“Eczema” is worldwide the most common of chronic (long-lasting) inflammatory skin diseases. Also called atopic dermatitis [“itis” means inflammation], it is a condition of red, inflamed, burning, itchy patches of skin. In severe cases, people experience blistering, bloody and peeling skin and raw, excruciating pain.
In the United States alone, over 30 million people have been diagnosed with dermatitis, with almost twice as many children having the condition as adults. As with most immune disorders, more females have the condition than males, and hospitalization due to flare-ups of the conditions or associated infections is associated with an 8-year reduction in lifespan.
Individuals with dermatitis are frequently embarrassed when they have an outbreak, and the itching “drives them crazy”. They have tried every approach including medications, acupuncture, herbals, creams, ointments, and different detergents. Having dermatitis leads to at least 40% of individuals turning down an educational opportunity or job.
Caregivers especially report feeling frustrated, helpless, sad and guilty when dermatitis occurs in children, placing the entire family under both emotional and financial stress. There is no medical cure for eczema.
Atopic dermatitis is attributed to a combination of genetic and environmental factors. Foods such as dairy, certain nuts, soy, wheat, and allergens such as dust mites, pets, pollens have all been implicated. Additionally there are more than 80,000 chemicals registered for use today in the USA. The bottom line is that researchers do not know what causes dermatitis.
What is known, is that atopic dermatitis is a sign that the immune system, via its inflammatory cells, is overreacting to some agent, and in the process of trying to protect itself, damages by-stander skin cells (autoinflammatory).
In moderate to severe atopic dermatitis, high numbers of inflammatory cells are found both in inflamed and unaffected skin, as well as in the blood. Long term, chronic inflammation leads to skin lesions, blisters and the other symptoms with which people with dermatitis suffer.
As Dr. Eric Simpson, a member of The American Academy of Dermatology has said, “We may not have a cure for atopic dermatitis just yet …[but] tackling inflammation is key.”
Suggestion:
There is no medical treatment for eczema however individuals that have been able to achieve immune balance, homeostasis, have found significant differences in their skin health.
Achieve balance by being physically active 4-6 days a week, consume a smart diet, maintain a healthy weight, do not smoke, or drink in excess. Do take walks outdoors and add a proven immune balancing supplement to your daily diet and see and feel the difference.
Contact Dr. Hellen– she is there for you. No fee is charged for the first 30 minutes of consultation. She may be contacted by using this form or calling: 302.265.3870 (ET-USA).
It is estimated that over 33 million people in the United States are uncomfortable leaving their homes or meeting with friends because they have an overactive bladder that forces them to be close to a bathroom at all times.
People with an overactive bladder may urinate eight or more times in 24 hours and multiple times during the night. Sixty percent of elderly women and 30% of middle-aged men and women experience symptoms of an overactive bladder, urinary incontinence (leaking urine). Individuals often hesitate to share this problem with their physician.
An overactive bladder, sometimes called a “spastic bladder”, is the name given to a group of urinary symptoms. There are two types of urinary incontinence, although one can have both at once. They are urge and stress incontinence. Urge incontinence is the strong, sudden urge to urinate that cannot be ignored. When one does not get to the bathroom “in time” there may be an involuntary leakage of urine. Stress incontinence happens when people leak urine while sneezing, laughing or being physical.
When it is time to empty the bladder, a signal goes out to the brain which “tells” the muscles of the bladder to contract, pushing urine out and to empty the bladder. In people with overactive bladders, the muscles of the bladder start to contract involuntarily even when the volume of urine in the bladder is low. This involuntary contraction creates the urgent need to urinate.
Several conditions are associated with an overactive bladder. These include diabetes, certain medications, stroke, urinary tract infections, bladder stones, tumors and excessive consumption of alcohol or caffeine. In too many cases the cause is unknown; this is called an idiopathic overactive bladder condition.
Recent studies suggest that individuals with an overactive bladder have higher levels of inflammation. High levels of the inflammatory marker, C-reactive protein, and inflammatory cytokines are found in patients. When analyzing over 1800 men and 1800 women with overactive bladders, and adjusting for other conditions including smoking and alcohol consumption, the higher the C-reactive protein levels, the greater the odds of having urgent episodes and frequency. The clinicians concluded that there may be a role of inflammation in the development of this condition.
Summary.
An overactive bladder is a common condition affecting all ages and has a severe impact on quality of life. Keeping the body and bladder in homeostasis, in balance, may be an important key to reducing the sudden urge tourinate.
Contact Dr. Hellen, she is there for you. No fee is charged for the first 30 minutes of consultation. She may be contacted by using this form or calling: 302.265.3870 (ET-USA).
The Centers for Disease Control in Atlanta, Georgia reports that estimated 6-7 million people have been, or are currently sick with viral flu during the current flu season. Half of these individuals saw a health practitioner for their illness but nevertheless approximately 69,00-84,000 people were hospitalized. Much of the illness and deaths from the flu are the result of bacterial infections that often accompany the disease (secondary infections) and excessive inflammation. Unfortunately, a total of 22 influenza-associated pediatric deaths have been reported during the 2018-2019 season to date.
CDC expects flu activity to continue for many more weeks or even months, and it continues to recommend flu vaccination and antiviral medications for high-risk groups such as children 5 years of age (but especially those younger than 2 years of age), older adults, pregnant women and residents of long-term facilities.
Not everyone experiences the same flu symptoms, but symptoms range from chills, severe cough, sudden and high fever, stuffy, runny nose, severe aches and pains, bad headache, extreme fatigue, vomiting and/or diarrhea. Some people go on to develop serious complications caused by viral infection of the nasal passages and throat and lungs.
The presence of virus and bacteria triggers a robust inflammatory response in the body’s attempt to rid the body of disease. Inflammation is the body’s primary weapon to destroying pathogens, but it is a double-edged sword since “uncontrolled” inflammation in response to the virus may result in significant lung damage, followed by death.
It has recently become apparent that during influenza infection, large numbers of inflammatory immune cells leave the lungs and travel to the small intestines. Here they interact with the microbiome (communities of organisms that occupy the gut) destroying the proper the balance of beneficial organisms and permitting the overgrowth of certain classes of bacteria.
These inflammatory cells may be trying to defend the body against pathogens, but instead they produce so much inflammation that the gut lining is injured by them. (Interestingly, in animal studies, antibiotic treatment of the bacteria in the gut reduces damage.)
Inflammation is the protective process by which the body removes harmful pathogens and substances and initiates healing. It is a tightly regulated process that involves molecular signals that start and maintain inflammation (pro-inflammatory) followed by signals that turn “off” the inflammatory process (anti-inflammatory signals). Imbalances of these immune factors results in damage to the tissues and organs.
