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Teri Heede and MS - Cannabis saved my life

This is the story of Teri Heede, who went from being bedbound and pain racked to taking on the system with the help of medical marijuana. It's just one of the stories profiled in Resets new book Cannabis Saved My Life by award-winning journalist Elizabeth Limbach. The book features interviews and testimonies from 46 different patients who were able to reclaim their life after facing serious illnesses, everything from cancer to depression, thanks to the little herb that could.

Active is the last word usually used to describe those with multiple sclerosis. A degenerative disease that affects over 2 million people worldwide, MS often causes paralysis, blindness, and cognitive dysfunction that worsens over time, as well as excruciating daily pain.

The entire central nervous system of MS sufferers, including the brain, spinal cord, and optic nerves are under constant attack and the medical community still does not know exactly why.

Nor do they have a cure.

This is where medical marijuana comes in. For MS sufferers, cannabis offers immediate pain relief, although its benefits do not stop there. Far from it.

"I have a theory about MS," says Teri Heede, a Vietnam War veteran who was diagnosed with MS twenty years ago. Now a politically involved cannabis crusader in her community in Oahu, Hawaii, Teri is definitely active in every sense of the word.

"It's kind of like an electrical cord in your body," she tells Reset. "If you went around and ripped off the cover of all the electrical cords in your house, what would happen? Short circuits, misfires, and everything goes wrong. I can have muscle spasms so bad it will pull a muscle. So my theory is that the THC receptors in the body can mediate this, Teri explains. When the nerve fires off and hits that lesion, and MS is local lesions, THC circumvents that process."

While there are dozens of studies that prove the efficacy of cannabis in treating the symptoms of MS, a 2012 study at the Queen Mary University in London that looked at the underpinning biology of cannabis-based medicines for MS shows that Teri is pretty spot on with her assessment of the mechanics of the medicine and how it works at a much deeper level than just suppression of the symptoms.

"MS results from disease that impairs neurotransmission and this is controlled by cannabinoid receptors and endogenous cannabinoid ligand," the study states. "This can limit spasticity and may also influence the processes that drive the accumulation of progressive disability."

The endocannabinoid system, for those who havent been paying attention to what is probably the most important biological discovery in recent history, interacts with the immune, nervous, and other systems in the human body though cannabinoid receptors in everything from the brain to connective tissue. While the interactions are complex and numerous, the purpose of the system is straightforward: homeostasis, the stabilization of the system involved.

This is why cannabis, the plant for which the system is named after, is so effective in treating everything from cancer to insomnia, all conditions where something biological is out of balance.

For multiple sclerosis, cannabis is like a miracle drug, correcting neurological misfiring, reversing inflammation, reducing pain, and returning muscle plasticity all at the same time.

"I feel like it has stopped the disease from progressing," Teri says. I am sixty years old and up and around."

Proving Teri right once again, an Oxford University study found that cannabinoids are highly neuroprotective and can, in fact. "slow the neurodegenerative processes that ultimately lead to chronic disability in multiple sclerosis."

"With the endocannabinoid system, we have to start educating not just the public but the doctors that there is a SYSTEM here,"
said Teri.

What it is in fact, is a powerful biological system activated by marijuana that can dramatically turnaround the lives of those who are disabled by MS and scores of other diseases.

"I was down for a year," Teri tells us. "I fell down at work and I couldn't get back up. I was like 'Whao, what happened?!?' "

"I thought I cracked my tailbone, because that's how much it hurt, but six months later I wasn't getting better, I was getting worse. After I did everything they told me to do, including hot water therapy, which only made it worse, I found out I had a lesion along my entire spinal column."

"I went to the neurologist and she told me I had MS,"
Teri continues. "I said, I am a widow with PTSD and you cant tell me that now I have MS too."

"Luckily my doctor was very open-minded."
She said,'Try everything you can, as we have nothing more we can give to you.' So I went to Humboldt County in Northern California and bought a quarter pound and took it home and sat on top of it."

"And I will tell you, within three weeks I was on my feet again."


As soon as cannabis put Teri back in action, she began what has become a lifetime mission to spread the word and fight back against the stigma that marijuana is just a drug.

"If you have ever seen a child in seizures or in pain, you just want to help that child, and this Reefer Madness attitude is really not helping at all," she says.

Active in the fight for safe access at the local level in Hawaii, one of the most restrictive states in the nation, she often shows up for important legislative meetings as a living testimony to the power of medical marijuana.

"Without this cannabis therapy I would have a basketful of old prescription medication. I actually used to walk in with the basket in front of the legislature just to show them," Terri tells us.

"I still have to take a stomach pill, because I have taken so many pharmaceuticals that I have what's called watermelon stomach, your stomach lining regrows every three days normally, but mine doesn't," she explains. It's because of all the pharmaceuticals, they just ate my stomach lining away."

"We need to make these herbal alternatives legal and available. These pharmaceuticals are killing people."


Teri is now the Female-at-Large for the Democratic Party for the county of Oahu, meaning she represents Democratic voters at the State Central Committee for Hawaii.

"I am also working heavily with the League of Women Voters, which is non-partisan," she tells us. "Our main focus is registering voters."

"We have such a low voter turnout here in Hawaii that getting people to the polls to elect people that represent them is our goal."


Full legalization of cannabis is only part of the plan though. In the larger picture, Teri knows that the movement must also ensure that access to the medicine remains in the hands of the people that need it the most, the patients.

"A lot of patients are afraid of legalization, they think that they will lose their medicine and only have access to a homogenized strain that is developed to make a profit off of," She muses, "While I do see that as a possibility, if we as patients get together and preserve our strains for ourselves we will be ok."

Part of that is ensuring that patients have the right to grow their own plants, as although Hawaii is one of the major cannabis producers in the United States, medical marijuana patients are currently limited to only seven personal plants. And even that may be in danger.

"We have these Democratic legislators who have told me as soon as it goes legal they want all patient grows to stop," Teri tells us.

This is exactly what has happened in states like Pennsylvania, which just passed a large medical marijuana bill after several years of intense pressure from the public, including serious campaigning by former talk show host Montel Williams, himself an MS patient that found relief from pain and other symptoms through cannabis.

"This is an issue of compassion and that is it," Williams said at a rally for legalization last year.

But while the PA bill opens up medical marijuana treatment for a wide variety of conditions, including MS, it also prohibits patients from growing their own herb. Legalization also means regulation, and there are powerful interests that would like to capitalize and monopolize on the fast growing medical marijuana market.

With a shifting landscape in terms of access and legality, the future of medical marijuana is in the hands of those who take a stand for patients rights, like Teri Heede.

"I am there in the legislature when they have their hearings. I go door to door trying to spread the word about the many people who benefit from cannabis therapy," says Teri. "There are believers out there now, huge believers."

"I just want more people to get active about this. We are coming out of a time of a lot of preconceived notions and we need to move forward with this medicine."


Once crippled with pain and unable to walk, Teri is now one of the forerunners in the battle to make and keep medical marijuana accessible to all that need it. And that's as active as it gets.

http://reset.me/story/cannabis-saved...ple-sclerosis/
 
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Clare Hodges and MS

Clare Hodges, also known as Elizabeth Brice, was an English activist who advanced the medical understanding of cannabis and campaigned for its widespread benefit as a therapeutic medicine in the United Kingdom. Clare Hodges is the pseudonym that Elizabeth Brice used, Clare being her middle name and Hodges her mother's maiden name.

She was diagnosed with multiple sclerosis (MS) at age 26 but it was nearly 10 years before she tried cannabis to alleviate the symptoms. Hodges found that cannabis greatly alleviated her condition. It was this that motivated her to become an avid cannabis rights campaigner.

Consequently, Hodges founded the Alliance for Cannabis Therapeutics (ACT) in 1992 with two other patients. The ACT worked to provide advice and assistance to other MS suffers and individuals with other medical conditions which might benefit from the use of cannabis.

Hodges took the matter to the House of Lords in 1998 where she spoke about the benefits she had found from the therapeutic use of this illicit drug. She stated "Cannabis helps my body relax. I function and move much easier. The physical effects are very clear. It is not just a vague feeling of well-being."

Despite the backing of several members of the House of Lords, and Austin Mitchell MP, the ACT was unable to change the law in the UK with regards to the use of cannabis. Hodges later went on to join the Board of Directors of the International Association for Cannabinoid Medicines (IACM) as a patient representative.​

Nonetheless, Hodges worked with Dr William Notcutt to ensure GW Pharmaceuticals took up the issue and as a result Sativex is now available as an alternative.

She also addressed the European Parliament in Brussels following which the law was change in Belgium.

