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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
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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

 

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).

http://www.npr.org/sections/health-shots/2015/11/29/457255876/loneliness-may-warp-our-genes-and-our-immune-systems
medicalxpress.com/news/2015-11-cellular-symphony-responsible-autoimmune-disease.html
http://www.news-medical.net/news/20151121/Brain-imaging-reveals-distinctive-aspects-of-high-inflammation-depression.aspx
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http://www.news-medical.net/news/20151030/Study-shows-link-between-physical-activity-and-depression-in-patients-at-risk-for-heart-disease.aspx
http://neuroscience.mssm.edu/nestler/brainRewardpathways.html
http://www.ncbi.nlm.nih.gov/pubmed/26302141
www.ncbi.nlm.nih.gov/pmc/articles/PMC3181880/
www.pnas.org/content/early/2015/11/18/1514249112.full.pdfcause-illness-and-early-death.html
www.psychologytoday.com/blog/the-compass-pleasure/201104/exercise-pleasure-and-the-brain
http://www.pnas.org/content/early/2015/11/18/1514249112.abstract
www.psychologistworld.com/biological/neurotransmitters/dopamine.php

Asthma is an inflammatory condition which affects the lungs in negative ways. It is not a single disease, but a group of symptoms that arise from the abnormal immune responses to environmental triggers.

Asthmatics suffer from limited air flow, difficulties in breathing, heightened sensitivity to particles or toxins in the air, wheezing, coughing, and tightness of the throat and chest.

Asthma can be triggered by allergens, air-borne pollutants, upper respiratory infections (like a cold or the flu), exercise, and nonsteroidal anti-inflammatory drugs, such as acetaminophen.

The cells that line the airways, the epithelium, are the first point of contact when particles are inhaled. Until recently, scientists were unaware that these cells contribute to inflammatory responses within the lungs.

Scientists are busily trying to clarify the role of over 50 different cytokines that are involved in regulating the amount of lung inflammation that asthmatics experience. When challenged with antigens, lung cells produce great numbers of inflammatory cytokines, immune messages. These immune factors regulate the activity of genes that result in inflammation and the body’s efforts to control inflammation.  Inflammatory cytokines increase the levels of inflammation to help the body remove the antigens, while other cytokines dampen excessive immune responses, trying to bring inflammatory responses back to balance.

Structural changes in the airways result from the actions of different classes of inflammatory cells and their immune proteins and biologically active molecules. Lung cells can also release molecules that cause the muscles and blood vessels in the airways to become stiff and narrow.

The lungs become overly sensitive to environmental stimuli triggering the production of excessive levels of mucus, perhaps to help dilute and wash antigens out. These fluids can clog the airways of the lungs making it even more difficult to breathe. The hypersensitivity of the lungs results in a vicious cycle of over-active immune reactions, inflammation, and more mucus production.

10.28.15 Ashma PNG grpahic

 

As always the key to healthy immune support is balance. The body needs to produce enough inflammation to help us heal and protect us from external and internal challenges, but the inflammatory response must be well balanced and controlled.

Dr. Hellen’s major passion in life is helping people get more energy, become more productive, and enjoy life at its fullest. She may be contacted by using this form, drhellen@drhellengreenblatt.info, or at: 302.265.3870 (ET, USA).

www.gluegrant.org/inflammation-asthma.htm
http://jaoa.org/article.aspx?articleid=2094079
http://www.worldallergy.org/professional/allergic_diseases_center/cytokines/
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http://www.ncbi.nlm.nih.gov/pubmed/26425339

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).

 

www.theatlantic.com/health/archive/2015/06/the-overlooked-danger-of-delirium-in-hospitals/394829/
www.mayoclinic.org/diseases-conditions/delirium/basics/definition/con-20033982
www.ncbi.nlm.nih.gov/pmc/articles/PMC2911011
intl-biomedgerontology.oxfordjournals.org/content/early/2015/07/24/gerona.glv083.full
www.sciencedirect.com/science/article/pii/S2210833511000773
www.ncbi.nlm.nih.gov/pubmed/17504139

 

 

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, 2013 also 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.
http://www.ncl.ac.uk/press.office/press.release/item/scientists-crack-the-secret-of-the-centenarians
http://www.ebiomedicine.com/article/S2352-3964(15)30081-5/fulltext
www.ncbi.nlm.nih.gov/pubmed/26265203
www.ncbi.nlm.nih.gov/pubmed/26263854

 

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).

