Anti-Inflammatory Strategies–Achieving Homeostasis
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Borrelia burgdorferi, is a bacterial infection that results from an infected tick, originally from mammals or birds, biting and injecting the microorganism into a human host. Individuals treated early in infection are likely to recover completely; however, delaying treatment may result in long recovery times, or result in disease that will last for years, or for life.

Infection Affects Multiple Organ Systems
Lyme disease can affect any organ or multiple systems including, skin, joints, nervous system, muscles, and skin. Early symptoms are a red, expanding rash, erythema migrans, that often appears at the tick bite site, and flu-like symptoms such as body aches, fever, chills, headache, and fatigue.

Left untreated, unfocused severe pain may, irregular heart beat and other heart problems, chronic inflammation of the joints (especially the knees, i.e., Lyme arthritis), liver inflammation (hepatitis) and eye problems. Unremitting fatigue, memory problems, and brain “fog” may also accompany the disease.

Incomplete recovery from Lyme disease may result in significant neurological problems, including Bell’s palsy (paralysis of one side of the face), weakness or numbness of limbs, impaired muscle movement, and meningitis (inflammation of brain membranes).

Twenty to fifty percent of patients with neurological issues may continue to experience difficulties for years.

Immune Responses to Lyme Infection
The extent of recovery from Lyme disease depends on factors such as the numbers of bacteria initially injected and the types of immune responses triggered by the infection.

As with healing from most infections, recovery from Lyme disease is a highly complex process requiring the correct interplay of inflammatory and anti-inflammatory cytokines, immune regulating molecules. Successful recovery requires a homeostatic, a balanced immune attack with enough inflammation to kill the organism without damaging by-stander cells and organs.

For example, the cytokine interleukin-6 (IL-6) stimulates inflammation but is also, depending on what the body needs, able to decrease inflammatory responses. (IL-6 is also triggers pain receptors and helps nerve cells regenerate.) Transforming growth factor-β (TGF-β) is another cytokine that helps the body control the amount of inflammation produced in response to infection.

Another cytokine, tumor necrosis factor-α (TNF-α) is an inflammatory cytokine that stimulates certain immune cells to find, engulf, and digest invading organisms. Mice susceptible to Lyme disease are unable to manufacture enough of this factor which may account for their susceptibility.

In humans as well, patients that were recovering well had significantly higher levels of tumor necrosis factor-α compared to those with on-going disease. Once again, these responses likely reflect the powerful inflammatory response that helps the body eliminate the disease.

Additionally, recovering infected individuals had higher levels of transforming growth factor than individuals with severe symptoms. These findings suggest that transforming growth factor was successfully limiting the amount of inflammation being produced in response to infection.

Similarly, in mice with Lyme arthritis, animals that did best were those in which high TNF-α cytokine levels helped kill the bacteria, followed by an aggressive IL-6 response that dampened the inflammatory response.

In further support of these findings, patients with rashes (early infection) had high levels of the anti-inflammatory cytokine, transforming growth factor, as compared to those who had more severe neurological involvement.

Conclusion:
The body uses inflammatory responses to protect itself from infection and heal itself. Inflammation helps the body destroy organisms, almost as if the body was “burning” the infection out. However, just like a forest fire, if inflammation is not well controlled the person with Lyme disease may suffer symptoms for years or for life. This is why it is essential for the body to produce a balanced, immune inflammatory response to infection.

 

Contact Dr. Hellen at: 302.265.3870 (ET), DrHellen@DrHellenGreenblatt.info, or by using the contact form: http://drhellengreenblatt.info/contact-dr-hellen.


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Post-traumatic stress disorder (PTSD) occurs in some individuals that are exposed to emotionally disturbing events such as combat, rocket, and terrorist attacks. Individuals that have suffered traumatic brain injury (TBI) or experienced natural disasters and sexual assault are also at higher risk of having this disorder.

Symptoms may include quality of life issues such as explosive outbursts of anger, difficulties in concentrating, being easily startled, feeling constantly “on guard”, expecting a threat to occur at any moment, depression, problems sleeping, avoiding people and circumstances that can trigger unpleasant memories or outbursts, limiting emotional relationships, and avoiding crowded locations.

Up to twenty percent of veterans serving in Iraq and Afghanistan, 10% of Gulf War (Desert Storm), and 30% of Vietnam Veterans have been diagnosed with post-traumatic stress disorder.

PTSD is not only a psychiatric issue. Individuals suffering with PTSD are at higher risk of being physically ill, and at increased risk of death from a multiple of causes.

PTSD is Associated with Inflammatory Responses.
Clinical studies suggest that individuals with post-traumatic stress disorders suffer from chronic low-level inflammation. This is reflected in their greater propensity to have inflammation-associated diseases such as autoimmune, cardiovascular, gastrointestinal, musculoskeletal, and respiratory diseases.

A combination of high blood sugar, cholesterol, and blood pressure, coupled with excess fat around the abdomen (abdominal visceral fat), increases the risk of individuals for stroke, heart disease, and diabetes. This cluster of symptoms, metabolic syndrome, is associated with inflammation and is found in 48% of individuals with post traumatic stress syndrome compared to 25% of controls. Such clinical issues result in patients with PTSD utilizing a greater proportion of medical services and prescription medications.

IL-6 is a cytokine, an immune messenger, which plays a major role in inflammation, helping the body heal after tissue injury, and defending the body from pathogens. C-reactive protein (CRP) is another biological marker that is strongly related to heightened levels of inflammation. Elevated levels of IL-6 and CRP are associated with an increased risk of heart attacks and other cardiovascular events that are inflammatory in nature.

Reports of increased presence of inflammatory cytokines in individuals with PTSD are inconsistent. However, the evidence suggests in military personnel with PTSD or depression, IL-6 levels are higher than found in control subjects, and that the quality of life of these soldiers is poorer as well. Similarly, individuals with PTSD are more likely to have significantly higher amounts of circulating CRP than those not diagnosed with PTSD.

Intermittent explosive disorder is one of the more troubling aspects of some individuals with post traumatic stress disorder. This condition involves repeated episodes of impulsive, angry, verbal outbursts, and violent and aggressive behavior. CRP and IL-6 levels are significantly higher in personnel with intermittent explosive disorder compared with normal or other psychiatric controls, suggesting a direct relationship between inflammation and aggression.

Summary:
Fifty percent of individuals with post traumatic stress syndrome do not seek treatment, and of those that do, only half of these persons will get “minimally adequate” treatment. Until now, the primary treatments for PSTD are psychological counseling and psychiatric medications.

Inflammation is the result of a delicate balance between inflammatory and anti-inflammatory responses, and the body constantly strives to maintain a state of “immune homeostasis”, immune balance.

As in most disease, chronic low-grade inflammation is a likely contributor to post traumatic stress syndrome. If individuals with PTSD better controlled the amount of inflammation produced by their bodies, their quality of life would improve, both emotionally and physically.

 

There is no cost to speak with Dr. Hellen. She can be reached at 1.302-265.3870 ET [USA] or contacted at: drhellen@drhellengreenblatt.info.

 

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