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Body response, often an immune/cytokine response, to infection or other foriegn agent.

Nitric Oxide and CPn: Multiple sclerosis link

Nitric oxide has long been suspected as the possible damaging factor in multiple sclerosis. The logic goes like this: The body for some unknown reason starts attacking the brain as if it were a foreign protein (like a bacteria). The microglia (the cells in the brain which are responsible for immune responses that might be needed inside the blood brain barrier-the regular white blood cells are kept out by the BBBi)produce large amounts of nitric oxide (NO) which damage the nearby nerves and support cells. If only we could get rid of the NO then we could control MSi. An example of this kind of research can be found HERE<. Also another one HERE<. It is clear that the researchers consider the production of NO an abherrent and undesirable response and a contributor to autoimmunity. You might note that they also are very clearly believing the autoimmune model. Many physicians and researchers forget that this is just a model, not a proven fact.

Circle that date! Chronology up until I found this site.

8/13/04 Just a little over a year ago. On 8/13, and for several months prior to that, I was accustomed to riding a bicycle at least an hour, 5 nights per week. I usually covered 12 miles or so, riding by myself in town traffic. Occasionally I'd cover 14 miles in hilly terrain, just to challenge myself a little more. If you don't ride, I will tell you that this is a decent ride for a middling club rider, and a really good ride for a 54 year old guy.

8/14/04 Went to the hospital emergency room with heart palpitations that lasted on and off for about 6 hours. They were continuous enough to cause dizziness. My wife could see the heart monitor over the bed, and she'd say "There was one", or "Oh, that was a big cluster", etc. They were quite distinct on the monitor -- she's a teacher, not a medical person. Released to home -- "Something's going on, but it's not dangerous. See Family Dr."

8/14 - 9/30 Began having exertional intolerance and gall bladder attacks. Cardiologist found "nothing significant" on EKG/Holter Monitor. Felt cold during prolonged exertion instead of warming up. Took days to recover from vigorous rides. Eliminated virtually all fat from diet.

11/04 Lap. Cholecystectomy -- uncomplicated. Advised by surgeon that fatigue was probably not related to GB symptoms, and to exercise regularly, "push yourself a little." Back to normal diet.

2/05 Stress Echo on heart "normal". BTW, this is "office nurse-patient-normal," which in the US means "you won't collapse coming in from the parking lot, and I am very busy." I once had a blood lipids panel in which every single test was at least slightly outside "doctor-normal," but which was reported to me as "normal." I later found out that the Stress Echo wasn't "doctor-normal," either -- just abnormal in a way that they felt was safe to gloss over. (inverted/ prolonged t-wave.)

2/05 "Usual fatigue suspects" blood work normal. I mean 'doctor-normal;' I'd learned to get the results myself w/o the benefit of the office nurse's opinion.

5/05 Decided I was being a wimp, went for a ride -- covered 14 miles in one hour over hilly terrain. IQ for the next 3 days slightly lower than dryer lint, slept 12 hours per day, arms shaking, breaking into spasmodic dyspnea. I either shouldn't be able to do a ride like that at all, or it shouldn't take 3 days to get over it.

5/05 Asked Dr. to call in scrip for prostatitis -- Bactrim almost eliminated symptoms. Walked all over San Franscisco for 3 days. Every day was like 3 stress tests back-to-back. Felt great.

6/05 Following their brief vacation, symptoms returned with a new attitude, up and doing, ready to take me down and keep me down. Began having problems understanding simple English sentences, missing turns while driving, etc. Very difficult to keep "fronting" at my work. I am a computer programmer; most days my duties are like two college entrance tests back-to-back. Some days I couldn't understand the programs I wrote the day before.

Dr. did more blood tests, came back 'doctor-normal'. Advised me to have a sleep study (I have Obstructive Sleep Apnea, have had for years.)If sleep study was essentially unchanged, I was to start taking Wellbutrin -- "shown to be helpful in conditions like this." Q: does Wellbutrin improve exercise tolerance? The manufacturer would be tickled to add that to their claims, I'm sure.

Discovered that my ESR, while 'doctor-normal' in the US, would be considered abnormally low in the UK, where it would be considered a marker for CFSi, Idiopathic Cardiomyopathyi, or Sickle Cell Anemia, depending on other symptoms.

8/05 Sleep study shows no change in oxygenation levels, but development of 'hypersomnia' (if I am not moving, I fall asleep), and Intermittent Limb Movements, both consistent with CFS. No explanation of cause was offered: started Cinemet for ILM; Wellbutrin because Dr. secretly suspected depression, I think.

Cpn, Stroke, and Sed Rate;27/12/2207< is a 1997 study associating Cpni with stroke. It also mentions that ESR is not elevated in the study population.



Question about steroids

David Wheldoni and Dr A were asked about the reason that steroids and immunosuppressants do not cause CPN to go out of control in the case of MSi. If people with MS actually have CPn, why are steroids or things like tysabri apparently helpful? Why do they not make people worse? answer follows:

DR A's response (the MD who is close to the VU work who is expert)
As far as steroids are concerned, the cellular immune system isn’t very effective against C. pneumoniae infections (The C. pneumoniae can infect every cell in the cellular immune system.). Therefore, interfering with the cellular immune system ( by giving something like steroids or suppression of the immune system ed.) would be predicted to have little to do with making the disease worse – and might make the symptoms better if the symptoms were related to inflammation.

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