 

www.coalitionforpf.org/cytokine-functions/
www.nhlbi.nih.gov/health/health-topics/topics/ipf
www.ncbi.nlm.nih.gov/pubmed/26132817
www.immuneworks.com/autoimmune-lung-diseases/idiopathic-pulmonary-fibrosis-ipf-treatments
www.ncbi.nlm.nih.gov/pubmed/26150910
faculty.ksu.edu.sa/hadilalotair/Chests%20Library/IPF.pdf

 

 

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.


www.cdc.gov/coronavirus/mers/
www.nejm.org/doi/full/10.1056/NEJMoa1401505
www.nlm.nih.gov/medlineplus/ency/article/007192
www.cdc.gov/coronavirus/mers/
www.nejm.org/doi/full/10.1056/NEJMoa1401505

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.

 www.sciencedirect.com/science/article/pii/S0014483502003329
www.ncbi.nlm.nih.gov/pubmed/24174679
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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).

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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).


www.ncbi.nlm.nih.gov/pubmed/25750642
www.nature.com/jid/journal/v127/n3/full/5700701a.html
www.rndsystems.com/mini_review_detail_objectname_mr02_cytokinewoundhealing.aspx
www.ncbi.nlm.nih.gov/pubmed/25774966
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www.ncbi.nlm.nih.gov/pubmed/22564225
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www.bioscience.org/2004/v9/af/1184/2.htm
www.ncbi.nlm.nih.gov/pmc/articles/PMC3467878

Borrelia burgdorferi, is a bacterial infection that results from an infected tick, originally from mammals or birds, biting and injecting the microorganism into a human host. Individuals treated early in infection are likely to recover completely; however, delaying treatment may result in long recovery times, or result in disease that will last for years, or for life.

Infection Affects Multiple Organ Systems
Lyme disease can affect any organ or multiple systems including, skin, joints, nervous system, muscles, and skin. Early symptoms are a red, expanding rash, erythema migrans, that often appears at the tick bite site, and flu-like symptoms such as body aches, fever, chills, headache, and fatigue.

Left untreated, unfocused severe pain may, irregular heart beat and other heart problems, chronic inflammation of the joints (especially the knees, i.e., Lyme arthritis), liver inflammation (hepatitis) and eye problems. Unremitting fatigue, memory problems, and brain “fog” may also accompany the disease.

Incomplete recovery from Lyme disease may result in significant neurological problems, including Bell’s palsy (paralysis of one side of the face), weakness or numbness of limbs, impaired muscle movement, and meningitis (inflammation of brain membranes).

Twenty to fifty percent of patients with neurological issues may continue to experience difficulties for years.

Immune Responses to Lyme Infection
The extent of recovery from Lyme disease depends on factors such as the numbers of bacteria initially injected and the types of immune responses triggered by the infection.

As with healing from most infections, recovery from Lyme disease is a highly complex process requiring the correct interplay of inflammatory and anti-inflammatory cytokines, immune regulating molecules. Successful recovery requires a homeostatic, a balanced immune attack with enough inflammation to kill the organism without damaging by-stander cells and organs.

For example, the cytokine interleukin-6 (IL-6) stimulates inflammation but is also, depending on what the body needs, able to decrease inflammatory responses. (IL-6 is also triggers pain receptors and helps nerve cells regenerate.) Transforming growth factor-β (TGF-β) is another cytokine that helps the body control the amount of inflammation produced in response to infection.

Another cytokine, tumor necrosis factor-α (TNF-α) is an inflammatory cytokine that stimulates certain immune cells to find, engulf, and digest invading organisms. Mice susceptible to Lyme disease are unable to manufacture enough of this factor which may account for their susceptibility.

In humans as well, patients that were recovering well had significantly higher levels of tumor necrosis factor-α compared to those with on-going disease. Once again, these responses likely reflect the powerful inflammatory response that helps the body eliminate the disease.

