Anti-Inflammatory/Anti-Aging Strategies
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What is the Role of Inflammation?
When the body is injured or recognizes the presence of pathogens such as bacteria, viruses, molds, parasites or cancerous cells, its immune system is triggered to respond with inflammation to “burn” the threat out of the body.

Balance is Essential
Once the challenge has been met, a person in immune balance, homeostasis, will reduce the amount of inflammation that they are producing to “normal” levels. Uncontrolled, run-away  inflammation leads to autoimmune diseases (against oneself) in which its own tissues and organs are attacked.

Lupus
Systemic lupus erythematosus (SLE), lupus, is a complicated autoimmune condition affecting virtually every organ in the human body. Because of the wide-range of symptoms experienced, the disease is often difficult to diagnose. Common symptoms are extreme fatigue, swollen and/or painful joints, muscle pain, low-grade fever, thinning or loss of hair, butter-fly shaped rash across the nose and cheeks, chest pain when taking a deep breath, kidney and heart problems.

Butterfly rash

“Butterfly Rash” often associated with SLE
(
emedicine.medscape.com)

 

Females make up 80-90% of people with lupus and despite treatment, many individuals will experience flares and remissions (symptoms come and go) their entire lives.

Lupus and Inflammation
The hallmark of lupus is over-activity of the immune system and inflammation. Imbalances of inflammatory immune factors, cytokines, are significantly higher in lupus patients compared to people without lupus. These immune molecules promote inflammation and damage tissues.  High levels of these inflammatory factors are associated with the severity of disease but decrease as individuals are successfully treated.

Anti-malaria medications originally used to prevent or treat malaria has been used to treat lupus.It was not understood why these medicines were somewhat effective against SLE, but a recent study suggests that these medications inhibit inflammation.

Physical Activity
Every time a muscle contracts, it releases anti-inflammatory molecules that helps the body balance the amount of overall inflammation produced.

As would be predicted, weekly physical activity improves fatigue, depression and increases the quality of life of most individuals. Even moderate exercise, 3 days a week for 20 minutes, has been shown to make a major difference in the amount of energy and feelings of well-being experienced by lupus patients.

If  You Have Lupus
Frequent physical activity, eating in a healthful manner and daily consumption of an excellent immune balancing supplement helps the body control inflammation and achieve immune homeostasis (immune balance).

Dr.Hellen is passionate about helping people enjoy life at its fullest. She may be contacted by using this form, contacting her at: drhellen@drhellengreenblatt.info or feel free to call her at:  302.265.3870 (ET, USA).
www.niams.nih.gov/health_info/lupus/lupus_ff.asp
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The second leading cause of death for people under the age of 44 years is suicide. Overall, it is the the tenth leading cause of death in the United States, with veterans comprising 22.2% of this statistic.  Women are three times more likely to attempt suicide, but for every woman who takes her own life, four men will die from their attempt.

Although older adults make up only 12% of the population in the States, they account for 18% of all suicides. These fatal events in the elderly are probably under-reported by 40% with “silent suicides”, dehydration, “accidents”, medication over doses, etc. ending in death.  Additionally, double suicides involving spouses or partners occur most frequently in this population. Since the elderly are the fastest growing segment of the population, these later-life deaths are predicted to result in suicide becoming a major public health issue in the too-near future.

Inflammation and Suicide

C-reactive protein (CRP) is associated with high levels of inflammation found in people with inflammatory disorders, burn and trauma victims, in obese individuals, in people with infections or with cardiovascular disease. People with suicidal thoughts (known as suicidal ideation) or attempts, also exhibit high levels of C-reactive protein compared to people without such behaviors.

Inflammatory factors are triggered during stress and are associated with depression.

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When compared to patients being treated for psychiatric disorders who are not suicidal, individuals who have contemplated or attempted suicide have increased levels of inflammatory cytokines, immune cell molecules in their blood and/or brain.

