The Therapeutic Use of Cannabis

February 21, 2011 § Leave a comment

Cannabis has been with us for thousands of years and it has served us well. We depended on her to make clothes, ropes, to take some of the pain and stress away and sometimes even to float away from everyday’s life worries into the unexplored space between words and ideas. Though recreational use of cannabis is not supported or suggested by the writer, the therapeutic use of cannabis is an altogether different issue.

The use of cannabis has been for the most of human history well accepted both culturally and medically.

Cannabis demonization was motivated by social prejudices and racial discrimination. In the early 20th century it was used to barricade the US from Mexican immigrants and later on from African American Jazz Musicians and the “evil” and “immoral” culture they were generating. Cannabis illegalization was promoted by Randolph Hearst who did not want cannabis as an antagonist in the paper business, and pharmaceutical companies who did not want to compete with a cheap and easily accessed – even homegrown painkiller.163 As it is now, back then arguments did not have to be truthful to win over the support and sympathy of public opinion. They only had to appear credible and use fear and loathing to appeal not to the intellect but rather to the most primitive part of human nature. Even when people are unable to respond and conform to reason they can easily understand and comply to fear.

Today, thousands of otherwise law-abiding citizens are imprisoned as common criminals and thousands of patients are denied the therapeutic benefits of cannabis because of a social stigma that was adhered to it and a prohibitory culture which was, is and will be contradicting personal rights and freedom of choice.

Cannabis is not harmless. With the exception of side effects related not to cannabis itself but to respiratory problems associated with smoking, most of them are mild and fleeting. Still cannabis use may have some more severe implications like worsening the progression of liver fibrosis, triggering psychotic episodes,164 causing subtle immune suppression.165 But even some of these side effects can be turned into diagnostic and more easily therapeutic opportunities: cannabis-induced psychotic episodes have been suggested to have prognostic psychiatric value,166 whereas the endocannabinoids’ system immunomodulatory properties can inaugurate a whole new chapter in autoimmune disease therapeutics: the cannabinoid system in the central nervous system has been shown to regulate autoimmune inflammation, implying possible cannabinoid manipulation and treatment of multiple sclerosis!167 Cannabinoids are also being investigated for the treatment of other autoimmune disorders and allergies.168 The active component of cannabis, Δ9-tetrahydrocannabinol (THC) has been found to inhibit the formation of “Alzheimer’s plaques”, slowing or possibly halting the progression of this virtually untreatable debilitating disease. According to the research team:

Compared to currently approved drugs prescribed for the treatment of Alzheimer’s disease, THC is a considerably superior inhibitor of Aβ aggregation, and this study provides a previously unrecognized molecular mechanism through which cannabinoid molecules may directly impact the progression of this debilitating disease.169

Another study exhibited nerve growth promotion in the hippocampus of rats induced by the combination of high dosages of a synthetic cannabinoid alongside with the endocannabinoid anandamide.170 Cannabis compounds have also shown a potential in the inhibition of lung (in vitro and animal models),171 breast172 and brain cancer. In brain cancer especially, THC promoted cancer cell autophagy leaving healthy cells intact.173

A brand new brave world of cannabinoid therapeutic possibilities and options lies ahead of us. Cannabis is also invaluable in chronic or drug-resistant pain management and general quality of living of patients with chronic health conditions. Despite the mild cannabis-induced immune suppression that is probably a counter-indication for AIDS patients, cannabis use was found to be beneficial both in AIDS anorexia and in AIDS related neuropathic pain.174 175 Cannabis use has been shown to be beneficial also in nausea (especially drug-resistant cancer-chemotherapy induced nausea), vomiting, weight loss, premenstrual syndrome. Antioxidant properties have also been attributed to it.

After the illegalization of cannabis, medicalization happened to it. Instead of licensing patients in need of cannabis to even grow it at controlled amounts for personal therapeutic use, cannabis became a drug-industry property and cannabinoid compounds such as Nabinol, Marinol and Sativex that don’t have the much-wanted immediate symptom relieving effects that the inhalation of vaporized cannabis possesses have been promoted as legal medical forms of cannabis. Who’s next? Tea, chamomile, peppermint?

