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Pathology-supported genetic testing as a method for disability prevention in multiple sclerosis (MS). Part I. Targeting a metabolic model rather than autoimmunity
- Source :
- Metabolic Brain Disease. 36:1151-1167
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- In this Review (Part I), we investigate the scientific evidence that multiple sclerosis (MS) is caused by the death of oligodendrocytes, the cells that synthesize myelin, due to a lack of biochemical and nutritional factors involved in mitochondrial energy production in these cells. In MS, damage to the myelin sheaths surrounding nerve axons causes disruption of signal transmission from the brain to peripheral organs, which may lead to disability. However, the extent of disability is not deterred by the use of MS medication, which is based on the autoimmune hypothesis of MS. Rather, disability is associated with the loss of brain volume, which is related to the loss of grey and white matter. A pathology-supported genetic testing (PSGT) method, developed for personalized assessment and treatment to prevent brain volume loss and disability progression in MS is discussed. This involves identification of MS-related pathogenic pathways underpinned by genetic variation and lifestyle risk factors that may converge into biochemical abnormalities associated with adverse expanded disability status scale (EDSS) outcomes and magnetic resonance imaging (MRI) findings during patient follow-up. A Metabolic Model is presented which hypothesizes that disability may be prevented or reversed when oligodendrocytes are protected by nutritional reserve. Evidence for the validity of the Metabolic Model may be evaluated in consecutive test cases following the PSGT method. In Part II of this Review, two cases are presented that describe the PSGT procedures and the clinical outcomes of these individuals diagnosed with MS.
- Subjects :
- 0301 basic medicine
medicine.medical_specialty
Expanded Disability Status Scale
Neurology
medicine.diagnostic_test
business.industry
Multiple sclerosis
Magnetic resonance imaging
Bioinformatics
medicine.disease
Biochemistry
White matter
03 medical and health sciences
Cellular and Molecular Neuroscience
Myelin
030104 developmental biology
0302 clinical medicine
medicine.anatomical_structure
Brain size
medicine
Neurology (clinical)
business
030217 neurology & neurosurgery
Genetic testing
Subjects
Details
- ISSN :
- 15737365 and 08857490
- Volume :
- 36
- Database :
- OpenAIRE
- Journal :
- Metabolic Brain Disease
- Accession number :
- edsair.doi...........78a39b35809c5293ae61c1c1df3831ca
- Full Text :
- https://doi.org/10.1007/s11011-021-00711-w