The ratio of inflammatory molecules to anti-inflammatory molecules in the body either promotes inflammation or limits it.  A healthy immune system constantly strives to maintain these factors in a delicate balance, in immune homeostasis. 

Importance of Balancing Immune Factors

Imbalances in immune regulators are harmful and lead to disease. Taking the following steps should make a major difference in helping the body and mind return to homeostasis, to its natural, healthy balance:

  • Engage in physical activity at least 30 minutes a day 5 days/week.
  • Add one or more daily servings of a superior immune support supplement to your diet.
  • Maintain a healthy weight.
  • Eat a wide variety of colorful fruits and vegetables.
  • Spend some time outdoors.

For decades I have helped people enhance their quality of life.  I can be contacted at: DrHellen@DrHellenGreenblatt.info, use this form or give me a call at 302.265.3870 (ET USA) and let us talk. Your first 30 minutes are on me!  You’ve tried everyone and everything else, let me help you feel good again, you deserve it!

 
afsp.org/wp-content/uploads/2016/06/2016-National-Facts-Figures.pdf

www.sciencedirect.com/science/article/pii/S1043466615300090

www.ncbi.nlm.nih.gov/pubmed/28211584

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www.ncbi.nlm.nih.gov/pubmed/27824355

www.biologicalpsychiatryjournal.com/article/S0006-3223(14)00794-X/fulltext

Last week I talked with a young local Asian-American business owner who shared with me that he was “a little fatigued and stressed out”. I suggested that if he took steps to getting his immune system in balance, that since our physical and emotional well-being is dependent on homeostasis, he would feel much better.

He basically replied that, “he spends half the year in Florida, has a lot of friends that are “into” nutrition, he exercises and that he didn’t need any more information, thank you”.

Nothing like a person with an open mind, but unfortunately too many people think in this narrow way.  We all know individuals that eat nutritiously, exercise 5-7 days a week and watch their weight but they still do feel “off”.  Their fingers, elbows or knees hurt, they can’t eat everything they would like, or they have other health issues despite their “great” life style.

Nutritional Recommendations:

The evidence is strong that due to the hundreds of phytonutrients, plant nutrients, in fruits, vegetables, nuts, beans, whole grains and olive oil, that plant-based foods are important for our health. A broad variety of these phytonutrients are suggested since they appear to affect a wide-spectrum of biological functions. The consumption of plant-based foods influences the health of cells, blood pressure, risk of certain cancers, immune, dental, urinary, liver and gut health.

An additional dietary recommendation is to consume fish or fish oil 2-3 times a week for their omega-3 fatty acids. This “good” fat has multiple uses in our body, but the body cannot produced these fats by itself; we need an outside source.

Studies involving hundreds of thousands of people suggest that omega-3s reduce the risk of fatal heart disease, improve the flexibility of blood vessels, lower blood pressure and reduce immune inflammation. [Note: It is controversial whether omega-3 supplements are as beneficial as eating fish; in fact, they may cause certain health issues.]

Role of the Immune System

When the body is threatened by pathogens or cancer cells, or has been injured, the body responds with short-term inflammatory responses, acute inflammation.

Immune cells flood the area to destroy invading foreign organisms or cancer cells, or to start the healing process after trauma. If the body cannot get rid itself of the infection, or if it over-responds with excessive levels of inflammation, the immune response may become chronic, or long-term.

Chronic inflammation is abnormal and damages previously healthy tissues and organs. This sort of unlimited inflammation results in autoimmune diseases, diseases in which the body’s immune system turns on the body.  Conditions such as arthritis, diabetes, lupus, multiple sclerosis, Crohn’s disease, ulcerative colitis, celiac disease, hepatitis and asthma can result from such run-away inflammatory responses.

Knowledgeable individuals know that nutrition plays only an initial role in staying healthy. Good nutrition is the foundation upon which to build health, but it is NOT ENOUGH; it is the immune system that governs one’s health and must be optimized.

