Chinese Fungus a Potential Immunosuppressant to Treat MS

Saw an interesting article in the Wall Street Journal about a new drug being introduced by Novartis called fingolimod. The drug is used to suppress the immune system, treating some of the symptoms of multiple sclerosis. I'm generally not a big fan of immunosuppressants, but the article does suggest why many alternative therapies work.

The drug is based on a fungus known as "winter-insect-summer-plants". An excerpt describing the fungus:

Dr. Fujita says he reasoned that an even more powerful immunosuppressant chemical ought to be present in a group of Asian fungi known in Chinese and Japanese as "winter-insect-summer-plants." These fungi attack insects in the winter with their chemical arsenal. By summertime, the insect is dead and its corpse has been transformed into a vessel for the blooming fungus. Ironically, the same properties that make the chemical deadly in the insect world may also have a helpful side for people suffering from certain autoimmune diseases, in which an overactive immune-system response causes the body to attack its own cells.

There are many natural remedies used in Chinese and Japanese medicine, including herbs and fungus. Perhaps many of these work because they are immunosuppressive.

TRPV2 Protein Trips Up Germs

Another article on proteins related to the immune response. TRPV2 allows macrophages to get a better grip on bacteria, allowing the immune response to be more effective. There's no direct relationship found at this point with autoimmune diseases like Crohn's, but you never know. So thought I'd post it.

Here's an excerpt:

Citing the fact that TRPV2 is important not only in helping macrophages to bind to germs, but also in clearing bacterial infection, Caterina noted its potential as a useful drug target. And in cases of autoimmune diseases -- arthritis, lupus and asthma, for example -- it's possible that the inhibition of TRPV2 might help pull back an overactive immune system.

"We think there are going to be a lot of implications beyond just prevention of infectious diseases where this research about TRPV2's function in macrophages might be relevant," Link adds. "Macrophages consume cholesterol and contribute to hardening of the arteries. They also clear out debris when nerves are injured so that new nerves can grow through that area."

GM-CSF Protein Appears Key to Intestinal Balance

Saw this article and thought it was interesting. It's about a protein called granulocyte-macrophage colony-stimulating factor (GM-CSF) that helps regulate gut inflammation.

Here's an excerpt:

Reduced levels of the protein — granulocyte-macrophage colony-stimulating factor (GM-CSF) — could be an underlying factor in severe illness caused by pathogens such as E. coli and intestinal inflammation in inflammatory bowel diseases such asCrohn’s disease, the researchers said.

“The gut normally is in a chronic state of low-grade inflammation that is beneficial,” study author Dr. Martin Kagnoff, professor emeritus of medicine and pediatrics at the University of California, San Diego, School of Medicine, said in a university news release.

“This study shows that GM-CSF has a profound influence in the regulation of cells that determine whether the gut lives in peace with this inflammation or becomes severely inflamed during infection,” he said. “Any time that delicate balance is disrupted, all heck can break loose.”

Kagnoff said the findings might help explain why some people with Crohn’s disease benefit from receiving GM-CSF. A greater understanding of the role of GM-CSF in the gut could lead to new treatments based on the protein, he added.

Vitamin D may help fight Crohn's Disease

More evidence regarding the benefits of Vitamin D for Crohn's in this recent article. See my post from Sept 2009 for additional evidence - "Vitamin D and Why Immunosuppressants May Be Counterproductive".

Excerpt from the recent article:

“Our data suggests, for the first time, that Vitamin D deficiency can contribute to Crohn’s disease,” says Dr. White, a professor in McGill’s Department of Physiology, noting that people from northern countries, which receive less sunlight that is necessary for the fabrication of Vitamin D by the human body, are particularly vulnerable to Crohn’s disease.

Perhaps an argument to finally take that vacation to Hawaii.

Frankincense a Treatment for Crohn's?

Thought this article ("Frankincense and Myrrh: The Wise Men brought...healthcare?") was timely given it's the holiday season. Apparently frankincense has been studied as an anti-inflammatory and treatment for Crohn's disease. Here's an excerpt:

But frankincense (Boswellia serrata) is less commonly known as a traditional remedy. What does frankincense treat? It's been a remedy for children, and studied as an anti-tumor agent against bladder cancer. In terms of rigorous assessments, a British Medical Journal review of the data looked at all research results and found particularly notable "trials related to asthma, rheumatoid arthritis, Crohn's disease, osteoarthritis, and collagenous colitis. Results of all trials indicated that B. serrata extracts were clinically effective. Three studies were of good methodological quality. No serious safety issues were noted."

