Alzheimer's and those darn cytokines

"This new study highlights the importance of certain soluble proteins, called cytokines, in Alzheimer’s disease. The study focuses on one of these cytokines, tumor necrosis factor-alpha(TNF), a critical component of the brain’s immune system."

"The new study documents a dramatic and unprecedented therapeutic effect in an Alzheimer’s patient: improvement within minutes following delivery of perispinal etanercept, which is etanercept given by injection in the spine. Etanercept (trade name Enbrel) binds and inactivates excess TNF." 

http://www.sciencedaily.com/releases/2008/01/080109091102.htm

This is very interesting. Especially given the recent study by Balin, et al noted in this post http://www.cpnhelp.org/study_inhibition_of_apopt and that TNF is one of the immune agents used to kill Cpn. I can readily believe that blocking TNFalpha would lower inflammation, but it could also allow Cpn to run rampant in the brain. The researchers assume (at least apparently) that the inflammation in the brain is an autoimmune or accidental thing, and don't seem to be aware of the solid body of work done by Balin and others of possible infectious causes to Alzheimer's. Any of our more science minded care to speculate on the end results of blocking TNFalpha in an infected brain? 

CAP for Cpn 11/04. Dx: 25yrs CFS & FMS. Protocol: 200mg Doxy, 500mg MWF Azith, Tini 1000mg/day pulses; Vit D1000 units, INH 150mg, Magnascent Iodine 20 drps/day, T4 & T3

 

CAP for Cpn 11/04. Dx: 25+yrs CFS & FMS. Currently: 250 aithromycin mwf, doxycycline 100mg BID, restarted Tini pulses; Vit D2000 units, T4 & T3, 6mg Iodoral

Kind of like the idea that in order to end war, rather than even looking to see who the enemy is, they take the ammunition away from our own troops. That always seems to be the approach to any perceived "autoimmune" disorder. Puzzling, isn't it?

 Asthma, chronic sinusitis/rhinitis, chronic tendonitis, hypothyroid. Jan 9, '08 started Azithromycin 1000mg/week.

Kind of like the idea that in order to end war, rather than even looking to see who the enemy is, they take the ammunition away from our own troops. That always seems to be the approach to any perceived "autoimmune" disorder. Puzzling, isn't it?

Sort of... but remember: the possibilities for infectious pathogenesis do not end at the bounds of the classical infectious diseases. Some diseases might depend on infections which are not significantly harmful per se; some might not even be harmful during therapeutic immune suppression. Bechet's, for example, has been found to respond to both antibacterials and anti-TNFs, and the apparent paradox therein has been noted.

Likewise, I don't think anti-TNFs have been associated so far with long-term deterioration of RA or psoriasis, even though anti-TNFs have now been in use for several years. We don't know yet what happens after 20 years of anti-TNF use. Both RA and psoriasis have been formally shown to be responsive to antibacterials, though I believe the information is more preliminary for psoriasis, and is not that impressive in degree for RA (perhaps because mostly monotherapies have been tried).

Of the diseases widely termed autoimmune, not all are as poorly evidenced as autoimmune as MS is. There is little evidence that any of the autoreactivities in MS cause disease - though they certainly could - there are many autoreactivities which do not cause disease. For many diseases, including Graves', myasthenia gravis, pemphigus, etc, the evidence for the disease being caused by autoreactivities is excellent. As with infectious disease, the best way to show this is by adoptive transfer: add the proposed harmful agent (in this case autoreactive antibodies or T cells) to human tissue explants, or to animals, and see if disease is produced.

However, the question then becomes, what causes the autoreactivity; one possibility is that persistent infection is required to sustain the autoreactivity, and many other possibilities exist. In short, a single disease could be (in some or all of its cases) both autoimmune and infectious at the same time - just as a disease can be infectious and inflammopathic at the same time, or infectious and toxic at the same time.

 

Red

We do know, however not surprisingly, that anti-TNFs have been associated with infections. Here's a quick search through pubmed on "etanercept+infection" alone.

Pubmed Search: etanercept+infection

12 pages returned. And some of those infections look kind of nasty...

 

 

On Combined Antibiotic Protocol for Cpn in Rosacea 01/06 - 07/07, On Vit D3 + NAC since 07/07 and daily FIR Sauna since 08/07

Treatment for Rosacea

  • CAP:  01/06-07/07
  • High-Dose Vit D3, NAC:  07/07-11/08
  • Intermtnt CAP, HDose Vit D3:  11/08-01/09
  • HDose Vit D3, Mg, Zn: 01/09-