Anti-Inflammatory Strategies–Achieving Homeostasis
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Over the last 18 months, at least 25 children have been affected in the California area by a “polio-like” illness resulting in partial paralysis of five of the children.  As of this week, two out of five of these children have tested positive for enterovirus.  According to the news media, Australia and Asia have also report similar cases.

A commonly found virus, enteroviruses typically result in only mild symptoms such as runny nose, coughing, muscle aches, and sneezing. However, there are 60 different varieties of enteroviruses, and infection with certain types of these viruses results in spontaneous abortion, stillbirth, and congenital anomalies.  Infection with other varieties of enteroviruses can lead to damage of various tissues including skin, muscles, brain, spine, nerve cells, liver, and heart.

Some enteroviruses appear to specifically target the brain and the nervous system, leading to short- or long-term paralysis affecting mobility. So for example, polio enteroviruses attack the nervous system triggering an inflammatory response to destroy the viruses.  The resulting inflammation may lead to mild paralysis, or to an individual becoming completely paralyzed within hours.

Some persistent enteroviruses survive in the body for a prolonged time with continued inflammation and damage to tissues.   So for example, polio patients that initially recover from their disease may continue to experience damage of nerve and muscle cells by inflammatory processes.  This resurgence of symptoms can result in a post-polio syndrome (PPS) years after their original exposure to the virus.

Individuals with post-polio syndrome have high levels of inflammatory cytokines, immune factors, in the spinal fluids between the thin layers of tissues that protect the spinal cord.  Other conditions resulting from enterovirus infection are often associated with the production of inflammatory molecules. Even patients with relatively mild symptoms and no nervous system complications may show increased blood levels of inflammatory immune factors.  This suggests that excessive inflammatory responses are occurring throughout the body.

A delicate balance exists between inflammatory and anti-inflammatory responses of the body.  The immune system is always on alert defending itself against infection.  However, once the process is triggered, the inflammation must be a measured, controlled response that does not destroy healthy tissue.

www.decodedscience.com/polio-like-virus-california-enterovirus-68-paralyzing-kids/43034
www.ncbi.nlm.nih.gov/pubmed/18219253
www.ninds.nih.gov/disorders/post_polio/detail_post_polio.htm
www.ncbi.nlm.nih.gov/pubmed/24367714
www.enterovirusfoundation.org/associations.shtml
www.ncbi.nlm.nih.gov/pubmed/22776106
 

We humans exist in sea of microorganisms. According to the American Society for Microbiology, there are 10 fold the number of bacteria living in and on our bodies as cells that make up our bodies. Wherever our bodies are exposed to the outside world, for example our digestive tracts, skin, mouth, vagina, etc. we find specific varieties of bacteria and other organisms.

The totality of all the bacteria and other microorganisms that populate our bodies is called the microbiome. The microbiome is highly individualized, with the spectrum of bacteria differing from one person to another; much like an individual’s fingerprints. All people display wide variations in the kinds of bacteria that inhabit them. The types and numbers of bacteria in and on our bodies differ depending on our genetic makeup, our diet, and environmental factors.

Immune cells are found throughout the body where they are always on alert defending the body against infection. Inflammation is the primary way that the immune system controls infections and healing, but overactive immune responses can lead to debilitating inflammatory diseases such as atherosclerosis, diabetes, and bowel disorders.

There is considerable “cross-talk” between the microbiome and the immune cells. Microorganisms influence the responses of the immune system, and the immune system in turn affects the populations of the organisms that inhabit us. For example, evidence suggests that certain bacteria in the gut can decrease inflammation in the gut and decrease chronic disease. [Whether the organisms themselves are producing these molecules, or whether they are triggering immune cells to release anti-inflammatory compounds is not clear.]

Celiac Disease and Diabetes:
Individuals with celiac disease are highly sensitive to foods containing gluten, a protein found in barley, rye, and wheat. People with celiac disease have significant quality of life issues such as bloating, diarrhea, and/or constipation.

When the immune cells of celiacs see gluten, they mount an inflammatory response to try to eliminate the gluten from the intestines. The immune cells produce antibodies that attach to the inner surface of the gut and through inflammatory responses cause direct damage of the gut lining. Inflammatory responses against the body’s own tissues lead to autoimmune (against oneself) disease.

Diabetes is also the result of an autoimmune condition. Inflammatory immune cells destroy specialized cells in the pancreas that produce insulin, a hormone needed to control blood sugar.

