tl;dr lymphatic nodes go all the way up the back of your brain and into your sinuses. We'd been ripping them out and throwing them away every time we did autopsies or dissections because they were attached to the inside of the skull. Oops.
I'm not a doctor or neuroscientist, but this strikes me as a significant find if I'm understanding it correctly, right? "We were pretty sure the lymphatic system doesn't directly connect to the brain. Well we were wrong, (points) there it is."
We've known that there had to be a brain/immune connection of some sort. We didn't know that there was a tube.
Remember that most of the interesting stuff in biology is invisible to the naked eye. Also, despite a few hundred years of poking around in corpses, we're still pretty crude in terms of what we can see and understand anatomically. The assumption that we have this stuff "mostly figured out" strikes me more as wishful thinking than fact.
It's interesting to find a new tube lurking around, but then, it sounds like a pretty small tube. Animals are messy on the inside. Also, dark.
Loved this comment as you did a great job of distilling the level of wonder that still remains to be discovered.
While I'm not in any way qualified to assess this, it seems the fact that there's essentially a new piece of human anatomy that we've discovered is game changing. Potentially on the level of things that cause entire fields of medicine to re-evaluate what they thought they knew.
I wonder what this means for other things we've taken for granted about neurochemistry. Any qualified individuals care to speculate on the possibilities?
Very likely I will get downvotes for this but: I suspect we will find there was far less quackery in some of the eastern medicine practices than we thought.
How does the discovery that one culture's beliefs about medicine were less accurate than expected, make you think that a different culture's beliefs are more accurate? It's not like eastern and western medicine are binary opposites, where if one is wrong the other must be right. Especially since this inaccuracy was only discovered through careful dissection and observation: what comparable practices did historical eastern medicine use, that should make it any more accurate than the equivalent old western superstitions? If "western" medicine has missed this detail up until now, I highly doubt that "eastern" medicine somehow accounted for it.
Western medicine and science is often very dismissive of things that you can't observe and measure. Positive thinking for example. It is well known that negative thinking in the form of stress can have negative physiological effects. Yet there is little research into finding out if positive thinking can have a positive effect. And surprisingly little research into the placebo effect, considering that it can be as effective as prescribed drugs for some situations.
The downvotes likely are as a result of using the word "quackery," but I think the general sentiment of your post is relevant.
The issue I've had with Eastern medicine along with other folk remedies is the methodology and fact that they are not truly applying the scientific method in the way Western medicine does.
That said, I would not at all be surprised to find that many things in medicine, Eastern, Western, folk medicine, etc. that were previously unproven (by Western medicine standards) suddenly start having testable, verifiable reasons for why they work.
I don't know... Science does not discard what cannot be explained. a lot of western medicine is also based on empirical knowledge that was understood only later.
I have read that some points of acupuncture have been shown to have the effect they claim, and how it works can be explained. Some other points have been shown to have no measurable effect. And some point have been shown to have effects, but cannot be explained.
I assume your parent commenter is referring to the general concept of 'qi', and its manipulation in practices such as Qigong. If there really does exist a direct linkage between the brain and the immune system, the idea that through focused effort we can in fact change qualities of our health becomes much less radical. These ideas have already been partially validated in the multitude of studies showing the positive effects of mindfulness practice/meditation.
Exactly this. While the concepts had no reasonable explanation of "how" they work given our present understanding of biology, that does not mean there wasn't a real mechanism at play here. Heck, this exact linkage could entirely explain the placebo effect, couldn't it?
> If there really does exist a direct linkage between the brain and the immune system
The interaction of the CNS and the immune system has been more recently studied over the past 10 years. This field is known as neuroimmunology. The most recent and obvious clinical application of neuroimmunology are vagal nerve implants, where stimulation of the vagus nerve can help improve vagal tone and reduce inflammation. Meditation is another well known method of improving vagal tone; however, we live in a society of quick fixes.
