Pathology-supported genetic testing as a method for disability prevention in multiple sclerosis (MS). Part II. Insights from two MS cases

Rensburg, Susan J. van; Hattingh, Coenraad; Johannes, Clint; Moremi, Kelebogile E; Peeters, Armand V.; Heerden, Carel van; Erasmus, Rajiv T; Zemlin, Annalise E.; Kemp, Merlisa C; Jaftha, Mariaan; Khine, Aye Aye; Potocnik, Felix; Whati, Lindiwe; Engel‐Hills, Penelope; Toorn, Ronald van; Kotze, Maritha J.

doi:10.1007/s11011-021-00712-9

Cited by 5 publications

(5 citation statements)

References 59 publications

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“…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.…”

Section: Introductionmentioning

confidence: 99%

“…10,11 Details about the PSGT program and its beneficial effects have been comprehensively described in several publications. 5,6,7…”

Section: Introductionmentioning

confidence: 99%

“…10,11 Details about the PSGT program and its beneficial effects have been comprehensively described in several publications. 5,6,7 It is commonly accepted that nutrition is one of the possible environmental factors involved in the pathogenesis of MS, but its role as a complementary MS treatment is unclear and, to a large extent, ignored. Nutrition in MS has increasingly generated interest since the studies of Swank in the 1950's which suggested that dietary saturated fat intake was associated with prevalence and disability in MS. 12 Wider acceptance by the medical profession has however been limited by the fact that Swank's studies were observational and not randomized controlled trials (RCTs).…”

Section: Introductionmentioning

confidence: 99%

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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

Jaftha,

Robertson,

van Rensburg

et al. 2024

Preprint

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Background: Cerebral white matter lesions (WMLs) in people with multiple sclerosis (pwMS) are associated with the death of myelin-producing oligodendrocytes. MS treatment strategies aim to limit WML accumulation and disability progression. It is commonly accepted that nutrition is one of the possible environmental factors involved in the pathogenesis of MS, but its role as a complementary MS treatment is unclear and, to a large extent, ignored. Objective: A pilot case control study over a 10 year period to ascertain whether a dietary- and lifestyle modification Program in pwMS reduces or prevents WML formation. Methods: MRI was performed at baseline and after an interval period of at least 10 years or longer in 22 pwMS. WML volumes were determined using Sequence Adaptive Multimodal SEGmentation (SAMSEG) software, part of FreeSurfer 7.2. Other variables include age at MRI, disease duration, disability status and medication. Results: PwMS (n=13) who had followed the Program for more than 10 years, had significantly smaller lesion volumes (mm3) compared to pwMS who did not adhere to the Program (n=9) (4950 ± 5303 vs 17934 ± 11139; p=0.002). WML volumes were significantly associated (p=0.02) with disability (EDSS) but not with age (p=0.350), disease duration (p=0.709), or Interferon-β treatment (p=0.70). Conclusion: Dietary- and ± changes may lower the risk of developing cerebral WMLs in pwMS and potentially slow down disease progression. Larger studies are required to confirm the effectiveness of such interventions in pwMS.

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Section: Introductionmentioning

confidence: 99%

“…10,11 Details about the PSGT program and its beneficial effects have been comprehensively described in several publications. 5,6,7…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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

Jaftha,

Robertson,

van Rensburg

et al. 2024

Preprint

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“…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.…”

Section: Introductionmentioning

confidence: 99%

“…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] .…”

Section: Introductionmentioning

confidence: 99%

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

Kemp

Johannes

Rensburg

et al. 2022

Preprint

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Background: Although multiple sclerosis (MS) is an immune-related disorder, pharmaceutical interventions targeting the immune system do not stop or reverse disability progression; the major challenge for this condition. Studies show that disability progression in MS is associated with vascular comorbidity and brain volume loss, indicating that a multi-targeted approach is required to prevent debilitation. The aim of the present study was to examine the associations between vascular ultrasound, disability, biochemistry and lifestyle data in people with MS (pwMS). Methods: Extracranial vascular ultrasound was performed on 51 pwMS and 25 age-matched controls. Sonographic interrogation determined carotid intima-media thickness (cIMT) and abnormal blood flow patterns. Disability was assessed using the Expanded Disability Status Scale (EDSS). Biochemical and lifestyle data were obtained for all participants. Results: The EDSS had a highly significant positive association with the cIMT of the right (r = 0.63; p = 0.001) and left (r = 0.49; p = 0.001) common carotid arteries and negative associations with the peak systolic blood flow velocity of the right vertebral artery (r = -0.42; p = 0.01) as well as end-diastolic velocity of the left internal carotid artery (r = -0.47; p = 0.01). These associations were significantly influenced by biochemical and lifestyle factors. Both cIMT and age showed significant associations with the EDSS. When cIMT was adjusted for age in a regression analysis, the association between the EDSS and the cIMT remained significant (p < 0.01), while the age association was reduced to being significant only at 10% (p = 0.06). There was no association between the use of MS medication and the EDSS (p = 0.56). Conclusion: PwMS who had increased cIMT, a surrogate marker for atherosclerosis, and reduced carotid artery blood flow velocities were at risk for greater disability over and above the effect of aging. These findings provide important information for disease management and disability prevention in pwMS. Modification of diet and lifestyle may promote the unhindered flow of essential nutritional factors into the brain in pwMS.

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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

et al. 2021

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Pathology-supported genetic testing as a method for disability prevention in multiple sclerosis (MS). Part II. Insights from two MS cases

Cited by 5 publications

References 59 publications

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

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

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

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

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