Maybe Santa will leave some in your stocking.

Vitamin D and Why Immunosuppressants May Be Counterproductive

I just saw a post from the Napa County Science News Examiner (thank Google Alerts for that) commenting on an upcoming research paper that will be published in the September issue of "Annals of the New York Academy of Sciences" regarding Vitamin D's role in auto-immune diseases. The post talks about a recent research paper that discusses why Vitamin D may be even more important for women than in men (and could also explain higher rates of auto-immune diseases in women). The paper found that women have a higher number of Vitamin D receptors in their body, in particular in the endometrial cells (lining of the uterus). When Vitamin D binds with these receptors, many genes are expressed that help kick-up the immune system.

Here's an excerpt:

The key to how vitamin D plays its part is to understand what the VDR does. When the correct form of vitamin D (a form known as 1,25-D or calcitriol) binds to VDR, VDR then directly causes the expression of over 900 genes to occur. Two of the genes that are turned on produce proteins that are directly responsible for kicking the immune response into active mode. The reason for VDR in the endometrium is that it provides protection against infection for the developing fetus.

Another key to the puzzle has been the growing evidence that bacteria may play a role in the development of autoimmune disease. If so, why wouldn’t women, who have more VDRs, be better off than men? The problem is that bacteria of various kinds can interfere with VDRs and prevent vitamin D from binding. If vitamin is unable to bind, then the immune response is disrupted. Not only is the immune system affected, but thyroid hormone problems can result too.

There are many clear links that have been established between Crohn's and bacteria. However, this finding could point to why immunosuppressants could be hurting rather than helping the problem. Here's another excerpt:

Although these results do not provide a clear path to treatment, “the potential role of persistent pathogens in autoimmune disease mandates reconsideration of the use of corticosteroids as a first-line treatment for many autoimmune diseases. Corticosteroids effectively reduce the ability of the immune system to respond to pathogens, including persistent microbiota, which is counterproductive to recovery.”

This would suggest that Vitamin D supplementation, particularly in women, is important in recovery. Plus, it really calls into question usage of corticosteroids as a treatment for Crohn's.

With all that said, though, you don't want too much Vitamin D apparently. Another study (from 2004) conducted at UCLA found that people with Crohn's had very high levels of Vitamin D in their blood. The high Vitamin D level (contrary to what you would think) actually causes loss of bone density, which could lead to osteoperosis. Here's the excerpt:

ISLAMABAD: Contrary to expectations, people with the inflammatory bowel condition Crohn’s disease are likely to have excessive levels of the active form of vitamin D in their blood, researchers have found. This is associated with low bone mineral density, they report.

Dr. Maria T. Abreu from the Inflammatory Bowel Disease Center at Cedars-Sinai Medical Center in Los Angeles led the study. She told Reuters Health, "Most doctors think that Crohn’s patients automatically have decreased vitamin D levels and encourage supplementation with vitamin D. We would like to urge doctors to check vitamin D levels before making that recommendation."

As Abreu’s team explains in the medical journal Gut, under certain circumstances too much active vitamin D can actually contribute to the breakdown of bone, leading to osteoporosis. The researchers found "inappropriately high" blood levels of the active form of vitamin D in 42 percent of the 138 people they studied with Crohn’s disease. This was true of only 7 percent of 29 patients with ulcerative colitis, another type of inflammatory bowel disease.

Also, the higher the blood levels of active vitamin D in Crohn’s patients, the lower was their bone density -- regardless of whether they were treated with steroids -- the investigators found. "We believe that high vitamin D levels are most likely a manifestation of the underlying gut inflammation," Abreu said. A high vitamin D level is "an additional risk factor predisposing to development of osteoporosis" for some Crohn’s disease patients, the team concludes. Treatment of the underlying inflammation, "may improve metabolic bone disease."

I suppose it's a mixed verdict then. But at the very least it's worth getting your Vitamin D level checked to see where you are and then only supplement if necessary.