A properly balanced immune response is essential for the body to combat viruses like influenza and the bacteria that too often are associated with the illness.
Taking the following steps towards helps the body defend itself successfully against infections:
Wash your hands frequently and keep them away from your nose and mouth (mucous membranes).
Stay hydrated to keep membranes moist and resistant to invasion.
Be physically active 2.5 hours/week.
Be smart—eat healthy, especially vegetables and fruits.
Try to get outdoors a few minutes a day.
Stop excessive alcohol consumption.
Cut down or quit smoking—your lungs are working hard enough trying to bring oxygen into the body.
Consume a proven immune support supplement to help your immune system balance.
Enhance your quality of life. Dr. Hellen can be contacted by using this form, at drhellen@drhellengreenblatt.info or call her at: 302.265.3870 (ET, USA).
HIV, or the human immunodeficiency virus is a virus that left untreated may lead to acquired immunodeficiency syndrome or AIDS. Unlike some other viruses, even with treatment some people infected with HIV may never eliminate the virus.
In an animal model of HIV, within 24 hours of infection, the virus hitches a ride on immune cells and travels throughout the body. HIV has a special propensity for immune cells, especially T cells. T cells help the body fight infections by activating the production of antibodies (large molecules that neutralize pathogens) and triggers inflammation to kill pathogens or destroy cells containing microbes. Left untreated, HIV infection reduces the numbers of defensive immune cells in the body, leaving HIV infected people (HIV positive) highly vulnerable to infection with other foreign agents (opportunistic infections) and cancers.
DC (dendritic cell)- A type of immune cell that plays a primary role in infections with HIV. They are important regulators of immune system responses to infection. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4033703/
From 80-90% of immune cells are found in the walls of the intestines and in the tissues surrounding the intestines. HIV tends to accumulate in these tissues and attack them. These inflammatory responses may weaken the gut barrier resulting in inflammatory digestive issues for HIV positive individuals.
“Inflammation and immune activation accelerate heart disease and stroke, and chronic HIV infection results in both,” says Robert T. Schooley, AIDS researcher and Professor of Medicine in the Infectious Diseases division at the University of California at San Francisco. In addition, this population is at increased risk for certain cancers, gastrointestinal, liver and kidney problems.
There are no cures for HIV, but with proper medical care, the numbers of virus infecting a person and their symptoms may be controlled. Proper medical treatment dramatically improves and prolongs lives. Anti-retroviral therapy (ART or ARV) is used to treat HIV infections.
When the “cocktail” of medications is taken as prescribed, viral loads (the number of viruses in the body) are decreased. These medications can reduce the numbers of HIV down to very low levels (called “undetectable”). However, in some individuals HIV can continue to infectimmune cells. [Note: The CDC states that individuals with undetectable virus loads have no risk of sexually transmitting the virus.]
The body must be in immune balance, in immune homeostasis to protect the body from infection or fight infections. The immune system must produce the right ratio of inflammatory cytokines (pro-inflammatory) to anti-inflammatory cytokines. It needs enough inflammation to destroy the pathogen, or in this case HIV, but not so much that healthy tissues are damaged.
A recent study of people that have been treated over many years for HIV reports that HIV positive individuals are at a higher risk of getting diseases common to older individuals. Individuals that were infected in the early years with HIV are now in their 50s and 60s and develop inflammatory-related conditions at a significantly higher rate and lower age than uninfected people of the same age.
Summary:
The key to staying healthy is to remain in immune homeostasis, immune balance—this is true especially for people with chronic infections such as HIV.
Please contact Dr. Hellen if you wish to enhance your quality of life-don’t you deserve to do that? The first 30 minutes of discussion are gratis. Dr. Hellen may be contacted by using this form or calling: 302.265.3870 (ET-USA).
Back pain is one of the most common health complaints among adults in the US. From 75-80% of individuals will suffer from lower back pain sometime in their lives.
Symptoms of back pain include shooting or stabbing pains in the back, limited mobility, and/or pain that radiates down the leg.
The majority of individuals experiencing back pain will become more comfortable within days or weeks without medical treatment. Some people however may experience chronic pain lasting 2-3 months or more. Nonetheless, all low back pain results in major economic and social repercussions for both sufferers and society.
DrHellen 2018 (c)
There is no known cause of the pain in approximately 90% of patients; it is what is termed “idiopathic”. However, sitting too long or doing a physical task incorrectly may trigger back problems. The lack of physical activity, excess weight, genetics and the physical demands of a job also contribute to lower back pain. Sedentary lifestyles are associated with 1.41 times greater risk of developing back pain. Individuals that are not physically active, are 1.23 times more likely to develop lower back pain.
Individuals with back pain frequently have the same anatomically “abnormalities” as people without back complaints. Patients with occupation-related back pain who had magnetic resonance imaging (MRI) of their back were 8 times more likely to get surgery as those who had just x-rays. Since symptoms do not correlate with imaging testing, many practitioners will not recommend imaging testing within the first six weeks of pain (unless there is a strong suspicion of other underlying conditions)..
Inflammation in the body is tightly regulated, involving signals that initiate and maintain inflammation and others that turn inflammation off. Imbalances between the two, lead to unchecked inflammation.
Inflammation causes pain, and pain causes more inflammation. When the body hurts, inflammatory cytokines, immune molecules, are triggered that initiate the healing process. The release in the spinal cord of certain cytokines is associated with inflamed nerves and pain.
CRP (C-reactive protein) is a biological marker of inflammation. Individuals with the most severe lower back pain have nearly twice the amount of CRP levels as those with less pain.
Back surgery may relieve some causes of back pain, but it’s rarely necessary. Most back pain resolves on its own. There are a number of treatments that are used to reduce inflammation and pain: nonsteroidal anti-inflammatory drugs (NSAIDS), epidural steroid injections, topically applied creams or sprays, and for some, hot and cold packs.
One of the best approaches to relieving lower back pain is exercise, especially McKenzie exercises [find the exercise best for you on YouTube]. Individuals that do back exercises find significant relief and if practiced consistently will find that their backs will be strengthened and they will have less discomfort.
[As previous posts have suggested, backed by clinical trials, exercise increases naturally-occurring anti-inflammatory cytokines and can provide significant and faster relief to those suffering with lower back pain.]
Summary:
The key to healing is a balanced immune response. The body needs the right amount of inflammation to heal, but too much inflammation results in illness.
If you want to change how you feel, contact Dr. Hellen. No fee is charged for the first 30 minutes of consultation. Dr. Hellen may be contacted by using this form or calling: 302.265.3870 (ET-USA).
