DR Xxxxx : The auto-immune diseases are a diverse group of medical conditions affecting many different tissues and organs throughout the body.
They are loosely divided into two types: organ specific and multi-organ types. Organ specific diseases include conditions such as: Grave's Disease, Hashimoto's disease, Diabetes, or (classical) Addison's Syndrome. Multi-organ autoimmune diseases include conditions such as: SLE (Systemic Lupus), and other Connective Tissues Diseases or Rheumatoid Arthritis.
The thyroid: a gland at the front low neck.
All these conditions are characterized by the presence of unique antibodies that target specific body parts or tissues
- Grave's Disease: anti-thyroid receptor antibody, Immunity occurs to components of the thyroid gland.
- Hashimoto's disease: anti-thyroid microsomal antibody, anti-thyroid peroxidase antibody, anti- thyroglobulin antibody. Immunity occurs to components of the thyroid gland.
- Myasthenia Gravis (immunity to the acetylcholine receptor on voluntary smooth muscle, featuring anti acetylcholine receptor antibody).
- Primary Biliary Cirrhosis: immunity to the bile duct structures in the liver.
The thyroid: in reality:
see the bulge here
- Diabetes: anti-islet cell antibodies, anti-insulin antibodies
(Occur in Classical presentations). The Immunity is against the Beta cells of the pancreas that produce insulin.
- Addison's Syndrome: anti-adrenal corticotrophin antibody.
In Addison ’s disease, immunity occurs to the components of the cortex of the adrenal gland that produces steroid hormones .
SLE (Systemic Lupus): classically anti-DS DNA, but also ANF (=ANA aka antinuclear antibody) and a range of ENA as well.
- Other Connective Tissues Diseases (aka Collagen Diseases): usually characterized by positive ANF (ANA) and a specific range of ENA (extractable nuclear-antigen)
- Rheumatoid Arthritis: anti-rheumatoid factor antibody, ANF (ANA), anti CCP antibody (anti citrullinated peptide antibody)
Types of Connective Tissues: it is the vascular tissues, fibrous tissues and joints which are the main important groups.
There is a question as to whether there is a "true" distinction between organ specific and multi-organ immune diseases. Alternately, does this simply reflect that the affected “single” tissues in multi-organ immune disease are just present in multiple organs, so their clinical effects are seen, in multiple organs?
Let's discuss Connective Tissue Disease, Immune or Inflammatory Screening Blood Tests in Paill Spectrum Fibromyalgia
The name Fibromyalgia is often used by Rheumatologists, when the patient has some type of soft tissue aches and pains, but all the standard screening rheumatological tests are negative.
ANF = ANA = antinuclear antibody or antinuclear factor
RhF = Rheumatoid Factor or Rheumatoid Factor Protein
ENA = Extractable Nuclear Antigens: usually only done when the ANA is positive
ESR = Erythrocyte Sedimentation Rate: This test result is most typically "raised" by the presence of large cross linking antibodies which effectively make the blood more viscous. It is nothing more complicated than letting blood in a tube settle and measuring how far it sinks in a given time.
CRP = C Reactive Protein. This test is a protein marker of inflammation. The tests numbers usually vaguely mirror the ESR (a more classical test).
Anti-DS DNA: anti-Double Stranded DNA: This is regarded as a specific test for SLE (Systemic Lupus).
Esoteric antibodies: e.g. ANCA: antinuclear cytoplasmic antigen, usually used as a test for vasculitis.
There are a host of other tissue auto antibodies. They are often used to exclude specific diseases or tissue specific autoimmune diseases, rather than as a screen for multi-tissue autoimmune diseases. Lupus is perhaps one of the more common syndromes that doctors try to exclude when assessing the symptoms and signs of fibromyalgia.
The T Cell Team: cellular immunity in action.
And don't forget your Gamma-Delta T4 Lymphocytes: another T4 cell subset .
DR Xxxxx : About : Connective Tissue Diseases:
SLE or Lupus, Rheumatoid Arthritis,
Mixed Connective Tissue Disease
The key features of the Connective Tissue disease involve: arthritis and synovitis as well as vasculitis. Joints and organs like the kidneys are particularly affected. :-/
That's why it is so important to diagnose these conditions as a great deal of damage can be prevented if treatment is instituted. Arthritis and synovitis are easy to diagnose.
Where blood tests are negative, a nuclear bone scan will reveal the inflammation readily enough, if the affected area is big enough.
Vasculitis (and little microscopic foci of inflammation) are much more insidious conditions. The abnormal areas are too small to show up on most imaging tests. Most blood tests are not helpful.
Tests for vasculitis usually fail to show any positive result and there is no obvious cause for the observed symptom. Doctors normally reassure their patients there is nothing wrong. Realistically, I agree, there does appear to be nothing wrong. :->
Types of Autoimmune Diseases.
Dr. AXxxxx : The very concept of "autoimmunity" is the devil's work in my opinion. The immune system has evolved over billions of years with the imperative that every mistake is death. Strange that humans alone amongst so many species on this planet should suffer from "errant immunity " in such numbers. For example, it appears to me that the presence of nuclear antibodies may actually reflect immunity to the nuclear materials found in invading agents.
