Anti-Inflammatory Strategies–Achieving Homeostasis
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Pancreatic cancer is an aggressive and treatment-resistant cancer that appears to be driven by pancreatitis, inflammation of the pancreas.   Although most people with pancreatitis never go on to develop pancreatic cancer, drinking alcohol in excess, obesity, and particularly smoking, has long been associated with a greater risk of having pancreatic disease.

The Role of The Pancreas
The pancreas is a digestive organ with two main functions.  It produces digestive enzymes to break food down in our intestines, and it contains clusters of cells, Islets of Langerhans, that help the body regulate its blood sugar levels.

Inflammation as a Contributor to Pancreatic Cancer
Inflammation is a complex immune response.  Pancreatic inflammation, mediated by cytokines, immune messengers, up-regulate (increase) inflammation which may lead to pancreatic cancer. Once inflammation is triggered, more immune cells are attracted to the inflamed pancreas and additional cytokines are released that damage pancreatic tissue and attract other damage-causing immune cells.

One of the roles of the immune system is to recognize and destroy cancer cells.  There is a significant amount of “cross-talk” between cancerous cells and immune cells.  On one hand immune cells track down cancer cells in an attempt to destroy them.  They can “turn-on” (up-regulate) or “turn-off” (down-regulate) cancerous cells.  Signals from cancerous cells can result in marked imbalances of immune cells, or make them function in odd ways.

Role of Cytokines in Pancreatic Cancer.
For example, pancreatic tumor cells are able to dampen some of the immune responses of the immune system leaving pancreatic cancer cells to multiply more easily. Cytokines from immune cells can change the environment around tumor cells and act directly on them, triggering their growth and migration to other parts of the pancreas and body. Some cytokines transform cancer cells into becoming resistant to chemotherapy.

Others may act either to trigger inflammation or stop inflammation depending on circumstances. In one study of pancreatic cancer, the most invasive parts of a tumor were found in the midst of heavily inflammatory centers.

Bacteria May Drive Inflammation and Cancer
Interestingly, the studies of our microbiome, the bacteria that inhabit our digestive tracts and other parts of the body, suggest that the bacteria that inhabit us may trigger inflammation, thereby promoting the growth of cancers.

In summary, limiting inappropriate inflammation and achieving a state of immune balance, homeostasis, may be a significant contributor in reducing the risk of pancreatic disease.

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

 

www.ncbi.nlm.nih.gov/pmc/articles/PMC4145756
scitechnol.com/2324-9293/2324-9293-1-e104.phpwww.ncbi.nlm.nih.gov/pubmed/12020670
www.ncbi.nlm.nih.gov/pubmed/25170202
www.ncbi.nlm.nih.gov/pubmed/24855007
www.nature.com/bjc/journal/v108/n5/full/bjc201324a.html
www.ncbi.nlm.nih.gov/pubmed/24855007

The brain, being the “control center” of the body is cushioned by fluid, and is protected by bone and layers of membranes that support blood vessels that feed the brain.

Concussions
Direct or indirect mechanical impact to the brain may result from sports activities or workplace accidents. These may result in trauma to the brain. Rapid acceleration or deceleration, e.g., motor vehicle accidents or intense changes in pressure, e.g., blast exposures can also lead to brain damage.

The term “concussion” is commonly used to refer to a brain injury resulting from the head being hit with a great deal of force. Shaking the upper body and head violently can also cause brain damage.

Concussions alter the way the brain functions. The effects are usually short-lived, but may include being dazed, headaches, and problems with concentration, memory, balance, and coordination.

Brain injuries may result in loss of consciousness, but since the majority of cases do not end in “blackouts”, concussions often occur without the individual realizing they have had damage. The impact may seem relatively mild, and the individual may appear only to be dazed and with time and rest they may heal properly.

Serious untreated concussions can result in long-term brain damage and may even end in death.
Repetitive head injuries are a major issue especially when an individual sustains additional head injuries before the damage from the prior injury has been completely resolved.