According to the Centers for Disease Control and Prevention (CDC), this flu season is an unusually severe outbreak with wide-spread instances of disease in 49 States with many schools being closed. The season started earlier than usual, which is never a good sign. CDC Deputy Director Anne Schuchat has said “This year’s influenza season is proving particularly difficult”. Hospitals do not have enough beds and the prevalence of the flu has led to shortages of anti-viral medications that if prescribed in the first 48 hours may shorten symptoms by a day or so.
This season’s primary virus strain is H3N2, a deadly type of influenza A that tends to result in more severe illness and higher numbers of hospitalizations and deaths than other strains. H3N2 is especially dangerous for the frail elderly and children, although people between the ages of 50 and 64 are being hospitalized at alarming rates, second only to the elderly. As of this post, almost 100 children have already died from the flu.
Since vaccination may lessen the severity of the illness and there are few other options, the CDC recommends people be vaccinated with the current flu vaccine, even though it may only be 30% -40% effective. [Antibiotics are useless against viruses since they only kill bacteria.]
Although some people view the flu as “merely” annoying and inconvenient, those suffering from influenza along with COPD (chronic obstructive pulmonary disease), asthma, emphysema, diabetes and other pre-existing conditions are at a higher risk of hospitalization or death, especially if they contract a secondary bacterial infection.
The influenza virus is difficult for the body to protect itself from, because it is able to mutate rapidly and frequently. This forces the immune system to constantly change its tactics to combat the latest version of the flu.
Infection by influenza triggers an intense immune inflammatory response in the lungs in the body’s attempt to stop the virus from multiplying. The lungs’ immune cells release cytokines, small molecules that signal and recruit other cells into the lungs to increase or decrease their immune and inflammatory responses.
But such a response can be a double edged sword. Too much inflammation causes lung damage on top of the damage already caused by the virus and secondary bacterial infections such as pneumonia. Additionally, although rare, if the balance of cytokines is significantly upset, the normal level of inflammatory cytokines may become too high, resulting in a cytokine storm (or cytokine cascade) that can kill a previously healthy individual in hours.
A properly balanced immune system, one in homeostasis, is more fully prepared to defend us against invasion by foreign agents, and is ready to help us combat an infection if we get one.
Following the following steps will help keep your immune system functioning at optimum levels:
Eat healthful meals with an emphasis on whole grains and plenty of colorful vegetables and fruits.
Be physical active to help keep the immune system in balance; incorporate it into your daily life.
Get adequate amounts of rest and avoid fatigue.
Drink plenty of fluids to keep membranes moist and more resistant to invasion.
Wash your hands frequently and try to keep them away from your face.
Stop, or at least cut down, on your smoking—your lungs are struggling enough.
Consume a superior immune support supplement to help your immune system balance.
Dr. Hellen’s passion is helping people have a better quality of life. Contact her by using this form, drhellen@drhellengreenblatt.info, or calling at: 302.265.3870 (ET, USA).
From the time of the ancient Greeks, it has been clear that the mind-gut-body connection influences one’s health; however, only during the last century have we begun to understand why this is the case.
With new tools, scientists can show that there is cross-talk between the brain, the gut and the immune system. Immune molecules from white blood cells send messages to the brain and the gut and in turn, these organs signal back to the immune system, up-regulating (increase) or down-regulating (decrease) inflammation.
Chronic, long-term stress, affects immune cells by changing their gene activity. This prepares them to fight infection or trauma and increases inflammation. More immune cells are then enlisted for the fight, resulting in increased inflammation.
Inflammation is necessary for survival, but too much inflammation is linked to heart and autoimmune disease, diabetes, depression, and cancer. This is why it is essential to maintain the right balance of signals.
Stress responses are part of a vicious cycle in which stress triggers inflammation and inflammation triggers additional stress.
In stressed mice, there are four times the numbers of immune cells than found in non-stressed mice. Additionally in mice that are stressed 1100 genes are responsible for increasing (up-regulating) inflammation. These genes in non-stressed mice are not activated.
Similar outcomes are seen in humans under chronic stress. For weeks and months following natural disasters such as earthquakes and hurricanes, individuals, especially those who have suffered great personal loss, have imbalances of the immune system that affects them both physically and emotionally.
The immune system and its inflammatory responses are in exquisite balance (homeostasis). The body expands much of its energy maintaining its balance in a steady state. This may be the reason that people who are stressed out tend to be “tired a lot of the time”.
Let us say that your immune system consists of 30 billion cells and that 15 billion of these cells are in the attack mode with excessive inflammation (up-regulation). Let us propose that another 15 billion cells are trying to limit the inflammatory response (down-regulation).
A total of 30 billion cells expending a “trivial” amount of energy is a great deal of wasted energy. No wonder people become exhausted when they are not in homeostasis, balance.
CONCLUSION:
The key to reducing stress is to help the immune system return to homeostasis, to its natural balance.
To better manage stress: incorporate an immune support supplement into your daily diet, be physically active 2-2.5 hours/week, spend time outdoors, eat smart, stay within healthy weight limits and remember that you are only one person—be kind to yourself; give yourself a break.
Achieving immune homeostasis will make all the difference in the quality of your emotional and physical well-being.
Contact Dr. Hellen at: DrHellen@DrHellenGreenblatt.info, use the form or give her a call at 302.265.3870 (ET, USA) at no charge to you.
What is the Role of Inflammation? When the body is injured or recognizes the presence of pathogens such as bacteria, viruses, molds, parasites or cancerous cells, its immune system is triggered to respond with inflammation to “burn” the threat out of the body.
Balance is Essential Once the challenge has been met, a person in immune balance, homeostasis, will reduce the amount of inflammation that they are producing to “normal” levels. Uncontrolled, run-away inflammation leads to autoimmune diseases (against oneself) in which its own tissues and organs are attacked.
Lupus Systemic lupus erythematosus (SLE), lupus, is a complicated autoimmune condition affecting virtually every organ in the human body. Because of the wide-range of symptoms experienced, the disease is often difficult to diagnose. Common symptoms are extreme fatigue, swollen and/or painful joints, muscle pain, low-grade fever, thinning or loss of hair, butter-fly shaped rash across the nose and cheeks, chest pain when taking a deep breath, kidney and heart problems.
“Butterfly Rash” often associated with SLE (emedicine.medscape.com)
Females make up 80-90% of people with lupus and despite treatment, many individuals will experience flares and remissions (symptoms come and go) their entire lives.
Lupus and Inflammation The hallmark of lupus is over-activity of the immune system and inflammation. Imbalances of inflammatory immune factors, cytokines, are significantly higher in lupus patients compared to people without lupus. These immune molecules promote inflammation and damage tissues. High levels of these inflammatory factors are associated with the severity of disease but decrease as individuals are successfully treated.
