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Vascular Fundus Changes Observed In Patients With A High Probability of CCSVI Driscoll DL 1 , Francomano CA 1 , Driscoll RA 2 Harvey Institute For Human Genetics 1 , Total Eye Care 2 1a 1b 2a 2b 3a 3b 3c Figure Key 1a: MS, left eye 1b: MS, right eye 2a: MS, likely EDS, left eye 2b: MS, likely EDS, right eye 3a: EDS, left eye (has CCSVI) 3b: EDS, right eye (has CCSVI –IJV valve more affected in this eye) 3c: same patient; notice how right fundus corresponds to worse stenosis on right side.
Does metal-induced hypersensitivity, a risk factor for venous stenosis and restenosis, contribute to brain and venous abnormalities in multiple sclerosis sufferers? Stejskal V PhD 1 , Tsamopoulos N MD 2 , Manginas N MD 3 1 Dept of Immunology, University of Stockholm. 2 Dept of Interventional Neuroradiology, Mediterraneo Hospital, Athens, Greece. 3 Dept of Interventional Cardiology, Mediterraneo Hospital, Athens, Greece PURPOSE RESULTS We asked why restenosis occurred in the majority of multiple sclerosis patients treated by percutaneous transluminal angioplasty (PTA) for subsequent restenosis after PTA. 34 patients with central nervous (CNS) and systemic symptoms suspected to have been caused by dental amalgam. Similar changes were not ® patients with CNS symptoms and MRI changes were found against inorganic mercury, phenyl mercury, gold and lead. INTRODUCTION observed reduced signal density on T2 weighted magnetic resonance images (MRI) of the basal ganglia in the brain of MS patients and areas of low density in T2 weighted imaging and the location of iron deposits as well as the correlation between the extent of gray matter T-2 An important factor for restenosis, sometimes observed after cardiovascular stenting, is immune reactivity to metals in the stents. Thus, cellular hypersensitivity (Type 4, delayed type allergy) to stent materials increases the risk for restenosis in patients who are patch test positive to nickel Thus, patients suffering from gold allergy developed restenosis more frequently than similarly treated non-allergic patients, or patients with gold allergy but implanted with nickel or titanium-coated stents (Fig 1). The frequency of gold sensitization increases with the number of dental gold restorations. Further, in addition to cadmium and lead, which induce arrhythmias and high blood pressure, many studies indicate the role of In addition to patch testing, metal allergy may be diagnosed by determining the presence of memory T lymphocytes in peripheral blood. This so-called Lymphocyte Transformation Test (LTT) has been used for many years and has been standardized and validated in the form of MELISA ® ® detects abnormal cellular reactivity in patients suffering from is shown in Fig 2 and described in more detail below. The clinical relevance of MELISA ® reactivity following the replacement of sensitizing metals with non-metallic dental materials. In mercury-allergic patients suffering from multiple MATERIALS AND METHODS FIG 1 FIG 2 MELISA ® - MEmory Lymphocyte Immuno Stimulation A present in the environment and in dental restorations, as well as from other sources (Figs 3 and 4). FIG 3 FIG 4 Interestingly, titanium dioxide (TiO 2 ), previously thought to be “bio-inert”, stimulated the MS patients’ lymphocytes. Exposure to TiO 2 is very common, since it is added to pharmaceutical drugs as well as to foods, cosmetics and supplements. Titanium activates vein endothelial cells in vitro Further, TiO 2 and abnormal deposition of iron in the brain and veins of MS patients. Accumulation of iron around the vein endings in the gray matter and the presence of lymphocytes and macrophages around demyelinating plaques could be due to dissemination of metal ions released from dying blood macrophages entering the brain through a damaged blood brain barrier. Local brain macrophages (oligodendrocytes) might further ingest the metal debris and become damaged in the process. Since CONCLUSION deposits in the basal ganglia. FIG 11 FIG 12 TABLE 1 (SI). A value over 3 indicated a positive reaction to the given allergen. Baksi R et al. Gray matter T2 hypointensity is related to plaques and atrophy in the brain of multiple sclerosis patients. J Neurol Sci 2001; 185: 19-26 Dreyer BP et al. Magnetic resonance imaging in multiple sclerosis; decreased signal in thalamus and putamen. Ann Neurol 1987; 22: 546-550 Ekqvist S et al. High frequency of contact allergy to gold in patients with endovascular coronary stents. Br J Dermatol 2007; 157: 730–738 Guo M et al. Ti(IV) uptake and release by human serum transferrin and recognition of Ti(IV) – transferrin by cancer cells: understanding the mechanisms of action of the anti-cancer drug Titanocene dichloride. Biochemistry 2000 Vol 39(33): 10023-33 Houston MS. Role of Mercury Toxicity in Hypertension, Cardiovascular Disease, and Stroke. J Clin Hypertens (Greenwich)2011; 13: 621–627 Köster R et al. Nickel and molybdenum contact allergies in patients with coronary in-stent restenosis. Lancet 2000; 356: 1895-1897 Nemmar A, Melghit K, Badreldin H.Exp Biol Med 233: 610–619, 2008 Prochazkova J et al.Neuroendocrinol Lett 2004; 25(3): 211–218 Svedman C et al. A correlation found between contact allergy to stent material and restenosis of the coronary arteries. Contact Dermatitis 2009; 60: 158–164 Stejskal V et al. MELISA - an in vitro tool for the study of metal allergy. Toxic. in Vitro 1994(8), No. 5: 99-1000 Stejskal V et al. Diagnosis and treatment of metal-induced side-effects: Neuroendocrinol Lett 2006, 27 (Suppl. 1): 7-16 Tibbling L et al. Immunological and brain MRI changes in patients with suspected metal intoxication. Int J of Occupational Medicine and Toxicol 1995; 4: 285-294 Virtanen JK et al. Mercury, Fish Oils, and Risk of Acute Coronary Events and Cardiovascular Disease, Coronary Heart Disease, and All-Cause Mortality in Men in Eastern Finland. Arterioscler Thromb Vasc Biol. 2005; 25: 228-233 Wagner M et al. Heavy metals ion induction of adhesion molecules and cytokines in human endothelial cells. Pathobiology 1997; 65: 241-252 Zamboni P et al.Journal of Vascular Surgery 2009(50); 6: 1348-1358 Zamboni P et al. J R Soc Med. 2006 Nov; 99(11): 589-93 Zamboni P et al. CCSVI in patients with multiple sclerosis. J Neurol Neurosurg Psych 2009, 80: 392-399
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