The benefit/risk ratio of cannabinoid compounds and of cannabis herself is very attractive and superior to that of other drugs employed to treat severe medical conditions. Cannabis appears to be “a miraculous” multitask therapeutic agent and its therapeutic use should be and would be heralded by scientists, patients and relatives worldwide. Instead, the social and legal stigma that has been attributed to her has inhibited relative research. It is once again a matter of politics against science, of prejudice against reason, of myths against facts. Who in his right mind would compare or downsize Alzheimer’s disease or cancer or chronic drug-resistant pain, or multiple sclerosis to the side effects of cannabis use?

The hundreds of therapeutic applications, implications and possibilities of cannabis, even in conditions that there are no attractive, or not so effective or no therapeutic alternatives at all leaves us in awe of the extent to which human stupidity and stubbornness, political and financial mannerism and indecency, scientific cowardice and subjugation are halting medical progress.

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ADHD – A Disease in the Definition

February 21, 2011 § 4 Comments

ADHD – A Disease in the Definition

“Fetch,” I enthusiastically shouted but to no avail.

The ball passed by a disinterested dog and landed to the grass some yards away from him, unchallenged, unclaimed.

OK, I was the one who was doing the fetching. Again.

I kneeled and patted the dog softly on his head.

“What’s wrong with you, boy? Why can’t you be just like all other normal dogs and go fetch a ball? Is that too much to ask for a dog?”

The dog looked meaningfully at the far side of the park and off he was to his favorite butterfly chasing.

This dog is never going to make anything great of himself. He should become a poet but dogs don’t get to become poets, I thought sorrowfully, but kept the thoughts to myself not to hurt his feelings.

But I wasn’t the only one with problems or the only one who was keeping thoughts to himself not to hurt other people’s feelings. At the direction that the dog was facing a moment ago there was a father standing, throwing a softball at his son, waiting for him to strike it with his clumsily-held baseball bat.

But the boy was clearly not interested in baseball. He appeared to be interested in everything else, the grass, the dog, the butterflies, me, but not the ball. The ball landed on the grass, some yards from the boy, unchallenged, unclaimed.

It was as if I could hear the father’s disappointment resounding in my head: Why can’t you just be like all other normal boys and hit a ball? Is that too much to ask for a boy?

Then it struck me, almost as hard as a baseball bat: the dog and the boy were co-patients. I mean I may not be a psychiatrist, but it was crystal clear even to the eyes of the untrained, wasn’t it? The boy and the dog shared the same medical condition: ADHD, Attention Deficit Hyperactive Disorder.

Four letter medical abbreviations were almost a perfect match for three letter words like boy or kid and, hey, why not a dog?

I was thrilled with my finding. I had killed with the ADHD diagnosis two birds, well not two birds but rather a boy and a dog.

I dashed home to go refresh my DSM, the Statistical Manual of Mental Disorders, currently in its fourth edition. I opened the psychiatric bible, the great book that defines and separates the good from the damaged, the ordinary people from the deranged, the normal fellows from the nutcases, the functional from the certifiable, the people who are allowed a certain degree of exercising their free will from the cuckoos that need to be checked, supervised, restrained or regulated.

There it was: instant enlightenment. According to DSMIV, ADHD is defined as a:

persistent pattern of inattention or hyperactivity—impulsivity that is more frequently displayed and more severe than is typically observed in individuals at a comparable level of development.

In science it is critical for definitions to define the conditions or terms they attempt to define as thoroughly as possible.

So what is it then? Inattention or hyperactivity? Both? A bit of the one and a bit of the other? A racemic mixture of them? It is obvious that the two terms are not identical, and more often than not seem to even contradict each other. Hyperactivity does require attention in the very thing they want to be active in, with a corresponding disinterest in the thing you want them to be interested in. Normal people who are not interested in something will naturally find their attention shift away. If it shifts away quickly, is that a disorder? Do people who lose interest quickly, with their attention also shifting away quickly to something else, really have a disorder or a disorder related to being impulsive? Yet the same kids can run around and play games that they like.