Anti-malaria medications originally used to prevent or treat malaria has been used to treat lupus.It was not understood why these medicines were somewhat effective against SLE, but a recent study suggests that these medications inhibit inflammation.
Physical Activity Every time a muscle contracts, it releases anti-inflammatory molecules that helps the body balance the amount of overall inflammation produced.
As would be predicted, weekly physical activity improves fatigue, depression and increases the quality of life of most individuals. Even moderate exercise, 3 days a week for 20 minutes, has been shown to make a major difference in the amount of energy and feelings of well-being experienced by lupus patients.
If You Have Lupus Frequent physical activity, eating in a healthful manner and daily consumption of an excellent immune balancing supplement helps the body control inflammation and achieve immune homeostasis (immune balance).
Dr.Hellen is passionate about helping people enjoy life at its fullest. She may be contacted by using this form, contacting her at: drhellen@drhellengreenblatt.info or feel free to call her at: 302.265.3870 (ET, USA).
The second leading cause of death for people under the age of 44 years is suicide. Overall, it is the the tenth leading cause of death in the United States, with veterans comprising 22.2% of this statistic. Women are three times more likely to attempt suicide, but for every woman who takes her own life, four men will die from their attempt.
Although older adults make up only 12% of the population in the States, they account for 18% of all suicides. These fatal events in the elderly are probably under-reported by 40% with “silent suicides”, dehydration, “accidents”, medication over doses, etc. ending in death. Additionally, double suicides involving spouses or partners occur most frequently in this population. Since the elderly are the fastest growing segment of the population, these later-life deaths are predicted to result in suicide becoming a major public health issue in the too-near future.
Inflammation and Suicide
C-reactive protein (CRP) is associated with high levels of inflammation found in people with inflammatory disorders, burn and trauma victims, in obese individuals, in people with infections or with cardiovascular disease. People with suicidal thoughts (known as suicidal ideation) or attempts, also exhibit high levels of C-reactive protein compared to people without such behaviors.
Inflammatory factors are triggered during stress and are associated with depression.
When compared to patients being treated for psychiatric disorders who are not suicidal, individuals who have contemplated or attempted suicide have increased levels of inflammatory cytokines, immune cell molecules in their blood and/or brain.
The ratio of inflammatory molecules to anti-inflammatory molecules in the body either promotes inflammation or limits it. A healthy immune system constantly strives to maintain these factors in a delicate balance, in immune homeostasis.
Importance of Balancing Immune Factors
Imbalances in immune regulators are harmful and lead to disease. Taking the following steps should make a major difference in helping the body and mind return to homeostasis, to its natural, healthy balance:
Engage in physical activity at least 30 minutes a day 5 days/week.
Add one or more daily servings of a superior immune support supplement to your diet.
Maintain a healthy weight.
Eat a wide variety of colorful fruits and vegetables.
Spend some time outdoors.
For decades I have helped people enhance their quality of life. I can be contacted at: DrHellen@DrHellenGreenblatt.info, use this form or give me a call at 302.265.3870 (ET USA) and let us talk. Your first 30 minutes are on me! You’ve tried everyone and everything else, let me help you feel good again, you deserve it!
Last week I talked with a young local Asian-American business owner who shared with me that he was “a little fatigued and stressed out”. I suggested that if he took steps to getting his immune system in balance, that since our physical and emotional well-being is dependent on homeostasis, he would feel much better.
He basically replied that, “he spends half the year in Florida, has a lot of friends that are “into” nutrition, he exercises and that he didn’t need any more information, thank you”.
Nothing like a person with an open mind, but unfortunately too many people think in this narrow way. We all know individuals that eat nutritiously, exercise 5-7 days a week and watch their weight but they still do feel “off”. Their fingers, elbows or knees hurt, they can’t eat everything they would like, or they have other health issues despite their “great” life style.
Nutritional Recommendations:
The evidence is strong that due to the hundreds of phytonutrients, plant nutrients, in fruits, vegetables, nuts, beans, whole grains and olive oil, that plant-based foods are important for our health. A broad variety of these phytonutrients are suggested since they appear to affect a wide-spectrum of biological functions. The consumption of plant-based foods influences the health of cells, blood pressure, risk of certain cancers, immune, dental, urinary, liver and gut health.
An additional dietary recommendation is to consume fish or fish oil 2-3 times a week for their omega-3 fatty acids. This “good” fat has multiple uses in our body, but the body cannot produced these fats by itself; we need an outside source.
Studies involving hundreds of thousands of people suggest that omega-3s reduce the risk of fatal heart disease, improve the flexibility of blood vessels, lower blood pressure and reduce immune inflammation. [Note: It is controversial whether omega-3 supplements are as beneficial as eating fish; in fact, they may cause certain health issues.]
Role of the Immune System
When the body is threatened by pathogens or cancer cells, or has been injured, the body responds with short-term inflammatory responses, acute inflammation.
Immune cells flood the area to destroy invading foreign organisms or cancer cells, or to start the healing process after trauma. If the body cannot get rid itself of the infection, or if it over-responds with excessive levels of inflammation, the immune response may become chronic, or long-term.
Chronic inflammation is abnormal and damages previously healthy tissues and organs. This sort of unlimited inflammation results in autoimmune diseases, diseases in which the body’s immune system turns on the body. Conditions such as arthritis, diabetes, lupus, multiple sclerosis, Crohn’s disease, ulcerative colitis, celiac disease, hepatitis and asthma can result from such run-away inflammatory responses.
Knowledgeable individuals know that nutrition plays only an initial role in staying healthy. Good nutrition is the foundation upon which to build health, but it is NOT ENOUGH; it is the immune system that governs one’s health and must be optimized.
The Importance of a Balanced Immune System
Immune balance, immune homeostasis, is tightly regulated by the body. It allows the organism to respond to infection, cancer cells and injury with the right amount of inflammation. Any imbalances, either too much stimulation, or too little, results in immune disorders and health issues.
The key to good health and healthy aging is keeping the immune system in balance.
Dr.Hellen’s major passion is helping people to enjoy life at its fullest. She may be contacted by using this form, at: drhellen@drhellengreenblatt.info or feel free to call: 302.265.3870 (ET, USA).
As of this writing, the Centers for Disease Control (CDC) in Atlanta is strongly recommending that pregnant woman postpone travel to many countries across the world, including the popular Caribbean islands. The CDC is taking these steps due to the possibility that these women may become are infected with a mosquito borne virus called Zika. The World Health Organization (WHO) Director General Dr Margaret Chan, has said that Zika had gone “from a mild threat to one of alarming proportions” and expects the virus to spread through the Americas and affect between three million and four million people.
