 mm Hg between right and left arm measurements can indicate whether people are at risk for vascular abnormalities [9] . Lorefice et al [10] showed that vascular comorbidities, including hypertension, were significantly associated with brain atrophy in MS, which is the most important determinant of disability [1,3] .…”

“…Multiple sclerosis (MS) is the most common inflammatory disorder of the central nervous system affecting young adults worldwide. MS disability is related to the death of oligodendrocytes, the cells that synthesize myelin in the central nervous system (CNS), causing dysfunction of the fatty sheaths surrounding the nerve axons with consequent disruption of signal transmission from the brain to peripheral organs and, together with neuronal death, contributes to loss of brain volume [1]. Patches of dead oligodendrocytes visible as white matter lesions on magnetic resonance imaging (MRI), a hallmark of MS, occur predominantly in brain areas that are prone to oxygen deficiency, [2] suggesting that lesion formation is closely linked to oxygen delivery to the CNS by blood vessels.…”

White matter lesion volumes on 3-T MRI in people with MS who had followed a diet- and lifestyle program for more than 10 years

“…4,5 This has involved pathology-supported genetic testing (PSGT) to search for genetic and environmental risk factors for demyelination. 6,7 Following a study that recruited 118 pwMS to investigate the role of iron in MS, 8 subsequent sub-studies found that MS risk factors fall into two categories: (1) deficiencies : (iron, vitamin D, vitamin B12, antioxidants, unsaturated oils, decreased CNS blood flow) and (2) aggravators : (oxidation/inflammation, smoking, infections, dietary saturated fat, increased cholesterol/homocysteine/obesity; allergies/food sensitivity and psychological stress). The rationale was outlined previously 5,6,7 and in the Discussion below.…”