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One of the major complaints that people have is that “they are always tired”. “They just do not care anymore, they are just too tired.” [Kindly view a post that is relevant to this subject: Depression, Anhedonia and Run-Away Inflammation.]

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).

http://www.ncbi.nlm.nih.gov/pubmed/25905315
http://www.ncbi.nlm.nih.gov/pubmed/25905315
www.ncbi.nlm.nih.gov/pubmed/26589194
http://www.the-scientist.com/?articles.view/articleNo/43120/title/Brain-Drain/
http://www.ncbi.nlm.nih.gov/pubmed/26705751
http://www.ncbi.nlm.nih.gov/pubmed/25682012

 

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 often ask how they ended up getting an autoimmune disease, a condition in which their own immune system turns on themselves and destroys healthy by-stander tissues and organs.

My response-the not-yet-proven-hypothesis that molecular mimicry results in autoimmune disease.

Molecular mimicry is a phenomenon in which tissues in the body share a “barcode”, antigenic receptors,  with specific viruses or a bacteria.  The immune system responds by mounting an inflammatory attack against the invading pathogen.  This response targets not only the pathogen, but in addition, tissues that share the same antigenic makeup as the invading microorganism. In short, a terrible error occurs and the body starts destroying itself.

The inflammatory disease rheumatic fever is an excellent example of the possible outcome of molecular mimicry. Damage of heart valves may occur after infection with the bacteria Streptococcus. This development accounts for the panic that many parents experience when their kids come down with “strep throat”.

Antibodies, large unique proteins,  are produced by the immune system when the body is exposed to pathogens.  These specialized proteins attach to the invaders, “flagging” them for destruction by circulating immune cells.  In the case of rheumatic fever, since bacteria and heart valve tissue look alike to the body, antibodies are produced that attach to both surfaces, triggering inflammatory immune responses ultimately resulting in damage to heart valves, as well as death of the bacteria.

The data, controversial, but compelling, is that molecular mimicry, due to viral and bacterial infections,  may also be a trigger for neurological disease.

This concept is reinforced by the fact that multiple sclerosis is a condition in which nerve cells are damaged by uncontrolled levels of inflammation.  Immune cell products mistakenly attack myelin proteins, which make up the protective sheath that “insulates” nerves.  Damage to this covering results in nerve signals becoming intermittent, slowing down, or stopping entirely.  Such nerve damage affects vision, mobility, coordination, balance, bladder, or bowel control.

 A large body of data suggests that infection with herpes virus 6 and/or Epstein-Barr virus triggers  inflammation that leads to nerve cell destruction.  Different viruses and bacteria have been implicated as initiating inflammatory responses in other neurodegenerative diseases as well.

 To understand the role of excessive inflammation in your own condition, enter the condition in combination with the word “inflammation”.  The results you receive will help you understand the importance of achieving immune homeostasis, immune balance of our inflammatory responses.

Let me help you improve your quality of life, naturally. Please contact me at 302.265.3870 (USA ET) or email: DrHellen@DrHellenGreenblatt.info

http://www.bjmp.org/content/role-chronic-bacterial-and-viral-infections-neurodegenerative-neurobehavioral-psychiatric-au
http://www.ncbi.nlm.nih.gov/pubmed/22617826
http://www.ncbi.nlm.nih.gov/pubmed/18193392
http://www.ncbi.nlm.nih.gov/pubmed/9761770
http://www.ncbi.nlm.nih.gov/pubmed/22201827
http://www.ncbi.nlm.nih.gov/pubmed/12557285
http://www.ncbi.nlm.nih.gov/pubmed/21859892

Healthcare-associated infections (HAI), nosocomial infections, are caused by a wide variety of bacteria, fungi, and viruses.  One bacterium that commonly causes illness is Clostridium difficile, or C. difficile.  Hospitalized children and elderly people are at special risk of acquiring these bacteria, infections that result in severe diarrhea.  Individuals infected with C. difficile are more likely to be admitted to short and long-term care facilities, have longer hospital stays, are more likely to require colon surgery, and are at higher risk of death.

Nosocomial infections are on the increase, probably due to the heightened use of antibiotics used in hospitalized patients.  The antibiotics kill off beneficial bacteria that might offer protection against getting infections such as C. difficile.

Intriguingly, in a recent study, patients admitted to the hospital who were on statins, medications used to lower low-density lipoprotein (LDL) cholesterol levels, had a 45% lower risk of getting Clostridium difficile infections compared to individuals that were not on these sorts of medications.