Eighty percent of individuals who are infected with Zika do not show symptoms. However, when symptoms do occur, they can last up to a week or so and include fever, rash, pink eye, and joint pain. Some clinicians suggest that Zika virus infection may result in the autoimmune [against oneself] condition, Guillain-Barre syndrome (GBS). This is rare disorder where too much inflammation damages the nerve cells, causing muscle weakness and may lead to paralysis.
The greatest concern however right now is that health agencies “strongly suspect” that when a pregnant women is bitten by a mosquito that is carring the virus, that even if she does not experience symptoms, that her offspring may develop brain malformations.
This latest outbreak adds to concerns that infectious diseases are one of the top threats challenging our world—a major topic on the agenda of last week’s World Economic Forum world leader attendees. Until vaccines or treatments are developed, viral infections such as Zika, Ebola, SARS (severe acute respiratory syndrome), and MERS (Middle East Respiratory Syndrome) remain a threat to the world’s population.
Currently, there are no commercially available vaccines or treatments for Zika. Until recently the cost to develop a successful vaccine was far greater than what the manufacturers would recoup in vaccine sales. However, development of a vaccine for Zika will likely now escalate since Zika has spread so widely, infecting over 1.5 million individuals and its being linked to neurological problems, especially in newborns.
In addition to a lack of vaccines and treatments for a multitude of viral diseases, another significant health-care crisis we are facing is treatment of infection by anti-microbial-resistant pathogens. As Dr. Keiji Fukudaof the World Health Organization has stated: “We really hope to pull the world back from the brink where antibiotics don’t work anymore”.
When bacteria are stressed, for example by a killer antibiotic, their genetic material may change, mutate, so that they can tolerate and become resistant to such compounds. The bacteria can then replicate easily and outgrow bacterial strains that were not resistant to the antibiotic.
Fifty percent of antibiotic prescriptions written by U.S. physicians are of no benefit to the patient, and when used to fatten livestock and poultry it gives bacteria even more opportunity to acquire antibiotic tolerance.
It is our immune systems that identify, destroy, and remove invading pathogens. When our body recognizes that it has been invaded by foreign agents, a strong inflammatory responses is triggered to meet the onslaught of the pathogens. White blood cells accumulate in the area to combat the invaders. These immune cells release cytokines and other immune messages recruiting more white blood cells in an attempt to “burn out” the infection. Without a powerful inflammatory response, we cannot limit or survive infections.
In the absence of drugs or treatments that prevent and control the growth of viruses and other microorganism the immune system must be optimized to protect the body against them.
In the past, scientists thought that there was a blood-brain barrier that “isolated” the brain from the actions of the immune system. They labeled the brain “immune privileged”; because studies suggested that a healthy brain had few, if any inflammatory cells in it. Only when there was a brain infection did scientists think that immune cells migrated into the brain.
Researchers failed to take into account that chronic inflammatory diseases are associated the brain. For example conditions such as inflammatory bowel disease, psoriasis, liver disease, and rheumatoid arthritis may result in a lack of social interest, feelings of being unwell and unremitting fatigue—all which are governed by brain function.
Inflammation is activated when the body encounters pathogens and cancerous cells. The inflammatory response is a primary means by which the body will destroy these threats. Inflammation is basically a controlled “burn”. Firefighters will often have a “controlled burn” in a forest to get rid of dead trees and limbs. They strive to keep the fire limited to a specific area. Sometimes however firefighters are unable to control the fire and acres of forest are burned in error.
Similarly, once immune cells have taken care of a threat to the body, for example cancer cells, pathogens, etc., it is essential that the immune system “turn” down the inflammatory “flame”. Chronic, unnecessary inflammation leads to many autoimmune diseases that destroy their own organs, such as diabetes, Crohn’s bowel disease, multiple sclerosis, and lupus
Inflammation is all about location, location, location. If one has inflammation in the insulin-producing cells that control blood sugar, the person may get diabetes. If their intestines are inflamed they may suffer from Crohn’s. If there is too much destruction and inflammation of nerve cells, they may suffer from multiple sclerosis.
Let us hypothesize that an individual has two trillion immune white blood cells and that half of these cells are out of control and producing too strong an inflammatory response. This inflammation is destroying previously healthy tissues and organs. Since the body is always striving to balance inflammation, the other half a trillion of cells are working towards lowering the amount of inflammation and destruction that is going on in the body
Each of these cells is expending a trivial amount of energy trying to accomplish its task, but a tiny amount of energy multiplied by two trillion cells is a great deal of “wasted energy”. Is it any wonder why these people complain of being tired?
Individuals who have been diagnosed with autoimmune conditions have higher levels of inflammatory cytokines, immune messages, than people without disease. In heart failure patients, significant fatigue is associated with poor recovery and a higher risk of death. Patients with high levels of anti-inflammatory cytokines, molecules that decrease inflammation, recover more fully and rapidly than patients with high amounts of inflammatory cytokines. When patients are treated for their heart problems, their cytokine levels begin to resemble the cytokine ratios of healthy individuals, and their energy returns.
In mice with liver inflammation, immune cells from the liver travel to the brain and trigger other specialized immune cells called microglia releasing a biochemical that attracts more inflammatory cells into the brain, which in turn produces more inflammation.
In individuals with multiple sclerosis, a nervous system disease with a major inflammatory component, patients had less fatigue when they took anti-inflammatory medications.
The association of appropriate levels of inflammation with a healthy brain and high energy reserves is clear; the key is being in immunological balance. Once individuals balance inflammatory and anti-inflammatory cells they typically regain their energy and focus.
Aren’t you tired of being tired all the time? Don’t wait any longer. Contact Dr. Hellen to talk bout enhancing your quality of life. There is no fee for consulting with her for the first 30 minutes. She may be contacted by using this form or at: 302.265.3870 (ET, USA).
Without the ability to produce inflammation we die. The inflammatory response is the main weapon that the immune system uses to protect us from infection, keep cancer cells from growing out of control, and help tissues heal when they are damaged.
However, one has to have the right balance of inflammation to be healthy. We need enough inflammation to protect us, but too much of an inflammatory response leads to increased risk of developing diseases such as irritable bowel disease, multiple sclerosis, arthritis, lupus, and diabetes.
The mind as well as the body is negatively affected by run-away inflammation. Emotional problems such as depression, spikes of high or low moods (bipolar disorders), or schizophrenia are accompanied by uncontrolled inflammation.
Genes control the amount of inflammation that the body produces. When “inflammatory” genes are turned on, up-regulated, immune cells produce cytokines, inflammatory immune messengers, along with biological compounds such as C-reactive protein (CRP).
LONELINESS AND ANHEDONIA
Loneliness and feelings of isolation are linked to an increased risk of chronic disease and death and are associated with increased levels of inflammation.