Due to deteriorating health as a result of her MS, Hodges handed over the articles and patient transcripts to the Wellcome Trust in 2009.

https://en.wikipedia.org/wiki/Clare_Hodges
 
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Treating neurodegenerative disorders with CBD

by Cornerstone Wellness | 17 Sep 2014

Neuroinflammation is known to play a significant role in essentially all neurodegenerative processes. Diseases such as Alzheimer’s, Multiple Sclerosis (MS), Huntington’s Disease, and Parkinson’s Disease all involve hyperactive microglia, which are the live-in macrophages of the brain, spinal cord, and central nervous system. Macrophages are immune cells that capture and dissolve foreign substances, germs, and cancer cells within the body. The microglia in the brain and spinal cord form the first line of immune defense in the central nervous system. Unfortunately, in the case of aforementioned diseases, these cells have become overactive causing them to secrete excess substances, such as cytokines (cell signals that regulate cell group growth and response), glutamate, and harmful free radicals. This excessive production of chemicals causes inflammation, which leads to further cell death.

Cannabis and the family of chemicals it produces are known to act on two major cell receptor types named CB1 and CB2 respectively. The CB1 receptor is most commonly found in neurons throughout the brain. The psychedelic effects of cannabis come from this receptor’s function, which re-wires the way neurons signal each other. The CB2 receptor on the other hand, is found throughout the body, especially within the immune system cells. The effects of activating the CB2 receptor are more myriad, but within the immune system specifically four groups of effects have been identified:

1. Induction of apoptosis or forced cell death
2. Suppression of cell proliferation
3. Induction of regulatory T cells
4. Inhibition of pro-inflammatory cytokine/chemokine production and increase in anti-inflammatory cytokines

The last of these effects is the basis upon exploring using cannabinoids to halt the progress of neurodegenerative disorders. The idea is that if cannabinoids can prevent excess production of cytokine, inflammation will decrease, and the resultant cell death around that inflammation will not occur. This would go a long measure toward slowing progression of neuro-inflammatory diseases. However, it is important to note that tempering inflammation would still not allow the brain to recover to its pre-disease state and slow neural damage would inevitably continue to occur. Likewise, modern medicine currently utilizes a variety of treatments in these diseases as more or less palliative care.

Based on these observations, research groups worldwide have been testing specific cannabinoids and other CB2 agonists with various models of neuro-inflammatory disease, generally in rodents.

The following is a general review of effects noticed, grouped by disease:

Alzheimer’s Disease – In Alzheimer’s cannabidiol has been shown to “reduce the transcription and expression of pro-inflammatory molecules in the hippocampus of an in-vivo model of induced neuroinflammation.” The hippocampus is the part of the brain that controls conversion of memory from short to long-term and controls spatial navigation. In Alzheimer’s, it’s one of the first areas of the brain to suffer damage and why patients have memory problems. Another agonist, which has the name SR141716A, also prevents amnesia induced by certain peptides, so these both promise a future in treating the disease.

Parkinson’s Disease – In this disease, the agonist WIN55,212-2 has been shown to protect mouse neurons from the neurotoxin MPTP, which is the chemical which leads to the death of dopaminergic neurons and causes Parkinson’s Disease.

Multiple Sclerosis – Although the cause of MS is unclear, researchers have determined that both genetic susceptibility and environmental trigger play a role. Some patients develop their symptoms of MS after contracting a virus. Likewise, testing rodents injected with a virus that intentionally lead to animal models of MS provided ground to investigate the effects that CB2 agonists might have on MS in humans. As is, cannabis concentrate is already prescribed under the name Sativex to alleviate neuropathic pain, spasticity, and overactive bladder symptoms associated with MS. Although some agonists did increase symptoms, several, including THC, delayed onset and reduced severity of symptoms. Three agonists, WIN55,212-2, ACEA, and JWH-015 were shown to improve motor function by attenuating microglia and immune cell infiltration into the spinal cord.

Exactly how these effects are achieved is still unknown. Although it is presumed that the effects of the CB2 agonists (any molecules that can activate CB2 receptors, including cannabinoids) stem from CB2 receptor activation, other theories have been proposed. One research group at the University of Bari has explored the extra-cannabinoid receptor binding activity of cannabidiol (CBD). Researchers there found that CBD can surprisingly communicate with the nucleus of the cell directly through interaction with nuclear hormone receptors. There are several possible chemical pathways through which cannabinoids can achieve their effects, beyond CB2 receptors. Further research will illuminate these pathways.

https://cornerstonecollective.com/ho...der-treatment/
 
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Karolinska Institute

New clues to the Origin and Progression of MS

Mapping of a certain group of cells, known as oligodendrocytes, in the central nervous system of a mouse model of multiple sclerosis (MS), shows that they might have a significant role in the development of the disease. The discovery can lead to new therapies targeted at other areas than just the immune system. The results are published in Nature Medicine by researchers at Karolinska Institutet in Sweden.

Nature Medicine | Karolinska Institute | 11 Dec 2018

Mapping of a certain group of cells, known as oligodendrocytes, in the central nervous system of a mouse model of multiple sclerosis (MS), shows that they might have a significant role in the development of the disease. The discovery can lead to new therapies targeted at other areas than just the immune system. The results are published in Nature Medicine by researchers at Karolinska Institutet in Sweden.

2.5 million people around the world live with MS, with approximately 18,000 people in Sweden, and about 1,000 new cases annually. MS develops when the immune system's white blood cells attack the insulating fatty substance known as myelin that coats nerve fibres in the central nervous system. This interferes with the proper transmission of nerve electric signals and causes the symptoms of the disease. While it is unknown why the immune system attacks the myelin, a study by researchers at Karolinska Institutet shows that the cells that produce myelin, oligodendrocytes, might play an unexpected role. Oligodendrocytes are one of the most common types of cell in the brain and spinal cord.

"Our study provides a new perspective on how multiple sclerosis might emerge and evolve" says Goncalo Castelo-Branco, associate professor at the Department of Medical Biochemistry and Biophysics, Karolinska Institutet. "Current treatments mainly focus on inhibiting the immune system. But we can now show that the target cells of the immune system in the brain and spinal cord, oligodendrocytes, acquire new properties during disease and might have a higher impact on the disease than previously thought."

The researchers have shown that a subset of oligodendrocytes and their progenitor cells have much in common with the immune cells, in a mouse model of MS. Among other properties, they can take part in the clearing away of the myelin that is damaged by the disease, in a way that resembles how immune cells operate. Oligodendrocyte progenitor cells can also communicate with the immune cells and make them change their behaviour.

"We also see that some genes that have been identified as those that cause a susceptibility to MS are active (expressed) in oligodendrocytes and their progenitors," says Ana Mendanha Falcao, joint first author of the study with David van Bruggen, both at the Department of Medical Biochemistry and Biophysics at Karolinska Institutet.

"All in all, this suggests that these cells have a significant role to play either in the onset of the disease or in the disease process," says David van Bruggen.

The study was conducted using the recently developed technique, single-cell RNA sequencing, which provides scientists with a snapshot of the genetic activity of single cells and therefore with a much more effective means of differentiating the properties of individual cells. This has made it possible for researchers to identify the various roles and functions of the different cells.

Although the study was largely conducted on mice, some of the results have also been observed in human samples.

"We will now continue with further studies to ascertain the part played by the oligodendrocytes and their progenitor cells in MS," says Goncalo Castelo-Branco. "Further knowledge can eventually lead the way to the development of new treatments for the disease."

https://ki.se/en/news/new-clues-to-t...iple-sclerosis
 
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Tel Aviv University

Environmental factors may trigger the onset of MS

Tel Aviv University | Science Daily | 16 Oct 2018

A new study finds that certain environmental conditions like salt concentrations and temperature may precipitate structural changes that take place in myelin sheaths in the onset of multiple sclerosis (MS). Myelin sheaths are the 'insulating tape' surrounding axons; axons carry electrical impulses in neurons.

A new Tel Aviv University study finds that certain environmental conditions may precipitate structural changes that take place in myelin sheaths in the onset of multiple sclerosis (MS). Myelin sheaths are the "insulating tape" surrounding axons; axons carry electrical impulses in neurons.

The research demonstrates that myelin sheaths undergo structural transitions when triggered by changes in local environmental conditions, such as salt concentration (salinity) and temperature. These transitions, according to the study, render the body vulnerable to autoimmune attacks that can lead to MS.

The research was led by Prof. Roy Beck of TAU's School of Physics and Astronomy and conducted by Rona Shaharabani, a doctoral student in Prof. Beck's lab, and Maor Ram-On, a doctoral student in Prof. Ronen Talmon's lab at the Technion Institute of Technology. It was published in the Proceedings of the National Academy of Sciences of the USA (PNAS).

Earlier research by Prof. Beck revealed that changes in the structure of myelin sheaths are a factor in the development of MS.

"Current therapeutic approaches have focused on the autoimmune response without identifying the culprit," says Prof. Beck. "We have found that under certain environmental conditions, such as elevated salinity and temperature, myelin sheaths protecting neurons undergo structural transitions consistent with pathological myelin structures in multiple sclerosis."

Physiological conditions are regulated in the body itself, but temperature and salinity are subject to localized external changes. The results presented in the study suggest that even minor changes in these conditions may trigger multiple sclerosis.

