Multiple Sclerosis (MS) is a disabling disease of the brain and central nervous system caused by the immune system attacking the protective sheath that covers the nerve fibers.
The myelin is lost and communication between the brain and the rest of the nervous system is disrupted.
MS can cause permanent damage or deterioration of the nerve fibers. Therefore, the symptoms can be intermittent or chronic depending on the severity of the damage.
Multiple Sclerosis can develop at any age but is most common between the ages of 20 to 50 years old.
Children can get MS and currently there are approximately 5000 children in the US with MS and greater than 10,000 worldwide.
Current estimates are greater than 1 million people in the US have MS and 2.5 million people worldwide have been diagnosed with this disease.
Since 1975, the reported number of patients with MS in the US has doubled.
The countries with the greatest population of patients with MS are those with higher latitudes from the Equator such as Germany, United States, Canada, Norway, and Iceland.
The lowest population are among people of Native American, African and Asian descent.
People with relatively higher levels of Vitamin D are less likely to develop Multiple Sclerosis and those that do develop this disease with high levels of Vitamin D are likely to have a less severe form. Vitamin D levels can explain the North-South distribution of MS.
Sex is a risk factor for developing MS as females are 3-4 times greater incidence than males.
Genetic factors are a higher risk for development. Heritability is between 35-75% for those with a biologic relative. First degree relatives of someone with MS have a 2.5-5% risk of development of the disease.
The genetic predisposition to MS may be inherited but overall MS is not an inherited disorder.
If one identical twin has MS, there is a 25% chance the other will develop MS.
The exact cause of Multiple Sclerosis is unknown. The disease causes damage to the myelin, nerve fibers, and neurons in the brain and spinal cord.
Researchers speculate that a combination of genetic and environmental factors are associated with the disease, but exact etiology is not defined.
Overall, the immune system attacks normal cells in the brain and nervous system. The resulting damage to the myelin, which is the insulating layer protecting the nerves, disrupts signals to and from the brain resulting in varied and unpredictable symptoms.
In MS, an abnormal response causes inflammation and damage in the central nervous system.
Two important leukocytes involved in this process are T cell and B cells.
T cells become activated in the lymphatic system and enter the central nervous system through the circulation. Once in the central nervous system, T cells release chemicals causing inflammation and damage to the myelin. T cells then activates B cells to participate in this process.
B cells produce antibodies and stimulate other bio-active proteins which cause further damage to the nervous system.
The symptoms of MS are varied and different from person to person. This variability makes it extremely difficult to diagnose. In one study in Europe, the average woman had to visit their healthcare professional 5 times over a six month period before the disease was correctly recognized.
Some common symptoms of Multiple Sclerosis are:
- Blurred vision
- Hearing difficulty
- Abnormalities in smell or taste
- Numbness or tingling in the limbs
- Speech difficulties
- Facial pain
- Muscle spasticity
- Dizziness or vertigo
- Loss of balance, weakness or fatigue
- Sexual dysfunction
There is no single test for the diagnosis of Multiple Sclerosis, but common testing done include:
MRI brain and brainstem
Laboratory analysis of blood
EEG and evoked potentials
There are four basic types of Multiple Sclerosis.
- Clinically isolated syndrome
- Relapsing remitting
- Secondary progressive
- Primary progressive
Clinically isolated syndrome refers to the first episode of neurologic symptoms caused by the inflammation and demyelination in the nervous system. This may or may not progress to other forms of MS.
Relapsing remitting is the most common disease course. The hallmark are clearly defined attacks of new or increasing neurologic symptoms. These relapses are followed by periods of partial or complete recovery or remission. In the remission period, symptoms may disappear, or some may continue or become permanent. Approximately 85% of patients are diagnosed initially with this type of MS.
Secondary progressive follows the relapsing remitting course. This type is characterized by a worsening neurologic function and progressive disability. This type can also have periods of disease activity and stability.
Primary progressive type, the neurologic function worsens, or disability accumulates without relapses or remission typically.
There is no cure for Multiple Sclerosis, but current treatments can help manage symptoms.
The current medications are designed to lessen the frequency of relapses and to slow the progression of the disease.
Medications are injectable, oral and infused.
2016 economic analysis found the lifetime cost of treatment per person with MS to be $4.1 million.
The average yearly healthcare cost ranges from $30,000 to $100,000 based on the severity of the disease.
