Amyotrophic Lateral Sclerosis (ALS): Physiology Treatment

Amyotrophic Lateral Sclerosis (amyotrophic lateral sclerosis) Physiology TreatmentAmyotrophic lateral sclerosis Physiological traitsAmyotrophic lateral sclerosis (amyotrophic lateral sclerosis) much commonly referred to as Lou Gehrigs disease, is a progressive and deadly disease. Many with ALS experience grief and many families of those affected endure the same. At portray medical science has demonstrated great potential in finding a workable cure or efficacious therapy. However, at present no such cure or efficacious therapy exists. A number of treatments can prolong the fatal course of ALS but none can freeze it and ALS continues to significantly shorten the sufferers lifespan. 3.9 in every 100,000 individuals go away develop ALS in America, so while the prevalence is relatively low, ALS has generated a great deal of attention due in part to its severity, to numerous movements to raise funding for the disorder and for its generalized physiological symptoms and hypothetical relation to other dementing illnesses such as Alzheimers. Definitive answers as to the causes of ALS ar currently not known. numerous theories cast off emerged and question has pinpointed causes which partially explain occurrence or fill been plant in rat studies but have yet to reach human testing. Promising treatments for the disease have been found however none have made it beyond the query stage. Exposure to different toxins has been suggested as a potential cause, ranging from occupational exposure and physical operation to military exposure and trauma. Males have a higher prevalence rate than females. Particularly, white males ages 60+ are at highest risk for the development of ALS.ALS is characterized by muscle spasticity, which rapidly progresses to muscle wasting and difficulty breathing, speaking, and swallowing. Most individuals with ALS live for 3 to 4 years. About 5% live longer than 10 years and a very select few live still longer. The diseases symptoms are due to a result of the loss of amphetamine and lower motor neurons. Present research effort include stage II testing in Israel and soon, the United States at the Mayo Clinic.Physiological PathologyA2A Adenosine receptorsA2A Adenosine receptors have been thought to be a potential therapeutic objective but until a recent study (14) the neuromodulatory role of the said(prenominal) receptors has remained in question. A selective A2A agonist was applied known only as CGS 21680 at present. (Poff et al., 2014) The A2A agonist significantly enhanced average amplitude of endplate potentials (EPPs) and enhanced frequency of miniature endplate potentials (MEPPs) and giant end plate potentials (GMEPPs). The A2A adenosine receptor is now under scrutiny for its potential therapeutic role for presenting symptoms of ALS (Poff et al., 2014).Cortical cachexyCortical wasting in patients suffering from ALS was linked to neuropsychiatric and cognitive changes. Acidotoxicity has been implicated as a pote ntial cause or endorser to this phenomenon (Behan et al., 2013). With regard to patients with ALS-plus cortical atrophy presented significantly across motor and somatosensory areas. Additional cortical atrophy was found in frontal and parietal areas of the brain. In patients with ALS no significant cortical atrophy was shown, only brainstem atrophy. In patients with ALS-FTD atrophy also affected greater frontal area atrophy and temporal area atrophy in comparing with ALS-plus. Atrophy of the cortexes is implicated as a contributor to the presenting deficits of ALS (Mioshi, 2013).Genetic linksThe vast mass of ALS cases are sporadic and unrelated to genetics. However 5-10% of ALS cases are thought to be hereditary. Mutations in TAR DNA-binding protein, fused in sarcoma (FUS), and superoxide dismutase 1 (SOD1) comprise the causes for about 30% of classic inherited ALS. A gene known as UBQLN2 which is responsible for the encoding of the protein ubiquilin?2 can cause dominantly inheri ted, ALS and ALS/dementia. So although the majority of ALS cases occur from causes unknown, a select few cases can be explained by genetic mutation. Suggested from this data is the potential for retracing the steps of the gene and specifying the mechanism of action around exploitable in treatment for the disease. small-arm genetically link ALS is rare the basic mechanism of action is widespread, thusly insights into causes for the physiological outcome are valuable in treatment of ALS as a whole (Deng, 2011). snowy librate aberrationsWhite matter has been examined for its aberrations in shape in patients with ALS. What has been found is a link between symptoms indicative of the disease however, not the physiological changes typical in the disease itself (Rajagopalan et al., 2013). Scientists suspect that the name little physiological link between white matter changes and physiological changes caused by ALS may play a large role in the disorder. White matter changes specificall y have been correlated with