Additionally, recovering infected individuals had higher levels of transforming growth factor than individuals with severe symptoms. These findings suggest that transforming growth factor was successfully limiting the amount of inflammation being produced in response to infection.

Similarly, in mice with Lyme arthritis, animals that did best were those in which high TNF-α cytokine levels helped kill the bacteria, followed by an aggressive IL-6 response that dampened the inflammatory response.

In further support of these findings, patients with rashes (early infection) had high levels of the anti-inflammatory cytokine, transforming growth factor, as compared to those who had more severe neurological involvement.

Conclusion:
The body uses inflammatory responses to protect itself from infection and heal itself. Inflammation helps the body destroy organisms, almost as if the body was “burning” the infection out. However, just like a forest fire, if inflammation is not well controlled the person with Lyme disease may suffer symptoms for years or for life. This is why it is essential for the body to produce a balanced, immune inflammatory response to infection.

 

Contact Dr. Hellen at: 302.265.3870 (ET), DrHellen@DrHellenGreenblatt.info, or by using the contact form: http://drhellengreenblatt.info/contact-dr-hellen.


www.mayoclinic.org/diseases-conditions/lyme-disease/basics/definition/con-20019701
www.ncbi.nlm.nih.gov/pmc/articles/PMC1782772/
www.ncbi.nlm.nih.gov/pubmed/23945160
www.youtube.com/watch?v=xuTlC_0KzGU VIDEO
www.ncbi.nlm.nih.gov/pmc/articles/PMC2991005/

The act of conceiving, getting pregnant, requires many steps among which are: release of an egg from a follicle (ovulation), fertilization of the egg by sperm, transport of the egg through the Fallopian tubes to the uterus, and attachment to the uterine wall, (implantation).

Each step to becoming pregnant must occur in the right order and requires interaction with hormonal and immune system pathways.

Infertility is the inability to conceive after 1 year of unprotected intercourse. Ten to 15% of reproductive-age couples are unable to conceive. Thirty percent of the time infertility is due to issues with both the man and the woman, or no cause can be determined (idiopathic infertility).

Infertility Issues:
Hormonal and/or immunological imbalances.
Hormonal imbalances affect the way the body interacts with the immune system and affects the ability to conceive.

Seminal fluid, the liquid from male testicles that delivers sperm to the egg contains hormones, cytokines, and other immune messages that interact with the cells lining the female reproductive tract. The factors in seminal fluid prepare the site to receive sperm and set up the proper environment for implantation of the egg. The sequence of events resembles an inflammatory response, but too much inflammation can result in infertility issues.

Pelvic Inflammatory Disease:
Common pelvic inflammatory diseases such as appendicitis and colitis result in inflammation of the abdominal cavity, which in turn may affect the Fallopian tubes and lead to scarring and blockage of the tubes. Since the Fallopian tubes are the pathway by which the egg gets to the uterus for implantation, implantation may not occur. Abdominal surgery, scar tissue, and sexually transmitted infections can also result in inflammatory pelvic disease.

Endometriosis is an inflammatory and hormonal condition that occurs when the tissues lining the uterus grow and spread outside of the uterus. They release blood at menses, the monthly cycle. Thirty-five to fifty percent of infertility cases in women are due to endometriosis.

Poor Egg or Sperm Quality.
Life style decisions such as abuse of alcohol or drugs, smoking, poor diet, obesity, lack of consistent physical activity, and environmental factors may all contribute to poor viability of the egg or sperm.

Smoking contributes greatly to inflammatory responses of the body.

If either partner smokes, the chances of conceiving, via natural or clinical means, are reduced by 33%. Smoking by men lowers their sperm counts and affects the health of their reproductive organs. Women who smoke take longer to conceive compared to non-smokers and are at increased risk of miscarriage, premature birth, and low-birth-weight babies. Even women who do not smoke, but live in homes where they are passively exposed to smokers, may take more than a year longer to become pregnant than women living in smoke-free homes.

Infections and Medical Conditions.
Women and men with sexually transmitted diseases often show no symptoms. Untreated infections can result in excessive inflammatory responses which damage and scar reproductive organs.