The effects are cumulative. Cumulative sports concussions increase the likelihood of permanent neurologic disability. Complete recovery from an initial trauma can take from 6-18 months, and multiple concussions over time may result in long-term problems, including neurological deterioration, dementia-like symptoms, memory disturbances, behavioral, and personality changes, Parkinsonism, and speech and gait abnormalities.

In a minority of cases, additional trauma to the brain, even occurring from days to weeks following a prior event, can lead to collapse and death within minutes.

How quickly and completely one heals, depends on a number of factors including one’s genetic makeup. (This would be expected since genes determine a cell’s ability to withstand mechanical stress, regenerate, and heal.)

Inflammation and Concussions
For years it was thought that the membranes around the brain acted as a blood-brain barrier which stopped the brain from responding with inflammatory responses when it was confronted by infection. However, it has now been shown that concussions and other brain injuries, or infection or disease, will trigger inflammatory responses.

The types of immune cells found throughout the body are also found in the brain, but additionally, the brain has unique immune cells. When activated, brain-specific microglia and astrocytes, produce inflammatory cytokines that remain localized in the brain.

In response to brain injury, the immune system releases a tidal wave of pro- and anti-inflammatory cytokines, molecules that trigger and/or stop an inflammatory response depending on what is needed.

In small amounts, these cytokines help protect the brain and heal it. However, prolonged exposure to inflammatory cytokines, or too high a level of these proteins, will result in damage that accumulates after injury. High levels of inflammatory cytokines are localized at the injury site, and may be found on the opposite side of the head from the side that was hit.

There is increasing evidence suggesting that much of the neurological damage that occurs after the brain is injured is the result of a delayed inflammatory response that lasts hours, days, or even for months after the injury. This chronic inflammatory response may cause more damage to the brain tissue than the mechanical impact itself.

Immune Homeostasis, Immune Balance is the Key
Unfortunately, pharmaceutical treatments known to reduce inflammation appear to interfere with the brain’s natural repair mechanisms. Therefore it is necessary for the body to control its inflammatory responses. It has to produce enough of a response to help brain tissue heal, but not an overly exaggerated inflammatory response which may cause more damage after injury.

In order for the brain to heal after trauma, the immune system must generate the proper balance, and types, of pro-inflammatory and inflammatory cytokines. For those with brain injuries, maintaining immune homeostasis, immune balance, may be the best way to minimize damage.

 

Dr. Hellen is available at 302.265.3870 for discussion on the role of inflammation and immune homeostasis in our health.  She may be contacted at: drhellen@drhellengreenblatt.info, or use the contact form.  Thank you.

emedicine.medscape.com/article/92189-overview#a0107
www.ncbi.nlm.nih.gov/pmc/articles/PMC2945234/
emedicine.medscape.com/article/92189-overview
www.headcasecompany.com/concussion_info/stats_on_concussions_sports
www.ncbi.nlm.nih.gov/pmc/articles/PMC3520152/

 

This month was the 13th anniversary of the haunting September 11 event that has changed us, our Nation, and the world we thought we knew. It seems like yesterday that these events happened.

Three years ago, I posted my frustration of my inability to get First Responders, and/or their health practitioners, to consider addressing the issue of immune homeostasis, immune balance, to enhance the quality of life of individuals that had put themselves at risk to save others.

 Exposure to Air-Borne Particles

The World Trade Center Health Registry estimates about 410,000 people were exposed to air-borne particles and toxins attempting to rescue survivors and recover the dead, clearing the site, or cleaning the surrounding buildings.

 Despite the fact that early in the World Trade Center (WTC)’ construction, builders abandoned asbestos as a fireproofing material, over 400 tons of asbestos were used in the building of the World Trade Center (WTC). Additionally ”mineral wool”, minerals that were melted and spun into fibers and bound together by cement like components was used in construction.

 Massive amounts of hazardous fiber, asbestos, glass, gypsum, and cement were pulverized into ultra-fine particles when the Towers imploded and collapsed on September 11. Virtually every surface was covered with a fine, white particulate dust, and downwind from the complex, the fine particulate matter settled to a depth of 3 inches or more.