Platelets in Neurodegenerative Conditions
Platelets are primarily known for initiating coagulation following tissue injury and blood vessel disruption. Platelet count in a healthy human range from 150,000 to 400,000 per microliter of blood. Only a small fraction of the platelets (about 10,000) are necessary to act during hemostasis, therefore platelets exert many other functions.
Platelets contain a cytoplasm, messenger RNA, mitochondria and secretory granules such as lysosomes, dense granules and alpha granules. Platelet activation is required to fulfill particular functions as the granules are stimulated by this process and release their contents.
Upon activation, the alpha granules release abundant bioactive molecules which can either act as pro or anti protein clusters depending on which cluster was stimulated. This finely tuned mechanism whereby bioactive molecules are released, represents a critical regulatory process in many tissues.
However, disturbances in this regulation have implications in numerous disease states.
Platelets release extracellular vesicles containing active cytoplasm components such as exosomes and microparticles. These represent common ways for cell-to-cell communication.
If these particles are dysregulated, they are involved in neurodegenerative disorders such as Multiple Sclerosis.
These particles are small enough in size to cross the blood brain barrier and travel deep into the microcapillaries of the brain. Then, they can exert local, receptor mediated events.
Platelets can exhibit neuron like properties and can facilitate cross-talk between cells and the central nervous system.
Platelets and Neurons are remarkably similar in size and content. The molecular similarities are so close that some scientists consider platelets neuronal cells. Platelets interact with T cells representing a neuroimmunological synapse in the neurological tissues.
Platelets carry several neurotransmitters that are essential for communication with brain tissues. These chemicals include GABA, serotonin, glutamate, epinephrine, dopamine and histamine. This suggests platelets can send and receive signals to and from the nervous system and may act as a relay between the brain and other tissues.
Neurodegenerative diseases do not solely involve cells and tissue of the central nervous system, but rather systemic influences also play a role in the development and exacerbation of these diseases. Platelets are an important mediator of this relationship.
A few studies targeting platelets and their involvement in Multiple Sclerosis have shown that this condition is associated with abnormalities in platelet function. Evidence reveled platelets exacerbate the development of the disease by the recruitment of leukocytes to the neural tissue.
During the early stages, high levels of platelet derived serotonin stimulate the proliferation and differentiation of pathogenic T cells subsets promoting proinflammatory responses. However, later phases of the disease, platelets exhibit reduced serotonin levels and suppress T cell activation and central nervous system inflammation.
This suggests platelets could serve as a potential target for the amelioration of the systems of MS.
Impairments in platelet function are a common observation in neurodegenerative disorders. Healthy platelets and their secreted factors represent a possible approach for the development of therapeutic interventions in the treatment of these diseases.
Platelet rich plasma has beneficial effects on damaged tissues. This effect has been reported in thousands of peer reviewed studies. It has been shown to enhance the recovery of peripheral nerves following injury. In mice with transected spinal cords, PRP promoted locomotor recovery, local angiogenesis and neuronal regeneration.
When used in an animal model of MS, it considerably improved the clinical systems.
This effect was accompanied by significantly lower protein levels of inflammatory markers.
The platelet rich plasma also protected the cells from demyelination in the affected area.
During the onset of neurodegenerative conditions, factors released from healthy platelets could have a protective role. In cancer, platelets suppress tumor angiogenesis. Platelets have an endocytic machinery and could collect products that are released into the blood from malfunctioning cells attempting to clear the systemic environment.
Platelets and platelet microparticles are potential vehicles for the delivery of therapeutic drugs. With their specific cell to cell communication capacity, platelets could serve as selective non -toxic drug delivery vehicles to target specific cells and tissues in neurodegenerative disorders.
Juventix Regenerative Medical is an industry leader in the regenerative medical field. Our Platelet Rich Plasma Kits are FDA cleared and designed for safety and effectiveness. They are cost effective and easy to use. Our kits have been scientifically manufactured to provide a consistent platelet concentrate, devoid of red blood cells with a minimum number of leukocytes critical to the regenerative cascade.
Juventix Regenerative Medical offers a patent pending LED Activator to activate the platelets and begin the regenerative process. The activation is a critical step in the release of cytokines, growth factors and bio-active proteins and is accomplished with LED light. This negates the use of chemical additives such as Calcium Chloride, Thrombin or Collagen.
RESTORE, REVIVE, REGENERATE- JUVENTIX REGENERATIVE MEDICAL
Dr. Robert McGrath
J Neuroimmunol 2019 Aug 15;333:476958 PMID 31103935
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