And so let’s look at it again: “…impulsivity that is more frequently displayed and more severe than is typically observed…”

More frequently displayed… Meaning? How often, I mean like every ten seconds, every minute, every hour? And what about “severe impulsivity”? What does severe impulsivity mean? To be honest I have never heard a human creature accusing another as being severely impulsive. Too impulsive for his own good perhaps, but severely impulsive? And what is the golden standard to which ADHD persons are compared to? But of course the typically observed impulsivity. The typically observed impulsivity. It has a nice ring to it as if it was meaning or describing or actually defining anything. What behavior is typical? Or perhaps the definition refers to typical observers, or to typical acceptance amongst typical experts on what constitutes typical behavior? Where do they come up with such ill-defined definitions of illness?

And that brings us to critically look at what is to be typical? Was Einstein typical? Was Newton typical? Was Leonardo da Vinci typical? Was Galileo typical? And do you want to be typical? An impulsive response may not be typical but is it always part of a disorder? And what disorderly biochemistry typifies it?

A typical impulsivity in Harvard Law School is not the same as the typical impulsivity in the streets of Harlem. The typical modern behavior has nothing to do with the typical Victorian behavior. Things that are considered scandalous or way out of limits in one place today were considered as normal, accepted, well tolerated and even expected in other societies of the past and the present and vice versa…

 

Read more in: Pulp Med, coming out in June 24 2011, by O-books

The placebo effect: a neglected phenomenon

February 21, 2011 § Leave a comment

One of the most commonly used terms in medical language is the word placebo. The placebo effect is used as a scale for evaluating the effectiveness of new drugs. But what exactly is the placebo effect and what are its consequences in the deterministic structure of Western medicine? The placebo effect has been frequently abused by health professionals to denote and stigmatize a fraud or fallacy. Alternative therapies have often been characterized as merely placebos. But the placebo effect is not a fraudulent, useless or malevolent phenomenon. It occurs independently of the intentions of charlatans or health professionals. It is a spontaneous, authentic and very factual phenomenon that refers to well-observed but uninterpreted and contingent therapies or health improvements that occur in the absence of an active chemical/pharmacological substance. Make-believe drugs – drugs that carry no active chemical substances – often act as the real drugs and provoke therapeutic effects when administered to patients. In many drug trials, the manufacturers of the drug sadly discover that their product is in no way superior to the effect of a placebo. But that does not mean that a placebo equates to a null response of the human organism. On the contrary, a placebo denotes nonchemical stimuli that strongly motivate the organism towards a therapeutic course. That is, the placebo effect is dependent not on the drug’s effectiveness but solely on therapeutic intention and expectation.

Effects of positive and negative thinking

The placebo effect has been often misunderstood as a solely psychological and highly subjective phenomenon. The patient, convinced of the therapy’s effectiveness, ignores his symptoms or perceives them faintly without any substantial improvement of his health; that is, the patient feels better but is not healthier. But can the subjective psychological aspect of the placebo effect account for all of its therapeutic properties? The answer is definite: the placebo effect refers to an alternative curative mechanism that is inherent in the human entity, is motivated by therapeutic intention or belief in the therapeutic potential of a treatment, and implies biochemical responses and reactions to the stimulus of therapeutic intention or belief.

But placebos are not always beneficial: they can also have adverse effects. For example, administering a pharmacologically inactive substance to some patients can sometimes bring about unexpected health deteriorations. A review of 109 double-blind studies estimated that 19% of placebo recipients manifested the nocebo effect: unexpected deteriorations of health.1 In a related experiment, researchers falsely declared to the volunteers that a weak electrical current would pass through their head; although there was no electrical current, 70% of the volunteers (who were medical students) complained of a headache after the experiment.2

In a group of patients suffering from carotid atherosclerosis, prognosis and progression of the disease were burdened when their psychological health was bad (i.e., they were affected by hopelessness or depression). In another group of carotid atherosclerosis patients, prognosis and progression were burdened not only by hopelessness but also by hostility.3 In patients with coronary heart disease, hopelessness was a determinative risk factor.4 Social isolation, work stress and hostility comprised additional risk factors.5

Positive or negative thinking seems to be a decisive risk factor for every treatment, perhaps even more important than medical intervention.