"The myelin sheaths undergo structural transitions at the molecular level when affected by different environmental conditions. These small modifications create structural instabilities that allow the immune system to attack neurons," says Shaharabani.

The researchers used X-ray scattering and cryogenic transmission electron microscopy (cryo-TEM) to track and measure the myelin sheaths in healthy and diseased animal models. They found that healthy lamellar membranes spontaneously morphed into different pathological structures of nano-scale tubes called inverted hexagonal shapes.

"These results highlight that local environmental conditions are critical for myelin function. These conditions should be considered as alternative possibilities for early diagnosis and as a means of avoiding the onset of demyelination," says Shaharabani. "Since we believe that these structural modifications result in myelin membrane vulnerability to the immune system attacks, it can help explain the causes of MS and perhaps pave the way for a treatment or a cure."

"Since we now have a new biophysical understanding to investigate the degradation of myelin sheaths, we are following up on other candidates that can induce such structural transition. There are several molecular candidates, including specific proteins and other alterations in the myelin's fatty acids, that are relevant, which may unravel further insights to fight multiple sclerosis and related disorders,"
Shaharabani concludes.

https://www.sciencedaily.com/release...1016132003.htm
 
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From medpot to the next frontier – Psychedelics as Medicine

by Kieran Delamont | Now Toronto | 3 Oct 2018

Alison Myrden eats a lot of magic mushroom: most days, she’ll have around 50 grams. For even the experienced drug user this would be a stratospheric volume of psilocybin to ingest.

But for Myrden mushrooms are more medicinal than mystical. She experiences no psychedelic effects from them. They are the best form of medication she has to get relief from the pain associated with multiple sclerosis and trigeminal neuralgia, a nerve disorder that causes a searing, electric pain in a person’s face. It’s been called the “suicide disease” because the pain is so excruciating and acute that it has been known to drive people to kill themselves.

Myrden is preparing to go to court to fight for a legal exemption to consume medicinal mushrooms. She and her legal team – made up of prominent cannabis lawyers Paul Lewin and Jack Lloyd – are currently preparing an application and court challenge to get an official exemption from the Controlled Drugs and Substances Act (CDSA).

As the country prepares to blow the doors open on legalized cannabis, Myrden and her lawyers are looking to what they see as the next frontier: psilocybin. And they’re willing to take it all the way to the Supreme Court.

An ex-corrections officer, Myrden, 53, has a long history of self-medicating, and a pretty good track record of convincing the Supreme Court of Canada to let her do it. In the mid-1990s, she was one of the first cannabis users to push the government, through legal challenges that also rose to the Supreme Court, to legalize medical cannabis.

That would prove to be a tectonic shift for cannabis in Canada.

Myrden’s discovery of the medicinal properties of psilocybin was almost entirely by accident.

“I was having a really bad day, and I was at a friend’s place,” Myrden says. That friend handed her a mushroom – a Blue Cambodian.

“It weighed in at about five grams, and I ate pretty much the whole thing,” Myrden says. “I was so frustrated, and I was trying to get relief. And bang, within 10 minutes, my face changed, and all of a sudden I had no pain. I was a brand-new person.”

That experience became foundational in how Myrden treats her own illnesses, and she wants it to be legally available for everyone “like we did [with] cannabis,” she says.

Myrden’s use of psilocybin lies somewhere between sanctioned health care and self-medication.

She has a prescription for 50 grams of psilocybin daily – NOW has viewed a copy of the prescription, which is signed by Myrden’s doctor – just in case the cops show up. The prescription does not make them legal, but would potentially earn her some leniency.

It’s not as if Myrden can buy mushrooms in a pharmacy. She still has to source them from the street, which can be precarious. When I catch up with her in September, she tells me she isn’t feeling great since she can’t get a hold of any mushrooms. One time, her mushroom source disappeared for eight months.

However beneficial mushrooms are to Myrden and however safely she uses them, the initial application is still a long shot.

Lewin figures that the government is too fresh off legalizing weed to consider the idea of medical psilocybin. “My gut feeling, and this is just speculation,” says Lewin, “is that they’ve just done a little bit too much already.” In other words, the government is cracking the door open on drug use ever so slightly with legalized cannabis, but it’s not about to ram a mushroom-shaped truck through it.

Rebecca Purdy, a spokesperson for Health Canada, says that while the department has received similar applications for exemptions in the past, “to date, the department has not granted any exemptions.”

They aren’t ruling out the idea completely, though.

“Health Canada reviews all applications submitted for an exemption under subsection 56(1) of the CDSA on a case-by-case basis, on its own merits,” the department notes in a statement, taking “the public health and public safety objectives of the CDSA into account.”

Lewin says that “the plan isn’t to be refused,” but it sort of is, as a denial of Myrden’s application would open the door for a federal court appeal, and losing there would give them what it seems like they’re really gearing up for: a chance to fight out the merits of medical psilocybin in front of the Supreme Court in a kind of sequel to the medical cannabis court challenge of the 1990s.

There, says Lewin, the case would not be about Myrden so much as it would be about the merits of using mushrooms for medical purposes. There, they might actually have a shot, as the concept of psilocybin as medicine is gaining acceptance among medical professionals.

In an editorial published in a 2016 edition of the Journal Of Psychopharmacology, Dr. David Nutt wrote that “We have input from experienced psychiatric clinical trialists, leading pharmacologists and cancer-care specialists. They all essentially say the same thing: 'It’s time to take psychedelic treatments in psychiatry and oncology seriously, as we did in the 1950s and 1960s, which means we need to go back to the future.' ”

Nutt argues that “there was no evidence of psilocybin being harmful enough to be controlled when it was banned, and since then, it has continued to be used safely by millions of people worldwide with a very low incidence of problems.”

The concept that mind-altering substances can also have medical properties is not limited to cannabis and psilocybin. Psychoactive substances like MDMA have shown promise in treating conditions like anxiety and PTSD.

It seems that even Health Canada is open to the idea that psilocybin could be the next frontier in natural medicine. A spokesperson confirms to NOW that it has authorized at least one clinical trial using psilocybin in patients with treatment-resistant depression.

What comes next?

Lewin says his team is still working on lining up medical experts to testify on Myrden’s behalf.

At the centre of it, though, is Myrden, who has to get up every day and fight through almost unimaginable pain.

For most people, her fight is an abstraction, a debate about what is medicine and what is a drug, and the sometimes arbitrary lines we draw between those two things. For Myrden it’s her life and her ability to live it without pain.

Most days, she can’t walk – she’s on her third electric wheelchair, she says.

The impact that psilocybin has on Myrden is obvious: nearly an hour after we started talking, the life in her – the life that’s kept her fighting for the better part of 30 years – starts to show. Her warms as the psilocybin takes effect.

“I’ve got a lot of life in me, and I don’t want to be sitting in a wheelchair. I don’t want to be living in the pain I’m living in, so I’ve got to do something.”

https://nowtoronto.com/news/legalization-medical-cannabis-psychedelics/
 
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Real Life Cannabinoid Treatment for Multiple Sclerosis


As a blog concerned with new developments in CBD science, we tend to do a lot of writing about future treatments, or new scientific developments that may eventually lead to treatments.

Part of the issue is that large-scale, clinical testing of new cannabinoid based medicine is still years away in a lot of areas, particularly in cancer-related fields. That’s why reading a good, new large-scale study is always exhilarating. In this case, a recent study from the University of Bari in Italy took a look at a large scale, real-world application of a THC/CBD oral spray in treating adults with treatment-resistant Multiple Sclerosis (MS). In the past, we’ve written about treating MS models via lab mice with THC and CBD, and also the theory behind that treatment. So being able to finally see how things play out in real life with real patients is particularly rewarding for us and is yet another confirmation of the efficacy of cannabis based treatments.

To review, MS is an auto-immune disease in which the body’s immune system is confused into turning against the body and attacking cells. In particular, MS is caused by the immune system stripping neurons of their outer protective linings, which normally prevent “signals” from being crossed or lost in the brain, both for conscious and unconscious tasks. This stripping eventually results in loss of physical mobility and function and can prevent patients from fulfilling active, healthy lives. Spasticity, which affects about 2/3rds of patients, is particularly problematic. Unfortunately, at this time not many treatments are available that are effective. Aside from instructing patients to try to avoid seizure triggers, doctors often prescribe anti-spastic pharmaceuticals and muscle relaxers as a method of decreasing seizure rate. However, these medications, specifically benzodiazepines, are sedative and hypnotic, and come with risk of physical dependence and withdrawal. Additionally, many patients’ conditions are treatment resistant, meaning these medications make no difference in the first place.