Individuals with celiac disease have more than digestive issues, since they have almost 2.5 times a greater chance of developing diabetes than those without intestinal problems. Such conditions are associated with antibodies directed against the insulin-producing cells. When Individuals with celiac disease go on a strict gluten-free diet, they produce fewer anti-insulin-antibodies, suggesting that they are producing less of an inflammatory response.

Gluten intake changes the kinds of bacteria found in the gut. Diabetic-prone mice that eat regular mouse chow containing gluten are more likely to get diabetes than diabetic-prone mice on gluten-free chow. In addition, when the gut bacteria are analyzed, the diabetic-prone mice on gluten have the type of bacteria more often associated with inflammation, than the mice not on gluten. Thus, diet affects the responses of the immune cells and the microbiome.

As followers of this blog are aware, in the face of constantly changing external and internal challenges, the immune system of a healthy person makes adjustments to maintain immune balance, immune homeostasis.

One would expect that if inflammatory and autoimmune responses were better controlled by the body, that individuals with celiac disease and diabetes would experience a far better quality of life.

www.ncbi.nlm.nih.gov/pubmed/22699609
www.ncbi.nlm.nih.gov/books/NBK27169
www.ncbi.nlm.nih.gov/pmc/articles/PMC3256734
www.ncbi.nlm.nih.gov/pmc/articles/PMC2575488
www.ncbi.nlm.nih.gov/pubmed/22913724
www.ncbi.nlm.nih.gov/pubmed/24164337
www.ncbi.nlm.nih.gov/pubmed/24041379 www.sciencedaily.com/releases/2013/11/131113182423.htm
www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0078687

Alcoholism is a condition in which individuals drink alcohol in excess despite the fact that their habit causes physical and mental health problems, and social, family, and/or job-related issues. Heavy alcohol consumption results in damage to many parts of the body including the brain, liver, digestive system, and  joints. Alcoholics also suffer with dementia, memory loss, depression, emotional instability, and are at increased risk of cancer of the colon, liver, and esophagus.

Immune System Effects

Prolonged, heavy alcohol consumption negatively affects immune cells and their production of cytokines, immune messages.  Alcoholics have significantly higher rates of bacterial and viral infections and when hospitalized remain hospitalized longer than those that do not abuse alcohol.   Alcohol not only kills key immune cells, but excess amounts of alcohol results in an increased risk of autoimmune responses in which the body’s immune cells mistakenly attack the body’s own healthy cells as foreign.

The body constantly strives to maintain immune inflammatory homeostasis; to balance the amount of inflammation it produces to protect the body from infection.  Imbalances of inflammatory responses, loss of immune homeostasis, result from excessive alcohol consumption. For example, white cells, immune cells, search out and destroy and remove pathogens from the lungs.  After alcohol consumption, fewer immune cells respond to the call for “help”.  Those cells that do enter the lungs are unable to kill microbes as effectively as cells from non-alcoholic animals.

The inefficient immune responses of alcoholics lead them to be more vulnerable to viral infections such as hepatitis C, influenza, and HIV and bacterial infections including tuberculosis and pneumonia. Especially after experiencing trauma, e.g., surgery, alcoholics are more likely than non-alcoholics to get pneumonia.

A mouse study is one of many that demonstrates the decreased ability of alcohol-imbibing animals to fend off infection.  Sixty percent of mice that were exposed to the flu after imbibing alcohol for two months died of the flu as compared to a 15% mortality rate of mice that had not been drinking alcohol prior to exposure.

Hormone Effects:

Cortisol, the “stress-response hormone” affects nervous, immune, circulatory, and metabolic systems of the body.  After surgery, chronic alcoholics have higher cortisol levels compared to non-alcoholic patients.  The increased inflammation that accompanies stress also leads to higher levels of depression, other addictions, and mood disorders.

Other hormones effected by alcohol consumption are those a)that may interfere with the a women’s menstrual cycle, b) the ability for men and women to enjoy sex, or c) control blood sugar.

Nervous System Complications:

Alcohol is neuro-toxic to brain cells interfering with the development, repair, and communication of nerve cells. Consumption of large amounts of alcohol leads to shrinkage of white matter in the brain, adding to depression, confusion, short-term memory loss, “fuzzy” thinking, and a greater risk of getting dementia.  Alcohol also directly affects the nervous system in other ways, causing numbness, tingling, and pain in hands and feet.

Additionally, too great a consumption of alcohol, especially over a long period of time, results in problems with absorption of nutrients, the lack of which can become so severe that certain forms of dementia are triggered.