Other studies suggest that statins affect immune responses by down-regulating, inhibiting inflammation.  For example, statins prevent and reverse chronic and relapsing disease in an animal model similar to multiple sclerosis, reduce lung inflammation in animals that exposed to airborne particles, and have been shown to lower the risk of death of individuals suffering from 13 different types of cancers.

In atherosclerosis, primarily caused by an inflammatory response directed against the wall inside blood vessels, statin therapy reduces blood vessel inflammation and significantly reduces markers of inflammation such as hsCRP, high sensitivity C – reactive protein.

Health warnings have been issued by the FDA for statins.  These risks include:  memory loss and confusion, liver damage, heightened diabetes, and for certain statins, muscle weakness.  I am certainly NOT advocating that people use statins to limit inflammation.  Instead, I want the reader to focus on the fact that the effects of statins appear to be due, in the long run, to their ability to modulate acute (short-term) and chronic (long-term) inflammation.

 As I try to emphasize in all my posts, the key to good health is to achieve immune homeostasis, the appropriate balance of inflammatory and anti-inflammatory responses

 Immune homeostasis is most easily achieved through a) consistent physical activity, b) controlling fat deposits around the abdominal area, c) increasing consumption of vegetables and fruits, d) moderate exposure to sunlight (or vitamin D3 supplementation when the sun is not sufficient), e) ingestion of omega-3 fatty acids from a fish source, and f) and daily consumption of hyperimmune egg.

Feel free to contact Dr. Hellen at DrHellen@DrHellenGreenblatt.info with questions or to consult with her. A message may also be left at: 1.302-265.3870 or click on: http://drhellengreenblatt.info/contact-dr-hellen/.

 

http://www.cdc.gov/hai/organisms/cdiff/cdiff_infect.html
http://www.medpagetoday.com/MeetingCoverage/ACG/35590?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=
http://www.mdjunction.com/forums/lyme-disease-support-forums/medicine-treatments/1722560-pubmed-report-c-diff-death-from-lyme-disease/limitstart/40
http://content.onlinejacc.org/article.aspx?articleid=1389315
http://www.medpagetoday.com/HematologyOncology/BreastCancer/35856?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&xid=NL_DHE_2012-11-10&eun=g409635d0r&userid=409635&email=spider1222%40hotmail.com&mu_id=5510283
http://www.nejm.org/doi/full/10.1056/NEJMoa1201735
http://content.onlinejacc.org/article.aspx?articleid=1389317
http://www.ncbi.nlm.nih.gov/pubmed/20421792
http://circ.ahajournals.org/content/106/16/2041.full
http://www.ncbi.nlm.nih.gov/pubmed/22910717
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1986656/
http://www.nejm.org/doi/full/10.1056/NEJMoa1201735

 

Alzheimer’s and IVIG Rx
Last week John Gever, Senior Editor, MedPage Today brought attention to the results of a small study presented at the 2012 Alzheimer’s Association International Conference held in Vancouver, British Columbia.  In this study, patients with mild to moderate Alzheimer’s were given antibody preparations, immunoglobulin preparations, which were obtained by pooling plasma from numerous blood donors.  This sterile, medical product, IVIG, intravenous immunoglobulin, consists mostly of immunoglobulins, antibodies,  and is administered intravenously (IV). 

After receiving IVIG twice a month for three years, patient’s ‘ ability to function or think, their mood, or memory did not worsen over the three years. [Untreated Alzheimer’s disease patients typically show measurable declines in 3 to 6 months.]

The FDA, The U.S. Food and Drug Administration, has approved the use of IVIG for only six conditions.  However, it has been used “off-label”, to try and treat about 50 other conditions, including infectious diseases, a wide-range of autoimmune conditions, organ transplant and cancer patients, blood, and neurological conditions to mention a few.

When practitioners are asked how s/he thinks IVIG works, the response is typically, except for infectious diseases, “we are not sure”.

 IVIG Contains Immunoglobulins and Smaller Immune Factors
IVIG contains antibodies to organisms such as streptococcus, hepatitis, measles, polio, etc., that can specifically neutralize infectious agents.  Other immunoglobulins may be directed  against specific immunological factors. 

However, viewing reported results in chronically ill populations, I have always been of the opinion that IVIG also contains cytokines, or cytokine-like immune molecules, with potent immune system-modulating properties, which help the body return to immune homeostasis, immune balance. 

 I suggest that the reason that Alzheimer’s patients receiving IVIG saw a stabilization of their symptoms, is that IVIG limited inflammatory responses and thus slowed the progression of disease.