As a result, the medical community has been searching for more effective treatments. Enter cannabis. Cannabis is a well-established anti-inflammatory agent and has been shown to help dampen immune system over-stimulation in a multitude of conditions. Initial lab tests also confirmed that THC and CBD were helpful in animal models of MS. As a result, the authors of this study decided to conduct a large-scale human trial. At the time being, Sativex, produced by GW Pharmaceuticals, is one of the most respected and convenient cannabinoid based treatments for conducting such a trial. Currently available in 15 countries, Sativex is a 1:1 preparation of THC:CBD which can be sprayed orally multiple times daily. Realistically, Sativex faces a much easier time acquiring approval than cannabis in many countries, both because cannabis is more difficult to standardize, and also because cannabis itself carries a lot of cultural baggage as a recreational drug.

The MOVE 2 EU study is a multi-institution, non-interventional study of patients in Europe with MS spasticity receiving THC:CBD oral spray in an outpatient setting. Non-interventional means that patients’ current treatment plans are not altered, rather Sativex is added to their treatment to see what changes. The MOVE 2 EU study specifically aims to “determine the effectiveness of THC:CBD, collect data on tolerability/safety, determine patient satisfaction with THC:CBD, and determine resource use by patients over a 3-month period after adjustment” to the spray. The set up, of course, is straight-forward. Patients are prescribed Sativex and data is collected three times: once at the beginning of the study, once one month later, and finally three months later at the conclusion of the study. Data collection consists of not only patient surveys, which answer questions about patient satisfaction and usage, but also two tests known as the Modified Ashworth Scale (MAS) and the Numerical Rating Scale (NRS), which rank spasticity severity and spasticity numerically in a more objective manner. Other scales are used in addition to establish mobility and pain and fatigue symptoms.

While the study will eventually expand to multiple countries, Italy was the first to reach the initial target of 300 enrolled patients, with a total of 322 patients responding and 203 patients following the study through to completion. In this case, the trial population was mostly female with an average age of around 50.

The results are that spasticity dropped significantly in both cases after three months of treatment, proving that in a large population, Sativex appears to be capable of making a significant difference! Of course, you’ll also notice that the “n” number under each bar, which stands for the number of patients data was available for, decreases with each successive data point. This occurs as patients drop out of the study for various reasons, mostly due to lack of impact or inability to tolerate the side effects of Sativex (although in some cases due to pregnancy). Assuming those patients were to be factored in, the drop in spasticity would be lower. What that means is that Sativex is helpful to a little under 70% of patients, with another 30% either seeing no real change or being unable to tolerate treatment. For the rest, a roughly 20% improvement is observed on average, indicating that the treatment “works” in a clinical sense. In fact, after three months’ treatment, over half of the original population “were deriving sufficient benefit in the opinion of their treating physicians to warrant continued use”. However, beyond asking if Sativex simply works, researchers sought to understand how practical the treatment is for MS patients and how likely they are to adhere to using it. In this particular study, patients averaged between only 6-7 sprays a day, which combined with the portable, quick method of administration, makes it a very reasonable treatment.

As the study spreads to other countries, we’ll keep you posted on new developments. However, we already expect to see more real-life studies based on the outcomes here, particularly in America. In the meantime, patients with treatment-resistant MS may benefit from discussing cannabinoid preparations with their physicians.

https://cornerstonecollective.com/re...ple-sclerosis/
 
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The endocannabinoid system and Multiple Sclerosis

Baker, Pryce

Multiple Sclerosis (MS) is a neurodegenerative disease that is characterised by repeated inflammatory/demyelinating events within the central nervous system (CNS). In addition to relapsing-remitting neurological insults, leading to loss of function, patients are often left with residual, troublesome symptoms such as spasticity and pain. These greatly diminish "quality of life" and have prompted some patients to self-medicate with and perceive benefit from cannabis. Recent advances in cannabinoid biology are beginning to support these anecdotal observations, notably the demonstration that spasticity is tonically regulated by the endogenous cannabinoid system. Recent clinical trials may indeed suggest that cannabis has some potential to relieve, pain, spasms and spasticity in MS. However, because the CB(1) cannabinoid receptor mediates both the positive and adverse effects of cannabis, therapy will invariably be associated with some unwanted, psychoactive effects. In an experimental model of MS, and in MS tissue, there are local perturbations of the endocannabinoid system in lesional areas. Stimulation of endocannabinoid activity in these areas either through increase of synthesis or inhibition of endocannabinoid degradation offers the positive therapeutic potential of the cannabinoid system whilst limiting adverse events by locally targeting the lesion. In addition, CB(1) and CB(2) cannabinoid receptor stimulation may also have anti-inflammatory and neuroprotective potential as the endocannabinoid system controls the level of neurodegeneration that occurs as a result of the inflammatory insults. Therefore cannabinoids may not only offer symptom control but may also slow the neurodegenerative disease progression that ultimately leads to the accumulation of disability.

https://www.ncbi.nlm.nih.gov/pubmed/18781983
 
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Case report: Ketamine therapy for treatment-resistant depression in a patient with MS

Messer, Haller

Depression is a frequent finding in patients with multiple sclerosis (MS), with the lifetime prevalence rates for major depressive disorder (MDD) ranging from 36 to 54 percent, more than twice of that in the general population. Even with advances in pharmacological options for treating depression, an estimated 33 to 66 percent of patients with MDD in the general population do not respond to the first antidepressant, and a reported 15 to 33 percent of patients do not respond to multiple interventions. For patients with severe or treatment-resistant depression unsuccessfully treated with multiple pharmacological options, electroconvulsive therapy (ECT) is often the only available treatment.

Here we present a case of a patient with MS and TRD. She was initially considered for ECT after not responding to oral antidepressants, but her depression was successfully treated with intravenous ketamine. Shehad maintenance of the recovery from depression over two years with significant reduction of her depressive symptoms. This observation suggests a potential alternative to ECT in treating TRD in a patient with MS.

A 45-year-old woman was referred to psychiatry for worsening depressive symptoms. She had been diagnosed with MS in 2004, presenting with initial symptoms of left arm and hand numbness. Her magnetic resonance imaging (MRI) scan revealed 4 to 5 periventricular white matter lesions and an anterior cervical involvement at C5. She had two exacerbations of her symptoms during the following three months, fulfilling the diagnosis criteria of relapsing remitting MS, and was enrolled in the Beyond medication trial.

The clinical course for this patient followed a similar trajectory as seen with other patients who have TRD. The presence of MS did not make her more or less sensitive to the antidepressant effects of ketamine. Her antidepressant medications remained at a stable dose throughout the course of treatment. She was able to maintain a stable and non-depressed mood with this treatment and to date has had no worsening of her MS symptoms.

In the case described here, a patient with MS and TRD was successfully treated with intravenous ketamine for her depression over two years and had significant reduction of depressive symptoms. Thus, ketamine may be an alternative treatment to ECT for resistant depression. In particular, ketamine may have a special use in patients with MS and TRD, as ECT has the potential for side effects in this patient population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5373796/
 
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Fibromyalgia vs. Multiple Sclerosis - Comparing symptoms, diagnosis, and treatment

by Emily Lunardo

While fibromyalgia and MS do share the symptom of pain, fibromyalgia is a musculoskeletal condition and multiple sclerosis is a neurological condition. There is still much unknown about the exact cause of fibromyalgia, but it is believed that the condition increases one’s sensitivity to pain. The cause of MS is the destruction of myelin, the protective coating surrounding nerves. Multiple sclerosis is an autoimmune disease, meaning, the body mistakenly attacks itself. Over time, due to myelin destruction, the nerves can no longer function properly, which results in a slew of symptoms.

Both disorders are debilitating and can negatively affect a person’s quality of life. Furthermore, both conditions can result in chronic pain. And yet, despite their shared similarities, they are two unique conditions with different symptoms, diagnostic processes, and treatment methods.

Fibromyalgia vs. multiple sclerosis: prevalence

Fibromyalgia affects roughly six million Americans and multiple sclerosis affects roughly 400,000. Women are most commonly affected by both fibromyalgia and multiple sclerosis, compared to men. Furthermore, both conditions are commonly diagnosed in individuals in their 20s to 50s.

Fibromyalgia and multiple sclerosis share many overlapping symptoms and health conditions, including depression, anxiety, headache, irritable bowel syndrome, chronic fatigue syndrome, systemic lupus erythematosus, rheumatoid arthritis, and pain.

Due to this overlap, the two conditions may be confused with one another during the initial diagnostic process until further testing is completed to confirm the diagnosis.

Fibromyalgia vs. multiple sclerosis: signs and symptoms

Now that we know which signs and symptoms are the same, let’s examine each condition’s own unique symptoms.

Fibromyalgia symptoms include: memory issues known as fibro fog, changes in mood like depression and mood swings, and chronic fatigue. Many patients also experience sleep disorders and sleep-related problems.

Multiple sclerosis symptoms include: difficulty walking, slurred speech, and vision problems such as eye pain.

Fibromyalgia generally causes muscular pain, and patients often have tender points - areas that are most sensitive to pain and are common among patients. In order for a doctor to confirm a fibromyalgia diagnosis, they must be able to not only find any other underlying causes for the patient’s symptoms, but also run all possible tests to rule out other causes.

