Chronic Cerebrospinal Venous Insufficiency in Multiple Sclerosis: The Hydrostatic-Immune Paradigm and the Flow Cytometry as a Diagnostic Tool
Tsamopoulos NG, Kalodimou VE, and Vlachos S

“...Conclusions: MS is considered a primarily autoimmune disease but this paradigm is slowly shifting towards a combined autoimmune neurodegenerative model [79]. The pathogenetic mechanism is almost certainly multi-factorial and even though the initial trigger is still unknown, some of the waypoints on the road leading to demyelination and axonal loss have been discovered. It is not clear yet to what extend venous outflow abnormalities contribute to this process. Altered neuronal microenvironment and changes in antigen presentation to regional lymph nodes may provide a theoretical framework combining hydrostatic and immune effects. Lymph nodes are a site of sensitive immune regulation where both immune suppression and immune activation take place [80,81] CCSVI and its treatment may act via tipping the balance towards one or the other side of the scales...”

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