Although the scientific community's common refrain is that the etiology (cause) and pathogenesis (cause and perpetuation) of MS are unknown, research has brought to light many underlying issues that are linked to MS and that are believed to be involved in its etiology.

Proposed model of the pathogenesis of multiple sclerosis based on currently known information | Sort Out This MS

Introduction

In MS, we know that immune cells cross the blood-brain barrier into the CNS and attack nerves.

But what are some of the factors that lead up to those events?

In reviewing the information out there, it seems reasonable to assert that the primary causal factors are infection, gut dysbiosis, and intestinal hyperpermeability.

That's not to say all of these issues are relevant to you (or to any other particular MSer), but chances are that at least one of these issues applies to you.

These three issues may lead to secondary issues such as metabolic dysfunction, food sensitivities, and mitochondrial dysfunction--all of which are strongly linked to MS and cause downstream problems observed in MS patients. A good many of those secondary issues can be explained rather succinctly by my TLR4/macrophage model.

Pathogenesis of Multiple Sclerosis: Infection Model | Sort Out This MS

Infection Model

MS is linked to several types of viruses, bacteria, and fungi, partly because elevated levels of antibodies against a number of these pathogens are found in MS patients. The infection hypothesis is supported additionally by the stories of MSers who claim to have "cured" their MS through by treating their infection.

Pathogenesis of Multiple Sclerosis: Infection Model | Sort Out This MS

In this model, an infection leads to both chronic inflammation and dysregulated immune tolerance, which makes it likelier to develop autoimmunity.

Learn about the Infection model here.

Pathogenesis of Multiple Sclerosis: Dysbiosis Model | Sort Out This MS

Gut Dysbiosis Model

MSers are known to have an altered gut microbiome, which means that there is an imbalance in the populations of microbes in their gut. This condition, which is known as gut dysbiosis, is being linked to a growing number of neurological conditions including celiac disease and autism spectrum disorder.

Pathogenesis of Multiple Sclerosis: Dysbiosis Model | Sort Out This MS

In this model, various factors such as infection, diet, lifestyle habits, pharmaceuticals, and pesticides lead to chronic inflammation. Gut dysbiosis develops as a result of those factors (in addition to predispositions), and that leads to dysregulated immune tolerance and less protection against inflammation. Such conditions are a prime for autoimmunity to develop.

Learn more about the Dysbiosis model here.

Pathogenesis of Multiple Sclerosis: Intestinal Permeability Model | Sort Out This MS

Intestinal Hyperpermeability Model

The lining of your intestines is semi-permeable; under normal circumstances it allows digested nutrients to pass into the blood stream, which allows the nutrients to travel to the rest of the body.

It's hypothesized that when the gut lining is compromised (e.g., from damage or from chronic exposure to substances that loosen the lining) larger particles can enter the blood stream and cause problems.

Intestinal hyperpermeability is increasingly being seen as a causal factor in chronic illnesses, including autoimmune disorders.

In this model, various factors such as infection, diet, lifestyle habits, pharmaceuticals, and pesticides lead to chronic inflammation. Intestinal hyperpermeability issues develop as a result of those factors (in addition to predispositions), and that leads to food sensitivities.

Unchecked, the food sensitivities may develop into autoimmunity as inflammation becomes more acute and antibodies cross-react with other tissues in your body (e.g., myelin).

Pathogenesis of Multiple Sclerosis: Intestinal Hyperpermeability Model | Sort Out This MS

Learn more about the Intestinal Hyperpermeability model here.

Obligatory disclaimer: This content is meant to be informational. As everyone's body is different, what works for others may not work for you. I am not a doctor and you're probably not either. You should consult with your doctor before trying anything. Don't sue me.
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