Not being overly familiar with the depth of research around Eastern concepts like 'qi,' can you share any insights around the depth of Western medical research that have attempted to explain it under more measurable standards?
I'd be shocked if a concept so widely believed in like that had not gone under insane scrutiny by Western practitioners.
'Qi', or more accurately 氣 (traditional) or 气 (simplified) dates way back to very early Chinese history and is not exclusively used in the medical or health fields.
In later and current periods of Chinese history it's usually considered to mean air or breath, but also vital energy or life force, this latter sense being the sense in which it is deployed for traditional medicinal techniques such as 'Qigong' - 氣功 （traditional) or 气功 (simplified) - which is literally '[getting positive results from] [the energy]'. However, not many people are aware that initially it was used to refer to 'sickening vapors that rise from a corpse' (an early concept for bacterial/airborne illness, a concept later repurposed in premodern Chinese medicinal thinking to describe the acquisition of malaria and similar illnesses in tropical areas).
Qi today is basically a catch-all word for energy flowing (possibly 'in a manner roughly like vapor') and could be reasonably roughly seen, from a medical perspective, to refer to the combined effect of circulatory, lymphatic and respiratory systems.
Being such a vague term, approaching it from a western perspective seems difficult. You would perhaps get further looking for western studies of the health benefits of Qigong practice.
In Vagina: An Autobiography, Naomi Wolf explains how the clitoris wasn't fully mapped out until (IIRC) the 70's. There is a lot of internal structure that was missed for a long time... I find it amazing that this could have happened, and it doesn't surprise me that there are still important features of human anatomy to be discovered.
BTW, I don't think I agree with everything she writes, but It's a really interesting book.
Heh. If you want to be cynical about it, pretty much anything anyone has a grant to research is a known unknown. We don't give money to people to look for unknown unknowns; those happen accidentally while looking for the known unknowns.
CRISPR would be an example of something that we really didn't know about popping out of research into other questions. Those kinds of discoveries are the really interesting ones, IMO: you aren't even looking for it, and suddenly, you've discovered a pathway that changes your understanding of bacterial genomics, and provides a crazy new tool for molecular biology.
I don't know if the authors of this set out to find a lymphatic duct connecting to the brain, but the existence of one was not completely unpredictable.
Sorry if I came out as cynical, that wasn't my intention. I'm genuinely interested in knowing if there any other big mysteries to solve, like this one or the neurons found in the gastrointestinal system.
You didn't. I was the one being a little cynical -- there's obviously more "known unknowns" in the world of science than those that get funding, and science does occasionally go after blue-sky research. ;-)
I'm not a doctor or neuroscientist either, but from what I gather it is indeed significant.
It potentially makes the link between the brain and the body chemically study-able. Up to now there's always been the assumption of a brain/blood barrier stopping much of the chemical transfers. Now it appears there's a mechanism that might bypass that.
Again, this is just what I gather from reading. I have no special expertise.
So I have MS. I go to any link that has to do with the Immune system. Recently I see tons of "discoveries" and attempts to link it to MS. Which gets me excited but than I start to think how much of this is truth and how much is bullshit? Or that MS and others like it are so complex that all of the findings are true... Either way starting to have a hard time finding hope in any of these articles.
I think we are just beginning to scratch the surface of the link between our immune systems and things like MS. I think the fact that we have so much coming to light bodes well. I do think much of it is overstated; but that there is so much activity makes me think we'll start seeing real progress.
In case you didn't see it earlier (a week or two ago, perhaps in a comment somewhere?) http://www.nih.gov/researchmatters/january2015/01122015reset... Apparently reseting the immune system can halt MS to a certain degree. And that's what I think our real progress will be: by degrees, because those things are complex.
One reason why researchers inappropriately link their findings to a disease is because grant agencies don't really fund basic research anymore. So if you want to do basic research, you just think of the most relevant disease and spin the impact of your results when reporting back to the grant agency and to the press. The actual paper won't actual make any grand claims, except something at the end of the discussion that's like "oh and this will let us figure out MS."