Fibromyalgia vs. multiple sclerosis: diagnosis

Diagnosis of both fibromyalgia and multiple sclerosis is done by ruling out all other causes for symptoms. As mentioned, fibromyalgia is diagnosed when all other conditions are ruled out. Furthermore, patients would have to have experienced muscular pain for at least three months for fibromyalgia to be considered. Tender points are also used in the process of fibromyalgia diagnosis along with analyzing the symptoms.

Multiple sclerosis diagnosis occurs with a multitude of testing including a spinal tap and MRI scans. Your doctor may also perform other tests, including blood work, to rule out other conditions. The MRI scan looks for lesions on the brain and spinal cord, as these are signs of multiple sclerosis.

Fibromyalgia vs. multiple sclerosis: treatment

There is no cure for either fibromyalgia or multiple sclerosis, so once a diagnosis is confirmed, your doctor will offer treatment methods in order to help minimize symptoms. Fibromyalgia may be treated with over-the-counter painkillers, prescription medications like antidepressants, alternative remedies such as acupuncture, massage, and yoga, and even lifestyle changes including improving sleep schedule, exercising regularly, limiting caffeine intake, and reducing stress.

Multiple sclerosis treatment can include over-the-counter pain medications, prescription medications, physical therapy, speech therapy, acupuncture, stress management, cognitive behavior therapy, and lifestyle changes such as increasing fiber intake, eating a low-fat diet, exercising regularly, and stretching.

Either condition is not life-threatening, but both are life-altering. Adjustments would need to be made in order to live with either multiple sclerosis or fibromyalgia. Although it may be stressful, working closely with your doctor and reaching out to the loved ones can help ease stress and improve treatment.

https://www.belmarrahealth.com/fibr...s-comparing-symptoms-diagnosis-and-treatment/
 
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5 MS patients talk about how the new drug, Ocrevus, has changed their lives

by Larry Luxner | April 17, 2018

It’s been a little over a year since U.S. regulators approved Genentech’s Ocrevus (ocrelizumab) as the first treatment for both relapsing and progressive forms of MS — a disabling neurological disease now believed to affect nearly one million Americans.

While the jury’s still out regarding the therapy’s long-term effectiveness and safety, five MS patients we spoke to across the United States say Ocrevus — an intravenous infusion therapy that carries a retail price of $65,000 a year — has made a dramatic difference in their daily lives.

Here are their stories:

Lorraine Lee

Lorraine Lee is a registered nurse in Austin, Texas. She first spoke to MS News Today a year ago, shortly after receiving Ocrevus for the first time, and two and a half years after first being diagnosed with primary progressive multiple sclerosis. PPMS affects about 15 percent of all MS patients.

Since then, Lee’s had two more Ocrevus infusions six months apart, each one lasting about four hours. All treatments have been covered by her husband’s insurance plan.

“I still see small improvements,” she said. “It’s not as fast as I’d like it to be, but the fact there’s been no more regression is meeting the goal of Ocrevus, and I’m also starting to see small improvements in my mobility.”

Lee has already been to Taiwan twice in the past year — accompanying her husband on business trips — and her MS hasn’t seemed to slow her down.

“The first time, I took my walker and used it extensively. The second time I went, I took my walker and never used it,” said Lee, who now reviews medical records for her state’s government.

“When I first wake up in the morning, I feel really stiff and I use my cane. But then I put it to one side and do all my things in the kitchen without it,” she said. “Then I load everything into the walker, which has a basket on it, and load that into my car. I use my walker for toting things back and forth.”

Lee, who now walks up to a mile a day, said she’d rather sit for an Ocrevus infusion twice a year than take any other kind of medicine. “Give me my infusion and get it over with. I’ve never had any side effects, and last time I didn’t even get sleepy,” she said.

“If you’re really in tune with your body, you notice little improvements,”
added Lee, who maintains a strictly dairy-free, gluten-free diet, and eats lots of vegetables and protein. “For example, I had gotten to the point, before Ocrevus, where my husband had to fill out all my paperwork because I could not write. And now I’m independent with my writing again.”

Charles Dick

Before being diagnosed with relapsing-remitting multiple sclerosis (RRMS) some 15 years ago, Charles Dick was a promising graduate student specializing in agricultural genetics. After his diagnosis, he transferred to pharmacy, hoping to develop a cure for MS.

But his condition worsened, and Dick was forced to drop out of school altogether.

“Since my diagnosis, I had been on Copaxone. I also take vitamin D and other supplements, which also help me quite a lot,” he told us by phone from Spokane, Washington.

Now 46, Dick said that since his diagnosis he’s occasionally noticed some unsteadiness in his legs, as well as forgetfulness, difficulty concentrating, numbness, and a lack of energy, among other symptoms. After several years on Copaxone, his condition again took a turn for the worse.

“Luckily, Ocrevus had just been approved, so I talked to my doctor about switching,” he said. “Since then, my condition seems far more stable.”

After the first two infusions, he felt a slight tingle in the back of his throat. But Ocrevus, he said, has definitely made him feel more intact.

“My symptoms are gradually getting less severe since I’ve been on it,” Dick said, adding he’s “been doing very well on Ocrevus and have no complaints at all,” excepting that “it’s still not a cure …the gold standard we’re looking for.”

“What I want,”
Dick said, “is something to take once — and then no longer have MS.”

Roberta Sloniker

Roberta Sloniker, 74, was diagnosed with PPMS at age 50. She used to wake up at 5 a.m. and walk four miles every day. That helped Sloniker lose 75 pounds — but it didn’t stop her disease from slowly crippling her, until she needed a walker just to get around the house and a wheelchair to move more than 20 feet.

“I’m obviously not very mobile. The whole right side of my body is extremely weak,” said Sloniker, who lives in the Oregon coastal town of Brookings, just north of the California state line. “My right hand is curling, and I can’t straighten it out, so I have very little use of it.”

After a first Ocrevus infusion in November, she said she started feeling better immediately. She called it the first medication in more than 15 years, other than baclofen, that helped to stop cramps.

“I can stay up and do more things, but I just feel better all over. People are telling me they can see that,” she said, explaining she can now be on her feet for up to half an hour, as opposed to 10 minutes at most before Ocrevus. “In fact, I felt really good after the infusion because they give you a steroid, and that really took all the aches and pains away for about two weeks.”

Sloniker will return to a clinic in nearby Medford, Oregon, on May 3 for her next Ocrevus treatment. “I’m excited to get the next infusion,” she said.


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Cheryl Sickler


Cheryl Sickler of Deltona, Florida, was diagnosed with optical neuritis in 1996. She also suffered from dizziness, loss of balance and frequent falls. She finally received an MS diagnosis in December 2002, and by 2005, her health was deteriorating rapidly.

“They did an MRI and found over 40 active lesions on my brain,” said the Cincinnati native, who worked on hospital computer systems until MS forced her to quit. “My neurologist told me I’d have full-blown dementia within two years if I didn’t do anything.”

Sickler’s neurologist prescribed a steroid treatment that required her to take 16 pills every six hours, or 192 pills over a three-day period.

“I did that once every four months, but it didn’t help. I had bad side effects and ended up getting a couple rounds of chemotherapy,” she said. “I did that twice and went on a completely raw diet with herbs. After two years, the lesions were finally inactive, but still, none of the drugs were working.”

Sickler tried Rebif, Copaxone and Tysabri, all to no avail. She could no longer hold down her job at UF Health Shands Hospital in Gainesville, and in early 2010 filed for disability.

“I wasn’t able to do much of anything. I was using a walker and a cane, and if I went anywhere at all, I’d have to be pushed around in a wheelchair,” she said.

But things started turning around for Sickler, now 52, after her first infusion of Ocrevus in June 2017, at a clinic in nearby Daytona Beach. A second infusion was given in December.

“It wasn’t long after the first infusion that I didn’t need the wheelchair. Then I got rid of my walker, and maybe three weeks after the second infusion, I was barely using a cane at all, and I haven’t used one for about three months now.”

She added: “I’m just amazed. Ocrevus has been remarkable. Even my cognitive abilities are getting a little better.”

Sickler will receive her third infusion in June. Thanks to her Medicare coverage, she said her only out-of-pocket expense is a $50 per infusion co-pay.

Steven Slobodzian

A former executive for Pepsi-Cola, Steven Slobodzian of Overland Park, Kansas, took early retirement at the age of 58 — one year before he started having health issues.

In 2011, Slobodzian was diagnosed with PPMS, and within a year the disease had progressed so quickly that he soon found himself in a wheelchair. Slobodzian’s doctor put him on Solu-Medrol (methylprednisolone), a steroid to reduce the pain in his legs. But that required his wife to drive him five days in a row, every three months, to Kansas University in nearby Kansas City for his Solu-Medrol infusions.

Slobodzian, now 65, has been confined to a wheelchair for the last six years. When he found out about Ocrevus, he told his doctor he wanted to hold off on Solu-Medrol to give the new therapy a chance.

