There’s uproar about a supposedly effective treatment for multiple sclerosis (MS). Patients have their hopes up and are demanding for it whereas health experts are asking for prudence and patience while they examine the evidence and test the hypothesis behind the treatment. In this series, I will try to bring you the latest about this treatment.
How it all began
Brilliant ideas sometimes arise when tragedy strikes people where they hurt the most – their family. Paolo Zamboni, a professor of medicine at the University of Ferrara was confronted with the debilitating effects of MS right within the four walls of his home when his wife was diagnosed with MS in 1995. The vascular surgeon conducted an extensive literature research on MS. He found some possible answers in old medical literature. Thus, his “big idea” popular known as chronic cerebrospinal venous insufficiency (CCSVI) was conceived although he prefers to call it the “liberation theory” because it liberated his wife from the debilitating symptoms of MS.
Autoimmune vs vascular disease
MS has always been thought to be an autoimmune disease, wherein the cells of the immune system attack the myelin sheath that protects and insulates the nerves.
Zamboni found some old medical articles which hypothesized MS to be caused by iron overload in the brain. In digging further, he found some similarities pathogenesis and physiology of MS and chronic vein disease (CVD). CVD causes weakness and lesions in the lower extremities (legs) because of the occlusion of the veins.
Zamboni then looked at ultrasound scans of the veins in the neck of MS patients and found some anomalies. 90% of the MS patients he examined had blocked or narrowed veins which drain the blood from the brain. Zamboni believes the blockage causes a reflux or backflow, observable in the scan, which can lead to accumulation of iron deposits. Iron damages the walls of the blood vessels and allows cells in the blood, including immune cells, to penetrate the blood-brain barrier and attack the myelin.
Thus, according to Zamboni, MS is not an autoimmune disease but a vascular disease.
Zamboni’s idea is simple: clear the blockage and cure the disease. The procedure is very like angioplasty wherein a catheter is inserted in the blood vessel in the groin up to the neck where a balloon is then inflated to clear the blockage. As soon as the blockage is cleared, normal blood flow will be restored and the symptoms will go away. Zamboni performed the simple procedure on his wife and it worked. She has been symptom-free for about 3 years now.
Since then Zamboni has tested the procedure on several MS patients, with promising outcomes.
Is CCSVI the cure we have been waiting for? Next week, I’ll be bring you the opinions and insights of experts.