The problem is that basic research really is crucial to understanding many diseases, but you can't get it funded because it's not sexy enough (or really, because funding has been cut so much in most countries). So on one hand, the claims that you see are definitely blown out of proportion, but it doesn't mean that something useful wasn't learned. You'd have to read the paper to really know.
I risk getting downvoted for this, but have you tried any dietary changes? There are cases of people with MS who have seen tremendous improvement on a low histamine or paleo style diet. There are no guarantees, of course, but what do you have to lose? I would think it would be worth the inconvenience of trying it out for a few months even if the odds of success are very small.
"I risk getting downvoted for this, but have you tried any dietary changes?"
Because you should be downvoted for this.
People who have long-standing health conditions, that they have perhaps battled their whole lives, don't need people on the Internet arm-chair quarterbacking their treatment. They have medical professionals that they've worked with for years and trust, they have almost certainly done more research than you or I about their condition, and they have heard the latest fad cure-all from everyone, everyday, for years. They get it on their facebook wall, they get it from well-meaning (but poorly informed) friends and family, and they get it from strangers on the Internet.
Don't be that stranger on the Internet. Your intentions are positive and laudable, your actions are not.
In short: Unless someone has asked for advice about treatment options for their chronic condition, it is probably impolite to offer it.
Source: Conversations with friends with MS, CP, disabilities, autism spectrum disorders, and various trainings in how to provide safer spaces for people with a variety of conditions.
I have a health condition that is just as serious as MS (and is similar to MS in some ways). None of my doctors (over a 20 year period) ever suggested that I change my diet, but for me, changing my diet is the closest thing to a treatment that I will ever see. I WISH that somebody had suggested that I change my diet, because if I had done it years ago, I might not have progressed as far as I have. So I'm sorry if the guy I responded to has had tons of people suggest to him that he should change his diet, but for me, it was the opposite. No one suggested it. I tried it on my own, out of desperation and despite my doctors poo-pooing the idea. And it worked. I guess I got lucky, but there are lots of stories just like mine.
The fact is that doctors are often NOT that helpful for people with complicated neurological conditions (no one knows this better than I do!), so some of us are left to fend for ourselves. Given that that's the case, I don't see what's so terrible about asking someone whether they have tried a treatment that some people have found to be effective. My perspective is that an elimination diet is worth a try for anyone with an autoimmune or difficult-to-diagnose neurological condition. That opinion is based on a lot more knowledge and personal experience than you have assumed it is, but it's true that I didn't make that clear in my comment.
The only reason I even responded to MyBunny was that he said that he was having "a hard time finding hope." I thought that if there was even a sliver of a chance that my suggestion could help him find hope, then it was worth getting downvoted to oblivion. But if my voice is merely one of a chorus that have suggested the same worthless idea to him, then for that I am sorry.
Ultimately, I do see your point, and thank you for your perspective, but I don't think that I can entirely agree with you.
Apologies for making assumptions about where you were coming from. I may have gotten a bit preachy and reactionary. We're both obviously coming from a place of wanting to be helpful.
Though I still think the advice to only offer treatment suggestions when asked is always sound. The Internet seems to exacerbate the problem of overwhelming amounts of unsolicited advice, which can breed its own sort of despair.
From my experiences in a hospital I've seen doctors that can hardly spend any time with a patient and it's really up to the patient and their advocate to look out for themselves.
Thank you so much for this.
I have a chronic condition and I assure you that discussing it is the least exciting thing possible for me, and for the last 7 years the doctors and I have tried every damn thing at least twice. Everybody tries to help with concerned advice, but they don't get the pain of discussing the paleo diet for the 300th time (which didn't help the 3 times I tried it).
I don't think there is a problem suggesting changing diet in addition to "proper" medical treatment. Its when people are encouraged to use it in place of other treatments it becomes a problem.
Research into ketogenic diets is pretty new, (and as far as I am aware, has been shown to have positive effects on neurodegenerative diseases in rat studies). There is a possibility that it may help.
