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December 2, 2016
Written By: Jack Florin, Neurologist, Headache Medicine and Multiple Sclerosis Specialist
Could that same virus be the antigen that triggers the immune response in MS?
If confirmed, these observations carry monumental implications.
A recent report was published in Neurology, October 25, 2016, by lead author Lauren Bowen, MD. Five patients with HIV infection who later developed an ALS-like disease were reported. Three of the five patients who received anti-retroviral therapy within 6 months of onset had reversal of their symptoms. The other two had slow progression over several years. In 3 of the patients, blood levels for the human endogenous retrovirus K (HERV-K) were elevated. Further, those levels responded to antiviral therapy. This is an archaic virus that has been integrated into the human genome for thousands of years and, in fact, endogenous retroviruses constitute approximately 8% of the human genome. The specific HERV-K group is the most recently required of these retroviruses.
ALS associated with HIV infection has been recognized for over 15 years, but the association with HERV-K virus is new.
Regarding MS, studies are controversial, but some seem to indicate that the virus is in the brain and that it triggers the immune response, and this supports the concept that MS is “inside-out” rather than “outside-in.” This theory explains progressive MS better.
It does not take much imagination to envision patients and families of patients with ALS clamoring for treatment with anti-retroviral therapy. According to Drs Berger and Power in an editorial in the same issue, commenting upon the article by Bowen, patients with ALS that is not associated with HIV infection should receive this treatment only in a clinical trial.
Keep in mind that much is lost between the cup and the mouth
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