Anti-Inflammatory Strategies–Achieving Homeostasis
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Alzheimer’s and IVIG Rx
Last week John Gever, Senior Editor, MedPage Today brought attention to the results of a small study presented at the 2012 Alzheimer’s Association International Conference held in Vancouver, British Columbia.  In this study, patients with mild to moderate Alzheimer’s were given antibody preparations, immunoglobulin preparations, which were obtained by pooling plasma from numerous blood donors.  This sterile, medical product, IVIG, intravenous immunoglobulin, consists mostly of immunoglobulins, antibodies,  and is administered intravenously (IV). 

After receiving IVIG twice a month for three years, patient’s ‘ ability to function or think, their mood, or memory did not worsen over the three years. [Untreated Alzheimer’s disease patients typically show measurable declines in 3 to 6 months.]

The FDA, The U.S. Food and Drug Administration, has approved the use of IVIG for only six conditions.  However, it has been used “off-label”, to try and treat about 50 other conditions, including infectious diseases, a wide-range of autoimmune conditions, organ transplant and cancer patients, blood, and neurological conditions to mention a few.

When practitioners are asked how s/he thinks IVIG works, the response is typically, except for infectious diseases, “we are not sure”.

 IVIG Contains Immunoglobulins and Smaller Immune Factors
IVIG contains antibodies to organisms such as streptococcus, hepatitis, measles, polio, etc., that can specifically neutralize infectious agents.  Other immunoglobulins may be directed  against specific immunological factors. 

However, viewing reported results in chronically ill populations, I have always been of the opinion that IVIG also contains cytokines, or cytokine-like immune molecules, with potent immune system-modulating properties, which help the body return to immune homeostasis, immune balance. 

 I suggest that the reason that Alzheimer’s patients receiving IVIG saw a stabilization of their symptoms, is that IVIG limited inflammatory responses and thus slowed the progression of disease.

 Alzheimer’s and Inflammatory Cytokine Levels
This supposition is further supported by the fact that animal models suggest that excessive production of inflammatory cytokines, inflammatory messages, are implicated in Alzheimer’s disease. These animals have a condition similar to human Alzheimer’s, and also have higher levels of inflammatory cytokines in their blood.  When a drug was administered that inhibited the cytokines, there was less damage to nerve cells and neurological outcomes in the animals improved.  

 The scientists suggest that blocking production of high amounts of inflammatory cytokines may be beneficial for any number of brain conditions, such as “Alzheimer’s and Parkinson’s disease, multiple sclerosis (MS), motor neurone disease, frontotemporal dementia, and complications from traumatic brain injury.” (1)

 Immune Homeostasis, Immune Balance the Key to Health
Thus improvements, or at least delay in the onset of Alzheimer’s, or other brain –associated conditions, may be associated with the body achieving immune homeostasis.  A body in inflammatory balance controls the immune system’s  inappropriate inflammatory responses which otherwise may lead to damage of bystander tissues.

Feel free to contact Dr. Hellen at DrHellen@DrHellenGreenblatt.info with questions or to consult with her. A message may also be left at: 1.302-265.3870 or click on: http://drhellengreenblatt.info/contact-dr-hellen/.

 


www.medpagetoday.com/MeetingCoverage/AAIC/33780
http://emedicine.medscape.com/article/210367-overview#aw2aab6b3
www.alz.org/aaic/tues_1030amct_ivig_trial.asp
www.jneurosci.org/content/32/30/10201.abstract?sid=349221d1-e12f-411a-80a6-80285ed5db54
www.ncbi.nlm.nih.gov/pubmed/22806462

A previous posting (1) discussed the relationship between obstructive sleep apnea and inflammation. Evidence was presented, that levels and types of inflammatory cytokines, as well as other blood markers, are different for individuals suffering with sleep apnea as compared to controls.

Steven Park,MD, a renowned sleep apnea expert in NYC, has discussed the contribution of inflammation to sleep apnea and vice versa (2).

Arthritis, Sleep Apnea, and Inflammation
Recently Dr. Park discussed a Mayo Clinic study in which 50% of rheumatoid arthritis patients were diagnosed with sleep apnea, compared to 31% of the rest of the population. Rheumatoid arthritis is a disease of runaway inflammation affecting the joints. (Older individuals are also at greater risk of sleep apnea, and they trend towards higher levels of inflammation.)

Cancer, Sleep Apnea, and Inflammation
Dr. Park has also mentioned a study concluding that sleep issues are associated with a heightened risk of cancer. Moreover, it is known that there is substantial “cross-talk” between cancerous cells and inflammatory immune cells. Cancer patients experiencing high levels of inflammation, have reduced survival rates. Clinicians have suggested that decreasing levels of inflammation in cancer patients may improve their prognoses.

Obesity, Sleep Apnea, Asthma, and Inflammation
As Dr. Park and others have pointed out, there is a strong association between obstructive sleep apnea and obesity. Fat cells, adipocytes, not only serve as fat depots, but also produce cytokines, immune messages, that up regulate or increase, inflammatory responses.

Obesity is also associated with a higher rate and severity of asthma. Overweight individuals with asthma have increased levels of TNF-apha, an “inflammatory” cytokine than healthy controls.

Obstructive Sleep Apnea Symptoms May be Reduced by Physical Activity
One of the most important steps one can take to lower inflammation, besides controlling weight, and eating a healthy diet, is consistent exercise.

This concept is supported by a recent study from Brazil suggesting that physical exercise affects the cytokine makeup of obstructive sleep apnea patients and may reduce inflammation and symptoms of their disease.

Immune Homeostasis, Immune Balance
The key to excellent health, and healthy aging, is to achieve immune homeostasis, immune balance. The immune system needs to produce enough inflammation to meet healing and infectious disease challenges, but it must be a “controlled” burn, so as not to damage innocent, by-stander cells and tissues.

Lifestyle changes are some of the simplest ways to correct immune imbalances and should be considered as part of anyone’s “preventive and treatment” protocol.

www.jrheum.org/content/36/9/1869.short
www.ncbi.nlm.nih.gov/pubmed/22758643
www.ncbi.nlm.nih.gov/pubmed/22377793
www.ncbi.nlm.nih.gov/pubmed/22610391
www.ncbi.nlm.nih.gov/pubmed/21339327
www.ncbi.nlm.nih.gov/pubmed/22720220
www.ncbi.nlm.nih.gov/pubmed/22751736
www.ncbi.nlm.nih.gov/pubmed/22773729
http://drhellengreenblatt.info/2012/02/inflammation-cancer-chemotherapy-and-brain-fog/

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