Chronic Cerebrospinal Venous Insufficiency in Multiple Sclerosis: The Hydrostatic-Immune Paradigm and the Flow Cytometry as a Diagnostic ToolTsamopoulos NG1*, Kalodimou VE2, and Vlachos S3
- Corresponding Author:
- N.G. Tsamopoulos, MD, PhD
Mediterraneo Hospital - Department of Interventional Neuroradiology
8-12 Ilias str. Glyfada, 166 75 Greece
E-mail: [email protected]
Received date: March 21, 2014; Accepted date: April 22, 2014; Published date: April 26, 2014
Citation: Tsamopoulos NG, Kalodimou VE, and Vlachos S (2014) Chronic Cerebrospinal Venous Insufficiency in Multiple Sclerosis: The Hydrostatic-Immune Paradigm and the Flow Cytometry as a Diagnostic Tool. J Mult Scler 1:103. doi:10.4172/2376-0389.1000103
Copyright: © 2014 Tsamopoulos NG, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
In recent years, chronic cerebro-spinal venous insufficiency (CCSVI) has been associated with multiple sclerosis (MS). Balloon angioplasty of the affected veins (internal jugulars, azygos) has been proposed as a treatment method, with controversial results. The conflict is based on how a primarily immune disease can be affected by a primarily hydrostatic condition and its reversal. In our paper we briefly review novel paradigms in multiple sclerosis pathogenesis and propose a mechanism by which CCSVI could theoretically lead to blood brain barrier disruption, altered neuronal microenvironment, astrocyte and oligodendrocyte loss and demyelination. Altered antigen transfer to regional lymph nodes, affecting antigen presentation and processing could also contribute, affecting the sensitive balance between tolerance and immunity. Thus, a combined hydrostatic-immune paradigm of MS emerges, which may explain the potential role of CCSVI in MS pathogenesis and provide a theoretical framework for future research.