Re-posting Dec 2018 news. This month’s news coming soon.
Wishing everyone a happy and healthy New Year !. If you have MS, I hope reversing this condition is your #1 goal to achieve in 2019 and you have an action plan.
Talking about having an action plan- there is a new study on this topic. Having a self-management plan is necessary to deal with MS. In this new study, researchers looked at the habits of those participants who successfully deal with MS. The following strategies were used: adjusting outlook, managing stress, managing symptoms, healthy lifestyle, effective communication, and setting priorities and planning.
As per recent guidelines, exercise is an essential component of the clinical management of people with MS with mild or moderate degree of disability. This new study. shows that a 40-week training program is both feasible and safe.
Sports Practice and Motor Imagery help improve the quality of life and balance in people with MS, according to this new study
HIIT has many health benefits for many health conditions, including MS. High intense exercise is an efficient rehabilitation strategy in MS. A home-based, 6 minute HIIT training in those affected mildly by MS seems feasible, is the conclusion of this study.
Aerobic exercises (swimming) have potential to improve myelination, likely by lowering inflammation. This study was conducted in animal models, and some of them received interferon beta. Technical: The results of this study suggest that physical activity compared to interferon beta-1 treatment significantly increases BDNF, IL-10, and decreases TNF-α in serum.
Herbs/Natural Supplements For Managing MS Symptoms
Natural Products Work. This new study will be published in February 2019, but I came across it, so ‘ll share it now. Here are the highlights of this systematic review: Natural products are effective in the treatment of MS. Key mechanisms of action:they inhibit inflammation and regulate the immune response in MS. Some protect the central nervous system in MS. Some of them repair damaged myelin sheath in MS. There are over 25 natural products reviewed here- including Icariin, Apigenin, Hesperidin, Cannabidiol, Epigallocatechin‑3‑gallate, Quercetin, Ginsenoside Rd and Berberine. My note: we need more studies (in humans) to further explore the benefits of all these phytochemicals.
Medical Marijuana. Four new studies plus one book on this topic. New meta-analysis (of 17 randomized, placebo-controlled trials) found that medical marijuana produces mild relief from MS symptoms (spasticity, pain, and bladder dysfunction) and is overall well tolerated. Studies on cannabis use -year in review in this book. Great review. Pharmacological treatment with the endocannabinoid 2-AG improves the clearance of scar tissues, promotes differentiation of myelin producing cells, resulting in complete remyelination and a thickening of the myelin sheath. (animal study).
Vitamin D (and sunlight). Fours new studies on this topic. This new review of studies supports the importance of vitamin D for treating MS. Vitamin D maintains balance between inflammatory and anti-inflammatory cytokines and can also improve survival due to its antioxidant effect and reduction of oxidative stress. There may be an association between vitamin D deficiency and increased risk for MS, suggests this study. More MS related disability found in those overweight and vitamin D deficiency, according to this new study. More time indoors during childhood and early adolescence increases the risk of MS, suggests another study. Note: more time indoors means less exposure to sun and more likely to be vitamin D deficient
Melatonin can significantly improve fatigue associated with MS, according to this double-blind clinical trial (daily dose: 3 mg melatonin for 8 weeks). My note: Great to use short term using this dose. Keep in mind that it is possible to stop responding to melatonin over time. Your body may start to make less melatonin, too. I recommend low doses (less than 1 g) for long term use.
Coffee. Enjoy your coffee. High doses of coffee intake may protect against neurodegenerative disorders such as Parkinson’s and MS. Furthermore, coffee (and caffeine) has a positive impact on disease course, according to this review (a review of over 50 articles).
Ellagic acid may promote myelin repair (animal study). Technical: 80 mg/kg of EA effectively decreased activation of astrocytes and microglial, creating environment for migration of OPCs to the lesion area and shifting from damage course into the repair progressions.
Vitamin B2 (riboflavin) may have beneficial effects on disability, acting synergistically with interferon beta-1a and increasing BDNF (animal study).
Scrophularia megalantha has anti-inflammatory and immunomodulatory effects, showing to ameliorate animal models of MS.
Leonurine also seem to promote myelin repair in animal models of MS, suggests this study.
