Multiple Sclerosis discovery could end disease's chronic inflammation
newsroom.uvahealth.com
newsroom.uvahealth.com
- Inflammation in experimental autoimmune encephalomyelitis (EAE), an animal model of MS, is driven to some extent by aryl hydrocarbon receptor (AHR) activation in the gut.
- AHR knockout mice are resistant to, or recover more swiftly from, EAE.
- An investigation of AHR knockout mice revealed that their microbiomes were different from normal mice in that they produce more bile acids of a certain type, as well as more of certain short-chain fatty acids.
- It was hypothesized that these metabolites, which enter circulation generally, alter the disease course of EAE, and affect susceptibility to EAE.
- Taurocholic acid, a bile acid that's available as an OTC drug in certain nations, was the most effective AHR-knockout-boosted-metabolite at suppressing EAE, when administered orally. It is suggested as a potential treatment option for MS.
- The paper doesn't mention this, but taurocholic acid is hepatotoxic. I believe it remains to be seen whether or not liver-safe bile acids are effective, e.g. tauroursodeoxycholic acid.
Excuse my rudimentary question but does this mean it would still be possible for administration intravenously?
Bile acids might be less toxic if administered via IV infusion, in comparison with oral administration. Then again, they might be more toxic. (Due to rapid excretion or poor absorption via the oral route.) I don't know offhand if one delivery method or the other would be preferred in this regard.
But though most bile acids are toxic, not all of them are. TUDCA and UDCA are not only liver-safe, they're first-resort drugs for resolving drug-induced liver damage and promoting liver health. If these "healthy bile acids" can combat MS, that would be a very interesting result. TUDCA and UDCA are very cheap, and their safety profiles are well established.
You: TUDCA and UDCA are not only liver-safe, they're first-resort drugs for resolving drug-induced liver damage
Me: I think I have a stupid idea
How does one calculate their dose?
Looks like I need to find a reputable brand and seller, that's lab made (rather than bear bile) if anyone has suggestions.
EDIT: Okay this is quite shocking to me so had to share, in searching for reliable sources of TUDCA it looks like pharmaceutical versions are now being approved in Canada and the US for treatment of ALS that cost $13,000 per month!
https://biopharma.media/amyotrophic-lateral-sclerosis-new-dr...
Long term TUDCA use seems like it also lowers good cholesterol.
NAC would be a more appropriate year-round liver support for general supplementation.
https://www.science.org/content/blog-post/n-acetyl-cysteine-...
I hope this wont end the same way like edaravone.
The linked article is a fluff piece written by the university PR. According to them every lab in their university is curing cancer and MS and AIDS every day.
I'm also not going to tell them what to do with their own body. But "run it by your doctor first" seems like a reasonable thing to suggest, even if they ultimately decide to do it anyway.
I wouldn’t either.
> But "run it by your doctor first" seems like a reasonable thing to suggest, even if they ultimately decide to do it anyway.
Sounds like we’re mostly on the same page. I just trust the people I know with serious illness to know this stuff already, even if they get zealous about something that might improve their lives. Because even my friend with MS who has a long history of impulsive mistakes isn’t just injecting random things just based on news stories.
I would not take anything my doctor didn't say would at least not cause harm. But the calculus is different for other people.
Among groups of people with MS I've chatted with there is kind of an unspoken rule to not advise treatment because we all know that we are all different in treatment, symptoms, probably cause... you can get off into the weeds pretty easily.
Lipolic acid, vinpocetine, curcumin, lots of things are anti-inflammatory or good for neuropathy. I've had people recommend getting controlled bee stings, hensbane, obviously meditation for reducing stress and cortisol, and if we go in the direction of alternative methods (which I know people with MS who have used) you get acupuncture and yoga and herbal medicines. CBD in Europe is a treatment, I'm sure other cannabinoids would help different people in different ways too. I just have to tune it out, I want to spend my attention on what I'm good at and enjoy, and trust my [MS specialist] doctor to let me know about new treatments.