The nocebo effect appears to have a specific biological substrate. A group of 15 men whose wives suffered from terminal cancer participated in a small perspective study. After their wives’ deaths, the men experienced severe grief that caused immunodepression. The spouses’ lymphocytes for a period of time after their wives’ deaths responded poorly to mitogens.

Grief had assaulted their immune system. The study proposed that grief and grief-induced immunodepression resulted in high level mortality of the specific group.6

A short history of a small miracle

The term placebo (meaning “I shall please”) was used in mediaeval prayer in the context of the phrase Placebo Domino (“I shall please the Lord”) and originated from a biblical translation of the fifth century AD.7 During the 18th century, the term was adopted by medicine and was used to imply preparations of no therapeutic value that were administered to patients as “decoy drugs”. The term began to transform in 1920 (Graves),8 and through various intermediate stages (Evans and Hoyle, 1933;9 Gold, Kwit and Otto, 1937;10 Jellinek, 194611) was fully transformed in 1955 when it finally claimed an important portion of the therapeutic effect in general. Henry K. Beecher, in his 1955 paper “The Powerful Placebo”, attributed a rough percentage of 30% of the overall therapeutic benefit to the placebo effect.12 In certain later studies, the placebo effect was estimated at even higher, at 60% of the overall therapeutic outcome. In a recent review of 39 studies regarding the effectiveness of antidepressant drugs, psychologist Guy Sapirstein concluded that 50% of the therapeutic benefits came from the placebo effect, with a poor percentage of 27% attributed to drug intervention (fluoxetine, sertaline and paroxetine). Three years later Sapirstein, along with a fellow psychologist Irving Kirsch, processed the data from 19 double-blind studies regarding depression and reached an even higher percentage of therapeutic results attributed to the placebo effect: 75% depression therapies or ameliorations were placebo induced!13

Hróbjartsson and Gotzsche (2001,14 200415) doubted the effectiveness of the placebo phenomenon, attributing it solely to the subjective factors of human psychology. And indeed, there is a major aspect of the placebo effect related to psychology. In two studies where placebos were exclusively administered, the placebo effect seemed to be effected from the subject’s perception of the applied therapy, i.e., two placebo pills were better than one, bigger pills were better than smaller, and injections were even better.16 The placebo induced a reaction not only to the therapy but also to its form, suggesting that the placebo phenomenon is shaped according to the personal symbolic universe of the patient. Before the placebo response occurs, human perception has already interpreted the applied therapy and has prepared a certain response to it. It would appear that not only chemical but also non-chemical stimuli participate in the motivation of the human organism towards therapy. But is the placebo reaction solely a psychological phenomenon or does it have additional tangible somatic effects? One of the more dramatic events regarding placebo therapy was reported in 1957 when a new wonder drug, Krebiozen, held promise as the final solution to the cancer problem. A patient with metastatic tumors and with fluid collection in his lungs, who demanded the daily intake of oxygen and the use of an oxygen mask, heard of Krebiozen. His doctor was participating in Krebiozen research and the patient begged him to be given the revolutionary drug. Bent by the patient’s hopelessness, the doctor did so and witnessed a miraculous recovery of the patient. His tumors melted and he returned to an almost normal lifestyle.