Bone Loss

Alcohol damages osteoblasts, the cells needed to grow and maintain bone.  Destruction of osteoblasts results in decreased bone mass and susceptibility to fractures and other orthopedic problems.  When a bone fracture occurs,  immune cells rush in to start the healing process. They release immune signals, cytokines that start the inflammatory process that recruits more cells into the area. However, when there is too much inflammation, healing, and bone growth is delayed with the result that bones become brittle, thin, or misshapen.

Vitamin B12, vitamin D,  phosphate, and magnesium are needed to grow bone.  Excessive intake of alcohol is associated with low or subnormal levels of these elements, further inhibiting the growth of and repair of bones.

Skin and Injuries

The cells in the skin help defend the body from pathogens, and keep the skin healthy, youthful, and supple.  The immune cells in the skin interact with the microbes that live on the surface. Although the numbers of bacteria on healthy skin stays constant, the types of bacteria that exist change depending on environmental and immune interactions

Heavy use of alcohol significantly slows the movement of immune cells, upsetting the balance, the homeostasis of the skin. Alcoholics experience a greater number of severe skin infections than individuals that drink responsibly.

Almost half of all patients coming into an emergency room with an injury, trauma cases, have high levels of alcohol in their blood.  Drunken patients have more severe symptoms, and take longer to recover.  They also have higher rates of death as compared to non-intoxicated patients.

Because these patients have imbalances of inflammatory response, it takes them longer to heal, and wounds may become more severe, more quickly. Alcohol damage to the skin continues even after they stop drinking. Alcoholics experience longer hospital stays, especially if they are patients in an intensive care unit.

In a study of two groups of animals with burns, 50% of the animals that had not consumed alcohol survived, compared to 20% of the alcohol-consuming animals.

Summary:

Although not discussed in this post, moderate intake of alcohol has a beneficial effect on inflammatory markers.  However, heavy drinking results in uncontrolled amounts of inflammation leading to a myriad of health consequences.  Controlling the amount of inflammation the body produces will make a major difference in the quality of life of an individual.

Some steps abusers of alcohol can take to help their body modulate inflammation are:

  •  Limit the number of drinks consumed*
  •  Exercise 30 minutes/day for 5 days a week (150 minute minimum/week)
  •  Have smaller food portion sizes.
  •  Consume more fruits and vegetables.

*It is recommended that women limit their alcohol intake to one drink** per day, and men to two drinks/day. [Women absorb and metabolize alcohol differently from men and are more susceptible to alcohol-related organ damage and trauma than men.]

**One drink is defined as 1.5 fluid ounces of 80-proof distilled spirits, 12 ounces of beer, or 5 ounces of wine (a pinot noir wine glass about 1/4 full).

Dr. Greenblatt  looks forward to assisting you in reaching your goals:   http://drhellengreenblatt.info/contact-dr-hellen or 1.302-265.3870 [USA, ET].

 

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www.ncbi.nlm.nih.gov/pubmed/23981442

 

 

 

This is the second part of a two day posting. Please see yesterday’s posting for the introduction to this posting. Thank you.

Cancer Risks

Responders are 19% more likely to develop cancer than their non-exposed colleagues, with skin, prostate, thyroid, and non-Hodgkin’s lymphoma, being the most common of the cancers. Many of the airborne toxins to which individuals were exposed, benzene, volatile organics, metals, polycyclic aromatic hydrocarbons, pulverized building materials, glass fibers, asbestos, lead, hydrochloric acid, polychlorinated biphenyls, organochlorine pesticides, and polychlorinated dioxins and furans are linked to causing cancer.

Cancer is an illness that may take years to develop and detect. Dr. Ware Kuschner, Stanford School of Medicine, CA says, “Carcinogenic effects, if any, will not be observed for a very long period of time.” [As an aside, according to the University of Pennsylvania School of Veterinary Medicine, eight search and rescue dogs have died from cancer since their exposure to rubble from the Sept. 11 terrorist attack.]

 

Pulmonary Function Declines

We do not have sufficient data from the general population residing and working in lower Manhattan, nor detailed health information of individuals that returned to their home states or countries after their contributions to rescue efforts. However, of the rescue, recovery, and clean-up personnel that were monitored, 42% have respiratory problems.

Steep declines in pulmonary function were first detected after 9/11 and they have largely persisted. Over the last nine years, 28% of those monitored have had asthma and 42% sinusitis (inflammation of sinuses). They also suffer from upper airway cough syndrome (UACS) and sarcoidosis. Sarcoidosis is an inflammatory autoimmune disorder in which the body’s own immune system attacks and destroys the tissues of the body. There has been a 36-fold increase in the number of individuals with this disease that can affect the lungs, lymph nodes, eyes, skin, heart, liver, and brain. The hallmarks of the disease are clusters of inflammatory cells throughout the body and often, significant, life-altering declines in breathing and other bodily functions.