Study says "inflammation decreased" which is great. But lots of things do that, so the question is how much... I wouldn't trust it without a fair bit of statistical evidence without my doctor telling me that whatever random supplement is safe enough to risk.
https://cfah.org/cbd-legal-states/
I'm glad you have a specialist doctor whom you trust. MS is a relatively known quantity, having being first described by a neurologist in 1868. Not all diseases and not sufferers have such a privilege. For something newer at the edge of medical sience, like AIDs was in the 1980s or like Long Covid is now, patients are finding doctors of only limited use, and the FDA an impediment rather than helpful. If there was a cure for MS available in Mexico, would you not start a Dallas Buyers Club for others afflicted?
In that case it seems like there's more reason to try, at first, but there is a real cost. The cost of time spent focusing on enjoying what you have in the search for a better that may or may not come. And the cost of spending your days dissatisfied that it's not better than it is.
I don't think chasing medical miracles is a good way to spend my days. If the treatment is safe and works I'm confused why you believe the FDA would prevent it's use, is that a common scenario?
However, the FDA, critically, has totally different and vastly less difficult regulations for supplements as opposed to drugs. Where by drugs I mean things the manufacturer wants to sell as a treatment for a specific condition, for which they were required to provide evidence.
I totally agree that the funding incentives are not good for studying cheap supplements. I have no idea why you think that has anything to do with the FDA, just buy the supplements if you think the circumstantial evidence is good enough.
Edit: For instance, I have been trying R-Lipoic Acid lately. No one stopped me. No one advertised it as a treatment. I found some research papers that said it might help and my doctor said it wouldn't hurt. I don't think it helped, but certainly the FDA didn't get in the way.
Can the FDA turn the circumstantial evidence into real evidence? I think they can.
- testing food for contamination
- inspecting food facilities and farms for safety
- ensuring drugs are not contaminated and that safety reports are coordinated
The NIH is the one that provides funding for health studies... please understand that I'm not saying it's good or correct that studies of supplements aren't getting funding, I'm saying that the FDA is not involved. Direct frustration at the right target, pharmaceutical companies (i.e. capitalism) having no interest in unpatentable low cost treatments and NIH/government not funding such studies when they should.
I agree, the NIH should study all these things -- and does if you look at their budget, via tens of thousands of individual academic research groups with less incentive to not study supplements. Capitalism is still there, but if anywhere can study it without worrying as much about profit motive it'd be academia or a national lab.
I also agree that NIH should have more money targeted at low-profit drug studies. That's unfortunately the kind of thing that gets determined by congress unless they decide to do it on their own.
The best situation is one where the legislature requires a minimum amount be spent by an agency to support certain kinds of research (for instance, they do this across the federal government through the SBIR program for small businesses).
https://www.nih.gov/ABOUT-NIH/WHAT-WE-DO/BUDGET
> The NIH invests most of its $45 billion budget in medical research for the American people.
> Over 84 percent of NIH’s funding is awarded for extramural research, largely through almost 50,000 competitive grants to more than 300,000 researchers at more than 2,500 universities, medical schools, and other research institutions in every state.
> In addition, over 10 percent of the NIH's budget supports projects conducted by nearly 6,000 scientists in its own laboratories, most of which are on the NIH campus in Bethesda, Maryland. The remaining 6 percent covers research support, administrative, and facility construction, maintenance, or operational costs.
And if the treatment is $50k in another country there's no reason that pharmaceutical companies in the US wouldn't pursue it as a treatment, so there's not the same argument as there is with supplements where they simply don't have funded studies. They'd want to upcharge it to $500k I'm sure, but I think the profit motive would be there for them to make it available.
If there's a complex and expensive surgery that might fix a problem, I guarantee there is funding available to make sure it's actually safe and won't give me a brain infection or something. If it could be solved with supplements, the issue is that there's no one funding such research but my doctor also doesn't object to taking stuff that might work. Like curcumin and R-Lipolic acid, and have been actively told to take D3. No harm likely, probably not helping but why not?
