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According to the World Health Organization smoking is the second largest preventable cause of disease and premature death. Globally, tobacco products are responsible for 5 million deaths annually. A person dies every 6 seconds from smoking-related diseases including chronic diseases and cancer.

Among its many effects, smoking triggers an immunologic response in arteries and veins which is associated with increased levels of inflammatory markers, such as C-reactive protein and increases in white blood cells. C-reactive protein is strongly associated with lifetime smoking exposure as measured by pack-years. Several studies have shown that such markers predict future cardiovascular events including atherosclerosis.

However, once smokers quit, their risk of future cardiac events and death gradually declines, and within 5 years, smoking-associated inflammatory responses start to return to normal.

Cigarette smoking has also been linked to increased risk of autoimmune diseases, including lupus, rheumatoid arthritis, multiple sclerosis, thyroid, and liver. Autoimmune diseases are immune disorders where the body attacks itself resulting in excessive inflammation and tissue damage.

Considering that cigarette smoke contains over 7000 chemicals, the likelihood that smoking triggers autoimmune and other excessive inflammatory immunological responses makes sense. An example of smoke-induced illness is chronic obstructive pulmonary disease (COPD) in which a person has difficulty in getting enough air.

The lungs, in response to cigarette smoke, activate cells lining the lungs and immune cells, resulting in inflammatory responses. If an individual is infected with a bacterial or viral infection in addition to the smoke assault, it results in a vicious cycle of more difficulties in breathing and greater inflammation. Studies have indeed shown that patients with COPD have autoantibodies and inflammatory responses against lung cells.

Researchers have reported that in female smokers, physical activity, known to help reduce inflammation, reduced their relative risk of developing lung cancer by more than 65 percent.

Thus, it might be expected that if smokers were better able to control their inflammatory responses and return to immune homeostasis, that they might be less likely to develop chronic diseases.

 

www.ncbi.nlm.nih.gov/pmc/articles/PMC1160597/

www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.0020160

www.ncbi.nlm.nih.gov/pubmed/21907865

www.ncbi.nlm.nih.gov/pubmed/17975205

www.medicalnewstoday.com/releases/58661.php

 

Bernard Lown, MD The Lost Art of Healing Boston New York Houghton Mifflin Company 1996

Medicine in the United States is widely regarded as the best in the world*. Hardly a day passes without a major scientific breakthrough. Many formerly fatal diseases are now curable. People are healthier and live longer than ever. Still, patient dissatisfaction with doctors has rarely been more acute. Although physicians are increasingly able to cure disease and prolong life, the American public is suspicious, distrustful of, even antagonistic to, the profession. Doctors, uneasy, astonished, resentful, and angry, universally acknowledge a crisis in health care. With the focus on colossal medical expenditures, amounting to a trillion dollars annually, most of the numerous solutions involve containing runaway costs….

Medicine’s profound crisis, I believe, is only partially elated to ballooning costs, for the problem is far deeper than economics. In my view, the basic reason is that medicine has lost its way, if not its soul.

* And yet, depending on the Agency that sponsored the study on longevity, America ranks either 27 or 30th , in the world in terms of mortality. Countries like Malta and South Korea have longer life expectancies than individuals in the U.S.

Next week the United Nations will hold a unique Summit, the first one focusing on the worldwide chronic diseases such as diabetes, cancer, heart, and lung disease. These are also the major diseases that challenge Americans.

And it has become increasingly obvious that uncontrolled immune inflammatory responses are major contributors to disease. Inflammation results in illnesses of many types, and vice versa. For example in the case of cancer and inflammation, there is “cross talk” between immune and tumor cells with inflammatory responses playing major roles during different stages of tumor development.

The key to health is immune balance, immune homeostasis. Immune homeostasis is a state where the level of inflammatory cytokines, is inhibited by anti-inflammatory cytokines and other immune factors. The right ratio of these cell messages restores the body’s delicate immune balance, and lessens the likelihood that one will become ill. Controlling inflammation is a primary approach to decreasing chronic disease.

 

http://hdr.undp.org/en/statistics/

www.jci.org/articles/view/25102

www.ncbi.nlm.nih.gov/pmc/articles/PMC2866629/

 

An article this week from Shirley Wang, a Wall Street Journal reporter, brought the public’s attention back to the fact that there is no cure for the usually fatal disorder, amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease. Amyotrophic lateral sclerosis (ALS) is a paralytic disease caused by the gradual degeneration of nerve cells in the brain and spinal cord. The breakdown of neruons interrupts the ability of muscles of the body to send messages to the brain. ALS results in difficulties in talking, swallowing, moving, and paralysis, and eventually, the loss of the ability to breathe.