The recovery didn’t last long. The patient read articles about Krebiozen’s not delivering what it promised in cancer therapy. The patient then had a relapse; his tumors were back. His doctor, deeply affected by the aggravation, resorted to a desperate trick. He told his patient that he had in his possession a new, improved version of Krebiozen. It was simply distilled water. The patient fully recovered after the placebo treatment and remained functional for two months. The final verdict on Krebiozen, published in the press, proved the drug to be totally ineffective. That was the coup de grâce for the patient, who died a few days later.17 In spite of the melodrama of the Krebiozen case, there is no single case or personal testimony that can denote or prove a therapy to be effective. Statistical studies, not personal testimonies, can verify a proposed therapy’s effectiveness, and well planned studies are able to concur that the placebo phenomenon has somatic properties. One such study was implemented in 1997. The two study groups consisted of patients with benign prostatic hypertrophy. One group took actual medication while the control group received placebo treatment. The placebo recipients reported relief from their symptoms and even amelioration of their urinary function.18 A placebo has also been reported to act as a bronchodilator in asthmatic patients, or to have the exact opposite action—respiratory depression—depending on the description of the pharmacological effect the researchers gave to the patients and therefore the effect the patients anticipated.19 A placebo proved highly efficient against food allergies and, subsequently, impressively effective in the sinking of biotechnologies on the stock market. How could that be? Peptide Therapeutics Group, a biotech company, was preparing to launch on the market a novel vaccine for food allergies. The first reports were encouraging. When the experimental vaccine reached the clinical trials stage, the company’s spokesperson boasted that the vaccine proved effective in 75% of the cases—a percentage that usually suffices to prove a drug’s effectiveness. But the good news didn’t last long. The control group, given a placebo, did almost as well: seven out of 10 patients reported getting rid of their food allergies. The stock value of the company plunged by 33%. The placebo effect on food allergies created a nocebo

effect on the stock market!20 In another case, a genetically designed heart drug that raised high hopes for Genentech was clobbered by a placebo.21 As aptly put by science historian Anne Harrington, placebos are “ghosts that haunt our house of biomedical objectivity and expose the paradoxes and fissures in our own self-created definitions of the real and active factors in treatment.”22 The placebo’s pharmacomimetic behavior can even imitate a drug’s side effects. In a 1997 study of patients with benign prostate hypertrophy, some patients on a placebo complained of various side effects ranging from impotence and reduced sexual activity to nausea, diarrhea and constipation. Another study reported placebo side effects as including headaches, vomiting, nausea and a variety of other symptoms.23

The placebo effect in surgery…

 

Read more in: Pulp Med, coming out in June 24 by O-books

Mitochondria, Self, Health and the Universe

February 21, 2011 § 2 Comments

One fundamental characteristic of the current civilization is selfishness permeating all levels and spheres of human existence: from the individual perceptions of being, to the social implications of co-existing, to the economic theories of managing and turning co-existence into a profitable network, to the environmental issues of ecologic co-dependence and to the scientific innovations that promote knowledge in all of the aforementioned fields and in even more, selfishness has governed and spawned most of the theories and practices that we today encounter. This solipsism, this egomania, this perception that only I and Mine exist and are worth serving, saving and caring for has already created huge financial problems with the 2008 crash, and is creating even huger environmental problems that no one can confidently predict if and how we are going to be able to resolve and restore balance to our cosmos. In other words, this approach, though a sometimes admirable driving force of the Western world, has an innate limitation: it considers expansion of “self” and exploitation of others as limitless. But since space exploration is underdeveloped, for the next decades we are bound to live in a “sphere” called earth, a world whose limits are well defined and known, a limited world not a limitless one. When expansion has reached exhaustion, when new sources, ideas, innovations, markets, technological breakthroughs are hard to find, when “self” has expanded to such a degree that it can no longer transpose or transfer or dump its problems into new grounds, into fresh “others”, once self has become almost “everything”, at least everything it knows and owns of the cosmos, than “self” has to encounter all of the problems of the “others” that it has by now conquered, phagocytosed, incorporated. And when this time comes, “self” is left only two options (actually only one but for the sake of argument we’ll propose that there are two). One is to try to survive by metamorphosing, to become more introvert, reinvest some of the dynamics of the expansionistic aggressiveness onto solving the internal problems by creating more detailed and extensive networks and regulations and attempt to stabilize and redefine this uncontrollable “self”. This is a model of internal expansion, of expansion within one’s self, an introspective approach. The other is to attempt to expand further at the same or higher rate than previously when expansion is no longer viable and to ultimately collapse, collapse onto itself like a black hole.