 Alzheimer’s and Inflammatory Cytokine Levels
This supposition is further supported by the fact that animal models suggest that excessive production of inflammatory cytokines, inflammatory messages, are implicated in Alzheimer’s disease. These animals have a condition similar to human Alzheimer’s, and also have higher levels of inflammatory cytokines in their blood.  When a drug was administered that inhibited the cytokines, there was less damage to nerve cells and neurological outcomes in the animals improved.  

 The scientists suggest that blocking production of high amounts of inflammatory cytokines may be beneficial for any number of brain conditions, such as “Alzheimer’s and Parkinson’s disease, multiple sclerosis (MS), motor neurone disease, frontotemporal dementia, and complications from traumatic brain injury.” (1)

 Immune Homeostasis, Immune Balance the Key to Health
Thus improvements, or at least delay in the onset of Alzheimer’s, or other brain –associated conditions, may be associated with the body achieving immune homeostasis.  A body in inflammatory balance controls the immune system’s  inappropriate inflammatory responses which otherwise may lead to damage of bystander tissues.

Feel free to contact Dr. Hellen at DrHellen@DrHellenGreenblatt.info with questions or to consult with her. A message may also be left at: 1.302-265.3870 or click on: http://drhellengreenblatt.info/contact-dr-hellen/.

 


www.medpagetoday.com/MeetingCoverage/AAIC/33780
http://emedicine.medscape.com/article/210367-overview#aw2aab6b3
www.alz.org/aaic/tues_1030amct_ivig_trial.asp
www.jneurosci.org/content/32/30/10201.abstract?sid=349221d1-e12f-411a-80a6-80285ed5db54
www.ncbi.nlm.nih.gov/pubmed/22806462

A properly functioning immune system protects the body against infections by bacteria, viruses, fungi and other pathogens, and helps it heal. When our bodies detect a threat, or a stimulus that is “perceived” to be a threat, it orchestrates a delicate but highly aggressive immune inflammatory response to meet that threat.

There are two initial phases of immune responses:

  • Innate/early phase — a “built-in” or “automatic” response that is prepared at all times to defend the body against infection and cell mutations, such as those seen in cancers, and
  • Acquired– a more “educated” immune response that takes time to evolve in response to a specific trigger.

Inflammation is a complex event during which immune cells migrate into an area in response to various immune factors. These messages, such as cytokines, are used to to communicate and coordinate an organize attack against pathogens, or to help the healing process. After the threat has been resolved, other immune cells come in to carry away dead organisms and cells, and start the repair process.

A well-balanced immune system, a system in immune homeostasis, will mount enough of an inflammatory response to eliminate the threat, and then go on to repair damaged tissues. However, problems may arise if the immune system continues to generate an inflammatory responses after a challenge has been met —when inflammatory responses do not lower in intensity.

In such cases, the immune system is “over-responsive”; it is unbalanced, out of homeostasis. An over-active immune system leads to conditions where the body starts to destroy its own healthy tissue (e.g. diabetes, thyroid, lupus, multiple sclerosis, fibromyalgia, etc.) or it may lead to allergies and chemical sensitivities, or poor healing.

Many people have the mistaken impression that “boosting” immune function at all times is useful. This is simplistic. People with autoimmune conditions, such as those mentioned above, are already “over responding”. The last thing they need is to further “boost” their immune response, increase their autoimmune responsiveness.

Another example of “boosting” immune response is artificially increasing the level of natural killer (NK) cells within the body. NK cells often make up part of the body’s “early response”. “Boosting” numbers of certain white cells is unnatural and may cause other difficulties due to excessive numbers of these cells.

Increased levels of NK cells, as well as autoimmunity, have been associated with women who have difficulty conceiving. Women who have experienced spontaneous abortions and miscarriages, have higher than normal levels of NK cells.

Additionally, other types of specific immune cells, for example those that play a role in protecting the body from infection, may promote miscarriage and premature births, when they are at higher than normal levels.

The lesson here is that all of our immune cells and their components have to be balanced, or in a state of homeostasis, for our body to naturally heal and protect itself.

There are a number of simple steps that one can take to return the body to homeostasis, including using recovery proteins, exercise, smarter food choices, and maintenance of healthier weights.

http://www.ncbi.nlm.nih.gov/pubmed/20237962
http://www.ncbi.nlm.nih.gov/pubmed/20528832
http://www.ncbi.nlm.nih.gov/pubmed/21162648
 

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