Affected groups of Responders include firefighters, police, health professionals, clean-up crews, construction workers, truck drivers, transit workers, lower Manhattan residents, and office workers.

 Increase Risk of Cancer

Responders were exposed to hundreds, if not thousands, of toxic particulates, dust, and gases at Ground Zero. As many of these are known to be potential carcinogens, it is not surprising that two years ago, 58 different types of cancers were added to a list of diseases with which many World Trade Center responders suffer.

 Overall, First Responders at Ground Zero have a 15% increased cancer risk with a 239% higher risk for thyroid cancers. However, unfortunately, asbestos-related lung cancers such as malignant mesothelioma may not appear for 20-40 more years.

 Signature Illness: PSTD and Respiratory Illness

If having a significant increase in cancer risk was not enough, according to the findings of the Stony Brook [NY] Medicine’s World Trade Center Health Program, as many as 60% of 9/11 World Trade Center responders continue to experience “clinically significant symptoms of post-traumatic stress disorder (PTSD) and … respiratory illness”.

Coughing and breathing problems have been a major issue, even in Responders that were only “moderately” exposed. Additionally individuals with the most exposure were more likely to find that their asthma symptoms became worse.

Benjamin Luft, MD, Medical Director of the Stony Brook Program is of the opinion that “a signature illness” of a WTC Responder is having both PTSD and respiratory problems at the same time.

 Respiratory Difficulties and Inflammation

Inflammatory biomarkers have been monitored in those exposed to WTC dust and smoke. Elevated levels soon after exposure were associated with increased risk of difficulty breathing in the years that followed.

 PTSD and Inflammatory Responses

A few months ago I stated “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.”

 “…individuals with PTSD are more likely to have significantly higher amounts of circulating CRP [an inflammatory marker] than those not diagnosed with PTSD.”

 The Combination of PTSD and Respiratory Issues

To repeat from my previous post,“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 … 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, are ideal 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.”

 A Plea to Readers

I am convinced that immune inflammatory imbalances contribute in large portion to the reason that that First Responders experience so many health challenges.

 It is my heart-felt hope and expectation that helping individuals return to immune homeostasis, immune balance, may be the key to changing their quality of life. Despite numerous attempts and avenues, I have been unable to make reliable contact with decision makers or Responders.   I hope that you will forward my note to individuals that are still suffering the consequences of serving others.

 I can be reached at: DrHellen@DrHellenGreenblatt.info or at 302.265.3870. Thank you.

www.asbestos.com/world-trade-center/
sb.cc.stonybrook.edu/news/general/140910wtc.php
911research.wtc7.net/wtc/evidence/dust.html
www.sciencedaily.com/releases/2014/09/140910185910.htm
www.health.ny.gov/environmental/investigations/wtc/health_studies/responders.htm
www.cnn.com/2013/09/11/health/911-cancer-treatment/
www.thelancet.com/themed-911
www.mesothelioma.com/blog/authors/barbara/help-running-out-for-911-first-responders.htm
www.ncbi.nlm.nih.gov/pubmed/21998260

During the 1970′s and 80′s, the saga of the “boy in the bubble” was followed with great interest. David Vetter, a young Texas boy had severe combined immunodeficiency (SCID), a disease caused by life-threatening defects in his immune system. His immune system was unable to protect him from infection, resulting in the necessity of having to live in a germ-free, isolation containment center designed by NASA engineers. He lived in this plastic bubble from the time of this birth until he died at the age of 12 following a failed bone marrow transplant.

The containment center was supposed to keep David separated from any pathogens that might harm him. Unfortunately, it was likely that it was a virus-contaminated bone marrow transplant that resulted in lymphoma, an immune system cancer, which ended David’s life.

Living in a sea of pathogens, a functional immune system is essential for our survival. Inflammation is among the first steps the body takes to heal after injury or disease and it uses immune inflammatory responses to protect us from cancer cells and pathogens. But too much inflammation is as serious a problem as too little inflammation. The body constantly struggles to limit the amount of inflammation that it produces, with uncontrollable amounts of inflammation acting like as if it was an out-of-control forest fire, destroying healthy cells in its path.