the ALS-FTD-Q, a screening tool for behavioral disturbances in ALS. So while the behaviors correlate, the physiological changes beyond white matter shape change have not yet been linked specifically, leaving room for spare research in this area (Rajagopalan et al., 2013).Cervical roots and fringy nervesA sonogram study found that in patients with ALS, cervical roots and peripheral nerves exhibit reductions in size in comparison to their former size and those in patients without ALS. The study found that the aforementioned both reduced in size and became physically thinner although more significantly the latter(prenominal) (Nodera et al., 2014). Although this phenomenon was measurable in patients with and without ALS it was not related to gender, progression of the disease, and severity of disease symptoms. Despite these setbacks it is suggested that peripheral root atrophy may present a viable marker for detection of the presence of the disease and thus increase progress made on treatment due to decreased false supportive diagnoses (Nodera et al., 2014).TreatmentMetabolic therapy (Deanna protocol)Aside from motor neuron devolution ALS is associated with metabolic dysfunction. A mouse study found that mice given the Deanna Protocol (DP) a metabolic therapy reported to result in some symptom alleviation in patients with ALS. The study found that mice given the treatment had significant extensions in excerpt time in ALS mice 7.5% (pHuman stem cellsHuman stem cells have long been considered for their curative abilities toward various diseases. ALS is one such disease. The degeneration of motor neurons can theoretically be counteracted using motor neurons created from stem cells. (Lee et al., 2014 Morgan Srivastava, 2014). Stem cells present what seems to be a highly promising treatment for ALS. In one study, patients were injected with stem cells and followed up upon 12 months later and not acceleration of the disease was detected (Kim, Lee, Kim, 2013). A large proportion of future research will center upon investigation of this.guanabenzguanabenz is now under scrutiny for its therapeutic benefits to those suffering from ALS. Guanabenz was found to have an impact on post-apoptic protein deductive reasoning such that scientists conducting the experiment hypothesized that its introduction would have therapeutic effects on ALS patients. In a mouse model female mice were given Guanabenz and were found to have delayed symptom trespass, prolonged life span and increased motor ability (Jiang et. Al 2014).ThalidomideInflammation from the cytokine tumor necrosis gene alpha TNF is believed to be a critical factor in the development and pathology of ALS. TNF is reduced by thalidomide. Thus the rationale for research skirt the efficacy of the use of thalidomide in ALS patients. The study found no results suggesting that this theorized mechanism may need revision (Stommel et al, 2009).DiscussionALS as aforementioned is a neurodegenerative disease which causes the motor neurons to atrophy and die. Victims of ALS typically suffer from motor impairments which eventually exacerbate to impairments in breathing, swallowing and speaking. Sufferers experience many psychological symptoms as secondary effects from the physiological damage which occurs. Physiologically, impairments typically relate to motor movement. In some cases movement changes but in most cases it becomes more difficult. Numerous treatments are emerging in the research phase due in part to massive donations to the research of a cure or treatment for this disorder. While ALS is unique to other neurodegenerative disorders scientists suspect that some aspects of the treatments used and developed will translate due to the similarities ALS shares.Evidence has suggested that certain cases of ALS are inherited while others are developed due to toxins which has helped scientists narrow down the possible mechanisms of action which facilitate t his disease. While some are known, the cause of most cases is yet to be determined the outcomes have been more apparent. ALS outcomes include changes in shape of the white matter in the brain, cortical atrophy and carving of cortical and peripheral nerves. The treatment has made relative progress. Perhaps most promising is the use of stem cells as replacements for motor neurons. Stem cell research has had difficulty using stem cells in large quantities as a corrective measure however motor neuron use requires the use of less cells than most treatments making it especially promising. Other theoretical treatments such as metabolic therapy and Guanabenz have shown some potential in improving the lives of ALS sufferers and perhaps prolonging them somewhat. Guanabenz, an intervention targeted specifically at cell apoptosis has demonstrated an effect on symptoms, speed of progression, and lifespan. Metabolic therapy has demonstrated an effect on symptoms and lifespan. in concert therapeu tic treatments have a supplementary benefit until a more lasting solution is found.Future