Some depressed individuals experience anhedonia, a condition in which they lack motivation and do not enjoy life. These people find no joy in food, spending time with their family or friends, concerts, or activities that others find pleasurable.
Individuals with anhedonia experience persistent brain inflammation, among other biological events and typical treatments for depression are often not helpful.
BRAIN REGIONS COMMUNICATE WITH ONE ANOTHER
Different parts of the brain communicate with one another as they control a person’s response to pleasure and rewards such as social interactions, food and sex. Reacting positively to these stimuli motivates one to repeat them in the future. The ability of these regions to communicate with one another is called “connectivity”.
Individuals with low connectivity have increased inflammation and deeper feelings of anhedonia. High CRP (an inflammatory marker) levels were also correlated with the inability to experience pleasure.
One of the medications used for individuals suffering with anhedonia is infliximab. This medication is prescribed for patients with inflammatory conditions such as bowel disease and arthritis. Additionally, administrating cytokines, immune messengers of inflammation, changes the reward-related regions of the brain.
DOPAMINE
Dopamine, which is produced brain cells, is strongly associated with the brain’s pleasure/reward regions. Dopamine helps us feel enjoyment and motivates us to participate in or continue to engage in activities that give us pleasure.
Decreased production of dopamine is associated with heighted inflammation and decreased connectivity between the pleasure centers of the brain. Administering inflammatory cytokines over a long period of time may lead to decreases in dopamine production.
THE LINK BETWEEN PHYSICAL ACTIVITY AND DEPRESSION
Every time muscles contract, they release anti-inflammatory molecules that help the body balance the amount of inflammation it produces. Additionally, exercise activates the brain’s pleasure centers. The evidence shows that there is a strong link between physical activity and mental and physical health.
Regular physical activity decreases one’s risk of depression. Researchers tracked individuals that experienced their first heart attack and had been physically active for 10 years prior to the event. Heart attack survivors who exercised for years prior to the event had a 20% lower risk of developing depression compared to individuals that had not been physically active.
Also, people who had become physically active before their first heart attack had a better protection against depression compared to those who had been active at one time, but then became inactive.
SUMMARY
Increased inflammation has been associated with depression and other negative emotional states. Maintaining the body’s balance of inflammatory and anti-inflammatory responses helps support healthy emotional responses.
Dr. Hellen’s major passion in life is helping people to enjoy life at its fullest. She may be contacted by using this form, at drhellen@drhellengreenblatt.info, or at: 302.265.3870 (ET, USA).
Delirium is an under-reported condition that may affect up to 56% of older individuals after surgery, patients that have been heavily sedated for a length of time, burn, cancer, and patients on ventilators for long periods. Patients experience vivid hallucinations that may be part of a vicious cycle if doctors attempt to control the delusions with larger amounts of sedatives; the medications may disorient and confuse the patient even more.
The delusions and accompanying cognitive issues can persist for months after patients leave the hospital and can lead to a misdiagnosis of dementia, rather than delirium. [Dementia develops gradually and gradually worsens, while delirium may be of sudden onset.]
Delirium is associated with excessive inflammation in the brain resulting from triggering specialized immune cells the microglia. If stimulated over a long time, the cells release inflammatory cytokines, molecules that damage nerve cells and contribute to damage and break down of the capillaries in the brain, the blood-brain barrier.
C-reactive protein, CRP, is one measure of inflammation. CRP levels were measured in elderly surgical patients who had ended up with complications such as delirium, cardiovascular issues, or infection. The levels of CRP in their blood were predictive as to how fully they recovered.
A recent study measured the levels of 12 different inflammatory and anti-inflammatory cytokines in older patients undergoing surgery. Those having episodes of delirium had consistently high levels of inflammatory cytokines as compared to patients that did not have high levels of cytokines. Similar results were seen in patients that developed delirium after procedures such as open-heart surgery and hip fracture repair.
Conclusion
In order for the body to heal after it is hurt, or to fight an infection successfully, a delicate balance of cytokines, immune messages are required. Too little of an inflammatory response and the individual may not survive an infection. Too much of an inflammatory response and healthy tissue is destroyed. Homeostasis, balance, is what the body strives for every moment.
Dr. Hellen would be pleased to provide guidance to helping enhance your quality of life. She may be contacted by using this form or at: 302.265.3870 (ET, USA).
For over two decades I have noticed that individuals in immune homeostasis, immune balance, are on fewer medications or no medications than their cohorts, and the majority of them look and feel 10 years younger than other people their age. Comparing photos of how these individuals look now with photos as how they looked 10-20 years ago, it is amazing how great they look! Their youthfulness is especially apparent when I compare these photos to those of individuals that have not made the effort to control inflammation.
Too many older individuals suffer from chronic inflammatory diseases such as arthritis, diabetes, cognition deficits, Parkinson’s disease, lung, kidney, and bladder problems. Over the years there have been numerous studies associating chronic (long-term) inflammation with the development of mutating cells and cancers. However because of the time it takes to do longevity studies it is difficult to prove that limiting inflammation makes a difference in how well people age.
Just this month, a team of scientists from Keio University School of Medicine, Tokyo, Japan and the Newcastle University’s Institute for Ageing in the UK published a study of the immune status of over 1500 individuals ranging in age from 100-115 years.
The study group was divided into two: centenarians, 100-104 years of age, and semi-supercentenarians aged 105 and above. The result was that these long-lived individuals had lower levels of inflammation as compared to the general public.
Dr. von Zglinicki, one of the investigators, said, “Centenarians and supercentenarians are different – put simply, they age slower. They can ward off diseases for much longer than the general population… it’s only recently we could mechanistically prove that inflammation actually causes accelerated ageing in mice…This study, showing for the first time that inflammation levels predict successful ageing even in the extreme old….”
Dr. Yasumichi Arai, the first author on the study said, “Our results suggest that suppression of chronic inflammation might help people to age more slowly…However, presently available potent anti-inflammatories [medications] are not suited for long-term treatment of chronic inflammation because of their strong side-effects. Safer alternatives could make a large difference for the quality of life of older people.”
As I have pointed out for decades, controlling the delicate balance of inflammatory responses, i.e., achieving immune homeostasis, makes all the difference in one’s youthfulness and quality of life.
P.S. My post of May 20, 2013also discusses the role of inflammation in longevity.
Please contact me directly if you would like to learn simple approaches to making a difference in your health.
Idiopathic pulmonary fibrosis (IPF) is a disease in which the tiny air sacs or “alveoli” that make up the lungs become inflamed and are gradually replaced by scar tissue (fibrosis). As the amount of scar tissue increases, the lungs stiffen and are unable to transfer oxygen from the lungs to the blood stream. This results in the brain and other organs becoming oxygen deprived.