My opinion about offering unsolicited treatment advice has nothing to do with whether the suggested treatment is effective or not. My suggestion to not offer treatment advice to people with chronic conditions comes from a recognition that most people with chronic conditions receive exhausting amounts of advice from folks every day, and it is often not what they want to talk about, but politeness dictates they not simply say, "stop talking, you're not helping".
Certainly there may be gems of valuable input that may come from strangers on the internet, but with no other signals indicating quality, it is just more noise in an already complicated topic.
Again: In conversations with someone who has a chronic condition, unless the person has asked for advice (in some way) about their treatment, it is generally rude to offer your thoughts on the matter. Just as I wouldn't suggest you go on a diet if I think you're a little overweight or that I think you should be on antipsychotic drugs because I saw you get angry one time, your knowledge of a strangers situation is too low to be helpful. And, they hear it all the time, and most of the time the advice they get is bullshit.
MS responds very well to a whole range of therapies that have no proven disease modifying abilities. It is an almost perfect disease for a methodology to claim success on. The Relapsing Remitting course is variable, so people with the condition are likely to seek new treatment during worse periods, and thereafter regress to the mean. The knock on effects of the lesions in brain and spine can often be self-limiting (tiredness, pain, lack of coordination, mood changes, diminished vision), so are very conducive to placebo effects. MS can in some patients plateau and relapse rates drop off or cease (not often, but sometimes), so it is perfect for testimonials of dramatic benefits, if you don't systematically count the failures.
If you check out just about any 'alternate' modality, you'll have a very good chance of finding it claims high success on MS. In comparison, most modalities don't tend to claim success rates on amputations. Though both involve the destruction of tissues.
It's a great case study in science based medicine.
"what do you have to lose?" - in general time, often money, and a demonstrated reduced likelihood of pursuing scientifically valid treatments. The more claims of beneficial treatments adding to therapeutic noise, the harder it is for individuals to assess treatments properly. On aggregate, we're worse off for the claims of well meaning (and hucksterish) folks.
"it would be worth the inconvenience of trying it out for a few months even if the odds of success are very small." - isn't that the sales pitch of every snake oil salesman or true believer?
FWIW: I have PPMS, and I've heard literally hundreds of claims, ranging from many different (and contradictory) diets, through 'eastern medicine' to revival prayer meetings. The details of the method change, but the structure of the claims, and the way they use evidence, are remarkably similar.
> In comparison, most modalities don't tend to claim success rates on amputations. Though both involve the destruction of tissues.
That comparison deliberately wipes out the actual differences between immune disease and amputation which give rise to the idea that the immune system can be affected by diet in ways amputation cannot. If you want to be scientific, use reason.
> "it would be worth the inconvenience of trying it out for a few months even if the odds of success are very small." - isn't that the sales pitch of every snake oil salesman or true believer?
That is an invalid answer to that pitch. There are many times that pitch is completely valid, too; when a small inconvenience is worth trying even if the odds of success are very small (such as this article's study itself!).
I still can't understand why there's so much anti-reason surrounding "defense" of "science-based" medicine. If it's an overreaction to quackery, then it's an ineffective one.
I actually have changed my diet and take drugs that help prevent more events. Additionally its really hard to track the progression since you can have an event (damage) without actually knowing (mild issues). However the damage is there and IMO is what produce the most day to day trouble. Tricking your brain into thinking your feet are on fire or your arm is weak weird shit like that. When I finally got MRI they found 7+ lesions in the brain and spine. For me to be honest most days I'm ok but it really sucks take these crazy expensive drugs every day. It's a very expensive disease that produces lasting damage even if a cure is to found.
I'm sorry. I have a different condition that has responded to dietary changes, which is why I mentioned it, but I realize that I may just be very lucky in that regard. I wish you well.
