Friday, February 1, 2013

Dr. De Meirleir lecture at WPI -- summary

Dr. Kenneth De Meirleir recently spoke at the WPI. Below is a portion of
the WPI summary of his lecture from the Wings of Hope blogspot:

Dr. De Meirleir's talk included years of significant research which is very
technical and complicated. Therefore, this review is not meant to be a
summary of the underlying science but rather a summary of the practical
application of this work. However, we will place a recording of this talk
on the WPI website: www.wpinstitute.org, as soon as possible for those who
are interested in the actual research data.

Dr. De Meirleir uses a number of diagnostic tests to diagnose his patients'
underlying biological abnormalities and to guide his successful treatment
protocols. Biomarkers include abnormally low NK cell number and function,
cytokines indicating a shift in the balance of Th1 and Th2 immune
responses, up regulation of Th17 immune cells, and abnormal levels of
nagalase and elastase activity.

He also tests for various active infectious agents including Borrelia,
Bartonella, Brucella, mycoplasma, parasites, and various herpes viruses. He
stated that environmental and genetic factors contribute to aberrant
protein conformation in some patients. Other diagnostic tests include
fecal analysis and tests for levels of LPS or soluble CD14 as an indicator
of gut inflammation.

Basic to Dr. De Meirleir's treatment protocol is a plan that addresses
specific dietary restrictions. He reported that many patients are fructose,
lactose, casein and/or gluten intolerant. His patients often begin feeling
better after eating a diet free of these substances, as they are most
likely to cause an inflammatory response.

In addition, he includes a fecal microbial analysis to determine whether or
not to begin treatment with pulsed antibiotics. Based on the fecal
analysis, which indicates whether or not his patients are suffering from a
compromised intestinal barrier, he also prescribes specific probiotics,
prebiotics such as lactoferrin, and digestive enzymes. When viruses or
other pathogens become chronic Dr. De Meirleir prescribes antiviral
therapies and/or additional antibiotic treatments.

It is generally accepted knowledge that ME patients have difficulty
controlling various herpes viruses and other pathogens, in addition to
exhibiting abnormal natural killer cell function. Subsequent searches for
immune modulating drugs have included trials of several different products.
Gc-MAF is a macrophage stimulating substance that has recently shown great
promise. Dr. De Meirleir highly recommends that patients address any leaky
gut issues before beginning treatment with Gc-MAF. He also mentioned risks
that can be associated with this type of treatment. Risks include a shift
to autoimmunity and an immune reconstitution reaction known as IRIS
although none of his patients have developed autoimmune disease as a
result of Gc-MAF treatments and less than 20% have experienced IRIS.

Dr. De Meirleir routinely monitors his patients for IRIS cytokines after
starting them on very low doses of Gc-MAF, as a method of prevention. Other
immune supportive therapies include the use of Kutapression/Hepapressin
complex (Nexavir), which has been reported to inhibit EBV and HHV-6, and
Isoprinosine for those with low serum uric acid levels. Finally, Rituximab,
a B-cell depletion immune therapy, has been used successfully in a small
trial of patients with ME by oncologists Fluge and Mella.

Because of the delayed therapeutic response of two to seven months, the
authors of this study remarked that there is a possibility that ME has an
autoimmune component. (Note: These two physicians are now looking for
collaborative research sites and additional funding to engage in a much
larger clinical trial due to their 67% rate of success.)

Dr. De Meirleir concluded his talk with a detailed slide describing the
various pathways that are disrupted in ME and several other autoimmune
diseases. He spoke about a continuum of autoimmune diseases including ME,
lupus, RA, type 1 diabetes, and remitting MS that involve a dysregulation
of two important immunological pathways, 2'-5'OA synthetase and Th1/Th2
immunity.

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