The Importance of a Balanced Immune System

Immune balance, immune homeostasis, is tightly regulated by the body. It allows the organism to respond to infection, cancer cells and injury with the right amount of inflammation.  Any imbalances, either too much stimulation, or too little, results in immune disorders and health issues.

The key to good health and healthy aging is keeping the immune system in balance.

    Scales Immune Reponses Partial

Dr.Hellen’s major passion is helping people to enjoy life at its fullest. She may be contacted by using this form, at: drhellen@drhellengreenblatt.info or feel free to call:  302.265.3870 (ET, USA).

  

nutrition.ucdavis.edu/content/infosheets/fact-pro-phytochemical.pdf
www.hsph.harvard.edu/nutritionsource/fish
www.harvardprostateknowledge.org/high-intake-of-omega-3-fats-linked-to-increased-prostate-cancer-risk
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www.ncbi.nlm.nih.gov/pubmed/27357102

 

As of this writing, the Centers for Disease Control (CDC) in Atlanta is strongly recommending that pregnant woman postpone travel to many countries across the world, including the popular Caribbean islands.  The CDC is taking these steps due to the possibility that these women may become are infected with a mosquito borne virus called Zika.  The World Health Organization (WHO) Director General Dr Margaret Chan, has said that Zika had gone “from a mild threat to one of alarming proportions” and expects the virus to spread through the Americas and affect between three million and four million people.

Eighty percent of individuals who are infected with Zika do not show symptoms.  However, when symptoms do occur, they can last up to a week or so and include fever, rash, pink eye, and joint pain. Some clinicians suggest that Zika virus infection may result in the autoimmune [against oneself] condition,  Guillain-Barre syndrome (GBS).  This is rare disorder where too much inflammation damages the nerve cells, causing muscle weakness and may lead to paralysis.

The greatest concern however right now is that health agencies “strongly suspect” that when a pregnant women is bitten by a mosquito that is carring the virus, that even if she does not experience symptoms, that her offspring may develop brain malformations.

This latest outbreak adds to concerns that infectious diseases are one of the top threats challenging our world—a major topic on the agenda of last week’s World Economic Forum world leader attendees.  Until vaccines or treatments are developed, viral infections such as Zika, Ebola, SARS (severe acute respiratory syndrome), and MERS (Middle East Respiratory Syndrome) remain a threat to the world’s population.

Currently, there are no commercially available vaccines or treatments for Zika.  Until recently the cost to develop a successful vaccine was far greater than what the manufacturers would recoup in vaccine sales.  However, development of a vaccine for Zika will likely now escalate since Zika has spread so widely, infecting over 1.5 million individuals and its being linked to neurological problems, especially in newborns.

In addition to a lack of vaccines and treatments for a multitude of viral diseases, another significant health-care crisis we are facing is treatment of infection by anti-microbial-resistant pathogens. As Dr. Keiji Fukudaof the World Health Organization has stated:  “We really hope to pull the world back from the brink where antibiotics don’t work anymore”.

When bacteria are stressed, for example by a killer antibiotic, their genetic material may change, mutate, so that they can tolerate and become resistant to such compounds.  The bacteria can then replicate easily and outgrow bacterial strains that were not resistant to the antibiotic.

Fifty percent of antibiotic prescriptions written by U.S. physicians are of no benefit to the patient, and when used to fatten livestock and poultry it gives bacteria even more opportunity to acquire antibiotic tolerance.

It is our immune systems that identify, destroy, and remove invading pathogens.   When our body recognizes that it has been invaded by foreign agents, a strong inflammatory responses is triggered to meet the onslaught of the pathogens.  White blood cells accumulate in the area to combat the invaders.  These immune cells release cytokines and other immune messages  recruiting more white blood cells in an attempt to “burn out” the infection. Without a powerful inflammatory response, we cannot limit or survive infections.

