Wednesday, April 22, 2009

Starting the MS Engine

Since I was first diagnosed with Multiple Sclerosis six years ago, I've probably been asked a thousand times, "What causes MS?" Seems like a pretty simple question, but the unfortunate truth is that nobody knows the root cause of Multiple Sclerosis. As with cancer, diabetes, and a host of other diseases, decades of research have allowed our best medical minds to only make educated guesses as to the genesis of the MS. Over the last 20 or so years, the prevailing hypothesis has been the "autoimmune" theory, which states that a patient's immune system for some reason goes haywire, and starts attacking their own cells. I often get the sneaking suspicion that diseases whose cause stumps our scientists are often labeled autoimmune, simply for lack of a better theory. Modern science isn't comfortable saying "I don't know", and when I see the word "autoimmune", I often put the words "I Don't Know" in its place. Multiple Sclerosis is an "I Don't Know" disease.

Through the years, I've come to look at the MS disease process as kind of resembling an automobile engine. In order to start a car engine, you must have gasoline in the tank, oil in the pan, and a key for the ignition. If one or two of these elements are missing, the car just won't start. In much the same way, MS requires a number of elements to be present for it to take hold of a patient's physiology. There is solid evidence that bacterial or viral infections play some part in the disease. Likely culprits include Epstein-Barr virus, Chlamydia Pneumonia, Varicella Zoster, and the Human Herpes Viruses. Many of these bugs infect large proportions of the population; for example, EBV is present in at least 85% of adult Americans. Obviously, only a tiny proportion of them develop MS, so EBV alone can't be the cause of the disease. There is also strong evidence that environmental toxins play a role in starting the MS disease process. Again, though, the vast majority of people exposed to common environmental toxins don't come down with MS. Therefore, there must be another component required for MS to take hold, most likely a genetic susceptibility.

It's been theorized that some people carry within their DNA remnants of ancient retroviruses that have over the eons incorporated themselves into the human genome. This retroviral DNA is normally inactive and completely benign, but perhaps the presence of a combination of infections and/or toxins can activate this DNA, and thus cause a person's immune system to see their own cells as harmful invaders.

So, to get back to the engine analogy, for a patient to get MS, they must have gas in the tank (a chronic viral or bacterial infection), oil in the pan (exposure to another environmental toxin or infectious agent), and a key to the ignition (a genetic predisposition to the disease). Without the right combination of elements present, even a person genetically susceptible to MS might never get the disease. Likewise, without genetic susceptibility, a person might be exposed to any number of MS triggers, and never develop Multiple Sclerosis. In my opinion, it's an unfortunate synchronicity of seemingly unrelated elements that turns the key that starts the MS disease engine. These elements may differ from patient to patient, and these differences in triggering elements might account for the vastly different ways that MS can present itself from case to case.

So, gentlemen (and women), start your engines. Or better yet, don't...


  1. take my engine please. i prefer walking.

  2. And then there's those different components that lead to different types or presentations of MS. I'm no mechanic, but I surmise that my vehicle model is a lemon!

  3. i love your blog wheelchair kamikaze! but the slideshow goes over the text:

    I'm on ubuntu and firefox, so i don't think it's for the majority of users.

  4. I changed the width of the slideshow, hopefully that will solve the sizing problem...

    Thanks everyone for your comments. I'm hoping to have another video up sometime soon...

  5. ah Great! For me at least, the sizing problem is much better now. much easier to read your posts! looking forward to your next video!

  6. Hi Marc, I can't remember how I found your site, but your comments during your videos really made me laugh (and that's hard to do). I'm in AZ and have never been to NY, so I appreciated your stroll(I mean roll) thru Central Park. I will be visiting your site often, as I need to laugh! Thanks so much! I've fallen off my scooter in the house & my husband threatens to post Speed Limit signs-!

  7. Thanks for trying, Mark. I'm still seeing overlap, but am disabling your CSS as a workaround.

  8. Ahhh..synchronicity. I know that well. My doctor told me all the stars lined up for my diagnosis. I like to think of it as the pinball machine hitting TILT.
    1. grew up in the northeast in a cold climate
    2. mother had MS
    3. had a serious Vitamin D deficiency
    4. came down with a 9 month long case of Epstein Barr virus infection (othewise known as mono) about a year before my diagnosis.