Neither of these cases seem like they involve the FDA, so I'm just super confused. The two people replying here seem to both be under the impression that the FDA drives the profit motives for pharmaceutical companies or stop people from taking random supplements so long as they aren't known to hurt you.*
I honestly do not have a problem trusting that the FDA uses a basically reasonable process to evaluate these things, and that if the treatment was available in the US I have vastly less objection to doing it elsewhere where it costs less.
But this is just me. I've lived through flare ups, and have had this since interferon was all we had to work with. I do not think it is a good idea to assume that you are somehow going to have a better outcome than median. Once my doctor agrees my prognosis is bad enough that the median outcome of a treatment is positive, my opinion changes.
I'm a scientist, maybe other people can't think this way. I think it is a very bad idea to think you are different from average, particularly about things that are certainly out of your control. It's just... it's gambling with your health, double or nothing... but if my family and doctor think it's worth the bet it's a much simpler choice.
I would not try to override my spouse or doctor or family if they felt it was too dangerous to be worth the potential benefit, I think they are much more objective than I am.
* Let's ignore DEA nonsense, it's important but tangential.
Among our community I say, make your calculations and take your dose. Don't talk to your doctor, you'll receive no usable feedback, instead, report your results.
?
Medicine is science.
The definition of “scientist” includes someone learned in science, and so a physician absolutely is a scientist. Traditionally trained physicians learn physics and chemistry, biology, biochemistry and molecular biology, and later, anatomy and physiology basics.
But I suppose if MDs had any brains they would have forgone medical school and just got an HN account. Then they could have known everything instead of merely diseases and drugs.
And if trying to take physics and organic chem at a community college during the summer so that the "hard classes" dont pull down their GPA is hardly a training in what you think science is.
I'm not trying to demean them, but its not their job to understand the complexities of these drugs. I know alot of MDs and I can guarantee you they would agree. I've had these conversations with them before. Bottom line, they wouldn't be the first ones to ask if I wanted to experiment on myself with some new chemical.
I myself don’t trust most doctors and do my own research. But I make it a point to find ones I can trust. I did a PhD in biomedical engineering and know a metric ton of biology and still wouldn’t trust myself to decide stuff like this myself. A good doctor will bring a ton of experience, a keen understanding of human physiology, and a network he can tap into for more tips. Underestimate them at your own bodily peril.
For this compound in particular, here’s my amateurish warnings already: it’s clearly hepatotoxic, it’ll likely not even have an effect (EAE models have no real relevance to human MS) and will likely interact with other drugs you take as well.
Simply supplementing with D3 would run into problems without that. Nevertheless, they do cite studies showing improvements with lower doses.
Normally I'm pretty sceptical about 'named doctor' websites as they are usually some kind of grift, but this one doesn't seem to be.
Probiotics would likely be a safer thing to play with. Journaling and isolating specific things the first time you try it can allow an individual to track more complex processes than clinical trials can handle.
Taurocholic acid is a huma bile acid. I may increase liver enzyme levels with some patients, but to say it is toxic to the liver is fear mongering.
https://www.ncbi.nlm.nih.gov/books/NBK548276/
Not that I think their research is useful in anyway. Anytime you want to treat a disease through a receptor you always end up with changes in receptor density which make the drug useless.
"an immune system controller found in 'barrier tissues' such as the intestine"
This sounds like academic wording for "leaky gut."
"doing so had a dramatic effect on the production of bile acids and other metabolites in the microbiomes of lab mice. With this receptor out of commission, inflammation decreased and the mice recovered."
Who might have guessed MS could be caused by an imbalance in a bile humor? Physicians from antiquity.
Which is to say, bloodletting.
But it was nothing. Just a slightly off scale number, unusual but not dangerous.
She is a clinical professor of medicine at the University of Iowa Carver College of Medicine.
I do have an issue with telling folks to eat a specific style of diet, which is difficult to maintain, especially with the promise that it'll cure a disease, one that leaves some folks with little hope. There is no quality research proving her right.
If you were as sick as we are would you wait for research that is never going to happen because capitalism?
What we do know is that oxidative stress seems to play a huge role in MS, and we also know that eating certain diets reduces oxidative stress.