Nutrition
Food allergies linked with increased disease activity (more relapses, MRI lesions, compared with those with no food allergies), according to this study. Note: It is worth testing for these allergies and eliminate those foods from your diet.
Nutritional profile of MS. This new study shows increased tendency to gain weight and develop muscle loss as the disease progresses. The deficiency of polyunsaturated fatty acids, fiber and vitamin D also worsens with progression. My note: improving the lifestyle (diet, supplements, exercise) can easily reduce all of the above risks.
High carb diets could be linked with MS like condition called Neuromyelitis Optica Spectrum Disorder (NMO), suggests this study.I wrote about glucose metabolism and MS here.
Other Natural Therapies That Work
Auriculotherapy significantly reduced stress, anxiety, and depression associated with MS, according to this new double blind randomized clinical trial. Auriculotherapy combines reflexology and acupuncture.
Applied kinesiology seems to help people better cope with MS, increased sense of well being and even stabilize MRI results, according to this study which included 3 case studies.
Transcranial and pulsed focused ultrasound that activates brain can accelerate remyelination, according to this new study in animal models of MS. Previous research showed that transcranial pulsed focused ultrasound can activate the neuron circuits across in various animals as well as humans.
Emotional Well Being is Super Important
Emotional well-being should be supported, because love of life (defined as positive attitude toward life) increases happiness (defined as increased life satisfaction, excitement, lack of depression or anxiety)- suggests this study conducted in Iranian population with MS.
Continuous psychological distress destroys myelin sheath. This study conducted in animal models of MS shows that stress, particularly psychological stress causes intense demyelination.
Positive psychological changes in people with MS ? Yes, it is possible. Despite causing negative psychological changes, MS may lead to positive ones as well, is the result of this new study. By reducing the score of negative emotions (demoralization), the score of positive psychological changes (called “post traumatic growth”) increased in the participants of this study. My note: I wish I would have more details about the form of therapy or counseling that participants received. It just says they are members of an MS association.
The Gut Microbiome
Gut mycobiome (the fungi from gut flora) and its link with MS in the news again. It is true, most studies focus on bacteria and archaea microbes, while the fungi are very little explored. Yet, they work closely with the bacteria and have a strong influence on the immune system and brain health.
Improving the gut microbiome with fecal transplantation. The benefits of fecal transplantation for treating MS are evaluated in this new study.
Propionic acid can successfully improve the immune response. In this study, was added to the MS drugs. Propionic acid is a short chain fatty acid, which is found in lower amounts in individuals with MS (stool samples), reflecting an imbalanced gut microbiome. Technical: After two weeks of PA intake, there was a significant and sustained increase of functionally competent Treg, while Th1 and Th17 significantly decreased. Retrospective analyses of up to 3years of PA-intake show fewer relapses, stabilization of disability and reduced brain atrophy.
This study explores the benefits of treating MS with Prevotella histicola, a friendly bacterium found in the gut. Yes, MS is associated with lower than normal levels of Prevotella species. For changes in gut microbiome in MS check out this article.
Infections, Environment Factors, Genetics & MS
Herpes viruses HSV 1 and 2 are likely contributing to neurological conditions like MS and Parkinson’s, according to this new study. This link between HSV and MS had been explored before. Mechanism: HSV viruses 1 and 2 seem to initiate an autoimmune reaction against nerve cells. That’s because nerve cells have proteins that resemble portions of the virus from a structural and genetic standpoint.
Epstein -Barr virus (EBV) consistently linked with MS. This study confirms previous findings, showing that all (100%) the participants tested EBV seropositive (compared with 93-94% found in healthy controls). A second study this month exploring the link between EBV and MS and how some EBV-related laboratory parameters could be used as biomarkers in clinically isolated syndrome and early MS.
H.Pylori.The impact of H Pylori infections on MS. This study found a correlation between the level of anti- H pylori antibodies. This study found significant high level of anti- H pylori antibodies called Hp hsp60), especially in those with SPMS. The levels of these antibodies also correlate with age, duration of diseases and disability (Hp hsp60=anti-Helicobacter pylori heat shock proteins 60) .I did write about H pylori infections here. I treat this infection with natural antibiotics- more details here.