In the absence of drugs or treatments that prevent and control the growth of viruses and other microorganism the immune system must be optimized to protect the body against them.

 

www.cdc.gov/mmwr/index.html
www.scientificamerican.com/article/who-extremely-alarmed-by-zika-cases-could-reach-4-million/?WT.mc_id=SA_DD_20160128
www.wsj.com/articles/health-threats-spur-vaccine-hunt-1453337493
ecdc.europa.eu/en/healthtopics/zika_virus_infection/factsheet-health-professionals/Pages/factsheet_health_professionals.aspx
www.vox.com/2016/1/20/10795562/zika-virus-cdc-mosquitoes-birth-defects
www.wsj.com/articles/SB105768561135341800
www.cdc.gov/features/antibioticresistancethreats/
www.cdc.gov/media/dpk/2013/images/untreatable/img2_sm.jpg
www.bbc.com/news/health-35427493

One of the major complaints that people have is that “they are always tired”. “They just do not care anymore, they are just too tired.” [Kindly view a post that is relevant to this subject: Depression, Anhedonia and Run-Away Inflammation.]

In the past, scientists thought that there was a blood-brain barrier that “isolated” the brain from the actions of the immune system. They labeled the brain “immune privileged”; because studies suggested that a healthy brain had few, if any inflammatory cells in it. Only when there was a brain infection did scientists think that immune cells migrated into the brain.

Researchers failed to take into account that chronic inflammatory diseases are associated the brain. For example conditions such as inflammatory bowel disease, psoriasis, liver disease, and rheumatoid arthritis may result in a lack of social interest, feelings of being unwell and unremitting fatigue—all which are governed by brain function.

Inflammation is activated when the body encounters pathogens and cancerous cells. The inflammatory response is a primary means by which the body will destroy these threats. Inflammation is basically a controlled “burn”.  Firefighters will often have a “controlled burn” in a forest to get rid of dead trees and limbs.  They strive to keep the fire limited to a specific area.  Sometimes however firefighters are unable to control the fire and acres of forest are burned in error.

Similarly, once immune cells have taken care of a threat to the body, for example cancer cells, pathogens, etc., it is essential that the immune system “turn” down the inflammatory “flame”. Chronic, unnecessary inflammation leads to many autoimmune diseases that destroy their own organs, such as diabetes, Crohn’s bowel disease, multiple sclerosis, and lupus

Inflammation is all about location, location, location. If one has inflammation in the insulin-producing cells that control blood sugar, the person may get diabetes. If their intestines are inflamed they may suffer from Crohn’s.  If there is too much destruction and inflammation of nerve cells, they may suffer from multiple sclerosis.

Let us hypothesize that an individual has two trillion immune white blood cells and that half of these cells are out of control and producing too strong an inflammatory response. This inflammation is destroying previously healthy tissues and organs.  Since the body is always striving to balance inflammation, the other half a trillion of cells are working towards lowering the amount of inflammation and destruction that is going on in the body

Each of these cells is expending a trivial amount of energy trying to accomplish its task, but a tiny amount of energy multiplied by two trillion cells is a great deal of “wasted energy”. Is it any wonder why these people complain of being tired?

Individuals who have been diagnosed with autoimmune conditions have higher levels of inflammatory cytokines, immune messages, than people without disease. In heart failure patients, significant fatigue is associated with poor recovery and a higher risk of death. Patients with high levels of anti-inflammatory cytokines, molecules that decrease inflammation, recover more fully and rapidly than patients with high amounts of inflammatory cytokines. When patients are treated for their heart problems, their cytokine levels begin to resemble the cytokine ratios of healthy individuals, and their energy returns.

In mice with liver inflammation, immune cells from the liver travel to the brain and trigger other specialized immune cells called microglia releasing a biochemical that attracts more inflammatory cells into the brain, which in turn produces more inflammation.

In individuals with multiple sclerosis, a nervous system disease with a major inflammatory component, patients had less fatigue when they took anti-inflammatory medications.

