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(Message started by: catlind on Mar 11^th, 2004, 8:36pm)

Title: Autoimmune connection?
Post by catlind on Mar 11^th, 2004, 8:36pm

Or just the medications for it?

Quote:

Clobetasol propionate ointment and emollient cream are super-high potency corticosteroid formulations indicated for the relief of the inflammatory and pruritic manifestations of corticosteroid responsive dermatoses. Treatment beyond 2 consecutive weeks is not recommended, and the total dosage should not exceed 50 grams per week because of the potential for the drug to suppress the hypothalamic-pituitary-adrenal (HPA) axis. Use in children under 12 years of age is not recommended.

I have psoriasis, and I have been using this medication, and variations of the coricosteroid medications (topical) since I was 4. Wonder what that does to the hypothalamus - and how that may relate to the on/off, right/wrong, up/down, in/out, whatever the damn switch is in there for cluster headaches?

Coincidentally ?? ... With this latest round of battles with the beast, my psoriasis has flared severely as well.

Cat

Oh and this is the first time in 30 years that I've ever seen the warning about extended long term use of these medications....

Title: Re: Autoimmune connection?
Post by pubgirl on Mar 11^th, 2004, 8:42pm

Ree

Interesting on both counts.
CH and skin treatment.
I get dermatitis in bouts and I was told not to use my steroid creams for long periods, but was told it was because it "thinned the skin", nothing to do with affecting hormonal balance (which is what I guess the whatsit axis means????)

Wonder what exactly the effects are if this "axis" does go wrong?

Wendy

Title: Re: Autoimmune connection?
Post by Annette_Emond on Mar 11^th, 2004, 10:21pm

hmmmmmmmmm.... Dave suffered from ecezma as a child, and since this latest mystery illness he has more than several dry scaly patches of skin developing on his body. Not to the point where I would suspect eczema or psoriasis, but ........ interesting. :-/
Annette

Title: Re: Autoimmune connection?
Post by cootie on Mar 11^th, 2004, 10:24pm

I'm not sure if I am on base here and if not I appologize but I was told years back by a 'vet' that steroids in any form long term suppress the immune system as you said.....but if used or taken too long other diseases or virus's or bacertia's we have on us or around us we fight off daily can get an edge ! We had horses when we were raceing with conditions that needed to be on long term steroids (to stop there own bodies "reaction immune system" to an injury site long term causeing the pain) to stay sound so we had to weigh our options and decide what to do.....medicate to make them comfortable and risk other problems ariseing from it long term or not. Stress suppresses the immune system also so things can get an advantage there and strike or flare up and reek havoc that normally we keep at bay. Sort of a balance that gets uneven. Pam that may be adding a LAME answer to your question sounding STUPID as hell

Title: Re: Autoimmune connection?
Post by Cerberus on Mar 11^th, 2004, 10:28pm

Dunno anything about the stuff ya mentioned....BUT! I am told that Hemp Oil lotion with no other additives in it helps the scoriasis (however ya spell it) gotta be a pure hemp oil lotion tho....and I unnerstand that it has NO effect on anything else....might wanna have a look see. here's a link to start with.
http://www.totallyhemp.ca/conditions.htm

Ramon

Title: Re: Autoimmune connection?
Post by Kevin_M on Mar 11^th, 2004, 11:55pm

Interesting and thoughtful post Pammy. My dermatologist remarked quite similarly to me, explaining it comparatively that way, but not with horses. Your experience puts steroids in their proper usage. Good insight.

Though prednisone may serve a useful purpose for us, we should not forget what it also affects.

As for skin afflictions being treated with steroids, like we treat CH with prednisone, seems it should be a short term treatment and should be recommended only in that manner.