The four letters “itis” indicate an inflammatory condition. Typically, the name of the disease depends on the location in which the inflammation occurs. For example, arthritis (inflammation of the joints), colitis (inflammation of the intestinal tract, the colon), dermatitis (inflammation of the skin), nephritis (inflammation of the kidney), pancreatitis (inflammation of the pancreas), and uveitis (inflammation of a part of the eye).

Most immune cells do not have specialized names, however some organs have specialized inflammatory immune cells that detect infection and help resolve infection or injury to the body. Kupffer cells are most often associated with the liver. Microglia are associated with the brain and are involved in repairing damaged brain tissue and protecting the brain against disease. Dust cells, also known as alveolar macrophages, carry out similar functions in the lungs.

Inflammation is like real estate: location, location, location. The process of inflammation is substantially the same no matter where in the body the inflammation occurs. The intensity of the inflammatory response is determined by a balance between pro-inflammatory (molecules that cause inflammation) and anti-inflammatory (molecules that dampen inflammation) cytokines, immune messages that are released by immune cells.

The key to healthy immune responses is to be in immune homeostasis, immune balance. We must maintain the balance of enough inflammation to defend ourselves from pathogens, stimulate repair, and healing against the need to limit the amount of inflammation that too often leads to inflammatory diseases.

Contact Dr. Hellen for guidance in utilizing natural means to help the body return to immune homeostasis. She may be reached at:  DrHellen@DrHellenGreenblatt.info or or at 302.265.3870.

www.ncbi.nlm.nih.gov/books/NBK22254/
www.ncbi.nlm.nih.gov/pubmed/23720329
www.thedoctorwillseeyounow.com/content/mind/art3792.html?getPage=2
www.hindawi.com/journals/cherp/2012/490804/

 

Ebola virus disease (EVD), formerly known as Ebola hemorrhagic fever, is a severe, often fatal illness in humans. As of this post, the virus has spread through many African nations, and is the worst Ebola outbreak every recorded. The virus has infected over 1200 people and abuot 60% of these individuals have died from the disease.

Health practitioners have put themselves at great risk caring for those who have become infected. According to the BBC, one hundred health workers have been affected and half of them have died. At least three high-profile physicians in the forefront of care have succumbed to the virus, and three nurses who worked in the same treatment center as one of the physicians, are believed to have died from the virus.

Two Americans working to battle Ebola in Liberia, one a physician, have tested positive for the virus and are undergoing intensive treatment and workers from Doctors without Borders and the Red Cross are “overwhelmed” for the virus that has no cure.

Depending on the type of Ebola virus, up to 90% of those infected can die a rapid and difficult death. The onset of symptoms may be characterized by a sudden spiking fever, headache, joint, muscle, and stomach pain, diarrhea, vomiting, and in some cases, uncontrolled internal and external bleeding. Infected individuals die from failure of multiple organs in the body such as the nervous system, liver, and kidneys.

The disease is characterized by abnormal immune responses in which the Ebola viruses appear to evade attack of immune cells; dramatic immune imbalances occur in response to infection. There is evidence that the immune system responds with a “cytokine” storm during which certain immune cells “dump” large amounts of pro-inflammatory molecules, cytokines, into the body. Other biological compounds are released as well that contribute to the confused immune response.

Additionally, specialized cells produce insufficient amount of anti-viral cytokines, while at the same time, there is a significant increase in death of other types of immune cells. Scientists at the National Institute of Allergy and Infectious Diseases call this “a mixed anti-inflammatory response syndrome (MARS)”, and suggest that this “catastrophic uncontrolled immunological status contributes to the development of fatal hemorrhagic fever”.

Perhaps some of the symptoms that patients experience are due to autoimmune responses against individual classes of lymphocytes. This would account for the loss of certain immune cells, such as CD4 and CD8 cells. If they were available in higher numbers, they might be able to help the body fight the infection.