The association of appropriate levels of inflammation with a healthy brain and high energy reserves is clear; the key is being in immunological balance. Once individuals balance inflammatory and anti-inflammatory cells they typically regain their energy and focus.

Aren’t you tired of being tired all the time? Don’t wait any longer. Contact Dr. Hellen to talk bout enhancing your quality of life.  There is no fee for consulting with her for the first 30 minutes.  She may be contacted by using this form or at: 302.265.3870 (ET, USA).

http://www.ncbi.nlm.nih.gov/pubmed/25905315
http://www.ncbi.nlm.nih.gov/pubmed/25905315
www.ncbi.nlm.nih.gov/pubmed/26589194
http://www.the-scientist.com/?articles.view/articleNo/43120/title/Brain-Drain/
http://www.ncbi.nlm.nih.gov/pubmed/26705751
http://www.ncbi.nlm.nih.gov/pubmed/25682012

 

Delirium is an under-reported condition that may affect up to 56% of older individuals after surgery, patients that have been heavily sedated for a length of time, burn, cancer, and patients on ventilators for long periods. Patients experience vivid hallucinations that may be part of a vicious cycle if doctors attempt to control the delusions with larger amounts of sedatives; the medications may disorient and confuse the patient even more.

The delusions and accompanying cognitive issues can persist for months after patients leave the hospital and can lead to a misdiagnosis of dementia, rather than delirium. [Dementia develops gradually and gradually worsens, while delirium may be of sudden onset.]

Delirium is associated with excessive inflammation in the brain resulting from triggering specialized immune cells the microglia. If stimulated over a long time, the cells release inflammatory cytokines, molecules that damage nerve cells and contribute to damage and break down of the capillaries in the brain, the blood-brain barrier.

C-reactive protein, CRP, is one measure of inflammation. CRP levels were measured in elderly surgical patients who had ended up with complications such as delirium, cardiovascular issues, or infection. The levels of CRP in their blood were predictive as to how fully they recovered.

A recent study measured the levels of 12 different inflammatory and anti-inflammatory cytokines in older patients undergoing surgery. Those having episodes of delirium had consistently high levels of inflammatory cytokines as compared to patients that did not have high levels of cytokines. Similar results were seen in patients that developed delirium after procedures such as open-heart surgery and hip fracture repair.

Conclusion

In order for the body to heal after it is hurt, or to fight an infection successfully, a delicate balance of cytokines, immune messages are required. Too little of an inflammatory response and the individual may not survive an infection. Too much of an inflammatory response and healthy tissue is destroyed. Homeostasis, balance, is what the body strives for every moment.

Dr. Hellen would be pleased to provide guidance to helping enhance your quality of life.  She may be contacted by using this form or at: 302.265.3870 (ET, USA).

 

www.theatlantic.com/health/archive/2015/06/the-overlooked-danger-of-delirium-in-hospitals/394829/
www.mayoclinic.org/diseases-conditions/delirium/basics/definition/con-20033982
www.ncbi.nlm.nih.gov/pmc/articles/PMC2911011
intl-biomedgerontology.oxfordjournals.org/content/early/2015/07/24/gerona.glv083.full
www.sciencedirect.com/science/article/pii/S2210833511000773
www.ncbi.nlm.nih.gov/pubmed/17504139

 

 

For over two decades I have noticed that individuals in immune homeostasis, immune balance, are on fewer medications or no medications than their cohorts, and the majority of them look and feel 10 years younger than other people their age. Comparing photos of how these individuals look now with photos as how they looked 10-20 years ago, it is amazing how great they look! Their youthfulness is especially apparent when I compare these photos to those of individuals that have not made the effort to control inflammation.

Too many older individuals suffer from chronic inflammatory diseases such as arthritis, diabetes, cognition deficits, Parkinson’s disease, lung, kidney, and bladder problems. Over the years there have been numerous studies associating chronic (long-term) inflammation with the development of mutating cells and cancers. However because of the time it takes to do longevity studies it is difficult to prove that limiting inflammation makes a difference in how well people age.