Anti-sperm antibodies
Up to 50% of infertility problems in women and men may be associated with the presence of anti-sperm antibodies, large immune proteins that attach to the sperm and trigger immune responses.

In women, antibodies to sperm may attack her partner’s sperm and result in inflammation and damage of vaginal tissues. Over 70% of all men who get a vasectomy develop anti-sperm antibodies. If damaged sperm fertilizes an egg, chances of a miscarriage increase.

Summary:
The reasons behind idiopathic infertility are not understood. It has been my experience that when couples focus on returning to immune balance, to immune homeostasis, they appear to enhance their chances of having children.

Contact Dr. Hellen with the contact form, or  302.265.3870 (ET) or at DrHellen@DrHellenGreenblatt.info.


natural-fertility-info.com/top-10-causes-of-infertility.html
www.jimmunol.org/content/188/5/2445.full.pdf
yourfertility.org.au/for-men/smoking
www.ncbi.nlm.nih.gov/pubmed/25567620
www.ncbi.nlm.nih.gov/pubmed/25547201
www.ncbi.nlm.nih.gov/pubmed/24996040
www.ncbi.nlm.nih.gov/pubmed/24993978
www.ncbi.nlm.nih.gov/pubmed/25592078
www.ncbi.nlm.nih.gov/pubmed/24863647

(My initial post on endometriosis can be found at: http://drhellengreenblatt.info/archives/1448)

Endometriosis is a painful, chronic (long-lasting) condition from which over 5 million girls and women suffer. This is a condition in which the lining of the uterus, called the endometrium, overgrows itself, and actually starts to spread and grow outside of the uterus. These endometrial growths or lesions can end up in the abdomen, in other organs, or as part of abdominal scars after surgery.

Follows a Menstrual Cycle/Infertility
Oddly enough, the misplaced tissue continues to follow a menstrual cycle. As these cells are under the influence of female hormones, each month the cell cluster gets larger and sheds blood and tissue and then shrinks again. The shed blood and tissues trigger inflammation resulting in pain, scar tissue, and adhesions, tissues that stick to one another and neighboring organs. Thirty-40% of women who have endometriosis are unable to have children. (This rate is 2-3 times the rate of infertility of the general population.)

Inflammatory Environment
Excruciating pain, sometimes far from the source, is a major issue for women suffering with endometriosis. Endometriosis appears to create an inflammatory environment that stimulates nerve fibers close to the endometrial lesions and other parts of the nervous system.

Genetics
Genetically, there is a seven-fold increased risk of disease in patients with a family history of the disease and the cells in the endometrial growths have damaged chromosomes.

Toxic Chemicals Implicated
The causes of endometriosis have been under study for decades, but one factor may be toxic chemicals. For example, dioxins are a group of highly toxic environmental chemicals that accumulate in the water and the food chain. They are absorbed by fat tissues and stay in the body for decades. Dioxins appear to cause developmental problems for children, interfere with hormone production, and negatively affect the immune system.

In the test tube, dioxin-like chemicals affect the production of inflammatory cytokines, immune cell factors. In one case, 79% of monkeys exposed to dioxin developed endometriosis, and the greater their exposure, the more severe their disease. Further study suggested that these monkeys had similar immune issues as did women with endometriosis.

Immune Homeostasis: A Balanced Immune System
The immune system strives to maintain a fine balance between protecting the body from the damaging consequences of toxic chemicals and “over-reacting” by causing too much of an inflammatory response.

Endometriosis is an inflammatory condition. Women with endometriosis may experience significant quality of life changes when they approach immune homeostasis.

 

On a personal note, (modified from the previous post http://drhellengreenblatt.info/archives/1448):
Over a decade ago, a young female researcher from West Virginia reported that a large number of women in her West Virginia community had been diagnosed with endometriosis. She was researching this problem, and unfortunately, she herself had endometriosis. She reported that her quality of life improved dramatically when she began to return to immune inflammatory homeostasis. [Unfortunately, she lost contact with the scientist.]


