Azith

[kim]

I wasn't going to post this yet, but reading Emma's remark on the other thread, I thought I would anyway. There is a lot here, including the question of whether grapeseed extract would even be bad in a PANDAS situation. This is important for people who are thinking of, or using Bontech vits. I just started looking at this last night, but it looks like the mechanism by which azith modulates, is totally different. There still is the issue of high IL12, but I really am SO unqualified to make any determinations. These are simply things for discussion, and questions only a Dr. who understands all of this, can really advise on.

 

http://jac.oxfordjournals.org/cgi/content/full/46/1/19

 

Nevertheless, the present study demonstrates that azithromycin induces apoptosis in human neutrophils to a greater degree than other drugs. As apoptosis limits the ability of neutrophils to damage surrounding tissues and prevents further amplification of inflammation, additional studies are needed to determine whether this mechanism may contribute to the clinical efficacy of this azalide in the treatment of infectious pneumonia.

Emma, I can't get the full article...but thought of you regarding this one. Interestingly, there was on that talked about strep induced arthritis too.

 

 

http://www.ncbi.nlm.nih.gov/sites/entrez?D...Pubmed_RVDocSum

 

The acronym PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections) has been assigned to a subgroup of patients experiencing pediatric onset obsessive-compulsive symptoms and tics as a result of autoimmune response to group A beta-hemolytic streptococcal infection. It has been hypothesized that an immune process initiated by infection affects the basal ganglia and causes neuropsychiatric symptoms. In cases with severe neuropsychiatric symptoms, the use of treatment strategies that interrupt the autoimmune process responsible for the pathogenesis of PANDAS, such as therapeutic plasmapheresis or intravenous immunoglobulin, has been proposed. In this paper, we discuss the effect of plasmapheresis treatment in 4 adult cases of obsessive-compulsive disorder and tic disorder triggered by streptococcal infections.

[michele]

Kim, Is the article stating any tie to strep and affectiveness with azith? I notice it talking about pneumonia. What is apoptosis? neutrophils? I am lost here. So this is confirming it is modulating? I would lov to send to the Dr. Can you find any articles stating it is better for treating strep or PANDAS symptoms? I am not sure how others here were able to get azith from their Dr. but here in Ohio they are limiting its use because of resistance in the mid west to certain strains. Did others just go in and ask for it? Or was it suggested by the Dr.'s? This article doesn't seem to say it is better or recommended more then pen v does it? If I could only get my hands on it for a try! http://intramural.nimh.nih.gov/pdn/pub-9.pdf

 

Michele

 

I wasn't going to post this yet, but reading Emma's remark on the other thread, I thought I would anyway. There is a lot here, including the question of whether grapeseed extract would even be bad in a PANDAS situation. This is important for people who are thinking of, or using Bontech vits. I just started looking at this last night, but it looks like the mechanism by which azith modulates, is totally different. There still is the issue of high IL12, but I really am SO unqualified to make any determinations. These are simply things for discussion, and questions only a Dr. who understands all of this, can really advise on.

 

http://jac.oxfordjournals.org/cgi/content/full/46/1/19

 

Nevertheless, the present study demonstrates that azithromycin induces apoptosis in human neutrophils to a greater degree than other drugs. As apoptosis limits the ability of neutrophils to damage surrounding tissues and prevents further amplification of inflammation, additional studies are needed to determine whether this mechanism may contribute to the clinical efficacy of this azalide in the treatment of infectious pneumonia.

Emma, I can't get the full article...but thought of you regarding this one. Interestingly, there was on that talked about strep induced arthritis too.

 

 

http://www.ncbi.nlm.nih.gov/sites/entrez?D...Pubmed_RVDocSum

 

The acronym PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections) has been assigned to a subgroup of patients experiencing pediatric onset obsessive-compulsive symptoms and tics as a result of autoimmune response to group A beta-hemolytic streptococcal infection. It has been hypothesized that an immune process initiated by infection affects the basal ganglia and causes neuropsychiatric symptoms. In cases with severe neuropsychiatric symptoms, the use of treatment strategies that interrupt the autoimmune process responsible for the pathogenesis of PANDAS, such as therapeutic plasmapheresis or intravenous immunoglobulin, has been proposed. In this paper, we discuss the effect of plasmapheresis treatment in 4 adult cases of obsessive-compulsive disorder and tic disorder triggered by streptococcal infections.

[ad_ccl]

We got azith after everything else was not working. I was a last ditch effort - after reading the article. Now the doctors are ok with it as it is working for him at this time. I am not sure they would have agreed had other things been working.

 

This article is right over my head. I don't know how you understand any of this stuff Kim! (and others)

I did do some research early on when we were starting azith - on CF patients using is due to immuno modulating effects - I think in studies they were taking it daily. I seem to recall the ID doctor or allergist saying they were even starting to research the use of it prophylactically for asthma patients. (not 100% sure as it was a while ago).

[kim]

Michele,

 

I am only assuming that this is the same mechanism that is thought to be beneficial in relationship to PANDAS.