Just this month, a team of scientists from Keio University School of Medicine, Tokyo, Japan and the Newcastle University’s Institute for Ageing in the UK published a study of the immune status of over 1500 individuals ranging in age from 100-115 years.

The study group was divided into two: centenarians, 100-104 years of age, and semi-supercentenarians aged 105 and above. The result was that these long-lived individuals had lower levels of inflammation as compared to the general public.  

Dr. von Zglinicki, one of the investigators, said, “Centenarians and supercentenarians are different – put simply, they age slower. They can ward off diseases for much longer than the general population… it’s only recently we could mechanistically prove that inflammation actually causes accelerated ageing in mice…This study, showing for the first time that inflammation levels predict successful ageing even in the extreme old….”

Dr. Yasumichi Arai, the first author on the study said, “Our results suggest that suppression of chronic inflammation might help people to age more slowly…However, presently available potent anti-inflammatories [medications] are not suited for long-term treatment of chronic inflammation because of their strong side-effects. Safer alternatives could make a large difference for the quality of life of older people.

As I have pointed out for decades, controlling the delicate balance of inflammatory responses, i.e., achieving immune homeostasis, makes all the difference in one’s youthfulness and quality of life.

P.S.  My post of May 20, 2013 also discusses the role of inflammation in longevity.

Please contact me directly if you would like to learn simple approaches to making a difference in your health.
http://www.ncl.ac.uk/press.office/press.release/item/scientists-crack-the-secret-of-the-centenarians
http://www.ebiomedicine.com/article/S2352-3964(15)30081-5/fulltext
www.ncbi.nlm.nih.gov/pubmed/26265203
www.ncbi.nlm.nih.gov/pubmed/26263854

 

Idiopathic pulmonary fibrosis (IPF) is a disease in which the tiny air sacs or “alveoli” that make up the lungs become inflamed and are gradually replaced by scar tissue (fibrosis).  As the amount of scar tissue increases, the lungs stiffen and are unable to transfer oxygen from the lungs to the blood stream. This results in the brain and other organs becoming oxygen deprived.

As  IPF progresses, day-to-day activities such as walking short distances, climbing stairs, dressing, or even talking on the phone become a problem because the person cannot catch their breath (dyspnea).  The person feels as if they are suffocating and may require supplemental oxygen.

Advanced idiopathic pulmonary fibrosis makes people more susceptible to getting and fighting infections.

The term “ idiopathic” suggests that clinicians do not know what causes the disease.  Lung inflammation may be triggered by infection with pathogens, airborne hazards, or certain types of medical treatments.  Exposed to these types of challenges, the immune system boosts its inflammatory response to attack the pathogens and remove hazards or damaged tissues.  In a vicious cycle, the uncontrolled inflammation results in greater lung damage.

Idiopathic pulmonary fibrosis may be considered an inflammatory autoimmune disease.  Autoimmune (meaning against oneself) conditions result from the body’s overactive, defensive, inflammatory reactions to an immune challenge.  The  body’s own immune cells mistakenly attack and destroy previously healthy by-stander tissues or organs, very much like a forest fire damages healthy trees.

The body responds to injury by forming scar tissue, made mainly of the key protein collagen. Pulmonary fibrosis results in inflammation and scarring that occurs again and again.  It is an imbalance between the build-up of scars, and the breakdown of collagen that is needed for tissue repair.  In IPF, lungs with old scar tissue is found layered over old damage, while fresh scarring is seen over more recent damage.

 Lung damage in IPF patients is due to imbalances between inflammatory and anti-inflammatory cytokines, immune messengers generated in response to substances or circumstances that initiated the lung damage in the first place.  Imbalances of cytokines results in more and more fibrosis.

