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MS study casts doubt on surgical treatment

Fingers new genetic factors

By: Staff Writer

Posted: 08/12/2011 1:00 AM | Comments: 0 (including replies)

TORONTO -- A huge international study has bolstered the genetic evidence that MS has its roots in an aberrant immune system and has added to questions about the validity of a theory that obstructed neck veins are behind the progressive neurological disorder.

It comes as Ottawa and some provinces lay plans to conduct patient trials of the so-called Zamboni procedure that unblocks those veins in a bid to alleviate symptoms and possibly halt progression of the disease.

The genetics study, published in this week's issue of the journal Nature, identified 29 new genetic variants common in people with multiple sclerosis, compared to those without the disease, and confirmed 23 others previously linked to MS.

Many of those genes are critical to how the immune system functions, and some of them have also been implicated in other auto-immune disorders, including Crohn's disease, Type 1 diabetes and rheumatoid arthritis.

The findings are sure to add to the controversy over the theory by Italian vascular specialist Dr. Paolo Zamboni that narrowed neck veins -- which he's dubbed chronic cerebrospinal venous insufficiency, or CCSVI -- are a likely cause of MS. It's estimated that thousands of Canadian patients have flocked to clinics outside Canada, paying thousands of dollars for the procedure -- known as venous balloon angioplasty -- to open up their veins.

In Manitoba, advocates for the theorized role of CCSVI in MS shrugged off the study's findings as old news.

"We've known there's been a link between MS and the immune system forever," said Joanne Gauthier-Wiebe, who helps helm the group CCSVI Manitoba. "CCSVI (treatment) is showing a relief of symptoms... It's not a cure; everybody knows that. We're not hearing enough about the people who had significant improvements in the quality of life."

One of the most active supporters of CCSVI treatment called the researcher's comments "baseless propaganda."

"There is no doubt the immune system plays a significant role in MS," Ashton Embry wrote in a Facebook post for his organization, Direct-MS. "However, the question remains, is the immune component primary or secondary?"

Dr. John Rioux of the University of Montreal, a member of the international consortium that conducted the study, said the research was aimed at locating genetic factors underlying MS, not to look at whether or not the Zamboni procedure works.

That question can only be answered by well-designed clinical trials, he said.

Rioux said he doesn't believe there's any strong evidence suggesting blockages in neck veins are related to an immune response.

"So I think the clearest answer you can give is there's a preponderance role to play of the immune system, and although it doesn't directly ask the question related to venous blockage, it makes it less likely," Rioux said Thursday from Montreal.

With an estimated 55,000 to 75,000 Canadians affected, Canada has one of the highest rates of MS in the world.

-- The Canadian Press, with files from staff

Republished from the Winnipeg Free Press print edition August 12, 2011 A16

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