Many immunological factors contribute to Ebola virus fatalities. It is my contention that if  individuals were able to achieve immune homeostasis, immune balance, they would be better equipped to mount  controlled inflammatory responses which might help control the course of the disease.

 www.cdc.gov/vhf/ebola/pdf/fact-sheet.pdf
www.cdc.gov/media/releases/2014/t0728-ebola.html
www.who.int/mediacentre/factsheets/fs103/en/
www.nasw.org/users/mslong/2010/2010_09/Ebola.htm
www.vox.com/2014/7/23/5930311/ebola-virus-disease-outbreak-africa-facts-guinea?utm_medium=social&utm_source=facebook&utm_campaign=voxdotcom&utm_content=Sunday
www.ncbi.nlm.nih.gov/pubmed/20957152
www.ncbi.nlm.nih.gov/pubmed/21987781
www.ncbi.nlm.nih.gov/pmc/articles/PMC368745/

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.

 

www.ncbi.nlm.nih.gov/pubmed/23806967
www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml
www.ncbi.nlm.nih.gov/pubmed/24157651
archpsyc.jamanetwork.com/article.aspx?articleid=1833091
www.medpagetoday.com/Psychiatry/AnxietyStress/44519
www.cdc.gov/niosh/topics/traumaticincident/
www.ncbi.nlm.nih.gov/pubmed/19780999
www.biomedcentral.com/1471-244X/13/40
www.ncbi.nlm.nih.gov/pubmed/24948537
archpsyc.jamanetwork.com/article.aspx?articleid=1790358
www.ncbi.nlm.nih.gov/pubmed/24559851
www.ncbi.nlm.nih.gov/pubmed/24875221
circ.ahajournals.org/content/101/15/1767.full
www.veteransandptsd.com/PTSD-statistics.html
www.hindawi.com/journals/cherp/2012/490804/

Nearly every day people tell me that their joints are swollen and stiff, they hurt all over, and that they look and feel older than their chronological age. Most of these individuals have been diagnosed with rheumatoid arthritis.

Arthritis is a sign of a “boosted” immune system with excessive inflammation leading to joint damage. People report pain in areas such as their backs, fingers, hands, wrists, knees, and shoulders.

Rheumatoid arthritis typically affects the joints of the body. However sometimes even before joint symptoms appear, rheumatoid arthritis can involve other parts of the body including the lungs or eyes. Long-term inflammation of the lungs leads to scarring and shortness of breath, fatigue, weakness, and an on-going, chronic dry cough. If the pleura, the tissues around the lungs, become inflamed, fluid buildup may result in fever, pain when taking a breath, and difficulty in breathing.

Inflammation Is Essential for Our Survival:
Clinicians, and most lay people, focus on the harmful aspects of inflammation and try to stop the inflammatory response at all costs. Instead, all that is needed is to control the this immune response. The process of inflammation is normal, protective, and absolutely essential for our survival. Inflammation is the first step to healing after an injury or when the body is gathering its forces to stop an infection. Immune inflammation also helps the body destroy cancer cells before they grow and multiply.

When the body recognizes it has been injured or infected, the immune system releases antibodies and cytokines, smaller proteins that attract different types of immune cells into an area, to help eliminate and destroy threats to the body.

Once healing has started, the amount of inflammation that the body produces must be controlled. The genes that control inflammation have to be “turned off”, down-regulated, so that inflammatory responses are limited.

Arthritis is an Autoimmune Disorder:
Arthritis is one of many autoimmune disorders in which the body mistakenly produces autoantibodies, antibodies against its own tissues that attach to joint linings, and cartilage which acts as a shock absorber. The presence of autoantibodies may trigger immune cells to release inflammatory molecules that cause damage to the joints and other organ systems.

The Effect of Stress and Weight on Arthritis:
There are many factors that contribute to the discomfort experienced by individuals with joint issues. Two of these most recently investigated are: stress and weight.

Stress:
The body increases the amount of inflammation it produces when it is exposes to constant stress and the stress of pain. It becomes part of a vicious cycle. Stress causes inflammation, and inflammation leads to more stress. There is crosstalk between the nervous, hormonal, and immune systems. Changes in one system effects the other system.