Dr. Hellen is available to work with individuals who wish to enhance their quality of life. She can be contacted at: 302.265.3870 (ET), DrHellen@DrHellenGreenblatt.info, or by using the contact form: http://drhellengreenblatt.info/contact-dr-hellen.

www.ncbi.nlm.nih.gov/pubmed/25528731
www.endometriosisassn.org/endo.html
www.cwhn.ca/en/node/39753
genomemedicine.com/content/2/10/75
www.ncbi.nlm.nih.gov/pubmed/25465987
www.ncbi.nlm.nih.gov/pubmed/25433332
www.ncbi.nlm.nih.gov/pubmed/15731321
researchpub.org/journal/bmbn/number/vol1-no2/vol1-no2-2.pdf
www.ncbi.nlm.nih.gov/pubmed/16101534

The mouth is a unique bio-environment for bacteria and other microorganisms. The oral cavity must always be in microbial and immune homeostasis (balance).. Hundreds of types of bacteria need to be properly balanced to protect the mouth from infection or severe gum disease can result from microbial imbalances or “dysbiosis”.

Oral Disease
Many microorganisms in the mouth attach to the teeth. The accumulation of microbes on the surface of teeth is called a “biofilm”, which may eventually calcify into a matrix of hard material called “plaque”.

If not removed, biofilms can lead to inflammation of the gums; a first step in the development of dental caries and “gingivitis”. This mild form of gum disease results in swollen and red gums that may exude pus and bleed easily upon brushing. If left untreated, gingivitis may escalate to periodontitis. In periodontitis, pockets of microbes form and the infection spreads and grows below the gum line, damaging bone, and loosening teeth.

Oral Inflammation
Periodontal-causing pathogens in the mouth trigger defense mechanisms resulting in defensive inflammation. However, when inflammation is not controlled, bone and connective tissues are damaged; the gums pull away from the teeth and leave them in danger of falling out.

When dysbiosis occurs, pathogenic periodontal bacterial communities may overpopulate the mouth. The bacteria are able to circumvent immune cell attacks. As the number of bacteria increase, they stimulate more inflammatory responses leading to bone loss and worsening periodontitis.
As might be expected, treating periodontitis decreases the biomarkers of inflammation throughout the body.

Atherosclerosis and cardiovascular disease
Inappropriate levels of inflammation in the mouth can lead to inflammation throughout the body. It is therefore not surprising that periodontal disease increases the risk of having other inflammatory conditions such as atherosclerosis and cardiovascular disease. Indeed, individuals with atherosclerosis and periodontitis share genes that appear to stimulate similar inflammatory pathways.

Alzheimer’s Disease (AD).
Amyloid plaque accumulation in the brain is a major feature of Alzheimer’s disease (AD); heightened levels of amyloid have been associated with greater risk of periodontal disease. Even in seemingly healthy elderly individuals, those with periodontal disease have more amyloid in their brains than those without oral disease.

Individuals with strong immune responses to periodontal pathogens are at greater risk of developing Alzheimer’s than people who have more limited responses. This has led investigators to suggest that inflammation-associated periodontal disease may be a contributor to Alzheimer’s.

Homeostasis
A major function of the immune system is to keep the numerous bacterial communities on and throughout the body in check. To accomplish this, the body maintains immune homeostasis, exquisitely balanced inflammatory responses.

One might predict that maintaining good oral health would decrease one’s risk of inflammatory diseases including diseases such as cardiovascular and Alzheimer’s Disease.

www.ncbi.nlm.nih.gov/pmc/articles/PMC3183659
europepmc.org/abstract/med/765622
www.ncbi.nlm.nih.gov/pubmed/25434071
www.ncbi.nlm.nih.gov/pubmed/25435361
www.ncbi.nlm.nih.gov/pubmed/25466412
www.ncbi.nlm.nih.gov/pubmed/23746697

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

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

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

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

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

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

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

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

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

 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

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

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

 

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

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

 Exposure to Air-Borne Particles

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

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

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

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

 Increase Risk of Cancer

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

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

 Signature Illness: PSTD and Respiratory Illness

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

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

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

 Respiratory Difficulties and Inflammation

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

 PTSD and Inflammatory Responses

A few months ago I stated “Clinical studies suggest that individuals with post-traumatic stress disorders suffer from chronic low-level inflammation. This is reflected in their greater propensity to have inflammation-associated diseases such as autoimmune, cardiovascular, gastrointestinal, musculoskeletal, and respiratory diseases.”

