Is Multiple Sclerosis an Autoimmune Disease?

Multiple sclerosis is almost universally labeled an “autoimmune disease.” Yet after decades of research, there is still no proof that MS is the result of autoimmunity.

Several papers by Drs. Abhijit Chaudhuri and Peter Behan [1,2] discuss problems with the conventional explanation:

  1. Unlike other diseases which are known to have an autoimmune component (rheumatoid arthritis, systemic lupus erythematosus, and myasthenia gravis), MS has no specific immunological marker. This after 60 years of search for such a marker.
  2. The standard animal model for MS, experimental allergic encephalomyelitis (EAE), is generated by inducing autoimmunity against myelin basic protein in mice.  However, EAE symptoms do not closely resemble those of MS; rather, EAE mice look like humans with a different disease — acute disseminated encephalomyelitis (ADEM). Some differences: EAE and ADEM lack the characteristic large plaques radiating from a central focus seen in the brains of MS patients. EAE and ADEM both feature destruction of endothelial cells lining blood vessels, a pattern not seen in MS. 
  3. The autoimmune model does not explain the neurodegeneration and loss of brain matter in the brains of MS patients; the observation that widespread neuronal loss is present even at the earliest clinical stage of the disease; the absence or slight infiltration of lymphocytes in MS plaques; the role of vitamin D in MS prevention; and the general failure of immunotherapies.

Whether MS is an autoimmune disease has implications for treatment.  Autoimmune diseases are commonly treated by immunosuppression.  But if MS is an infectious disease, immunosuppression would be a terrible mistake.

After 60 years of research, the autoimmune model has failed to produce a single effective treatment for MS. Drugs have been found that improve mice with EAE, but none does much to help MS patients. Chaudhuri and Behan note:

The two most widely prescribed therapies for MS (interferon and glatiramer acetate) have no effect on the progressive forms of the disease (primary or secondary MS), although relapse rates may be reduced by about one third in some patients. A response rate of one third is considered to be a powerful placebo effect in treatment trials. [2]

The continued dominance of the autoimmune paradigm in MS research calls to mind Einstein’s definition of insanity. 

Meanwhile, other work has established that at least some cases of MS are infectious in origin, and can be cured with antibiotic and dietary therapies. That will be the subject of tomorrow’s post.

[1] Chaudhuri A, Behan PO. Multiple sclerosis: looking beyond autoimmunity. J R Soc Med. 2005 Jul;98(7):303-6. http://pmid.us/15994589.

[2] Chaudhuri A, Behan PO. Multiple sclerosis is not an autoimmune disease. Arch Neurol. 2004 Oct;61(10):1610-2. http://pmid.us/15477520.

  1. IIRC after many decades of failed treatment for ulcers, it was found they are caused by bacterial infections. Do you think that funding research with federal grants is locking in institutional thinking instead of allowing research to be free flowing and not bound by “guidelines” established by bureaucrats?

    Anyone who’s ever been associated with institutions knows that grant getting trumps every other talent.

  2. Yes, that’s a very astute comment erp.

    I do believe that federal grant funding is pernicious for science. With a single funding source predominating, there is not a lot of diversity in funding. There is intense competition for funds, and the established scientists who serve on review committees have a strong incentive to keep the established scientists funded. Of course, with money one can do better work, so the established scientists always look like more productive scientists than the outsiders.

    To get grants, it pays to flatter the existing paradigms. Review committees will usually be resistant to funding research that might invalidate their own careers and research programs.

    Of course, the self-interest of scientists isn’t necessarily best served by curing disease. Of course they are trying their best to do it, but only within the established paradigms. To follow the same track as peers, but outdo them, would win wealth and esteem. To cure a disease unconventionally might take decades and jeopardize one’s career.

    There is also great institutional pressure to bring in money. Hospitals and universities much prefer research that might produce patented drugs to research that doesn’t. That also influences research into some of these diseases. Proving that a disease is caused by bacteria and treatable by antibiotics is not going to generate a lucrative patent; patients can just take doxycycline.

    A better system of funding would give taxpayers and patients an ability to allocate money to research. Let researchers put research proposals on the web, and let every taxpayer contribute $500 of taxes to the project of his choice. Patients (and their relatives) would direct money in directions that patients, not established researchers, thought was most promising. Science would immediately get ten-fold more creative and more responsive to patient experiences.

  3. Probably the big money / heavy lobbyist pharmaceutical manufacturers are most to blame for discarding the Cpn cause and antibiotic/suppliment cure for MS. It is not in their best interest for research and/or substantial clinical trials be done validating the Vanderbilt Protocol for the AMA’s satisfaction, as their big money drugs would become worthless overnight. Money is the root of this evil, and big lobbying in congress the demon’s tool.

  4. I wonder if http://www.kickstarter.com/ would be a good platform for privately funded research…

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