For what it's worth (and perhaps it's worth nothing), I also experience the burning feet feeling that you describe, although it's usually just a tingle. My arm also goes numb sometimes. My neurologist says that I am having silent migraines, which is a type of migraine consisting of just the aura with little or no head pain.
For me, these silent migraines seem to occur after I eat a meal high in histamine. (A salad with balsamic vinegar produces a reliable, strong effect within a few hours.) There is some recent research coming out of Europe that suggests that histamine intolerance is very real, but doctors and researchers in the US haven't caught up to this yet.
On the bullshit side column, what's your view on Naltrexone? I take it for Crohn's and it has helped me a lot and know of many MS patients who have benefited from it too.
> The vessels were detected after Louveau developed a method to mount a mouse’s meninges – the membranes covering the brain – on a single slide so that they could be examined as a whole. “It was fairly easy, actually,” he said. “There was one trick: We fixed the meninges within the skullcap, so that the tissue is secured in its physiological condition, and then we dissected it."
Can someone explain what it means to fix the meninges to the skullcap? Do they mean they attached it to the skull bone? How then do they mount a curved bone to a slide?
They're referring to fixation [0], or preservation of the tissue, and not to affixation, the attachment of something.
So, basically, they fixed the tissue prior to removing it from the skull, causing it to keep form. Whereas, if they removed the tissue from the skull and then chemically fixed it, the tissue would have already lost form and the lymph would be undetectable (no longer be in original form).
Think about a cake in a pan. Baking = fixing. Remove the cake before "fixing" it, and it's a plot of mess. "Fix" it first, and you have a free-standing cake, it'll hold shape. Bad analogy, sorry. :)
I totally understand the feeling, but on the other hand, it's incredible that there is so much to explore, so many new things to learn, see and experience. Yes, everything around seems to be pretty complex, at least considering our current abilities [0], but I believe that we can choose how we look at the world/problems - pragmatic optimism may help with feeling overwhelmed :).
[0] Sometimes I think that the perceived complexity of the universe says more about the mind than the universe itself.
Awesome finding, I hope it is confirmed soon. Many neurodegenerative diseases are known to involve an immune component, but how that might occur has been a mystery.
It has very significant implications for diseases such as Alzheimer's disease, Lou Gehrig's disease (aka Amyotrophic lateral sclerosis, ALS), multiple sclerosis, Parkinson's disease, etc.
> "treatment of neurological diseases ranging from autism to Alzheimer’s"
It upsets me that the author keep referring autism as a disease. A high functioning autistic would be very offended if you say that their way of thinking is a disease.
Note to the downvoters: A developmental range of disorders is not a disease. If you don't agree you are invited to comment.
"Disease" is commonly used as a catch-all word for any malfunctioning of the body, including of the brain. For example if you click the medical definition (3rd bullet) on this page:
>"The term disorder is often considered more value-neutral and less stigmatizing than the terms disease or illness, and therefore is a preferred terminology in some circumstances"
Also, regarding mental disorders the link says:
"In mental health, the term mental disorder is used as a way of acknowledging the complex interaction of biological, social, and psychological factors in psychiatric conditions."
And the wikipedia entry even touch the point I was referring to:
"On the other hand, by emphasizing the medical nature of the condition, this term (disease) is sometimes rejected, such as by proponents of the autism rights movement."
Finally the link starts the section with this phrase:
"In many cases, terms such as disease, disorder, morbidity and illness are used interchangeably.[3] ##There are situations however when specific terms are considered preferable.##"
(emphasis is mine)
I am thinking this may be the reason vaccines appeared to cause autism. Of course, this is not a reason not to vaccinate, but the point of vaccines is to invoke the immune system.
Thanks to the HN comments which assured that it is important. Otherwise after reading the first sentence and processing it with standard sensational filtering regex of my brain, I wouldn't have proceeded forward.
"In a [stunning|amazing] discovery that overturns [years|decades|centuries] of [textbook teaching|beliefs|research] [researchers|scientists] at the <XYZ Lab> have discovered that the <PQR premise> holds false."