“Ocrevus basically took care of the pain, but also gives me renewed strength in my legs, like Solu-Medrol used to,” he said, adding that he hasn’t had any side effects from his first infusion.

“I do feel better in general. I seem to have more energy, but not sure if it’s because of Ocrevus or the biotin I’ve been taking,” Slobodzian said. “In all, it’s been a pretty positive experience, and I’m just super glad somebody came out with a drug for PPMS."

“I thought we were the forgotten people.”


https://multiplesclerosisnewstoday....describe-how-ocrevus-has-changed-their-lives/
 
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King's College London

Brain inflammation linked to depression in MS patients

New research by King's College London, Imperial College London and Imanova Center for Imaging Sciences, suggests that brain inflammation could lead to increased rates of depressive symptoms in patients with multiple sclerosis.

It is already known that patients with multiple sclerosis have higher rates of depression than the general population and that symptoms of multiple sclerosis arise from an abnormal response of the body’s immune system. Immune response has also been linked to depression, leading researchers to think it could be a shared pathological mechanism that leads to the increased rates of depressive symptoms in patients with multiple sclerosis.

This new study in Biological Psychiatry provides evidence that inflammation of the hippocampus, a region of the brain implicated in the genesis and maintenance of depression and in the pathology of multiple sclerosis, alters its function and contributes to symptoms of depression.

The research team combined two complementary brain imaging techniques to study the relationship between hippocampal immune response, functional connections, and depressive symptoms in 13 patients with multiple sclerosis and 22 healthy control subjects. Positron emission tomography (PET) allowed for quantification of activated microglia, a measure of immune response. Functional magnetic resonance imaging (fMRI) assessed the strength of hippocampal connections to an extensive network of brain regions involved in emotion.

First author Dr Alessandro Colasanti, from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London, explained that PET imaging revealed immune activation in the hippocampus of patients with multiple sclerosis. 'We also discovered that more inflammation was associated to more severe symptoms of depression,' he added.

Measurements of functional brain connections with fMRI during rest showed that immune activation in the hippocampus altered its connections with other brain regions. Dr Colasanti said: 'This study, combining two advanced complementary brain imaging methods, suggests that the inflammation of the hippocampus affects the brain function and causes depression.'

The findings suggest that hippocampal inflammation could be the contributing cause of high rates of depression in multiple sclerosis. The authors predict that an effective and targeted treatment of brain inflammation would help to restore brain function and protect against depression in multiple sclerosis.

https://www.kcl.ac.uk/ioppn/news/rec...sclerosis.aspx
 
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CBD given as an add-on treatment may help ease symptoms of spasticity

The Lancet | Dec 13, 2018

Oral spray containing two compounds derived from the cannabis plant reduced spasticity compared with placebo in patients already taking anti-spasticity drugs.

Chemical compounds derived from the cannabis sativa plant given as an add-on treatment may help ease symptoms of spasticity (tight or stiff muscles), a major cause of disability and reduced quality of life in people with motor neuron disease, according to a phase 2 trial of 60 adults published in The Lancet Neurology journal.

The findings show for the first time that adults with motor neuron disease taking first-line anti-spasticity drugs who were then treated with an oral spray (nabiximols) containing equal parts delta-9 tetrahydrocannabinol THC and cannabidiol (THC-CBD) experienced less spasticity and pain at 6-week follow-up compared with those given placebo.

While there are several drugs to relieve spasticity, evidence for their effectiveness is scant and they do not sufficiently improve symptoms in all patients. Moreover, they can have undesirable side effects, such as increasing muscle weakness and fatigue. In the study, participants continued taking other medications throughout the trial.

"There is no cure for motor neuron disease, so improved symptom control and quality of life are important for patients," says Dr Nilo Riva from the San Raffaele Scientific Institute in Milan, Italy, who led the research. "Our proof-of-concept trial showed a beneficial effect of THC-CBD spray in people on treatment-resistant spasticity and pain. Despite these encouraging findings, we must first confirm that THC-CBD spray is effective and safe in larger, longer term phase 3 trials."

Spasticity is a common symptom in motor neuron disease, a rapidly progressive, fatal neurodegenerative disorder affecting the nerve cells that control muscle movement (motor neurons). It occurs to a variable degree in people with amyotrophic lateral sclerosis (ALS), the most common and severe form of motor neuron disease, and is a defining characteristic of primary lateral sclerosis (PLS), that is rarer and progresses more slowly.

Previous research has found possible therapeutic benefits of cannabinoids (components of the cannabis plant) to include muscle relaxation, appetite stimulation, and pain-relieving, anticonvulsant, and anti-inflammatory effects in patients with other neurological conditions. Cannabinoids have been licensed in several countries for symptomatic treatment of spasticity in multiple sclerosis, and are increasingly recognised as a valuable option for the management of pain.

To investigate whether cannabinoids might also reduce spasticity in motor neuron disease, Italian researchers recruited 60 adults (aged 18-80 years) with ALS or PLS from four tertiary motor neuron disease centres in Italy. To participate in the study, patients had to have experienced spasticity symptoms for at least 3 months and be taking a stable dose of any anti-spasticity medication for 30 days before enrolment and throughout the study.

Participants were randomised to receive THC-CBD mouth spray (29 participants) or placebo (30) for 6 weeks. The number of sprays was gradually increased for the first 2 weeks of treatment until the optimum dose was reached, and then that dose was maintained for 4 weeks.

Change in spasticity was assessed by a physician who rated the spasticity of each participant's joints on the Modified Ashworth Scale (MAS) -- an objective tool to evaluate intensity of muscle tone. Participants were also asked to keep a daily symptom diary on spasticity levels, pain, spasm frequency, and sleep disruption.

At the end of treatment (6 weeks), spasticity was significantly improved in the THC-CBD spray group compared with the placebo group. Additionally, the number of participants treated with THC-CBD spray reporting an improvement was significantly higher compared with participants receiving placebo. Finally, pain scores were significantly improved in the THC-CBD spray group compared with placebo on a 0-10 scale.

Overall, THC-CBD spray was well tolerated and adverse events were mild to moderate and typical of cannabinoids -- asthenia (loss of energy and fatigue), somnolence (sleepiness), vertigo, and nausea. Twenty-one participants in the THC-CBD spray group, and four in the placebo group reported at least one potentially treatment-related adverse event. There were no serious adverse events and no participants permanently discontinued treatment. However, three patients temporarily discontinued treatment in the THC-CBD spray group, two because of adverse events, and one because of disease progression.

The authors note that an important limitation of the study was that the Modified Ashworth Scale has lacked sensitivity in studies assessing cannabinoids efficacy in multiple-sclerosis-related spasticity.

Writing in a linked comment, Dr Marinne de Visser from Amsterdam University Medical Centre, University of Amsterdam, the Netherlands, says: "Before asking for approval of cannabinoids for symptomatic treatment of spasticity in patients with amyotrophic lateral sclerosis, further studies are needed to establish the frequency of spasticity in the various presentations of motor neuron disease, and also whether reductions in spasticity improve quality of life. Natural history studies including all subtypes of motor neuron disease and better outcome measures aimed at assessment of spasticity are required. Riva and colleagues' data are encouraging, and larger multicentre randomised controlled trials should be done to identify which subgroups of patients derive clinically significant benefits from nabiximols."

https://www.sciencedaily.com/releases/2018/12/181213190606.htm
 
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Psychedelics and MS

I took a small amount MDMA and I could do things I couldn't before. For about five hours I could stand long enough to have a conversation without having to find a seat. I could dance for an entire song. It was rather amazing. I checked out the side effects and they list possible neurological impairment which I have ALL THE TIME!!

I had some fears about trying MDMA, but after 23 years of every activity in my life being hard I said f*** it! And I am glad I did. Life is so short and I don't know how long I will be walking around on my own. This year I got my first wheel chair and although it is wonderful for getting around it is still a wheel chair! It is not legal and I know the person well that gets me the drug so not a lot of fear of getting crap. I have been getting the same effect every time but have only been using it for about 6-8 months two to three times a week. This stuff is amazing, I can walk up a fight of stairs, better yet I can run! Unless someone tells me that it is going to kill me, I am going to keep taking 5 hours vacations from this crappy disease.

https://shift.ms/forums/topic/mdma-m...ay-for-5-hours

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I was diagnosed with MS at Christmas 2013, and you wouldn't believe how difficult it has been to get the medicine that I choose to use to manage my symptoms. That's cannabis, and man, it works every time. But how much better would it be if I could get access to particular strains which will alleviate specific symptoms. What I really want to say was that personally I love LSD for many purposes, including but not limited to, expanded, layered thinking! The torrents of creativity that fall from the mind like rain from the clouds! The glimpses beyond the veil of Maya, and the way it makes me feel. Which is kinda like superman. And aside, man I've been using LSD since I was 16, and I wouldn't change it for the world! It helps one to find clarity in the chaos that we call home today! In my opinion it should not be illegal, moreover it should be an obligatory right of passage into adulthood.