 

You honestly have to read these studies, very carefully and seach the terms that you don't understand. It may take you 3 or 4 attempts.

 

Apoptosis, preprogrammed cell death (I think the article states that) . That doesn't sound like a good thing, at a glance, but it is a process, when working properly, is a neccesary function of some cells.

 

If I were you, I would take the article to the Dr, point out that you are aware of the issues of resistance, but ask if Andrew's health, may warrant the benefit.

 

The article that I posted, I believe was showing that this process was not found to be beneficial when zithro was combined with stain/strains (?) of infectious pneumonia in this study, so I guess, I would go to Pub Med or Google and see if I could find any studies, relating specifically to StrepA.

 

Ihave had so little time to spend on this, but here is another page of articles. Don't know if there is anything helpful here or not.

 

edit

Shoot...can't find it, willpost asap

[michele]

Kim,

What is your background? I am amazed at how much you know and understand? I should have went into the medical field instead of teaching and library science. I feel so dumb when I read this stuff. I have a I should be able to figure this stuff out. I think all the meds I am on have put me in a brain fog. I wish we had a Dr. in the family!

Thanks for all your patience with me! You are so nice and helpful.

Michele

 

Michele,

 

I am only assuming that this is the same mechanism that is thought to be beneficial in relationship to PANDAS.

 

You honestly have to read these studies, very carefully and seach the terms that you don't understand. It may take you 3 or 4 attempts.

 

Apoptosis, preprogrammed cell death (I think the article states that) . That doesn't sound like a good thing, at a glance, but it is a process, when working properly, is a neccesary function of some cells.

 

If I were you, I would take the article to the Dr, point out that you are aware of the issues of resistance, but ask if Andrew's health, may warrant the benefit.

 

The article that I posted, I believe was showing that this process was not found to be beneficial when zithro was combined with stain/strains (?) of infectious pneumonia in this study, so I guess, I would go to Pub Med or Google and see if I could find any studies, relating specifically to StrepA.

 

Ihave had so little time to spend on this, but here is another page of articles. Don't know if there is anything helpful here or not.

 

edit

Shoot...can't find it, willpost asap

[kim]

Warning...rambling, disjointed post with repeat info (but I am trying to make a point here)!!!! I'm going to hit send, anyway, before I chicken out

 

 

What is apoptosis? neutrophils? I am lost here. So this is confirming it is modulating?

http://users.rcn.com/jkimball.ma.ultranet/.../Apoptosis.html

 

Cells of the immune system

 

The formation of the proper connections (synapses) between neurons in the brain requires that surplus cells be eliminated by apoptosis

 

and

 

As cell-mediated immune responses wane, the effector cells must be removed to prevent them from attacking body constituents. CTLs induce apoptosis in each other and even in themselves. Defects in the apoptotic machinery is associated with autoimmune diseases such as lupus erythematosus and rheumatoid arthritis.

 

 

 

 

Michele,

 

For the last 17+years, my profession has been sales. I don't sell anything related to the medical field either. Zip, zero, none, as far as medical experience. It's really important to me, that others realize this. I have made many inaccurate statements on this forum. One that comes to mind, is, I said something like "I'm sure my youngest son had elevated titers for a long time." I said that, because he was said to be a strep "carrier," many times. I now realize, like many harmful bacteria, they can live quite harmlessly among other naturally occuring bacteria within our nasal passage, gut, where ever, and not be invasive. He would not have necessarily shown any antibody formation due to a "carrier" status. Remember, when I talked about new strains s pnemoniae, colonizing, when the old ones were eradicated by Prevnar? This does not mean that the carrier, would necessarily become ill, but it can be passed to others and become invasive in that person. This is known as a "community aquired infection." You have people coloninized with a bacteria that has not previously been around much. When it hits the wrong person, they get sick. So, when you hear of people with meningitis, it's important that they identify what bacteria caused it. There may be several people that had been exposed to that person, that don't become ill, but they DO harbor the same bacteria. What determines who becomes ill, is their state of health. nutrition, lack of sleep, stress, many many things. Now,lets say that you have been on many anti biotics. A lot of the good bacteria in your body, may have been wiped out, leaving empty space, where other harmful bacteria can settle in. This is why the pro biotics are so important. You want to get the levels of "good" bacteria back up, and avoid those empty spaces, and leave less room for harmful bacteria to invade.

 

There is another problem with all of this. If a pathogen, that hasn't been around much, starts popping up, we don't have as fast of an immune response. Infection fighting cells have memory. Once they have "seen" a particular invader before, they mount an attack more quickly. So, if you have a new invasive bug going around, you may seen people become more ill, than a widely cirulating antigen.

 

When you run into a carrier of a bacteria/virus, and pick it up, you may have a response where your immune system produces antibodies without you ever knowing it happend. You don't become ill, but you got a "boost" none the less. That is one of the reasons why the chicken pox vax stinks, in my opinion. We count on that "boost" by running into the antigen in the community. When you get that boost, it keeps the infection from becomming active again. In older people, it usually reemerges as shingles.

