This morning, ISNVD presenter, neurologist Dr. Alireza Minegar, is discussing MS as a vascular disorder, marked by venous endothelial injury in the CNS. He believes the current MS model is myopic, in that it only focuses on what happens AFTER the immune system is affected, not what happens FIRST to endothelial cells. Here is a paper his team published in 2013. (Notice in the picture how laminar (or smooth flow) creates endothelial cell health, and how disturbed flow (like reflux or slow flow) causes a break down of the endothelial cell lining. Endothelial cells need strong, healthy flow to maintain their integrity--via nitric oxide (eNOS) expression. That's why shear stress created by exercise is so helpful for the endothelium. ) Joan

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