-K3el

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I too have MS, and I can tell you that there are times when you feel like you're at death's door. There are also times when you just can't function. That's frustrating enough if you're on disability, living with excellent caretakers, and free of responsibility. But what about those who have children? What about those who have demanding jobs and refuse to let MS take that away from them? What about those of us who are graduate students? Many of the FDA-approved medications available for treating the debilitating symptoms of MS come with dangerous side effects, sometimes far more dangerous than the side effects of illegal drugs.

I am a neuropharmacology and cognitive neuroscience researcher. There is no definitive evidence that drug use causes MS, or that illegal drugs exacerbate MS. I don't think its a good idea for anyone to regularly use illegal drugs (except of course, marijuana, and only if you have a condition for which its efficacy has been scientifically demonstrated). But, come on! MS SUCKS. So if you can get a few hours of relief from this living hell now and again, I certainly won't judge you. I think the scientific community needs to broaden their minds and think outside the box where MS treatments are concerned.​

https://ehealthforum.com/health/ille...177245_20.html
 
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Research performed on mice yielded positive results. Restoration of myelin sheaths in mice led them to believe that
stem cells could be a much simpler alternative to using embryonic stem cells. Since the human skin stem cells can be
isolated, they can possibly improve the chances of functional recovery in case of any injury to the neurons in the nervous
system. Dr Thomas J. Hornyak, lead investigator in the research plans to expand research into the area using collected data.


Pigment-producing stem cells found to regenerate myelin sheath

Neuroscience News | May 6, 2019

Neurodegenerative diseases like Multiple Sclerosis affect millions of people worldwide and occur when parts of the nervous system lose function over time. Researchers at the University of Maryland School of Medicine (UMSOM) have discovered that a type of skin-related stem cell could be used to help regenerate myelin sheaths, a vital part of the nervous system linked to neurodegenerative disorders.

The discovery into these types of stem cells is significant because they could offer a simpler and less invasive alternative to using embryonic stem cells. This early-stage research showed that by using these skin-related stem cells, researchers were able to restore myelin sheath formation in mice.

“This research enhances the possibility of identifying human skin stem cells that can be isolated, expanded, and used therapeutically. In the future, we plan to continue our research in this area by determining whether these cells can enhance functional recovery from neuronal injury,” said Dr. Thomas Hornyak, Associate Professor and Chairman of the Department of Dermatology, and Principal Investigator in this research. “In the future, we plan to continue our research in this area by determining whether these cells can enhance functional recovery from neuronal injury.”

Using a mouse model, Dr. Hornyak’s team of researchers discovered a way to identify a specific version of a cell known as a melanocyte stem cell. These are the precursor cells to the cells in skin and hair follicles that make a pigment known as melanin, which determines the color of skin and hair. These melanocyte stem cells have the ability to continue to divide without limit, which is a trait that is not shared by other cells in the body. Additionally, the researchers discovered that these stem cells can make different types of cells depending on the type of signals they receive. This research was published in PLoS Genetics.

Importantly, unlike the embryonic stem cell, which must be harvested from an embryo, melanocyte stem cells can be harvested in a minimally-invasive manner from skin.

Isolating skin stem cells for new therapies

Dr. Hornyak’s research team found a new way to not only identify the right kind of melanocyte stem cells, but also the potential applications for those suffering from neurodegenerative disorders. By using a protein marker that is only found on these specialized cells, Dr. Hornyak’s research group was able to isolate this rare population of stem cells from the majority of the cells that make up skin. Additionally, they found that there exist two different types of melanocyte stem cells, which helped in determining the type of cells they could create.

Using this knowledge, the UMSOM researchers determined that under the right conditions, these melanocyte stem cells could function as cells that produce myelin, the major component of a structure known as the myelin sheath, which protects neurons and is vital to the function of our nervous system. Some neurodegenerative diseases, like multiple sclerosis, are caused by the loss of these myelin-producing, or glial, cells which ultimately lead to irregular function of the neurons and ultimately a failure of our nervous system to function correctly.

Growing melanocyte stem cells

Dr. Hornyak et al. grew melanocyte stem cells with neurons isolated from mice that could not make myelin. They discovered that the stem cells behaved like a glial cell under these conditions. The cells ultimately formed a myelin sheath around the neurons that resembled structures of a healthy nerve cell. When they took this experiment to a larger scale, in the actual mouse, the researchers found that mice treated with these melanocyte stem cells had myelin sheath structures in the brain as opposed to untreated mice who lacked these structures.

“This research holds promise for treating serious neurodegenerative diseases that impact millions of people each year. Our researchers at the University of Maryland School of Medicine have discovered what could be a critical and non-invasive way to use stem cells as a therapy for these diseases,” said UMSOM Dean, E. Albert Reece.

 
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Small vesicles involved in MS seen to be affected by gilenya.

New culprit identified in MS relapses

Neuroscience News | May 8, 2019

Injecting extracellular vesicles from healthy mice into mice that had an MS-like disease resulted in the development of a relapse-remitting disease and active CD8+ cells, similar to that seen in human patients with multiple sclerosis. Examining the EVs in mice and humans with MS, researchers identified they contained fibrinogen, a protein normally associated with blood clotting and wound healing. According to researchers, the EVs with fibrinogen appear to activate the CD8+ immune cells. The findings could help with the development of new treatments for RRMS.

A molecule that helps blood clot may also play a role in multiple sclerosis relapses, researchers report in the May 6 issue of PNAS. The new research may help answer the mystery of why remissions happen, as well as find early markers of the disease.

The research also shows a new way to study multiple sclerosis (MS) in mice that is closer to the human form of the disease.

MS affects about a million people in the United States and many more globally. It damages the brain’s ability to communicate with the rest of the body, making it hard to walk, write, or hold a fork and knife. This happens because of damage to the insulation around the nerves. Just like a frayed wire, a nerve with damaged insulation can short out or send bad signals.

But the damage isn’t permanent, at least not at first. Most people with multiple sclerosis have recurring episodes of disability, followed by remissions when their symptoms lessen or disappear. Why these relapses and remissions happen is a great mystery. We know that the damage to the nerves is caused by the immune system, the army of cells in our body that is supposed to protect us from disease-causing invaders. For some reason, in MS, the immune system turns on cells in the brain and spinal cord. In MS patients, a particular type of immune cell – CD8+ cells, a part of the immune system that normally kills cells that are cancerous or infected – seem to be the ones doing the damage.

Although researchers have been able to develop drugs to help fight MS using a mouse version of MS, these experimental mice develop a slightly different immune system response than what happens in MS in humans. Different cells do the damage in MS mice: CD4+ cells. The mice have CD8+ cells, but those CD8+ cells are generally quiescent. This has been a big stumbling block to understanding how the immune system develops in MS.

But a team of researchers from UConn Health, the University of Illinois at Chicago (UIC), and the Gladstone Institutes have figured out how CD8+ cells are activated in MS mice, and the result seems very close to what happens in humans. The new findings hinge on how cells talk to each other. Cells will often secrete little bubbles containing proteins and genetic signals. These bubbles are called extracellular vesicles, or EVs. EVs are made by most cells in the body, and float in the blood stream like a message in a bottle.

So the team injected EVs from normal, healthy mice into mice that had that experimental MS-like disease. When they did this, the mice acquired a relapsing-remitting disease and active CD8+ cells, like human MS patients. The researchers examined the EVs in mice and patients with MS and found they contained fibrinogen, a protein that neuroscientist Katerina Akassoglou’s lab at Gladstone had been studying in MS. Fibrinogen normally helps blood clot and seal up wounds. But in these MS mice, the EVs with fibrinogen seemed to activate the CD8+ immune cells. When they injected the MS mice with EVs that did not have fibrinogen, they could not cause the relapsing-remitting illness.

“These findings expand our understanding of how fibrinogen contributes to the progression of MS pathology” says Akassoglou, senior investigator at Gladstone and professor of neurology at UC San Francisco.

“Fibrinogen in exosomes may have far-reaching implications for therapies and as a biomarker for disease progression in MS and potentially, other neurological diseases,” she says.

“We now have a robust model of relapsing/remitting disease driven by CD8+ cells,” says UConn neuroscientist Stephen Crocker, who directed the study. “There’s all these clinically important questions we can now ask.” Crocker and his colleagues want to study this model further to understand how and why the remissions of disease happen.

Most people with multiple sclerosis have recurring episodes of disability, followed by remissions when their symptoms lessen or disappear.

“Understanding the causes of relapses is a key step on the path to a cure for MS,” says study co-author Ernesto Bongarzone, an anatomy and cell biology neuroscientist and professor at UIC. “The results of this study and the identification of fibrinogen as a key molecule contributing to relapses are exciting steps forward.”

The researchers would like to understand how the fibrinogen stimulates the CD8+ cells that cause the relapsing and remitting disease activity. They would also like to test whether fibrinogen and related proteins found in the EVs also play a role in humans with MS, and test if these molecular signals in EVs might be early warnings of relapses or disease progression.