An international group of scientists recently reported in the journal Nature, that the lack of a certain protein might be the common underlying cause of neurodegenerative diseases such as ALS, dementia, Parkinson’s, and Alzheimer’s. The task of this specialized protein is to remove the debris of damaged nerve cells and help in their repair. When this function no longer occurs, normal transmission of signals from muscles to brain is blocked.

One individual commented on Ms Wang’s article. “It seems outrageous to me that in 2011 a quickly fatal disease that was brought to our national attention in 1939 continues to steal our best and brightest without any treatment and with few clues as to the cause. We must do better….”

I agree. Instead of treating a condition after damage has occurred, why not prevent excessive inflammatory responses from causing damage in the first place? The ALS Association does an excellent job explaining that, “The glia cells that usually support and nourish their neighboring neurons in the nervous system can become over active in certain diseases”. And that leads to over production of cytokines, immune signals, that are mediators of inflammation,and damage to the nerve cells.

Inflammation protects the body from infection and repairs tissue damage. But uncontrolled levels of inflammation damages healthy by-stander cells, and tissues. When it comes to the repair protein mentioned above, perhaps individuals with ALS, or other neurodegenerative diseases, are attacking this protein, and decreasing the quantities needed for clean-up and repair.

A body in immune homeostasis, immune balance, is unlikely to attack itself. Instead one approach that research should take is finding ways to help the body modulate inappropriate levels of inflammation.

 

www.ninds.nih.gov/disorders/amyotrophiclateralsclerosis/detail_ALS.htm

www.chicagotribune.com/health/ct-met-northwestern-als-breakthrough-20110822,0,4185292.story

www.nature.com/nature/journal/v477/n7363/full/nature10353.html

http://www.alsa.org/research/about-als-research/inflammation.html

 

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

 

It is ten years since the horrific 9/11/01 attacks on the World Trade Center in New York City, The Pentagon in Washington, DC, and Flight 93 in Pennsylvania. On that day at the World Trade Center alone, there were approximately 3,000 murders.

These events have not only left the families, friends, and citizen survivors distraught and at great emotional and financial risk, but the heroic responders, the rescuers, recovery, and clean-up personnel, and civilians that lived and worked in the area, continue to pay a significant price in terms of their health.

There will never be a true accounting of how many individuals were exposed to smoke, thick-coatings of dust, combustion materials, asbestos, polychlorinated biphenyls (PCBs), dioxin, asbestos, and metals. Fire fighters, police, military members, paramedics, construction and iron workers, municipal employees, security workers, residents and workers in the area, and those that came from afar to help, were exposed to these toxic chemicals for days, weeks, and months. Fires burned for 69 days and even eight months after the destruction, workers were still searching for body fragments (1).

For some, the years may be receding from memory, but there are many individuals, and rescue and recovery dogs, that have, or are, still, paying a significant price for their heroic sacrifices. If they are still alive, their emotional and physical health has declined significantly, and no one seems to be able to help them.

Only limited funding has been available to study and monitor individuals that were at Ground Zeroand its surrounding environs. When researching information for this article I was surprised at the relatively few, peer-reviewed publications on this topic, and there is even less information on the effects of this trauma on children and adolescents.

Multiple Health Issues

A primary investigation now led by Dr Juan Wisnivesky, Mount Sinai School of Medicine in New York, has said, “Our findings show a substantial burden of persistent physical and mental disorders in rescue and recovery workers who rushed to the site of the WTC and labored there for weeks and months. Many of these individuals now suffer from multiple health problems (2), since World Trade Center-related mental and physical health conditions often co-exist (3).

Mental Health Issues Persist

One year after 9/11, it was estimated that more than 420,000 people New Yorkers were suffering from post traumatic stress disorders (PTSD) as a result of the attacks (1). This month, the prestigious British journal, Lancet, reports that 32% of tested personnel experienced post traumatic stress disorders and 28% per cent experienced depression at some time after 9/11. The incidence of most of the disorders was highest in workers with greatest World Trade Center exposure (3,4). Other emotional problems such as recurring nightmares, flashbacks, self-medication with alcohol, etc. have also been persistent issues.