researchFuture research implications include additional research on stem cells. Stems cells are highly promising and may be an effective treatment and perhaps eventually have curative effects. Studies at present have found a link between symptom stabilization and treatment in human studies. As with all medical research clinical trials must be completed before anything is open to the public. Additional concerns for this treatment include the political implications of this treatment as some political groups disagree with stem cell research as a whole. Future research should also continue to focus upon the clinical implications of therapeutic treatments such as Guanabenz and Deanna Protocol metabolic therapy.ConclusionAt present ALS presents future challenges to scientists, doctors, and the people who suffer from it. While promising research and clinical trial have received unprecedented support the reality is that ALS continues to shorten and end lives. Researchers are far from finding the multiple causes of ALS however, researchers are rapidly gaining desktop on how to treat the effects of the disorder. Aside from stem cells, therapeutic treatments have emerged such as Gaunabenz and metabolic therapies such as the Deanna protocol.ReferencesAri, C., Poff, A. M., Held, H. E., Landon, C. S., Goldhagen, C. R., Mavromates, N., DAgostino, D. P. (2014). Metabolic Therapy with Deanna Protocol Supplementation Delays Disease Progression and Extends Survival in Amyotrophic Lateral Sclerosis (ALS) Mouse Model. Plos ONE, 9(7), 1-9. inside10.1371/journal.pone.010352Behan, ., Breen, B., Hogg, M., Woods, I., Coughlan, K., Mitchem, M., Prehn, J. (2013). Acidotoxicity and acid-sensing ion channels contribute to motor neuron degeneration. Cell shoemakers last Differentiation, 20(4), 589-598. doi10.1038/cdd.2012.158Deng, H., Chen, W., Hong, S., Boycott, K. M., Gorrie, G. H., Siddique, N ., Haines, J. L. (2011). Mutations in UBQLN2 cause dominant X-linked juvenile and adult-onset ALS and ALS/dementia. Nature, 477(7363), 211-215. doi10.1038/nature10353Lee, H. J., Kim, K. S., Ahn, J., Bae, H. M., Lim, I., Kim, S. U. (2014). Human motor neurons generated from neural stem cells delay clinical onset and prolong life in ALS mouse model. Plos ONE, 9(5), 1-9. doi10.1371/journal.pone.0097518Jiang, H. Q., Ren, M. M., Jiang, H. Z., Wang, J. J., Zhang, J. J., Yin, X. X., Feng, H. L. (2014). Guanabenz delays the onset of disease symptoms, extends lifespan, improves motor performance and attenuates motor neuron loss in the SOD1 G93A mouse model of amyotrophic lateral sclerosis. Neuroscience, 277132-138. doi10.1016/j.neuroscience.2014.03.047Kim, S. U., Lee, H. J., Kim, Y. B. (2013). Neural stem cell-based treatment for neurodegenerative diseases. Neuropathology, 33(5), 491-504. doi10.1111/neup.12020Mehta, P., Antao, V., Kaye, W., Sanchez, M., Williamson, D., Bryan, L., Hor ton, K. (2014). Prevalence of Amyotrophic Lateral Sclerosis United States, 2010-2011. MMWR Surveillance Summaries, 63(7), 1-13. Retrieved from http//ezproxy.pcom.edu2048/login?url=http//search.ebscohost.com/login.aspx? commit=truedb=hehAN=97269966site=eds-livescope=siteMioshi, E., Lillo, P., Yew, B., Hsieh, S., Savage, S., Hodges, J., Hornberger, M. (2013). Cortical atrophy in ALS is critically associated with neuropsychiatric and cognitive changes. Neurology, 80(12), 1117-1123. doi10.1212/WNL.0b013e31828869daMorgan, R. H., Srivastava, A. K. (2014). Clinical relevance of stem cell therapies in amyotrophic lateral sclerosis. Neurology India, 62(3), 239-248. doi10.4103/0028-3886.136895Nodera, H., Takamatsu, N., Shimatani, Y., Mori, A., Sato, K., Oda, M., Kaji, R. (2014). Thinning of cervical nerve roots and peripheral nerves in ALS as measured by sonography. Clinical Neurophysiology, 125(9), 1906-1911. doi10.1016/j.clinph.2014.01.033Nascimento, F., Pousinha, P. A., Correia, A. M ., Gomes, R., Sebastio, A. M., Ribeiro, J. A. (2014). Adenosine A2A Receptors Activation Facilitates Neuromuscular Transmission in the Pre-Symptomatic Phase of the SOD1(G93A) ALS Mice, but Not in the Symptomatic Phase. Plos ONE, 9(8), 1-10. doi10.1371/journal.pone.0104081Raaphorst, J., Beeldman, E., Schmand, B., Berkhout, J., Linssen, W., van den Berg, L., de Haan, R. (2012). The ALS-FTD-Q A wise screening tool for behavioral disturbances in ALS. Neurology, 79(13), 1377-1383. Retrieved from http//ezproxy.pcom.edu2048/login?url=http//search.ebscohost.com/login.aspx?direct=truedb=jlhAN=2011697440site=eds-livescope=siteRajagopalan, V., Liu, Z., Allexandre, D., Zhang, L., Wang, X., Pioro, E. P., Yue, G. H. (2013). Brain White Matter Shape Changes in Amyotrophic Lateral Sclerosis (ALS) A Fractal Dimension Study. Plos ONE, 8(9), 1-11. doi10.1371/journal.pone.0073614Stommel, E. W., Cohen, J. A., Fadul, C. E., Cogbill, C. H., Graber, D. J., Kingman, L., Harris, B. T. (2009). Efficacy of thalidomide for the treatment of amyotrophic lateral sclerosis A phase II open label clinical trial. Amyotrophic Lateral Sclerosis, 10(5/6), 393-404. doi10.3109/17482960802709416