This probably has not become a huge problem yet, because the first vax given to the kids, did not work as effectively as they had figured. If the 2nd one does, now we will no longer receive our boost, and will probably see more cases of shingles emerge possibly in younger people. Did you guys know, there is now a shingles vax? It's just a potent varicella (chickenpox) vax. It may be highly recommended for adults in the future. Now, is a case of shingles in an older person more problematic, that the vast majority of chicken pox cases in young children. My bet it, yes. So, what choice will we have?

 

Now this part is just me thinking out loud....

 

This whole thing, does get back around to strep. You know how it has been reported that kids develope symptoms with exposure only. The same concept applies. I guess the body is forming an antibody response, without the proof of invasive disease. Maybe. Dr. Yasko thinks that strep actually is being "masked" from the anti biotics, due to it taking aluminum into the cell with it, and it sort of hides. There is talk of biofilm, right now. This is where a protective coating is formed around a bacteria. Now, my question is, why do the symptoms stay masked with anti biotic use only, and why is one more effective than another, The info on zith. makes sense to me, but because of the inflammatory control.

 

If a neutrophil (an infection fighting white blood cell that eats the invader) hangs around too long(this dysregulated function can be caused by the bacteria that required it's presence in the first place, or something else ), it can cause excessive inflammation. Maybe zith is causing this neutrophil to commit suicide (apoptosis) and it keeps the damage, from the inflammation, from being a problem. So, they recommend a full dose of azith, to try to eradicate the majority of the bacteria that is causing the neutrophils to be called to the site, then a low dose, to keep it in check? But, it doesn't appear to me, that the main problem is solved. It hasn't really eradicated the strep (if the symptoms return as soon as the zith is stopped), Now, let's say that zith. works for a while and then stops. Why would that happen? Has it happened to anyone here?

 

One child, I don't know if it was Andrew or Airbucket's son, showed inflammation around the basil ganglia on a MRI, right? If it was Andrew, I know he hasn't had it, if it was Airbuckets son, I would like to know if he has been prescribed zith?

 

I would think in that situation, zithromax would be clearly indicated as something to try. Even if it only deals with the inflammation, and I would think a Dr. would be very intereted to see if these improvements happen, and what happens when stopped.

 

I couldn't find any studies on the theory regarding zith, in conjuntion with strep A. But then I realized, it probably has not been done, as the theory of PANDAS, itself, has not even been widely accepted.

 

Alison, you were right. This effect of zith is mainly being looked at right now, in regards to respiratory illness. They are trying to see if it may reduces inflammation in disease like asthma, CF, and others.

 

If this is proven to be a problem in relationship to strep, what has changed? The strep, or the children. Is the blood brain barrier compromised? Due to what? Are the neutophils functioning abnormally, why? More questions from this study.

 

 

http://news.ufl.edu/2007/02/06/strep-tic/

 

Analysis showed about 26 percent of children who had two or more strep infections displayed abnormal symptoms compared with 17 percent of children who were not infected or infected only once.

 

and

 

The medical perspective has always been that the carrier states are fairly benign, but maybe they are not as benign as we thought,” Murphy said. “That’s not to suggest that these states are increasing children’s risk for rheumatic fever or other problems that can develop after an infection, but maybe there is a milder spectrum of effects that shouldn’t always be ignored

 

 

If I'm reading this right, out of 693 children, 180 (26%) displayed abnormal symptoms, with 2 or more strep infections. 118 (17%) displayed abnormal symptoms with none, or 1. This is a total of 298 children, out of 693 exhibiting something, that they found unusual. That seems like a pretty high number to me. I think all they were really looking for was to see if there was an increase, which they felt there was, and correlated with a previous study that Dr. Nell was involved in. I'm sure the vast majority of these symptoms resolved or were just not significant, as far as life altering. But I have to wonder why it's happening at all.

 

 

Off, in another direction.....we have gotten back to talking about PANDAS as not being part of the TS spectrum. Ronna has posted articles, talking about them NOT being separate syndromes. So, is PANDAS just an additional problem, where all kids with tics/ts, don't have the antibody/brain response, but had the condition, which sets up tics and comorbid conditions anyway, or a whole different subset? What can be theorized, if they are NOT separte syndromes?

 

I guess this is quite enough for now. I wanted to include this abstract

 

 

Problems with carriage and anti biotic use ....had full study but lost when old computer crashed. I believe the Dr,s especially ID docs are reluctant to prescribe based on this. But they have no problem with vaxing for s. pneumonia? Why don't the same concepts apply? Do they have that much faith, that we can continue to vaccinate away harmful microbes? Has it not been proven, that some of the emerging strains, after vax, are harder to treat?

 

http://www.pidj.com/pt/re/pidj/abstract.00...#33;8091!-1

 

 

A snip from the biofilm article Dr Usman spoke of recently, and posted here

 

The other theoretical issue is that the

> > biofilm may be holding on to toxic metals such as aluminum and

lead.