Their have been many things written about steroid abuse but resulting in clusters has not arisen yet as a warning. The adrenal glands produce hormones. The pituitary gland is the master endocrine gland affecting all hormonal functions of the body. I haven't read where suppression of the pituitary gland's functions has
been related to clusters, though the hypothalamus regulates the pituitary gland creating the axis. I may be corrected but a suppression of hormonal secretion and a cause of clusters relationship hasn't been expressly noted.
Long term use of steriods is unhealthy, it is hard to relate them to clusters. Everyone has different reactions to medications.

Does anyone else see a relationship?

Cat, seeing hypothalamic in the warning would make
one wonder, I see your concern. Perhaps a dermatologist may have comments about the affects of extended use.

Thank you for the perplexing post. Your attention to the warning was a contribution for thought.

A couple years ago I was given a sample of Protopic (tacrolimus ointment). New and works well in a short period.

Notta answer inmyhead Kevin M.

Pammy, now I'm signing like you, what are you doing with my head?

Title: Re: Autoimmune connection?
Post by floridian on Mar 12^th, 2004, 2:42pm

Its not autoimmune as far as we know, but both clusters and psoriasis involve immune dysfunction. Both diseases are accompanied by a persistent Th1 bias. The body has two basic activation modes (Th1 and Th2) and the non-activated mode (Th0). Response to various threats (bacteria, virus, cancer, parasites, some chemicals) will switch the body from Th0 to one of the activated states. We are stuck in Th1.

In both CH and psoriasis, certain immune signaling molecules (IL-1 beta, Tumor Necrosis Factor) are elevated. In psoriasis, the activation pattern also includes IL-12 and interferon-gamma.

Steroids result in a massive supression of the immune system. They work, but they are inelegant and have a well documented set of risks that are pretty significant after a few weeks of daily dosing.

New psoriasis research has shown that injections of IL-10 and IL-4 are useful in treating psoriasis. These therapies turn off the strong Th1 state. Garlic does the same thing in preliminary trials with blood cells from humans with inflammatory bowel disease (another Th1 disease). Garlic boosted IL-10 and IL-4, and lowered TNF, IL-1B, IL-6, and the other unpleasant guests.

Garlic hasn't been tested to see if the beneficial changes spill through to improving IBD, or if it helps with other conditions like psoriasis or CH. But I'm not going to wait years in the hope that someone tests garlic on psoriasis; garlic is also beneficial for several heart and circulatory conditions that I am at risk for, and garlic has few side effects (apart from noticeable breath). Garlic is also considerably cheaper than lab produced IL-10 or IL-4, which costs $125 to $250 per 5 microgram vial. Even if a vial is good for a week, thats $5k per year. Ouch!

Turmeric is another good immunomodulator that supresses the Th1 response. Tea (green or black, decaf or regular) supresses some of the Th1 interleukins. Fish oil and other n-3 fatty acids also have some effects - they aren't strong enough to stop psoriasis by themselves, but do have some benefits.

I also believe that all this is tied in with the acetylcholine problem in CH patients. Clusterheads have low levels of choline - which limits the formation of acetylcholine, a neurotransmitter. Acetylcholine has anti-inflammatory action and a supresses IL-1B and TNF -- but only if there is enough acetylcholine. All this is probably linked to the high number of CHeads who smoke -- either there is a pre-existing lack of acetylcholine that causes an increased risk of nicotine dependency (nicotine acts on acetylcholine receptors), or smoking contributes to the derrangement of the choline system, which increases the risk of clusters.

Clusterheadaches, psoriasis and many forms of arthritis also involve elevated substance P (P is for pain).

I recently asked a question about clusterheads with arthritis because of all these connections and the fact that my arthritis got bad over the last few weeks. In the past 10 days, I have developed red patches on my elbows and fingers that are scaling over (doctor appointment tonight). And arthritis is fairly common among people with psoriasis - the inflammation destroys the connective tissue between the joints. Psoraisis is more than a skin disease; 65% of people with psoriasis have a particular type of eye disease (blepharoconjuctivitis). All the more reason to look for a systemic corrective, not just something to beat down the scale.

