It鈥檚 a great name for a possible cure for multiple sclerosis: 鈥淭he Liberation Procedure.鈥� Indeed patients suffering from MS feel that their body is being held prisoner by some strange force. Their arms and legs can grow numb, they experience visual problems, they may get strange tingling sensations and they鈥檙e constantly fatigued. Eventually most lose the ability to control their movements. Who would not want to be liberated from such a terrible affliction? Drugs like Avonex or Tysabri can slow the progress of the most common form of the disease, the relapsing/remitting variety, but none can stop it. But now there is a ray of hope! And one that hardly would have been predicted by neurologists. The common belief has been that MS is an autoimmune disease, meaning that for some reason the body鈥檚 immune system, which is supposed to fend off foreign substances, instead attacks its own healthy tissue. In the case of MS it is the protective myelin sheath around nerve fibers that bears the brunt of the attack by immune cells gone wild, and it is damage to this protective layer that disrupts nerve function. However, there may be an alternative explanation for the onset of MS, if Italian vascular surgeon Dr. Paolo Zamboni鈥檚 pioneering research stands up to scientific scrutiny.
Zamboni鈥檚 is an interesting scientific and romantic story. His wife was diagnosed with MS and the doctor was determined to leave no avenue unexplored in trying to help her. Did MS patients have any other common anatomical features than damaged myelin sheaths, he wondered? Because he was a vascular surgeon, his attention drifted to the circulatory system. Using ultrasound techniques, which are widely used to diagnose impaired blood flow, he found that MS patients were more likely to have either twisted or partially blocked veins in the neck than other people. This suggested that blood was not draining properly from the brain, which according to Zamboni could have resulted either in immune cells entering the brain or in the buildup of excess iron, which in turn can cause nerve damage. An interesting idea that can be readily put to a test by using balloon angioplasty, the same procedure used to open up blocked coronary arteries. Zamboni鈥檚 early results were riveting. Almost three quarters of his patients with the most common form of MS, relapsing/remitting, improved almost immediately and remained free of further attacks. But in about half the subjects the veins became blocked again within a few months, although in the future this can possibly be treated by introducing a stent to keep the blood vessel open. Unfortunately, none of the patients who suffered from the most serious form of MS, the progressive kind that offers no remission, were helped. In science one learns not to jump too high based on one hopeful result. There have been a number of MS treatments that at first looked promising then fizzled. Whether Zamboni鈥檚 liberation procedure will be one of these, or a true breakthrough, will become clear within a few years. A number of studies are already underway around the world. At the University of Buffalo roughly a thousand subjects are being enroled and will have their veins scrutinized by sophisticated ultrasound and MRI techniques. A third are to be MS patients, a third healthy people and a third who suffer from some neurological problem other than MS. The researchers who will analyze the results will have no knowledge of the subjects鈥� medical histories. It will be fascinating to see if the MS patients can be picked out. Of course that still would not prove that blockages cause MS, it may be that MS results in the blockages. But the second phase of the study will involve opening up the blocked veins to see what happens. Other medical centers are carrying out similar work. It will not be long before the situation is clarified.
Understandably, for MS sufferers, even a couple of years is too long. But proper science takes time and before submitting patients to a procedure that is not risk free, there has to be strong evidence of a potential benefit. Claims that the pharmaceutical industry is trying to throw a monkey wrench into the research to protect its drug interests are just nonsense. In any case, all of Zamboni鈥檚 patients continued with their drug treatment, and it may well turn out that the drugs are a necessary part of the procedure. The uncertainty of this research has not stopped some MS patients from paying large sums to carry out the liberation procedure privately. We will soon find out if they have been liberated of the disease or only of their money.