Environment as a risk factor to develop MS. This new study from Canada shows that immigrants were less likely to develop MS (0.066%) than long-term residents, although this lower risk attenuated with longer residence in Canada. Many factors involved — including the age of migration, gender, country of origin, other health concerns, etc. Noise and air pollution exposure may increase the risk of MS incidence while neighborhood green space had a protective effect, according to this new study from Canada
This new study investigated the role of certain synaptic and presynaptic membrane protein genetic polymorphisms (VAMP2, SNAP-25, Synaptotagmin, Syntaxin 1A) in individuals with MS.
More MS News
What causes fatigue in MS? This study looks into different factors (neuropsychological, neurophysiological and radiological). The results: MS fatigue was associated with anxiety, depression and alexithymia (alexithymia means inability to identify and describe emotions in the self). The results: issues around emotional awareness, social attachment, and interpersonal relating). A bit more technical: fatigue also correlated with short-interval intracortical inhibition, large caudate nuclei and small parietal cortex.
Mercury as a neurotoxic compound explored in this study. This study was done in dentists who have chronic exposure to mercury due to using dental amalgams. But be aware of other sources of mercury: thimerosal found in vaccines like flus shots, mercury thermometers, fluorescent bulb lights. Foods ie fish and shellfish also accumulate mercury.
Alcohol and smoking linked with increased MS severity, according to this study.
Could iron chelation be the next treatment for neurodegenerative conditions? This concept is explored (again) in this new study. Great review of iron metabolism and how is affected in brain traumatic injuries, MS and other brain conditions. Previous research investigated iron chelation therapy for treatment of MS, Parkinson’s and Alzheimer’s disease and showed to be quite effective to reduce progression in Parkinson’s disease.
Does pregnancy increase the risk of relapses or progression? Mixed opinions. No, according to this new study but yes, according to this one.
MS is usually linked with other eye conditions (such as double vision). This case report shows eye pain, with increased intraocular pressure and decreased vision (Acute hypertensive uveitis) — as the first (and unusual) manifestation of MS.
MS Conventional Therapies & Other Drugs (Including Side Effects)
The Good:
Cladribine — 2 new positive studies- does not increase risk of cancer, according to this study It is also effective (better than placebo, achievement of NEDA- no disease activity), according to this one. My note: I would like to see larger long term study to assess the risk of cancer with cladribine- they may get different findings. It seems like a great drug, but keep in mind that is a chemo drug and can have serious risks (technical: causes prolonged suppression of the CD4(+) T-lymphocyte counts, often more than 2 – 3 years).
Prolonged-release (PR) fampridine along with physiotherapy help improve walking problems associated with MS,according to this new study.
Omeprazole (yes the PPI), now researched to promote myelin repair, in this study. My note: smart move from big pharma, I must say. The whole class of PPI drugs (including omeprazole) are on edge of being withdrawn from the market. Just too many adverse reactions…. So why not market these drugs for other conditions, like MS?. Recent articles on Medscape recommend physicians to reduce the use of PPIs. My recommendation is also to stay away from them.
The Bad:
Autoimmune hepatitis linked with many MS drugs in this review study: immunomodulatory drugs, including interferon-beta (IFN-β) and steroids. If you take MS meds, is important to get tested for this condition (Autoantibody testing and liver histology)
Alemtuzumab: double trouble. Simultaneous Cytomegalovirus (CMV) reactivation plus Listeria meningitis following alemtuzumab use reported in this study.
Alemtuzumab causing serious thyroid dysfunctions. This new case reports new onset autoimmune thyrotoxicosis with alemtuzumab followed by hypothyroidism.
Alemtuzumab. A new case of autoimmune myositis after treatment with alemtuzumab for MS.
Alemtuzumab :Acute leukocytosis during alemtuzumab treatment for MS described in this study.
Alemtuzumab. Acute thrombotic microangiopathy following alemtuzumab use (case report).
Alemtuzumab. Autoimmune encephalitis following alemtuzumab use (case report).
Dimethyl fumarate. erythema nodosum following use of dimethyl fumarate for treating MS (case report).
Fingolimod – a case report of 3 demyelinating lesions after starting to use fingolimod.
Fingolimod increases the risk of Varicella-Zoster virus reactivation compared with other drugs, according to this study.
Methylprednisolone. Liver toxicity from taking methylprednisolone for MS (case report).
