Anti-Inflammatory Diet

All health care starts with diet. My recommendations for a healthy diet are here:
Anti-Inflammatory Diet and Lifestyle.
There are over 190 articles on diet, inflammation and disease on this blog
(find topics using search [upper left] or index [lower right]), and
more articles by Prof. Ayers on Suite101 .

Friday, September 19, 2008

Multiple Sclerosis and Inflammation

Multiple Sclerosis (MS) is an inflammatory autoimmune disease of the myelinated sheaths of neurons of the brain and nervous system. Anti-inflammatory dietary and lifestyle changes have a significant impact on prevention and treatment of MS.

A common criticism of the biomedical literature is the focus on therapy and cure rather than cause and prevention. This is evident with multiple sclerosis. This disease is dominated by an immunological attack on the insulating myelin sheaths of the nervous system. The symptoms increase in waves of increasing severity over a number of years. MS patients produce antibodies against a myelin basic protein. Risk factors include smoking, prior infection with Epstein-Barr virus (mononucleosis) and low vitamin D/sun exposure. Treatment focuses on the neurological symptoms of the disease. My interest is what caused the disease and an exploration of whether the subsequent removal of the initiating events can provide more effective therapy. Here is what I think happens, based in part on observations from other inflammatory autoimmune diseases.

The early events in many inflammation-based diseases include a disruption of the expression of heparan sulfate proteoglycans (HSPGs). One HSPG is a component of the extracellular matrix of the cells that line blood vessels and provides a barrier to prohibit cells and proteins from leaking from the blood serum into the brain, i.e. the blood/brain barrier. Inflammation blocks normal heparin synthesis by blood vessels, attacks the BBB and facilitates the recruitment of white blood cells, lymphocytes that can mount an immune attack on the brain.

Since HSPGs interact intimately with most proteins on the surface of cells and these binding interactions are the basis for signaling and internalization, changes in the HSPGs can disrupt the maintenance of immunological tolerance -- inflammation also leads to inappropriate immunological recognition, particularly of proteins with triplets of basic amino acids (strong heparin-binding domains common on nuclear proteins.) This is evident in diabetes, lupus and inflammatory bowel diseases (and also dozens of allergens.) In the case of MS the self-antigen is the myelin basic protein. The antibody binding portions of the myelin basic protein are similar to many nuclear proteins that would be expected by comparison to other autoimmune diseases and allergies to stimulate antibody production if exposed to the immune system during inflammation. Thus an immune attack on myelin in MS could be caused by trauma or viral infections in the brain that release cellular debris and cause inflammation. Subsequent flareups could be initiated by systemic inflammation that attacks the BBB and permits lymphocytes to leave the blood stream and attack the myelin.

The MS risk with smoking may be the unusual combination of potent carcinogens and inflammatory compounds with nicotine. These may have had an impact on the integrity of the BBB via chronic inflammation. Epstein-Barr virus exposure may also have affected the BBB and contributed to chronic inflammation. Vitamin D acts similarly to the steroid hormones in many ways and may have some powerful effects as an anti-inflammatory. It may act similarly to estrogen, which is a potent inhibitor of brain inflammation in response to trauma.

Omega-3 fatty acids of fish oil are now being tested as a treatment for MS. An anti-inflammatory diet and lifestyle may be a powerful deterrent to MS and may also be effective in reducing or reversing the progression of the disease.


Anna's Spot said...

Great article. I believe that inflammation in the body leads to many diseases. Unfortunately, so many things contribute to inflammation in the body. I love your blog and added you to my blog roll. Have a beautiful day.

Dr. Art Ayers said...

Thanks Anna. I just read your blogs about multiple chemical sensitivity syndrome. It reminded me that I haven't looked at that biomedical literature for more than a year. Take a look at Dr. Martin Pall's research. It is an eye opener! I will write an article in a couple of days to tell explain how his insights can provide answers to several related syndromes. There is room for lots of hope.

Tanya said...

A post I found interesting about "how bacterial theory can be compatible with autoimmune theory"

Cristian said...

Possible MS breakthrough!

The Globe and Mail reports: Using ultrasound to examine the vessels leading in and out of the brain, Dr. Zamboni made a startling find: In more than 90 per cent of people with multiple sclerosis, including his spouse, the veins draining blood from the brain were malformed or blocked. In people without MS, they were not.

[...]The researcher's theory is simple: that the underlying cause of MS is a condition he has dubbed “chronic cerebrospinal venous insufficiency.” If you tackle CCSVI by repairing the drainage problems from the brain, you can successfully treat, or better still prevent, the disease.

Tanya said...

I was searching out more info on the iron buildup/venous inflammation comment, especially since I have been looking into temporal arteritis as my 'diagnosis' for the symptoms I am dealing with. I was looking for natural iron chelators, and phytic acid came up...

From acid (IP6), derived as an extract from rice bran, is the most potent natural iron chelator and has strong antibiotic and antioxidant action. [Free Radical Biology Medicine, Volume 8, 1990; Journal Biological Chemistry, August 25, 1987] IP6 has been found to have similar iron-chelating properties as desferrioxamine, a drug commonly used to kill germs, tumor cells or to remove undesirable minerals from the body. [Biochemistry Journal, September 15, 1993] IP6 rice bran extract (2000-4000 mg) should be taken in between meals with filtered or bottled water only (no juice).