Individuals with IPF may find that if they are able to control the amount of inflammation produced by their immune systems, if they can stay in homeostasis, balance,  their quality of life may change for the better.

Please contact Dr. Hellen if you wish her assistance in changing your quality of life. There is no fee for her services.  She may be contacted by using this form or at: 302.265.3870 (ET, USA).

 

www.coalitionforpf.org/cytokine-functions/
www.nhlbi.nih.gov/health/health-topics/topics/ipf
www.ncbi.nlm.nih.gov/pubmed/26132817
www.immuneworks.com/autoimmune-lung-diseases/idiopathic-pulmonary-fibrosis-ipf-treatments
www.ncbi.nlm.nih.gov/pubmed/26150910
faculty.ksu.edu.sa/hadilalotair/Chests%20Library/IPF.pdf

 

 

Middle East Respiratory Syndrome (MERS) is a viral disease of the lungs that was first reported in Saudi Arabia in 2012 and has now spread to several other countries, including South Korea and the United States. Genetic material isolated from an individual that died of MERS was identical to genetic material found in one of his own camels. The infected camel possibly infected the owner and is responsible for the death of the man.

 People infected with the virus initially report mild symptoms of a cold, chills, body aches, sore throat, fever, difficulty in breathing, and a cough.  Some individuals report gastrointestinal issues such as diarrhea, nausea, and vomiting.  When symptoms become severe, death may follow failure of the lungs and kidneys.

Most of individuals that have succumbed to infection with MERS suffered with other medical conditions, such as diabetes, cancer, chronic lung conditions, heart, or kidney disease.

MERS and SARS

There is limited scientific information on MERS.  However, the MERS virus is in the same family of viruses as SARS, the virus that causes severe acute respiratory syndrome. Infection with this virus results in severe breathing difficulties which too frequently results in death. (Both the traveling businessman and his World Health Organization physician, Dr. Carlo Urbani who identified the infection as a new disease in the business person, died of the virus.)

 Although there are similarities in symptoms, two major differences between MERS and SARS are: a) MERS progresses to lung failure more rapidly than SARS and b) MERS affects older individuals more than it does younger people. [The high numbers of fatalities from MERS may be related to the older age of infected persons and the fact that individuals with other conditions are more susceptible to respiratory failure].

 Since so little is understood about the disease, people with diabetes, lung, kidney, and immune disorders should take precautions if they are exposed to infected individuals.

The Immune System and Infections

The only part of the body that protects us from infection is our immune system. The role of the immune system is to recognize threats from pathogens, stop, and then up regulate inflammatory responses to destroy the pathogens before they can multiply.

 When the immune system is recognizes invasion by pathogens, immune cells are triggered to produce antibodies and other immune factors, such as cytokines. Cytokines are proteins that help recruit immune cells into an area to help fight the battle, and orchestrate the protective immune responses.In SARS, an over-response of the immune system,  a “cytokine storm” occurs that too often results in the deaths of infected persons.  It is likely that infection with MERS triggers the production of high levels of cytokines, resulting in excessive inflammation and death.

Summary:

People with unbalanced immune systems are at higher risk of having severe symptoms when infected with pathogens.  It is essential that the immune system always be in balance, in homeostasis for optimal protection from disease.

The inflammatory response to infection has to be a controlled, limited response. There must be enough of an immune response to defend the body against disease, but not so great an inflammatory response that the body is harmed.


www.cdc.gov/coronavirus/mers/
www.nejm.org/doi/full/10.1056/NEJMoa1401505
www.nlm.nih.gov/medlineplus/ency/article/007192
www.cdc.gov/coronavirus/mers/
www.nejm.org/doi/full/10.1056/NEJMoa1401505

Mutating cells and invasion by pathogens triggers inflammatory responses in the body.  Inflammation consists of a series of events involving cytokines (immune messages), other immune factors, and circulating white blood cells. Uncontrolled levels of inflammation damages healthy tissues and organs.