Goo : What is an agent Dr. AXxxxx?
Dr. AXxxxx : Goo, I did not realise you were listening. An agent is probably best described as an invading little creature, but a single celled little creature.
Goo : Why do humans get infested with these things?
Dr. AXxxxx : I am afraid Goo, that all mammals may to some extent be infested with these life forms. In most circumstances an effective and active immune response reduces damage to the host to a minimum. This makes diagnosis very hard, because there's not much to find, and on which to base a diagnosis. There are other considerations.
CENSORED "ref AX1101" by order of “Frobisher” authorised by “The Commandant”.
Goo : A complex situation indeed. It worries me to think that something is using me as a food source.
Dr. AXxxxx : It will worry you even more, if you do nothing to control the progress of the illness. As I have stated before, Paill Spectrum may be a horrific illness, but at the same time you can appreciate its deadliness, efficiency and stealth. Beauty in technical specifications , I would say.
Kinkajou: Back to Fibromyalgia. So, Dr. Xxxxx, what is wrong with our current view of Fibromyalgia and Autoimmune Disease?.
DR Xxxxx : Autoimmune Disease & the Paill Spectrum Model
The current medical model underlying all these conditions states that these conditions arise because the body has developed an immune response inappropriately against its own tissues. This needs to be suppressed. Indeed steroids and cytotoxic medications are often used in the treatment of fibromyalgic and autoimmune disease.
The Paill Spectrum model implies that an appropriate immune response develops to foreign antigen either directly or where this foreign antigen attaches (as a “hapten”) to normal tissues. Auto-antibodies probably are not a real feature of the disease burden in human populations. Antibodies target non-self-antigens. These may be Paill Spectrum antigens.
CENSORED "ref AX1102" by order of “Frobisher” authorised by “The Commandant”. I also feel there is merit in Dr. AXxxxx's intimation that molecular germ agents are involved. The infection situation is however quite complex and there are likely many facets involved in illness .
The Paill Spectrum model predicts that treating people with steroids or cytotoxics will suppress the immune response and result in a temporary reduction in tissue inflammation with a reduction of patient symptoms.
Antigens and where they may come from.
These agents may also be useful, but not for the reasons we believe. Unfortunately, the infection continues. Most doctors, who use these types of treatments on their patients, find to their surprise that every 3 – 9 months the dose of the immune suppressive agents needs to be increased as the symptoms return. They then say that the condition must be getting worse. In fact due to the immune suppression helping the infection along, they will eventually need to increase the dose.
There is a natural cap on the process. Either the antigen load increases sufficiently to cause a breakthrough immune flare with germ destruction or the pain conducting nerves are exterminated by the body’s immune response with consequent reduction in patient symptoms.
The time period over which the clinical scenario is played out is also far too long for the average doctor to remember the clinical symptoms occurring and to allow the doctor to track the progression of the disease process over time. People forget. Doctors forget too. Paill Spectrum helps this process all too much. Once you are diagnosed, true or not, you become labeled and the path of your life follows the ancient rut.
Dr. AXxxxx :( Mainly because the medical treatment may eventually become responsible for many of the illness symptoms that people complain of.)
DR Xxxxx : You are a cynical man Dr. AXxxxx! One further comment. There is reason to believe that cytotoxic and immune medications actually work in quite a different fashion to what most doctors believe. They are not so much immunosuppressant as disease modifying. Perhaps we should focus on the medical explanation rather than the reality of response being the point of misunderstanding.
Dr. AXxxxx : Ah! I finally begin to see wisdom in a mammal.
Erasmus : I have heard people tell me that their doctor wants to use steroids to treat them. What should they do?
DR Xxxxx : God have mercy. But desperate people will do anything.
DR Xxxxx : Therapeutic Considerations in Cytotoxic & Steroid Therapy of Fibromyalgia & Related Conditions: >
Steroid therapy , in particular glucocorticoid therapy effects and side effects
How Doctors may fight Fibromyalgia
The Paill Spectrum model of disease as developed by Dr. Xxxxx, advises extreme care in introducing Paill Spectrum therapy in autoimmune conditions. For example, he has seen one patient with Myasthenia Gravis where the Paill Spectrum type therapy is causing a prolonged steady antibody titre fall in the acetyl-choline receptor antibody titres.
However, it is not safe to stop the immune suppressants as the antibody titre flare which is likely to follow, will cause a marked worsening of the myasthenia symptoms.
Treatment becomes a balance of controlling the underlying Paill Spectrum infective process as well ensuring the immune process perhaps responsible for causing the acetylcholine receptor antibodies to form, is gently suppressed until the Paill Spectrum antigen load falls sufficiently to allow the immune suppressive therapy to be reduced.
DR Xxxxx : Unfortunately, there is a lot more complexity in the involvement of immune processes in the causation of autoimmune diseases. While a steroid cytotoxic protocol may be useful, the Paill Spectrum Plus model actually predicts a number of layers of issues need to be addressed in treatment.
CENSORED "ref AX1103" by order of “Frobisher” authorised by “The Commandant”.