What TNF-alpha and Neopterin Tell Us About the Immune System in Autism. Reasons for Hope: Lessons from HIV and Hepatitis.
March 21, 2011 6 Comments
Ok – forgive me but I had to laugh when I found this on graphic on the web. It actually does a great job of explaining things. BUT!!!! (I know it is really complicated – but wait and all this will get explained).
Source: http://www.thetenthparadigm.org/mcs09.htm (an excellent discussion of ME/CFS by Professor Pall)
This graphic explains why I tell patients to avoid nitrous in the dentist office, why we observed increased oxidative stress and neopterin in autism, why Dr Chez finds high TNF-alpha in the CNS of children with autism, why anti-inflammatories like spironolactone and pioglitazone (Actos) help, why I tell parents too much calcium is a BAD thing, why ATP (energy reserves are bad in ASD), why we think they have mitochondrial dysfunction, and why Enbrel helped a 53 Italian woman to regain part of her missing life.
For me after years of looking into this mess we call autism, this one picture affirmed more for me than I can easily relate.
Neopterin in ASD often runs 2-5 x higher than typical children – who are not ill. Any acute infection kicks up the level of neopterin.
Neopterin comes from an activated immune cellular response. We think that if neopterin remains elevated ALL the time that demonstrates viral persistence: as in HIV and Hepatitis. But it also means autoimmunity. It also predicts the severity of atherosclerosis and a host of other disorders.
Neopterin in generated AFTER TNF-alpha is produced. TNF-alpha is produced AFTER NF Kappa B is transcribed from the DNA. It means the macrophages have been given the message (NF kappa B > TNF-alpha) to attack and macrophages are supposed to eat viruses and bacteria.
Graphic: Stylized macrophage attacking viruses like a PacMan game.
In hepatitis and HIV neopterin is elevation is typically seen in direct relationship to higher viral loads – whether we are talking about blood or spinal fluid. This link is to a website dedicated to exploring the details of neopterin. http://www.neopterin.net/hiv.htm
SO HERE IS THE BIG SECRET
The immune system is trying really – really hard to get rid of viruses, but it isn’t working. The high neopterin means high immune activation and it also seemingly paradoxically means high levels of virus. You might think – hey what’s up? High immunity should get rid of the virus. And you would be right IF that was all there was to the picture.
So what is keeping the immune system from functioning? In a nutshell the macrophages are blinded and cannot find their targets. They are getting the message to fight, but then they cannot find the enemy.
Tomorrow I will explain what I think has happened in autism. The good news is I think we have enough pieces of the puzzle now to make sense of the immune catastrophe we label autism.