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

 The Combination of PTSD and Respiratory Issues

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

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

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

 A Plea to Readers

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

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

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

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

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

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

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

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

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

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

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

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

www.ncbi.nlm.nih.gov/books/NBK22254/
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www.hindawi.com/journals/cherp/2012/490804/

 

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

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

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

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

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

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

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

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

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

Post-traumatic stress disorder (PTSD) occurs in some individuals that are exposed to emotionally disturbing events such as combat, rocket, and terrorist attacks. Individuals that have suffered traumatic brain injury (TBI) or experienced natural disasters and sexual assault are also at higher risk of having this disorder.

Symptoms may include quality of life issues such as explosive outbursts of anger, difficulties in concentrating, being easily startled, feeling constantly “on guard”, expecting a threat to occur at any moment, depression, problems sleeping, avoiding people and circumstances that can trigger unpleasant memories or outbursts, limiting emotional relationships, and avoiding crowded locations.

Up to twenty percent of veterans serving in Iraq and Afghanistan, 10% of Gulf War (Desert Storm), and 30% of Vietnam Veterans have been diagnosed with post-traumatic stress disorder.

PTSD is not only a psychiatric issue. Individuals suffering with PTSD are at higher risk of being physically ill, and at increased risk of death from a multiple of causes.

PTSD is Associated with Inflammatory Responses.
Clinical studies suggest that individuals with post-traumatic stress disorders suffer from chronic low-level inflammation. This is reflected in their greater propensity to have inflammation-associated diseases such as autoimmune, cardiovascular, gastrointestinal, musculoskeletal, and respiratory diseases.

A combination of high blood sugar, cholesterol, and blood pressure, coupled with excess fat around the abdomen (abdominal visceral fat), increases the risk of individuals for stroke, heart disease, and diabetes. This cluster of symptoms, metabolic syndrome, is associated with inflammation and is found in 48% of individuals with post traumatic stress syndrome compared to 25% of controls. Such clinical issues result in patients with PTSD utilizing a greater proportion of medical services and prescription medications.

IL-6 is a cytokine, an immune messenger, which plays a major role in inflammation, helping the body heal after tissue injury, and defending the body from pathogens. C-reactive protein (CRP) is another biological marker that is strongly related to heightened levels of inflammation. Elevated levels of IL-6 and CRP are associated with an increased risk of heart attacks and other cardiovascular events that are inflammatory in nature.

Reports of increased presence of inflammatory cytokines in individuals with PTSD are inconsistent. However, the evidence suggests in military personnel with PTSD or depression, IL-6 levels are higher than found in control subjects, and that the quality of life of these soldiers is poorer as well. Similarly, individuals with PTSD are more likely to have significantly higher amounts of circulating CRP than those not diagnosed with PTSD.

Intermittent explosive disorder is one of the more troubling aspects of some individuals with post traumatic stress disorder. This condition involves repeated episodes of impulsive, angry, verbal outbursts, and violent and aggressive behavior. CRP and IL-6 levels are significantly higher in personnel with intermittent explosive disorder compared with normal or other psychiatric controls, suggesting a direct relationship between inflammation and aggression.

Summary:
Fifty percent of individuals with post traumatic stress syndrome do not seek treatment, and of those that do, only half of these persons will get “minimally adequate” treatment. Until now, the primary treatments for PSTD are psychological counseling and psychiatric medications.

Inflammation is the result of a delicate balance between inflammatory and anti-inflammatory responses, and the body constantly strives to maintain a state of “immune homeostasis”, immune balance.

As in most disease, chronic low-grade inflammation is a likely contributor to post traumatic stress syndrome. If individuals with PTSD better controlled the amount of inflammation produced by their bodies, their quality of life would improve, both emotionally and physically.

 

There is no cost to speak with Dr. Hellen. She can be reached at 1.302-265.3870 ET [USA] or contacted at: drhellen@drhellengreenblatt.info.

 

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

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