Tomorrow: 9/11 Responders: Cancer Risks, Pulmonary Function, Immune Homeostasis, Balance.

1) www.guardian.co.uk/world/2002/aug/18/usa.terrorism

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

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

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

>Gina Kolata of the NY Times reports that many athletes, both professional and amateur, often have difficulties in finding the right approach when they injure themselves. They spend thousands of dollars visiting physicians who are confident that they can help, but too often, the procedures are not very helpful.

Research clinicians are questioning the benefits of certain procedures recommended by physicians. Their concern is that there is little “credible evidence” to back up many of the methods that their colleagues use (1).

Most physicians would probably agree that the pain their patients experience is due to excessive levels of inflammation. Inflammation is essential for good healing, but it is just as important that inflammation be a controlled event.

“Inflammation is the immune system’s response to injury and infection, and quick decisions must be made when one or both are present. If the immune system detects an infection, it also looks for signs of injury (broken cell parts, spilled cell constituents). The reverse holds as well — after sensing an injury, the immune system searches for telltale signs of the presence of microbes launching an infection. In many cases, both an infection and an injury set off an inflammatory response. After massive tissue damage caused by trauma …, a systemic inflammatory reaction can set in (2).”

Tissue injury is associated with “an inflammatory soup bathing small nerve fibers”. The immune factors, cytokines, that make up this “soup” are initially pro-inflammatory (2).  They trigger inflammation, resulting in pain sensation that occur throughout the body, including in the brain.

When athletes are injured, the key is for the body to heal the injury, and then down-regulate, “calm-down”,  the inflammatory response and return to immune homeostasis.

(1) www.nytimes.com/2011/09/05/health/05treatment.html?ref=health
(2) www.gluegrant.org/inflammation101.htm
(3) www.ncbi.nlm.nih.gov/books/NBK57275/

 

Dr. Cynthia L. Ogden at the Centers for Disease Control reported this week that nearly 50% of Americans consume drinks containing sugar, such as soda and energy drinks on a daily basis. Five percent of this population drinks the equivalent of more than four cans of soda each day. Teenagers and young adults drink the most, with males consuming more sweet beverages than females. Most of the sugar drinks consumed outside of the home, are purchased at stores, not schools or restaurants, and lower- income individuals consume more sugary drinks than those with higher incomes (1).

Sugar drinks or sugar-sweetened beverages (SSBs) are the largest source of added sugars in the diet of U.S. youths, and probably adults as well. Drinking excessive amount of calories contributes to the problem of obesity in this country (2). Previous studies have shown that the average teenager consumes about 300 calories a day from sugar-sweetened beverages. Over a period of a year, 300 calories/day is equivalent to an extra 30 pounds of weight!

The fat tissue around the belly, called abdominal or visceral fat, consists of immune-like cells that release pro-inflammatory cytokine molecules that result in body-wide inflammation. Extra weight around the midsection is linked to an increased risk of inflammatory diseases such as atherosclerosis (hardening and clogging of the arteries), heart attacks, diabetes, certain cancers, sleep apnea, arthritis, etc.

A healthy body controls the amount of inflammation it produces. Wellness is about maintaining “balance”, immune homeostasis. Balance one’s immune function and restore the proper and healthy balance of key systems that regulate the human body – metabolic, intestinal, hormonal, emotional, etc.–all mediated with the involvement of our immune systems.

An essential, simple step one can take to help the body regain immune and metabolic homeostasis and control weight, is to consume two or more servings/day of hyperimmune egg (http://www.HyperimmuneEgg.org ).

In addition, besides drinking less soda and other sugary beverages, incorporating the following steps will help achieve weight goals:
• Increase your physical activity-remember you have to use up more calories than you are consuming.
• Eat smaller portions then you typically consume.
• Increase intake of beans, nuts, lentils and colorful fruits and vegetables (berries, spinach, broccoli, etc.)
• Limit intake of:
Fast foods
Fried foods
Sugary desserts
Corn and potato processed products, (chips, nachos, French fries.)
White rice (use brown rice instead; it is higher in fiber and macronutrients)
Artificially-sweetened sodas and drinks—the body cannot tell the difference between “sweet”, and “sweet”

(1) http://www.cdc.gov/nchs/data/databriefs/db71.htm
(2) http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6023a2.htm?s_cid=mm6023a2_w

Rethink What You are Drinking: http://www.cdc.gov/healthyweight/healthy_eating/drinks.html

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