As IPF progresses, day-to-day activities such as walking short distances, climbing stairs, dressing, or even talking on the phone become a problem because the person cannot catch their breath (dyspnea). The person feels as if they are suffocating and may require supplemental oxygen.
Advanced idiopathic pulmonary fibrosis makes people more susceptible to getting and fighting infections.
The term “ idiopathic” suggests that clinicians do not know what causes the disease. Lung inflammation may be triggered by infection with pathogens, airborne hazards, or certain types of medical treatments. Exposed to these types of challenges, the immune system boosts its inflammatory response to attack the pathogens and remove hazards or damaged tissues. In a vicious cycle, the uncontrolled inflammation results in greater lung damage.
Idiopathic pulmonary fibrosis may be considered an inflammatory autoimmune disease. Autoimmune (meaning against oneself) conditions result from the body’s overactive, defensive, inflammatory reactions to an immune challenge. The body’s own immune cells mistakenly attack and destroy previously healthy by-stander tissues or organs, very much like a forest fire damages healthy trees.
The body responds to injury by forming scar tissue, made mainly of the key protein collagen. Pulmonary fibrosis results in inflammation and scarring that occurs again and again. It is an imbalance between the build-up of scars, and the breakdown of collagen that is needed for tissue repair. In IPF, lungs with old scar tissue is found layered over old damage, while fresh scarring is seen over more recent damage.
Lung damage in IPF patients is due to imbalances between inflammatory and anti-inflammatory cytokines, immune messengers generated in response to substances or circumstances that initiated the lung damage in the first place. Imbalances of cytokines results in more and more fibrosis.
Individuals with IPF may find that if they are able to control the amount of inflammation produced by their immune systems, if they can stay in homeostasis, balance, their quality of life may change for the better.
Please contact Dr. Hellen if you wish her assistance in changing your quality of life. There is no fee for her services. She may be contacted by using this form or at: 302.265.3870 (ET, USA).
Middle East Respiratory Syndrome (MERS) is a viral disease of the lungs that was first reported in Saudi Arabia in 2012 and has now spread to several other countries, including South Korea and the United States. Genetic material isolated from an individual that died of MERS was identical to genetic material found in one of his own camels. The infected camel possibly infected the owner and is responsible for the death of the man.
People infected with the virus initially report mild symptoms of a cold, chills, body aches, sore throat, fever, difficulty in breathing, and a cough. Some individuals report gastrointestinal issues such as diarrhea, nausea, and vomiting. When symptoms become severe, death may follow failure of the lungs and kidneys.
Most of individuals that have succumbed to infection with MERS suffered with other medical conditions, such as diabetes, cancer, chronic lung conditions, heart, or kidney disease.
MERS and SARS
There is limited scientific information on MERS. However, the MERS virus is in the same family of viruses as SARS, the virus that causes severe acute respiratory syndrome. Infection with this virus results in severe breathing difficulties which too frequently results in death. (Both the traveling businessman and his World Health Organization physician, Dr. Carlo Urbani who identified the infection as a new disease in the business person, died of the virus.)
Although there are similarities in symptoms, two major differences between MERS and SARS are: a) MERS progresses to lung failure more rapidly than SARS and b) MERS affects older individuals more than it does younger people. [The high numbers of fatalities from MERS may be related to the older age of infected persons and the fact that individuals with other conditions are more susceptible to respiratory failure].
Since so little is understood about the disease, people with diabetes, lung, kidney, and immune disorders should take precautions if they are exposed to infected individuals.
The Immune System and Infections
The only part of the body that protects us from infection is our immune system. The role of the immune system is to recognize threats from pathogens, stop, and then up regulate inflammatory responses to destroy the pathogens before they can multiply.
When the immune system is recognizes invasion by pathogens, immune cells are triggered to produce antibodies and other immune factors, such as cytokines. Cytokines are proteins that help recruit immune cells into an area to help fight the battle, and orchestrate the protective immune responses.In SARS, an over-response of the immune system, a “cytokine storm” occurs that too often results in the deaths of infected persons. It is likely that infection with MERS triggers the production of high levels of cytokines, resulting in excessive inflammation and death.
Summary:
People with unbalanced immune systems are at higher risk of having severe symptoms when infected with pathogens. It is essential that the immune system always be in balance, in homeostasis for optimal protection from disease.
The inflammatory response to infection has to be a controlled, limited response. There must be enough of an immune response to defend the body against disease, but not so great an inflammatory response that the body is harmed.
Mutating cells and invasion by pathogens triggers inflammatory responses in the body. Inflammation consists of a series of events involving cytokines (immune messages), other immune factors, and circulating white blood cells. Uncontrolled levels of inflammation damages healthy tissues and organs.
Excessive inflammation of the eyes may result in sight-threatening condition.
Uveitis
Uveitis describes a group of eye inflammatory diseases. Symptoms can develop gradually over a few days, or occur suddenly. Symptoms may include: photophobia (sensitivity to light), cloudy or blurred vision, increased floaters, difficulty in vision focus, headaches, “red eye” with pain ranging from a mild ache to intense pain, and loss of peripheral vision (ability to see objects at the side of one’s field of vision). Severe uveitis may lead to permanent damage to vision.
Many cases of eye tissue inflammation are “idiopathic”, i.e., without a known trigger. Some clinicians suggest that uveitis is caused by: a) autoimmune responses in which the body’s immune system mistakenly targets and attacks its own eye tissues, b) infections or cancer, c) trauma to the eye, or d) exposure to toxins. Uveitis is more likely to occur in individuals that have other immune and inflammatory conditions.
Ebola and Uveitis
Two months after an American physician was treated for Ebola, and despite the fact that the virus was no longer detectable in his blood, there were high levels of Ebola virus in his eye. His eye infection was accompanied by an intense inflammatory reaction, uveitis. After much effort, the physician was successfully treated and thankfully did not lose his sight.
In a study of 85 Ebola Virus Disease survivors in Sierra Leone, 40% reported that they had some sort of “eye problem”. (It is not known whether they also had uveitits.)
Retinitis Pigmentosa
Retinitis pigmentosa is a genetic disorder in which the light-sensitive retina, the “screen” at the back of the eye that captures images, becomes damaged . Its photoreceptors, rods and cones, begin to die off resulting in a loss of vision. This condition may end in blindness.
There are conflicting opinions as to whether inflammation plays a major role in this disease.
One study that support the contention that immune responses are involved in retinitis pigmentosa measured the levels of TNF-alpha. TNF-alpha is a cytokine, that among other functions, helps regulate immunological responses. Depending on when and how much of the cytokine is produced , TNF-alpha may be pro-inflammatory (initiate inflammation), or anti-inflammatory (inhibit inflammation). In animals with uveitis-like conditions, the levels of TNF-alpha in the eye are increased between 5-10 fold over control animals.