Excessive inflammation of the eyes may result in sight-threatening condition.

Uveitis
Uveitis describes a group of eye inflammatory diseases.  Symptoms can develop gradually over a few days, or occur suddenly. Symptoms may include: photophobia (sensitivity to light), cloudy or blurred vision, increased floaters, difficulty in vision focus, headaches, “red eye” with pain ranging from a mild ache to intense pain, and loss of peripheral vision (ability to see objects at the side of one’s field of vision). Severe uveitis may lead to permanent damage to vision.

Many cases of eye tissue inflammation are “idiopathic”, i.e., without a known trigger.  Some clinicians suggest that uveitis is caused by:  a) autoimmune responses in which the body’s immune system mistakenly targets and attacks its own eye tissues, b) infections or cancer, c) trauma to the eye, or d) exposure to toxins.  Uveitis is more likely to occur in individuals that have other immune and inflammatory conditions.

Ebola and Uveitis
Two months after an American physician was treated for Ebola, and despite the fact that the virus was no longer detectable in his blood, there were high levels of Ebola virus in his eye. His eye infection was accompanied by an intense inflammatory reaction, uveitis. After much effort, the physician was successfully treated and thankfully  did not lose his sight.

In a study of 85 Ebola Virus Disease survivors in Sierra Leone, 40% reported that they had some sort of “eye problem”. (It is not known whether they also had uveitits.)

Retinitis Pigmentosa
Retinitis pigmentosa is a genetic disorder in which the light-sensitive retina, the “screen” at the back of the eye that captures images, becomes damaged .  Its photoreceptors,  rods and cones, begin to die off resulting in a  loss of vision.  This condition may end in blindness.

There are conflicting opinions as to whether inflammation plays a major role in this disease.

One study that support the contention that immune responses are involved in retinitis pigmentosa measured the levels of TNF-alpha.  TNF-alpha is a cytokine, that among other functions, helps regulate immunological responses. Depending on when and how much of the cytokine is produced , TNF-alpha may be pro-inflammatory (initiate inflammation), or anti-inflammatory (inhibit inflammation).   In animals with uveitis-like conditions, the levels of TNF-alpha in the eye are  increased between 5-10 fold over control animals.

Also,  in retinitis pigmentosa, immune white blood cells are attracted to the retina, perhaps to clean up debris from dying cells. Some investigators suggest that when these immune cells are overly stimulated, they initiate an autoimmune response, destroying other light-sensing centers in the retina.

Immune Homeostasis, Immune Balance
Immune inflammation is essential to defend the body against cancerous cells and invading microorganisms.  However, the appropriate levels of  “protective” cytokines are needed to balance the “destructive” cytokines produced in the eye so that it can maintain immune homeostasis, immune balance. Unchecked inflammation results in tissue damage and an inability of the body to mount stable and proper immune responses in the face of various challenges.

Dr. Hellen is available at 302.265.3870 for discussion on the role of inflammation and immune homeostasis in one’s health.  There is no charge to speak with her.  She may be contacted at: drhellen@drhellengreenblatt.info, or use the contact form.  Thank you.

 www.sciencedirect.com/science/article/pii/S0014483502003329
www.ncbi.nlm.nih.gov/pubmed/24174679
www.ncbi.nlm.nih.gov/pubmed/24639355
www.ncbi.nlm.nih.gov/pubmed/23608634
eyewiki.aao.org/Retinitis_Pigmentosa
www.ncbi.nlm.nih.gov/pubmed/22986109
www.ncbi.nlm.nih.gov/pubmed/21787221
www.nhs.uk/conditions/Uveitis/Pages/Introduction.aspx
www.nei.nih.gov/health/uveitis
www.nejm.org/doi/full/10.1056/NEJMoa1500306#t=article
www.nytimes.com/2015/05/08/health/weeks-after-his-recovery-ebola-lurked-in-a-doctors-eye.html?smid=tw-nytimes&_r=0

 

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