 
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Stem cell transplant offers first-ever MS treatment that reverses the disability

Dr. Richard K. Burt performed the first hematopoietic stem cell transplant (HSCT) for a multiple sclerosis (MS) patient in the United States at Chicago's Northwestern Memorial Hospital. Now Burt, Chief of the Division of Medicine-Immunotherapy and Autoimmune Diseases at Northwestern University's Feinberg School of Medicine, is making headlines again.

Burt and his colleagues published the results of their newest HSCT study earlier this week in the Journal of the American Medical Association. Their results show that HSCT could be the first MS therapy to reverse disability. Though the study group was small, the results have experts hopeful.

In this trial, 151 patients underwent a stem cell transplant. First, their immune systems were tamped down using low-dose chemotherapy. Then, doctors used HSCT therapy, involving an infusion of the patients' own stem cells, previously harvested from their blood, to reboot their immune systems. After a short stay in the hospital, the volunteers went about their normal lives, needing no "maintenance" drugs.

Over the next several years, the volunteers were periodically given a series of tests to measure their disability. One test, known as the Expanded Disability Status Scale, or EDSS, measures cognition, coordination, and walking, among other things. Participants underwent MRI scans and completed questionnaires to measure their overall quality of life.

The researchers found that at two years post-transplant half of the patients showed a marked improvement in disability. Of the patients who were followed for four years, more than 80 percent remained relapse-free.

Since 1993, the FDA has approved 12 disease-modifying therapies to treat relapsing-remitting MS (RRMS). All are designed to suppress the immune system to one degree or another. These drugs cost about $5,000 per month and they must be taken indefinitely, since relapses will occur if the drugs are stopped. While patients now have many options to stave off disease progression, no DMT has been proven to reverse disability.

HSCT costs about $125,000 per patient. "Although we haven't done a cost analysis, given how expensive Tysabri is, and Fingolimod, since HSCT is a one-time treatment it should start paying for itself around 18 months," Burt told Healthline.

Who should have a stem cell transplant?

"The caveat," Burt conceded, "is this is not effective in progressive MS." He pointed out "the tendency among neurologists to try one DMT after another until the patient is out of options before offering HSCT. But by then the patient has entered secondary progressive and most likely nothing will help."

"If you're doing well on first-line therapies, interferons or Copaxone, good, that's where you should stay,"
Burt added. "But if you're having frequent relapses, two or more a year despite those therapies, I think that's the group that, rather than going to Tysabri or Fingolimod, should be given this therapy because it's so much more beneficial. Plus, if you wait until you've had all those other DMTs then you increase the risk of this treatment."

Even after stopping the drug, patients who have taken natalizumab (Tysabri) continue to have an increased risk of primary multifocal leukoencephalopathy (PML) for many months. If they were to undergo HSCT during that time, the risk for this rare but serious brain infection carries over and would make the procedure more dangerous.

"In their study," Burt pointed out, "we had no opportunistic infections, no PML, nothing, but my worry is, if you've had many years of prior treatment with Tysabri, and you're positive for John Cunningham virus, then you could get PML and people think it's our transplant, but it's really all that prior Tysabri."

Getting her life back

One of Burt's trial patients, Roxane Beygi, spoke on a panel at the Vatican Adult Stem Cell Conference in 2013. In a video of the event, she describes her life before the study.

Despite being on a DMT prior to the study, Beygi was relapsing regularly and could barely walk. She had trouble writing, brushing her teeth, and even performing simple tasks like drinking from a glass.

"Since I had my transplant, my life changed completely," said Beygi, speaking more than two years after treatment, "Before the transplant I had major fatigue where I couldn't even get out of bed. Now I get up at 6 ... and a lot of the time I'm studying and exercising until like 1 a.m."

Beygi ended her presentation by thanking Dr. Burt for giving her life back. She called him her "hero."

Although HSCT is currently only available in clinical trials and for "compassionate use" in certain cases, Burt is hopeful that more studies will lead the FDA to approve stem cell transplantation for MS.

https://www.healthline.com/health-ne...ility-012215#1
 
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MS-damaged myelin repair can restore function

There is a new promise of finding a multiple sclerosis treatment and restoring the affected cognitive functions through damaged myelin repair. Due to the National MS Society’s extensive efforts, we are steps closer to stop the progression of multiple sclerosis. Some initiatives currently underway include clinical trials to stimulate the brain’s natural capacity to repair itself, tests on the ability of stem cells to treat multiple sclerosis, research into the ways to protect the nervous system, and development of methods to monitor the successful repair.

The brain does have a natural ability to repair itself, it’s a fact, but myelin repair is often paused or blocked – and the reason for this is still unknown. The current clinical trials seek to better understand this process in order to find a way to promote myelin repair. The researchers are targeting oligodendrocytes as a means to promote myelin repair.

Stem cell therapy is also growing in popularity, and numerous advancements have been made over the last decade. Although much more research is needed to determine the effectiveness of stem cell therapy in multiple sclerosis, some studies have already found that transplanting stem cells to the brains of mice prompted myelin repair, while injecting stem cells into the spinal cord allowed mice to recover from MS-like symptoms.

Lastly, the Society is looking into means to protect the nervous system with medications and supplements, including ibudilast, lipoic acid, and phenytoin.

As the National MS Society continues to run clinical trials and conduct more research, there’s hope that one day multiple sclerosis can be better managed and even cured.

https://www.belmarrahealth.com/mult...ausing-an-autoimmune-response-against-myelin/
 
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Nanotechnology treatment found to reverse MS symptoms

Neuroscience News | June 5, 2019

A nanotechnology treatment derived from bone marrow stem cells has reversed multiple sclerosis symptoms in mice and could eventually be used to help humans, according to a new study led by University of California, Irvine researchers.

“Until now, stem cell therapies for autoimmune and neurodegenerative diseases have produced mixed results in clinical trials, partly because we don’t know how the treatments work,” said corresponding author Weian Zhao, an associate professor of pharmaceutical sciences and biomedical engineering who is affiliated with the Sue & Bill Gross Stem Cell Research Center. “This study helps unravel that mystery and paves the way for testing with human patients.”

In past experiments, intravenously injected stem cells – taken from bone marrow and activated with interferon gamma, an immune system protein – often got trapped in filter organs before reaching their target. For this study, published in the journal ACS Nano, researchers avoided that problem by extracting nano-sized particles called exosomes from the stem cells and injecting them into rodents with MS.

Loaded with anti-inflammatory and neuroprotective RNA and protein molecules, the exosomes were able to slip through the blood-spinal cord barrier. In addition to rejuvenating lost motor skills and decreasing nerve damage caused by MS, they normalized the subjects’ immune systems, something conventional drugs can’t do, said study co-lead author Reza Mohammadi, a UCI doctoral candidate in materials science & engineering.

“This novel treatment will be tested on humans in early 2020, initially on people with Type 1 diabetes,” said co-lead author Milad Riazifar. “If successful, it could pave the way for treating other autoimmune diseases, including multiple sclerosis.”

 
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Restoration of myelin sheath in mice led researchers to believe that human skin stem cells could be a much
simpler alternative to embryonic stem cells.


Myelin sheath regenerated with the help of skin stem cells

by Anubhav Sharma | May 7, 2019

In a world where Neurogenerative diseases affect millions of people worldwide, there is no significant cure that that can effectively help battle such diseases. In India alone, Multiple Sclerosis affects almost 1 million people yearly. As per latest news, Researchers at the University of Maryland School of Medicine have discovered a skin-related stem cell that can be used in the regeneration of myelin sheath, which is an integral part of the human nervous system.

Research performed on mice yielded positive results. Restoration of myelin sheath in mice led them to believe that stem cells could be a much simpler alternative to using embryonic stem cells. Since the human skin stem cells can be isolated, expanded and used therapeutically, they can possibly improve the chances of functional recovery in case of any injury to the neurons in the nervous system. Dr Thomas J. Hornyak, the lead investigator in the research plans to expand research into the aforementioned area using collected data.

Isolation and growth of melanocyte stem cells

Dr Hornyak and his team of researchers implemented a mouse model to identify a specific version of the melanocyte stem cell. As the name suggests, the cells produce melanin (the pigment that determines the color of skin and hair) and are present in the hair follicles and skin. These cells have a very unique ability – they can divide limitlessly. In fact, this ability is so unique that it is not present in any other cell in the human body. These stem cells can further develop different types of cells, which depends entirely upon the type of signal provided to them.

Dr Hornyak’s Team grew melanocyte stem cells with mice-isolated neurons that could not make myelin. These stem cells acted like glial cells (insulating cells), and eventually formed a myelin sheath around the healthy nerve cells/neurons. Researchers further state that this study holds a lot of potential for those who have very serious neurogenerative diseases. With the development of such a technique, scientists can develop cures for many more nervous disorders which involve the degradation of neurons in the nervous system.

 
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