Also, in retinitis pigmentosa, immune white blood cells are attracted to the retina, perhaps to clean up debris from dying cells. Some investigators suggest that when these immune cells are overly stimulated, they initiate an autoimmune response, destroying other light-sensing centers in the retina.
Immune Homeostasis, Immune Balance
Immune inflammation is essential to defend the body against cancerous cells and invading microorganisms. However, the appropriate levels of “protective” cytokines are needed to balance the “destructive” cytokines produced in the eye so that it can maintain immune homeostasis, immune balance. Unchecked inflammation results in tissue damage and an inability of the body to mount stable and proper immune responses in the face of various challenges.
Dr. Hellen is available at 302.265.3870 for discussion on the role of inflammation and immune homeostasis in one’s health. There is no charge to speak with her. She may be contacted at: drhellen@drhellengreenblatt.info, or use the contact form. Thank you.
Parkinson’s is a disease of the nervous system that affects mobility, memory, and cognition. Individuals may eventually experience rigid muscles, tremors of the limbs and head, loss of muscle control, monotonous speech levels, and a slow, shuffling gait.
Individuals tend to develop the disease as they age. Having a close relative with Parkinson’s disease (PD) increases the likelihood of developing Parkinson’s, with men more than 1.5 times more likely to develop the disease than females.
Although the causes of Parkinson’s disease are not clear, a recent study suggests that individuals with a specific gene are at a higher risk of getting Parkinson’s disease if they were exposed to pyrethroids, a class of chemicals found in the majority of household insecticides. Exposure of individuals to these pesticides may result in brain tissue inflammation.
Inflammation and Autoimmune Responses
In Parkinson’s disease, the body mounts an inflammatory response against its own brain cells, its dopaminergic neurons. (An immune response against oneself is called an autoimmune response.)
These specialized brain cells produce a biochemical called dopamine with many functions including controlling bodily movements, memory, ability to think, mood, and learning. The body’s long-lasting inflammatory response against its own nervous cells gradually destroys the dopaminergic neurons resulting in abnormal dopamine levels and brain activity, symptoms associated with Parkinson’s disease.
Microglial cells are specialized immune cells located in the brain. They are considered the “canary in the mine”. When microglial cells sense a threat, they become “activated” and release immune factors that may, depending on the types and amounts of these molecules, be beneficial or cause damage to nerve cells.
Activated microglial cells are found in large numbers in the brains of Parkinson’s patients, along with high levels of cytokines, biochemical molecules responsible for inflammation.
The brain and spine of the nervous system are cushioned by cerebrospinal fluid. This fluid helps to provide nutrients to the nervous system and removes waste products from the brain.
Individuals with Parkinson’s disease have high levels of immune inflammatory molecules in their spinal fluid. The more concentrated the molecules, the more likely the person is to severe fatigue, depression, and cognitive impairment.
Summary
Certain genes that control immune system responses are also strongly linked with the development of Parkinson’s disease.
Increasingly, scientific studies suggest that inflammation and autoimmune responses result in Parkinson’s disease.
Helping the body limit out-of-control inflammation, and achieving a more homeostatic, more balanced immune response, may go a long way towards changing the quality of life in individuals with Parkinson’s.
Feel free to contact Dr. Hellen. There is no fee for speaking with her. Dr. Hellen may be contacted by using this form or at: 302.265.3870 (ET).
Immediately after the body is injured, it starts the processes of stopping blood loss, restoring function, and preventing infection from pathogens on the skin or objects that may have caused the damage. The microenvironment of the injured area is in constant flux with the host cells continuously responding to the fluids, bacteria, and the dead and dying cells at the wound site.
One of the first phases of the healing process is for circulating platelets to attach to a fibrous scaffold, a matrix, to stop blood flow. Platelets, recently defined as immune cells, release cytokines, immune messengers, which permit cells to communicate with one another.
Once the flow of blood ceases, specialized immune cells enter the area setting up an inflammatory response that “cleans” the wound site and removes bacteria, damaged tissues, and foreign matter. In order to achieve the appropriate levels of inflammation, many complex cell-to-cell interactions occur in specific order.
Accumulation of fluids, exudates, results from inflammation, along with swelling at the wound site. Exudates are essential for the healing process and contain debris, inflammatory cells, bacteria, and a large variety of immune proteins. Depending on their concentrations, factors may enhance healing or interfere with the process. Proteins found in exudates have a variety of functions including regulation of inflammatory responses, triggering growth of new blood vessels, and stimulating growth of new cells.
A delicate balance of inflammatory and anti-inflammatory messengers is crucial and it determines the pace, and outcome of healing. Homeostatic, balanced, inflammatory responses are essential. Too little, too great, or too lengthy of an inflammatory response damages healthy tissue and delays healing.
The remodeling phase is one where tissues regenerate and close the wound. Closure occurs as cells cross-link and organize themselves attaching to a scaffold, a matrix that will draw edges of the skin closed and cover the area.
Poorly Healing Wounds
The presence of bacteria, foreign bodies, a lack of oxygen in the tissues, and/or fragments of necrotic, dead, tissue can stimulate inflammatory cells continuously, resulting in uncontrolled inflammation and wounds that heal poorly.
Infection of a wound site also interferes with proper healing. Communities of bacteria tend to organize themselves into a biofilm, a thin sheet of bacteria. Biofilms increase survival of bacteria colonies, reducing chances that inflammatory immune responses, or antibiotics, can control them.
Exudates in poor healing wounds contain an over abundance of inflammatory cells and immune mediators that increase inflammation. Sufficient anti-inflammatory factors to control the damaging effects of excessive inflammation may not be available.
Proteolysis is another one of the steps required for healthy healing. This is an event during which the body degrades necrotic tissue, and dead and dying pathogens. [Think of proteolysis as an acid/enzyme reaction that breaks down tissues.] When immune cells release too many proteolytic proteins over a longer period, they become destructive of healthy tissue, and the body’s ability to heal the wound is overwhelmed.
Individuals with non-healing skin ulcers, such as those found in diabetics, not only struggle with excessive inflammatory responses, but their proteolytic enzyme levels are significantly elevated giving rise to further imbalances in inflammatory responses and interference with the body’s repair mechanisms.
Summary
The sensitive balance between stimulating and inhibitory mediators during diverse repair of wound is crucial to achieving tissue homeostasis following injury. Once unbalanced and excessive inflammation is controlled, will healing begin.
There is no fee for speaking with Dr. Hellen. She may be contacted by using this form or at: 302.265.3870 (ET).