Stressed individuals suffering from rheumatoid arthritis produce much higher levels of most cytokines than people without arthritis. Immunologically they respond differently to stress.

Weight Issues:
Overweight and obese patients with rheumatoid arthritis have more pain and respond less well to medication, as compared to normal weight patients. Obesity is an inflammatory disease during which fat cells, especially those concentrated around the inner organs, pump out large numbers of inflammatory molecules. Certain inflammatory proteins are found in high number in the abdominal fat tissue of overweight and obese individuals.

Importance of Immune Balance/Immune Homeostasis:
Immune inflammation is tightly regulated by the body. It consists of a) triggering and maintaining inflammatory responses, and b) producing immune messages that decrease and/or entirely stop the inflammation. Imbalances between the two phases of inflammation results in unchecked inflammation, loss of immune homeostasis, and may result in cell and tissues damage like that experienced in rheumatoid arthritis.

The key is to incorporate lifestyle changes to help the body maintain immune balance.

 Help your body return to immune balance.  Dr. Hellen may be contacted at: 302.265.3870 ET USA, or use the contact form. Thank you.

www.mayoclinic.org/diseases-conditions/arthritis/basics/definition/con-20034095
www.hopkinsmedicine.org/Press_releases/2003/10_17_03.html
www.ncbi.nlm.nih.gov/pubmed/24846478
www.ncbi.nlm.nih.gov/pubmed/24738934
 www.ncbi.nlm.nih.gov/pubmed/24850878
ard.bmj.com/content/early/2014/05/12/annrheumdis-2013-205094
www.fasebj.org/content/27/12/4757

People who are heavy and are not physically active, are at greater risk for conditions such as: increased blood sugar, higher pressures on their artery walls (high blood pressure), increased rate and workload on the heart, stroke, joint problems, sleep disorders, difficulty breathing, and even certain types of  cancer.

There are other posts on this blog relevant to the issue of being overweight or obese, but there is little question that most individuals would feel a lot better if they were only 5 or 10 pounds lighter.

When compared to leaner people, adipose tissue, the fat deposits of obese individuals, have higher numbers of, and larger, fat cells.  These cells produce cytokines, immune factors, that are inflammatory in nature and trigger numerous inflammatory conditions including many mentioned above.

Adipose tissue has “immune-like” properties.  For example, macrophages, white blood cells which alert the body to the presence of invaders, are found in high numbers in fat cell clusters.  Additionally, obese individuals have been shown to have  increased levels of proteins in the blood stream that stimulate inflammation.  Overweight or obese people do not fight infections or heal as well as individuals at more appropriate weights.

 The following hypothesis may have validity.  The immune system may “see” components of adipose tissue as “foreign material” that must be eliminated from the body.  If this scenario is correct, when the body “battles” adipose tissue an autoimmune response is triggered, a response in which the immune system destroys its own tissues, resulting in high levels of inflammation. My hypothesis is supported by the fact that obese individuals produce high levels of autoantibody, antibodies against their own tissues. Rather than resulting from inflammation, these autoantibodies may be the trigger for inflammation.

Muscle cells, like fat cells, secrete cytokines, molecules which help the body regulate inflammatory responses. In response to exercise, many different types of cytokines are produced by muscles and other cells.  Cytokine measurements taken after a marathon demonstrated 100 fold increases of certain cytokines, whereas other cytokines were produced that typically dampen an inflammatory response.

The wide spectrum of immune factors that the body produces in response to physical activity helps the body maintain a steady state of inflammation, an immune balance that helps the body defend itself against infection and helps healing, but not so much that innocent by-stander tissues are damaged.  In fact, studies have shown that individuals that are overweight, nevertheless may be healthy, if they are maintain a level of physical fitness.

The bodies of overweight and obese individuals are consistently exposed to self-generated, inappropriate levels of inflammation.  Helping the body return to a healthy balance of immune responses, a state of homeostasis, will go a long ways towards changing their quality of life.

