It is disturbing that using the latest advances in MRI technology, the change in cell size detected on an MRI is likened to tumour activity(tumefactive).
Studies of electron microscope slides of real tissue, clearly demonstrate that cells enlarge and reduce in size as they ingest and digest myelin fragments. This is the first stage in remyelination.
Commentary in response to …Tumefactive demyelinating lesions: a diagnostic challenge. (2010)
Aria Fallah MD, Sarfaraz Banglawala MD, Shanil Ebrahim Bsc, John E. Paulseth MD and Neilank K. Jha MD, Can J Surg 53(1): 69-70.
It was shocking to read that we have another kind of MS – tumefactive characterized by lesions “… difficult to distinguish … from high-grade gliomas(tumors) …!”
The landmark study, Bunge et al (1961) of electron microscope slides of adult cat tissue, clearly shows that in the healing process, gitter cells ingest pieces of broken myelin, and, digest it. “ … much of the new myelin is formed before the remnants of former myelin have been removed … the neurological condition of the experimental animal begins to improve at a time when remyelination begins and has returned to normal by the time most axons are at least partly remyelinated.”
Slides show how engorged gitter cells are back to normal after digesting the myelin detritus. This is not the behaviour of a tumour, but a step in the natural healing process. Bunge’s work with adult cats assured me that I would always recover, as did the cats, with persistent efforts to move.
Electron microscope study by Adams observes, “… active plaques seem(s) to extend at their edges; proteolysis of myelin basic protein is perhaps an important factor in the myelin breakdown at the rim of these lesions …. hyperactive early plaque usually shows infiltration with monocytes, lymphocytes and plasma cells.”
A third study by Lemkey-Johnston describes how, 6 to 12 hours after damage to a neonatal mouse brain, “… microglia start to engulf debris … and continue this process through at least 48 hours. From 3 to 48 hours, a third cell type, tentatively identified as a Gitter cell, is preeminently involved in phagocytosis of neuronal elements. Nuclei of these cells enlarge and their parikarya become vastly expanded in a fashion typical of Gitter cells.” It is interesting that using the latest advances in MRI technology, the change in cell size is likened to tumour activity, resulting in a diagnostic challenge; studies of electron microscope slides of tissue clearly demonstrate that cells ingest and digest myelin fragments at the start of remyelination. Having lived with MS symptoms for 63 years, my concern is that this work will encourage more damaging, and useless chemotherapy.
I am only one of the millions of people around the world who looks to research for advances in the study of Multiple Sclerosis.
In light of evidentiary research that has been done with electron microscope slides, MRI studies should be reviewed.
1- Ultrastructural Study of Remyelination in an Experimental Lesion in Adult Cat Spinal Cord, (1961) Mary Bartlett Bunge, Richard P Bunge, Hans Ris, J Biophys Biochem Cyto 10:67-94, p 81-82.
2- The onset and progression of the lesion in Multiple Sclerosis, (1975) Adams CW, J Neurol Sci 25(2):165-82.
3- Glial changes in the progress of a chemical lesion. An electron microscopic study, (1976) Lemkey-Johnston N, Butler V, Reynolds WA . Comp Neurol;167(4):481-501.
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