Summary
Section 11


Dr. Charles R. Sachatello, a retired physician, announced today that he has published the single most comprehensive theory ever developed attempting to identify the inciting cause(s) and the reasons for the progressive course of neurodegenerative diseases, namely Alzheimer’s , Amyotrophic Lateral Sclerosis (ALS) ,Primary Dementias, (Non-Vascular Senile Dementias), Parkinson’s and age related macular degeneration and any or all other forms of degenerative brain diseases currently without an established proximate cause

This multi year effort prompted Sachatello to propose that most forms of degenerative brain diseases cited previously have a common cause: Neurotoxins generated in each patient’s own liver.

Hepatic generated neurotoxins most likely derive from the inability of the patient’s own liver to completely metabolize a variety of common substrates including intact native protein complexes it encounters during the daily routine metabolic processes necessary to sustain life. The great majority of these incompletely metabolized substrates are innocuous. Others could well have varying degrees of neurotoxicity. Specific neurotoxins will vary in the strength of their neurotoxicity, the quantity produced, their chemical composition, and spatial configuration and structure accounting for the variety of observable clinical manifestations.

Sachatello is acutely aware of the heretical nature of many of these currently preposterous ideas to the point that many can justifiably question his sanity. Nevertheless the basic premise of the Liver-Brain-Theory is easily testable. The logical conclusion of this heretical theory is simple and straight forward.

A liver transplant (replacement) may very well arrest the further production of the specific hepatic generated neurotoxins leading to ALS resulting in a dramatic decrease in any further loss of muscle strength typically seen in patients with ALS resulting in a near normal life expectancy for these ALS afflicted patients

A liver transplant will not be able to restore previously lost muscle strength or strengthen atrophied muscles in an ALS patient. A liver replacement should have minimal effect in altering the extent of memory loss in Alzheimer’s and Primary Dementia because of the extended prodromal course of degenerative brain diseases.

If only a single patient with ALS is confirmed to have documented cessation of additional muscle loss following a liver transplant, the basic premise of the Liver-Brain-Theory will have been validated: “Hepatic generated neurotoxins are the proximate cause(s) of ALS”.

Confirmation of this theory should encourage others to concentrate on isolating and identifying the exact chemical composition and structural configuration of these hepatic generated neurotoxin(s). A secondary corollary of the Liver-Brain-Theory is that nearly identical neurotoxins will be found to be the proximate cause(s) of most other forms degenerative brain diseases.

Once the specific neurotoxin(s) causing ALS are identified with absolute certainty, worldwide attention must be directed to finding the nearly identical hepatic generated neurotoxins that Sachatello predicts will be confirmed to be the proximate cause of Alzheimer’s. All subsequent research efforts should focus on studies of the spinal fluid, hepatocytes, glial cell cultures and brains of recently deceased patients with Alzheimer’s attempting to isolate and identify the specific Alzheimer neurotoxin(s).

This theory also predicts that it should be relatively easy to synthesize protein blocking or neutralizing agents which will be able to minimize or eliminate the neurotoxic effects of hepatic generated neurotoxins without the necessity of a liver replacement in the near future. Similar blocking agents should be able to prevent further symptomatic progression of most other forms of degenerative brain diseases.

***

(via email)
"January 5, 2016
Dr. Charles Sachatello

Dear Charles:

I always enjoy hearing from you and especially reports about your liver-brain-theory. As you have emphasized, the ultimate test of the hypothesis would be liver replacement.

Thus, it would be very difficult, particularly in today’s climate to justify liver transplantation for the indication of ALS. Be that as it may, I continue to watch your initiatives with lively interest.


With best regards,

Thomas E. Starzl, M.D., Ph.D.
Professor of Surgery
Starzl Transplant Institute
University of Pittsburgh, Pittsburgh, PA"


In view of the late Dr. Starzl’s opinion, that “it would be difficult, particularly in today’s climate to justify liver transplantation for the indication of ALS”, the author of this theory proposes an interim non invasive technique:” Repetitive Plasmapheresis”.

Repetitive Plasmapheresis has to potential to mimic a liver transplant with respect to neurodegenerative diseases on a short term basis by reducing the quantity of circulating neurotoxins, which I postulate to exist, as evidenced by a marked and measurable reduction in the rate of muscle loss and corresponding loss of muscle strength as evidenced by prolonging the life of patients afflicted with ALS.

Only a liver replacement will permanently arrest the production of additional hepatic generated neurotoxins until specific blocking agents can be discovered and manufactured.

9/25/2016, Revised 5/7/2017, 6/10/2017, 8/1/2017, 10/22/2017, 11/14/2017

CRS MD FACS

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