Both terms refer to barrier dysfunction in the tight junctions that make up the cell wall of the intestines. By becoming more permeable, the gut wall lets bacteria through and allows them to either colonize the surrounding tissue and/or enter the blood stream, a phenomenon known as bacterial translocation. Patients with intestinal permeability may have detectable levels of bacteria in their blood. A healthy gut absorbs nutrients and water through the gut wall, but protects the body against pathogens.
Studies show that some autoimmune conditions like psoriasis and Crohn's are associated with increased intestinal permeability. Unfortunately, "leaky gut syndrome" took this idea and ran with it, and as a result we have a lot of snake oil going around.
As for this paper, the connection is really interesting, and seems to fill in some gaps. For example, one of the newest medications for psoriasis, Vtama, is an aryl hydrocarbon receptor agonist. Psoriasis has also been successfully treated with bile acids in at least two studies.
All the support forums rage about how awesome it is. I had a nightmare of a time finding a doctor that had heard of it. Finally had to get an online doctor.
Diet changes also work, but I have to be really strict without LDN. Or a little strict with LDN.
Anecdotally it appears that if you get a strong effect then it is likely it'll be more beneficial long term. Most common effects are nausea which generally subsides in a few weeks, extremely vivid dreams that you can remember which lasts longer. Basically low grade serotonin sickness and perhaps some dopamine dysregulation - some people do get dopamine surges. It helps normalize neurotransmitter levels and your brain might not be used to it. Usually you sleep less but feel more refreshed. I had one of the rarer reactions which was extreme energy, I started LDN for ME/CFS and thought it had cured me and that I now had a new problem of too much energy. Unfortunately it wore off after a few weeks, but it did plateau to a higher baseline.
I ask because I'm genuinely curious, I'm ignorant of its use for this condition.
And the dreams are next level crazy vivid, it’s probably the most common complaint. Sometimes it can be hard to go to sleep knowing there is a dragon waiting to eat you again. There can be a dissociative feeling when you wake up as you try to work out what was real and what isn’t. Was I really just storming the beaches in Normandy? Hmm seems unlikely, but it feels like I was just there.
As soon as I got off the medication and let it clear out of my body for a month, I quit having auras or any other odd seizure-related symptom. Damn glad that didn't happen while driving.
I wake up with energy in the morning. First few months it was like viagra on steroids in morning. That eventually calmed down.
Otherwise I’ve had no side effects, and I tend to get all the crazy side effects of almost every medication.
https://www.frontiersin.org/articles/10.3389/fnins.2020.0082...
There will never be a singe treatment for MS. Never. Because genetics and exogenous influences. The only reason that MS has not been cured in anyone is they refuse to use Personalized Medicine.
If you have RRMS or know someone who does, I advise you to take this route, investigating sources and resolution of your own oxidative stress, to limit relapses.
By the way, most bile acids, like taurocholic acid, are antioxidants.
FWIW, other research shows that without soluble fiber, we can't absorb choline; we need a bacteria in the gut to transform it into a bioavailable form, apparently.
Choline is getting a lot more attention recently, from researchers.
Notoriously, MS is a disease of the last couple centuries, so far as we can tell, it simply didn't exist before that.
https://www.science.org/doi/10.1126/science.abj8222
I think this was a major breakthrough in recent years but no one mentioned it here so far.
Another proposed mechanism is inadvertent calorie restriction, which is common on high protein diets (because protein is so satiating), and on diets with few foods (because eating the same thing is boring). The effects of fasting on autoimmune diseases are well documented. It's thought that calorie restriction may be sufficiently similar.
Correct.
Why do you think mice with EAE are a reference in the research of MS?
Most mice studies don't go further.
I have no trouble at all with ursolic acid. I go to AliExpress.com place an order and 14 days laters, it in my hands, going down my neck.
Now whats hard about that?
Look up AIP diet if you want to reduce inflammation a lot. Changed my life
I had such bad IBS at one point I thought I was dying. Doctors weren't interested in helping me because they couldn't see anything wrong. The AIP diet turned my life around. Now eat most normal foods but still avoid gluten.
But some publications are really impressive like this one, which says that sugary drinks are particularly harmful: