19c. MS

Question 1

What is MS?

Answer 1

AI condition
Autoreactive
Inflammatory
Neurodegeneration

Question 2

What happens in MS?

Answer 2

Immune cells infiltrate the BBB and attack the myelin sheath

Question 3

What happens in MS if an attack is sustained?

Answer 3

Loss of oligodendrocytes
Neurodegeneration

Question 4

What is the myelin sheath?

Answer 4

Fat and protein compound which wraps around a nerve to support nerve impulses

Question 5

What is the myelin sheath made from?

Answer 5

Oligodendrocytes

Question 6

What are the two types of MS?

Answer 6

Relapsing/remitting
Primary progressive

Question 7

What happens during the relapsing/remitting form of MS?

Answer 7

Disease alternates between relapse/myelin loss and periods of remission

Question 8

What happens during the primary progressive form of MS?

Answer 8

Continuous and progressive loss of neurological function with no remission

Question 9

Symptoms of MS

Answer 9

Visual impairment
Nerve tingling/numbness
Intestinal/urinary problems
Fatigue/weakness
Poor co-ordination/balance
Speech difficulties
Difficulty walking

Question 10

What is MS called if it only happens once?

Answer 10

Clinically isolated syndrome

Question 11

What is MS called if it happens more than once?

Answer 11

Relapsing-remitting MS

Question 12

Which gender is MS more prevalent in?

Answer 12

Female

Question 13

Why is MS considered to be a T-cell mediated disease?

Answer 13

Shifts away from anti-inflammatory T-reg cells towards autoreactive Th17 T-cells

Question 14

Causes and risk factors for MS (ACTIVE)

Answer 14

AI diseases
Cigarette smoke exposure
Trauma
Infections
Vit D deficiency
Environmental toxins

Question 15

Why is vit D deficiency a risk factor for MS?

Answer 15

MS more prevalent in countries away from equator
Vit D helps shift autoreactive T-cells towards anti-inflammatory T-reg cells

Question 16

Which other vitamins are found to be deficient in MS (other than vit D)?

Answer 16

K
B12

Question 17

Why is a vit K deficiency a risk factor for MS?

Answer 17

Vit K needed for Gas 6

Question 18

What is Gas 6?

Answer 18

Vit K dependent anti-inflammatory protein
Protects oligodendrocytes
Promotes remyelination

Question 19

Why are MS patients thought to be low in vit K?

Answer 19

Poor microbial synthesis in gut
Low absorption
Low dietary intake

Question 20

Why is a B12 deficiency a risk factor for MS?

Answer 20

Phospholipids in myelin sheath are methylated
Need B12 to support methylation
Improves neuron growth
Regenerates myelin sheath

Question 21

Why is obesity a risk factor for MS?

Answer 21

Obesity makes the BBB more permeable leading to CNS inflammation
Leptin - raised during obesity - associated with CNS inflammation
Obesity leads to upregulation of M1

Question 22

Why is leptin associated with CNS inflammation?

Answer 22

Increases levels of Th17 autoreactive T-cells

Question 23

Why is childhood trauma a risk factor for MS?

Answer 23

Leads to thymic involution or atrophy
Amplifies production of Th17 cells
Negative impact on oligodendrocytes

Question 24

How does stress affect inflammation?

Answer 24

SNS and PSNS parts of ANS regulate inflammation by interacting with T-cells
Chronic stress undermines ANS connection to T-cells and drives inflammation

Question 25

How does reducing stress reduce inflammation?

Answer 25

Stimulating Vagus nerve decreases:
M1
Th17
Increases:
Myelination
T-reg cells

Question 26

Supplements to support MS

Answer 26

D
K (90mcg)
Quercetin (500mg)
Sulforaphane (250mg)
ALA (300mg)
O3
B12 (1000mcg)

Question 27

What is the Swank diet?

Answer 27

Low saturated fat diet
Fruit/veg
No red meat
White meat poultry (under 50g/day)
White fish (under 50g/day)

Question 28

What is the Wahls diet?

Answer 28

Paleo diet
Green leafy veg
Sulphur-rich veg
O3
Grass-fed meats
Seaweed