 Inflamamtion: The Body’s Defense Against Perceived Threats

The immune system mounts an immune, inflammatory response when the body is exposed to pathogens, pollutants, or toxins. The inflammatory cells release immune factors, such as cytokines, cellular messages, that are involved in cell-to-cell communication with the “purpose” of recruiting more inflammatory cells into an area to help eliminate a perceived threat.

Pollutants and chemicals can trigger airway inflammation and increase mucous production. Other immune molecules cause narrowing of airways resulting in the contraction of the muscles lining the airways. The combination of inflammation and increased mucous makes it difficult for air to enter or leave the lungs and can result in breathing issues.

Additionally, lungs that do not function properly, areideal for the multiplication of molds, bacteria, and viruses. The lungs continue their struggle to eliminate pollutants and pathogens, resulting in a chronic, persistent, dry cough and worsened lung function.

 Immune Homeostasis, Immune Balance

A healthy person produces the right amount of inflammation in response to environmental and biological challenges. If WTC responders and others involved in rescue and clean-up of the 9/11 destruction, were able to control the amount of inflammation in their bodies , the body could finally start its healing process. Returning the body to inflammatory homeostasis, to inflammatory balance, would result in significant differences in the quality of their lives.

 

A Personal Note

It has been my conviction for years that a compromised immune system is at the root of the majority of health issues of World Trade Center responders, recovery and clean-up workers.

As a former New Yorker, I, as most Americans and overseas friends, took the attacks on America’s premier city personally and we still feel-grief and compassion, especially around this time of the year.

But what has really gnawed at me all these years is that surviving workers,–individuals who thought only of others and risked their lives to help despite terrible odds, are still suffering emotionally and physically.

I have been frustrated by my inability to reach the right people to share my decades long experience suggesting a different approach to helping individuals regain their health.

Based on decades of working with individuals having immune issues, I am confident that World Trade Centers workers would experience major quality of life changes if they were able to help their body regain its delicate balance—return to its optimum immune homeostasis.

These brave souls have visited physician after physician, clinic after clinic without a solution to what ails them. Ten years of searching for answers is long enough. It is now time for these individuals to take control of their own health by helping their bodies return to inflammatory homeostasis, balance.

I am not a health practitioner, but I am a scientist who can provide the facts to you. You will know within a short period of time whether or not my suggestions work for you.

I encourage you to contact me so we can start on the journey.

Resources:

www.guardian.co.uk/world/2011/sep/02/world-trade-centre-rescuers-health-risk

www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60989-6/abstract

www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61180-X/abstract

www.thelancet.com/journals/lanonc/article/PIIS1470-2045(01)00543-5/fulltext

www.home2.nyc.gov/html/doh/wtc/html/know/mental.shtml

 

Many more bacterial genes than human genes are found in the body. Samples from 124 healthy Europeans found on average more than 530,000 unique genes in each sample and 99.1% were from bacteria. These bacteria live symbiotically, on, or in, our bodies. While we provide them with food and lodging, they help us stay healthy in many ways including helping us to digest our food, and providing vitamins and other nutrients for us to use.

Dr. David A. Relman of Stanford University, Palo Alto, CA has found that when people take bacteria-killing antibiotics, the microbial ecosystem that returns is different from the microbe population prior to taking antibiotics. Moreover, if the same antibiotic is taken again, even 6 months later, the bacteria take longer to come back and the bacteria are even more different.

Dr. Relman says, “Everything comes with a cost,” he said. “The problem is finding the right balance. As clinicians, we have not been looking at the cost to the health of our microbial ecosystems.”*

Once again, the importance of balance in the body is paramount. Considering that over 75% of the immune system is represented in the gut, immune balance, inflammatory homeostasis, helps the body provide natural resistance to disease. If the immune system is not functioning properly, if it is in disorder, the physical and emotional aspects of our life and health will be out of balance and in disarray.

A body in immune homeostasis is able to respond appropriately to challenges by either “boosting” the “fire power” of an inflammatory immune response to “burn out” an infection, or suppress an inappropriately excessive immune response to the challenge. The key is to maintain immune homeostasis.

*http://www.nytimes.com/2011/08/30/science/30microbe.html?pagewanted=2&ref=science

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