There are many paradigms that attest to the nature and outcome of expansion in a limited world. It begins with marvelous aggression, almost unobstructed, until it reaches its limits. Historically, all universal empires collapsed from within, when they could no longer sustain expansion. Rome lasted longer because it transformed some of its aggression into administration. In cosmology, if expansion speed does not overcome the escape velocity, the world will contract (and finally collapse), possibly back into a universal pre-Big Bang state. In biology, a cell culture grows geometrically until the nutrient substrate is exhausted. Then the culture starves to death and diminishes (in a sense collapses onto itself) until the proper ratio of available nutrients is restored. In the sociologic and financial Malthusian model, overpopulation can exhaust the planet’s available resources and lead to war, famine or both, again in a sense collapsing onto itself (off course Malthus took into consideration only overpopulation and not – as he should have done – also overexploitation).

That is what universally happens when expansion is no longer sustainable but it is still perceived as indefinite: collapse.

The sense of self and infinite expansion onto others has these implications in all other aspects of human activity and thought. But what about medicine?

Medicine and biology in general is fraught with selfish perceptions. From the Darwinian survival of the fittest to the neo-Darwinian selfish gene, from antidrugs (antibacterial, antiviral, anticancer etc.) to a genetically governed world, all these disciplines teach us of is Self. Self is good and must be preserved, non-self must be destroyed or controlled. Even cancer, which is a bizarre immortal yet often lethal and ultimately self-destructive expression of self, is treated by medicine as a non-self, as the enemy that has to be destroyed. Since the human body is limited and well defined, expansionism is expressed in exerting control and destroying the others. But even this introvert by nature expansion of self has limitations. Because – as the immune system knows all too well – the notion of self in medicine cannot be taken literally.

Our own genome consists also of incorporated inert (most of the time) viral genetic material. Our own intestinal flora consists of non-self bacteria, vital for our survival and well-being. And our own cells contain cell organelles that billions of years ago were non-self and still are not completely subjected to our cellular government of the nucleus.

We call them mitochondria. They are our power plants. They are matriarchally inherited to us. They have their own DNA (mtDNA) which is independent from our “core” DNA, the biological essence of our being and fate as “macho” medicine wants us to believe. They are not just organelles that are centrally and absolutely governed by core DNA. They are essentially symbiotes, merged with our viscera in our cellular ancestors billions of years ago, giving us now the energy we depend upon in order to live.78

When needed they multiply to provide our tissues with additional energy. But their DNA is also more sensitive than core DNA. They don’t have the complexity and the longitude of the core DNA repair system. So they get damaged more easily. And when they get damaged or depleted they can lead to or get involved in any type of non-infectious disease states one can imagine. Imagine a factory without power or with a shortage of power. It can be completely dysfunctional or the administration can choose to shut down sectors to save power for the most important ones. Some or all workers in the factory will work in the dark. Occupational accidents will happen. If there is a general power our shortage, the factory, no matter what the administration decides to do, will dysfunction or ultimately shut down. Our civilization will be seriously impaired or shut down if faced with serious energy shortages. There is no need to argue that our body will definitely do the same, deteriorate or die.

There are few to thousands of mitochondria in each cell. Each mitochondrion in turn contains multiple copies of mtDNA. This variable mitochondrial numerology has many implications and complications for health and for disease expression, duration, extent and severity. As it has been accurately described in the proceedings of the June 2008 NIH’s National Institute of Neurological Disorders and Stroke June 2008 workshop on Mitochondrial Encephalopathies and potential relationship to Autism:

“…mutations in mtDNA may affect all copies of mtDNA (homoplasmy), but frequently they only affect some copies (heteroplasmy). Since the many copies of mtDNA are distributed randomly between daughter cells during cell division, heteroplasmy can lead to significant variation in the proportion of mutated mtDNA over time and across different organs or tissues. This variation in mutation load can influence the clinical expression of mitochondrial disease. Heteroplasmy may also complicate the diagnosis of mtDNA diseases because the causative mutation may be present in only some tissues, such as specific brain regions or specific muscles, and not in others, such as blood or hair. In addition, an individual’s mtDNA haplotype can modify the effect of pathogenic mutations in mitochondrial genes. More broadly, mtDNA haplotypes may also modify susceptibility for diseases in which mitochondrial dysfunction may not be a primary cause, including diabetes, multiple sclerosis, and some cancers and neurodegenerative diseases.”79

One has to understand the complexity and the diversity of mitochondrial involvement in health and disease states. Mitochondrial deficiency, damage, inefficiency, mutation or any combination of the previous mitochondrial states does not manifest itself homogeneously, and may effect certain cells or tissues of the body or be systemic or even catholic. It may be sudden or slow or cataclysmic or acute or chronic or degenerative, episodic, chronic or both, triggered or remain “dormant”, with mild or severe symptoms or no symptoms at all or with subclinical symptoms that may not be necessarily associated to a disease state, such as fatigue and restlessness. It might contribute to other disease states or be affected by other disease states. It might even be associated with dysmotility, migraine, depression,80 anxiety,81 mood or other psychiatric disorders.82 In depression and especially in depression with somatization low energy production and mitochondrial dysfunction has also been indicated.83 The reverse process, that is whether depression with somatization causes mitochondrial dysfunction which in turn aggravates depression, should be also examined as this loop is in accordance with the “positive feedback” depression, low self-esteem and reduced motivation and physical mobility progression. And it is not only about non-infectious diseases. Infectious diseases can also cause direct damage to mitochondria complicating things even further.84 And there has been a novel discovery indicating that mitochondria play also a vital role in immune response and thus that mitochondria are vital in fighting off infections and especially RNA-Viral infections such as flu, hepatitis, West Nile Virus, SARS (and possibly the so-called HIV infection). A protein named MAVS (Mitochondrial Anti-Viral Signaling protein) located in mitochondrial membrane plays an initial role in triggering immune response against viruses:

The researchers modified normal cells so that the cells could not produce the MAVS protein, which is short for Mitochondrial Anti-Viral Signaling protein. Without MAVS, the cells were highly vulnerable to infection with two common viruses in a class called RNA viruses  Other RNA viruses include hepatitis C, West Nile, SARS and the flu viruses.
Cells altered to produce an overabundance of MAVS were protected from dying from viral infection.85

On the other hand, one of the key elements of the biochemical chain of events that comprise an immune response (co-triggered, as suggested, by MAVS) is interferon. Interferon has the ability to inhibit mitochondrial DNA expression and therefore function. As research suggests: We showed previously that type I interferon causes a down-regulation of mitochondrial gene expression. We show here that IFN treatment leads to functional impairment of mitochondria…

Possibly as a consequence of the inhibitory effect on mitochondrial gene expression, treatment with interferon causes a reduction in cellular ATP levels. The inhibition of cellular growth by interferon may thus be partly a consequence of a reduction in cellular ATP levels.”86 Furthermore there has been some mitochondrial involvement indicated in autoimmune diseases.87

So, in this long chain of events and counter-events, of effects and counter-effects, it is very hard to distinguish cause from effect, first from second. The mitochondrial realm is not governed by some linear strictly-deterministic rational, but it rather works in circular patterns with intertwining positive and negative feedback mechanisms. It is not about intervention, it is about balance. It is not about attacking or prohibiting. It is about regulating, coordinating and tuning. It is not only about finding and defining. It is about understanding, understanding the big picture. And these are tasks that the overspecialized lab-rat scientist will fail to address over and over again, tasks that Big Pharma will either ignore or conceal.

One has to completely understand that any kind of non-infectious, infectious, immune, autoimmune, acute, chronic health conditions, large or small, direct or indirect, primary or secondary may present mitochondrial involvement…

Read more in “Pulp Med”, coming out on June 24 2011 by O-books


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