I would be pleased to hear from you if you are interested in changing your quality of life.  I can be contacted at: drhellen@drhellengreenblatt.info or at:  302.265.3870 USA ET.

 


diabetes.diabetesjournals.org/content/56/6/1517.full

www.ncbi.nlm.nih.gov/pubmed/14679176
www.ncbi.nlm.nih.gov/pubmed/23562157
www.ncbi.nlm.nih.gov/pubmed/22429824
www.ncbi.nlm.nih.gov/pubmed/24761347
www.nature.com/icb/journal/v78/n5/full/icb200073a.html
online.liebertpub.com/doi/abs/10.1089/jmf.1998.1.171
brevets-patents.ic.gc.ca/opic-cipo/cpd/eng/patent/2355168/summary.html?type=number_search

In a previous post, I discussed the role of excessive inflamation in thalassemia,  a blood disorder in which individuals suffer from low numbers of red blood cells and hemoglobulin levels. This post focuses on another blood disorder that results in low hemoglobulin levels, sickle cell anemia.

Abnormal Red Blood Cells
Normally, blood cells are rounded, disc-shaped, and flexible enough to move easily through blood vessels.  In contrast, people with sickle cell anemia have crescent, sickle-shaped, red blood cells that are stiff and sticky, and tend to become “stuck” in various tight spots in blood vessels.  This blocks blood flow leading to pain and organ damage from inflammation in response to the blockages.  Additionally, since their hemoglobin structure is abnormal, the red blood cells are unable to carry their full complement of oxygen throughout the body, resulting in oxygen deficits.

Red blood cells typically live for about 4 months in the blood stream, but sickle cells die after only 10-20 days.  Individuals with sickle cell anemia, cannot make fresh red blood cells fast enough to replace the dying red blood cells.  The lack of oxygen leads to fatigue, feelings of weakness, shortness of breath, dizziness, headaches, cold hands and feet, pale mucous membranes, and a yellowish tinge to skin or the whites of the eyes. 

Pain Crises
Perhaps the most devastating symptom that many individuals with sickle cell anemia experience is excruciating pain that lasts for hours, weeks, or months. These are called “pain crises”. Painful crises are the leading cause of emergency room visits and hospital stays for people who have sickle cell anemia.

The pain results from inflammation and damage to blood vessels by the sickled cells.  When the red blood cells block the flow of blood to limbs and organs, immune cells come into the area and release inflammatory cytokines, immune molecules that result in a vicious cycle of more inflammation and pain.

Some individuals experience these crises a few times a year,  others may more frequent episodes.  Repeated crises can damage the bones, joints, kidneys, lungs, eyes, heart, and liver.  Moreover, in children, damage to their spleen, an immune organ, can leave them more susceptible to infection.

Cascade of Inflammation
Inflammation not only plays a major role in damaging blood vessels, but the immune cells release inflammatory cytokines, molecules that trigger inflammation,  and biological compounds that cause cells to become “sticky”.  The blocked blood flow leads to pain and other health issues.

When compared to those without sickle cell disease, individuals with sickle cell anemia have different profiles of messenger cytokines.  For example IL-6,  which helps the body return to immune balance, immune homeostasis,  is at significantly higher levels in sickle cell anemia patients.

Summary
Inappropriate levels of inflammation pose major challenges for the quality of life of individuals with sickle cell disease.  A rational approach to benefiting individuals with sickle cell is to help their bodies achieve inflammatory homeostasis, immune balance.

Help your body return to immune balance, immune homeostasis.  Dr. Hellen may be contacted at:  302.265.3870 ET USA, or use the contact form.  Thank you.

http://umm.edu/health/medical/reports/articles/sickle-cell-disease
www.ncbi.nlm.nih.gov/pubmed/8746787
http://www.ncbi.nlm.nih.gov/gene/3569
http://www.ncbi.nlm.nih.gov/pubmed/24383847
www.ncbi.nlm.nih.gov/pubmed/24589266
http://arthritis-research.com/content/8/S2/S3
 

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
 

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