From a patent application...The present invention provides a method treating multiple sclerosis comprising the step of administering to a subject afflicted with multiple sclerosis an effective symptom-alleviating dose of a compound selected from the group consisting of phytic acid, a mixed counterion phytate salt, an isomer or hydrolysate of phytic acid or mixed counterion phytate salt, or a mixture of any combination thereof. The preferred method of administration is by the oral route.

Interested to know what Dr. Ayers would say about this. I am really in need of some way to get the inflammation out of my vessels!

Dr. Art Ayers said...

The previous comments suggest that bacterial infection may be responsible for initiating MS and the inflammatory signaling associated with the infections may alter both brain tissue and blood vessels in the brain. Veins draining the brain may be particularly impaired (CCSVI). Improving brain circulation eliminates some MS symptoms. Some antibiotic treatments relieve symptoms, and anti-inflammatory diet and exercise also reduce symptoms.

The vein problems also result in iron buildup. I wouldn't expect that eating pytate or other iron chelators would have an effect on brain veins, because there is so much iron around and it is all locked up in carrier proteins. I would expect a bigger impact on the gut biofilms.

Tanya, I don't remember if you ever had your vitD levels checked and whether you are at a high omega-3/6 ratio.

If MS is caused by chlamydia pneumoniae infection of monocytes that have migrated to the major veins of the brain, then antibiotic treatment becomes an option for eradication. The anti-inflammatory approaches may keep the inflammation under control.

Thanks for your comments.

Tanya said...

Yes to the D check...was low and am supplementing with 10K units a day. Yes to the fish oil qualified...I was taking 8 capsules a day then realized the stuff I was taking had soybean oil in it switched to a better quality one and am on 4 a day.

I am considering standard medical doctor visit if I can find one that will not put me on prednisone or other stuff. In addition to the antibiotics I also am interested in low dose naltrexone...mostly because of what I read about autoimmune being an under-functioning rather than over-active immune system, and that LDN basically prompts your body to make its own cortisone. My only concern is that if adrenal fatigue/insufficiency is part of my problem, that LDN would make it worse.

I don't have any 'official' diagnosis of anything. MS is the first one they always throw out at me, but couldn't confirm the first time (7 yrs ago) and the second time the blood work showed Lyme and Lupus and vit d low and high CRP and ESD...the latter two with the painful spots on my scalp point to arteritis...all of which are inflammation...just can't figure the cause, unless it really is Lyme or bacterial...been doing anti fungal stuff too, including GSE and caprylic acid and no starches...gluten free except for a few bites of birthday cake since mid Oct.

Only pain free time I have had since it hit my head/neck was after a major deep hard massage followed by jacuzzi tub soak with epsom salts and baking soda. I came out of the tub able to move my head/shoulders without aches etc. Woke up in the a.m. the same only sore from the massage (a good soreness!).

Gardensongs said...

Hi Dr. Ayers,

I have been reading and trying to understand the research done by Valter Longo on fasting and the Fast Mimicking Diet he developed.

Have you read any of his work, and if so, what is your opinion? Can you "dumb it down" for those of us who need a simpler explanation?

Here is a link to a study he did titled: A Diet Mimicking Fasting Promotes Regeneration and Reduces Autoimmunity and Multiple Sclerosis Symptoms

I have celiac disease, Hashimoto's and RA.

Thanks for you time and all you do for all of us.


Dr. Art Ayers said...

I would initially expect that all of your problems started with gut dysbiosis that set the stage for your autoimmune and inflammatory problems by compromising your immune tolerance. Thus, the sequence was: dysbiosis > compromised immune tolerance > celiac (genetic risk) > Hashimoto's & RA.

The Diet Mimicking Fasting apparently relieves some of the symptoms of the autoimmune diseases and can repair compromised immune tolerance, presumably by bypassing gut dysbiosis.

High levels of probiotics by consumption of live fermented foods can also bypass gut dysbiosis. With both fermented food consumption/high level probiotics, or the DMF, the impact is temporary, because the underlying gut dysbiosis remains. [Typical probiotics do not adapt to the gut environment.] This is just like the gut flora in an exclusively breastfed baby. Breast milk establishes gut probiotic bacteria until the immune system is established, i.e. the aggressive and tolerance halves are functional. Addition of solid food or formula undermines the probiotic community and shifts to the adult gut flora. To make a healthy adult gut flora requires a source for the two hundred new bacterial species and that is typically other healthy people.

The bottom line is that a healthy gut flora requires both soluble fiber to feed the gut flora and a source of healthy bacterial species.

Fecal Microbial Transplants (FMT) can provide a source of healthy bacterial species, and a healthy diet to which the donor was adapted, can provide soluble fiber food for the bacteria. Unfortunately, celiac damages the gut and disrupts the environment needed for establishment of a healthy gut flora/immune system. Thus, it is essential to eliminate gluten and reestablish as normal a gut as possible, prior to a more lengthy course of FMT to gradually rehabilitate the gut and gut flora.

I think that it is possible to use FMT and an adapted diet to cure Hashimoto's, RA and most autoimmune/inflammatory diseases. There has simply not been enough work to establish cheap and effective protocols.

Let me know how this all works out for you. Good luck.

jaqulin said...

I liked the article but I loved this quote that is "A common criticism of the biomedical literature is the focus on therapy and cure rather than cause and prevention." It is true that most of us are very busy in commenting and badmouthing others. Where we can simply cure it. For multiple sclerosis there are many prompt multiple sclerosis treatment available in this era.