Pointless weekend project idea: A service that scans articles for matching regexes to classify the level of bullshit of what you are reading. It could even be a browser extension with the bullshit indicator automatically shown for each page in its icon.
This just requires some NLP to identify obvious hyperbole. In fact, you could probably just watch HN for long enough, establish some training data and have this happen somewhat automatically for you in the browser.
Ran it on this(http://www.naturalnews.com/049944_vegetable_oil_omega-3_pest...) NN article and it's still processing 20 minutes later. I'd like to think it's breaking whatever scale is being applied to it, but it's most likely the connection speed in my office. :P
Lymphatic tracing is generally more often done with dyes in the case of removal of sentinal nodes due to e.g. cancers.
However, there been work in injecting radioimmunoagent tracers into lymphatics especially in the case of melanomas. The likely reason why these haven't before detected these meningeal lymphatic vessels is likely because: (1) We don't bother imaging the brain because "the brain doesn't have lymphatics" and (2) tracers generally flow with the direction of fluid and the direction of lympth from the CNS is likely efferent rather than afferent.
Furthermore it is difficult these days to do such experiments especially on live subjects "just because".
Indeed! Though mouse anatomy doesn't entirely transfer over to human anatomy. I interpreted your comment to refer to experimentation in humans, I apologise if I misunderstood.
You seem to be surprised that our current knowledge of basic human anatomy is not yet exhaustive. Two recent notable discoveries are:
* Anterolateral ligament (Ligament of the knee, discovered 2013 after macroscopic examination of cadavers)
* Dua's layer (Newly discovered layer of the cornea, discovered in 2013 using electron microscopy)
You may also be surprised about the amount of variation in anatomy found between people. Some structures (commonly muscles) do not exist in some people, or may exist on only one side of the body. Similarly vessels and nerves can sometimes also take alternative or strange courses. This has clinical implications, especially wrt surgery.
Well ... it's great that finally the physiological structures of this connection are unveiled, but it's been known for a long time that you can measurably positively affect your immune system by means of meditation which is a mental process.
Self-promotion is suspect in this highly competitive, and not infrequently nasty field. It was known that there was some transport mechanism--now there are details. But I would caution some skepticism, especially when the discoverer trumpets the extraordinary significance of the discovery.
Downvoters can take a warm piss on a power line. The researchers are quoted asserting the profound significance of their discovery. This is reason to be skeptical, given the field has a reputation for Nobel prize winners rushing to publish work they hear about from less well known researchers, and then claiming the less known researcher stole their ideas from them.
I wonder if I will be alive if they ever figure out how the Placebo Effect works? With discoveries like this--maybe? I always used the Placebo Effect as the existence of a God. I will probally be proved wrong by science, if God decides to give me a few years? (Yes, I have faith. I am probably delusional? It helps me get through the day. I don't want to offend atheists? So, please don't hammer me.)
There's no particular reason to believe that the placebo effect is nonphysical other than the fact that we don't know exactly how it works. Lots of things fall into that category.
You can ascribe God to dark matter and placebo effects, but you just have a God of the Gaps.
If you really cared about the placebo effect, you would be reading papers on it and its mechanism. The placebo effect is not that mysterious: many instances can be traced to specifics like confirmation bias, genetics (particularly COMT variants), regression to the mean, etc.
The placebo effect is not that mysterious, and doesn't need religion to make sense. Opioids and neurotransmitters such as dopamine play a large part. The neurological and psychosomatic mechanisms have not been all figured out, but the solutions are not found in superstition.
I think I see what you mean and was looking for question like this, which is:
Does it mean that brain can control your immune system?
I don't think so. It looks like immune system protects your brain though. Also I am not medical scientist and it would be nice to hear others opinions.
I am not a believer, but until science comes up with a better explanation of where the universe came from, I am not going to bash anyone else's religion.
(The creationist part is pretty suspect to me though).
http://www.nature.com/nature/journal/vaop/ncurrent/full/natu...