Quote:

Cytometry. 2002 Aug 1;48(4):209-15.

Allium sativum (garlic) suppresses leukocyte inflammatory cytokine production in vitro: potential therapeutic use in the treatment of inflammatory bowel disease.

Hodge G, Hodge S, Han P.

BACKGROUND: Cytokines involved in inflammatory bowel disease (IBD) direct a predominantly cell-mediated T- helper-1 (Th1) immune response. The nonspecific anti-inflammatory treatment being used in the management of patients with IBD has not changed much since the 1970s and new therapeutic agents are keenly sought. ... METHODS: To investigate the possible therapeutic effects of garlic in the treatment of patients with IBD, whole blood and peripheral blood mononuclear cells (PBMCs) were stimulated in the presence of various concentrations of garlic extract and the effect on leukocyte cytokine production was determined in vitro using multiparameter flow cytometry. RESULTS: Monocyte interleukin (IL)-12 production was inhibited significantly in the presence of low concentrations of garlic extract (>or=0.1 microg/ml total protein). Monocyte IL-10 production increased significantly and monocyte tumor necrosis factor-alpha (TNF-alpha), IL-1alpha, IL-6, IL-8, T-cell interferon-gamma (IFN-gamma), IL-2, and TNF-alpha decreased significantly in the presence of >or=10 microg/ml garlic extract. Twenty to fifty percent of the immunomodulatory activity of garlic extract on cytokine production was acid labile. The inhibitory activity of methylprednisolone, a commonly used anti-inflammatory in IBD, with garlic on leukocyte cytokine production was additive. CONCLUSIONS: By inhibiting Th1 and inflammatory cytokines while upregulating IL-10 production, treatment with garlic extract may help to resolve inflammation associated with IBD. An in vivo animal odel study needs to be undertaken to determine the significance of these in vitro findings.

Title: Re: Autoimmune connection?
Post by Tiannia on Mar 12^th, 2004, 3:16pm

I have 2 autoimmune diseases.

Rhumitiod Arthritis and Hoshimoto's Disease

I have been regularly tested for Lupis and MS (my mother has MS), as I was told that once somoene has one auto immune disease, that they can easily develope more. Even had a doc tell me not to have gotten pregnent about 5 years ago, because they were afraid that my immune system might attack the baby. There is no clinical studies to prove it, but informal studies show that 2/3 of women with auto immune diseases miscarry in the 2-3 trimester. In the end of my pregnanace with my son (born August 16, 2002) I ended up with PITH (Preg. Indused Hyper Tension) and my kidneys shut down, but he was fine. We will not have anymore just because of the issues I had.

But I would not have throught f a connection between my Auto-immune disease and CH.

I will check out the Auto-immune Association website and see if they make any comment regarding it.

Tiannia

Title: Re: Autoimmune connection?
Post by catlind on Mar 12^th, 2004, 4:44pm

Floridian, that is absolutely fascinating!! It will probably take me a few weeks to interpret most of it into something I can understand fully, but I get the gist of it.

There is a specific form of arthritis that psoriasis sufferers get that used to be thought of as a separate disease and they now know is part and parcel of the psoriasis, and actually named psoriatic arthritis. Either condition can arise first.

I have seen where they are now studying beyond even systemic solutions for things such as psoriasis (most of the meds have nasty side effects) and are venturing into biologic medications, called biologic response modifiers that are more focused and selectively target the chemicals involved in psoriasis. Proteins and the like, so I'm going to take a giant leap and guess that involves the alphabet soup you mention that I don't understand yet.

The autoimmune connection has always been one of interest to me as they determined the cause of my endometriosis was fully autoimmune, and have found lesions on the heart and brain in autoimmune spawned endo. That was why they did a hysterectomy to fix my headaches - they honestly believed it was all connected.

Absolutely fascinating.

I also find it interesting that when they drew blood during a CH attack and did my ESR rates they came back at 77 and normal is between 1 and 20, that was what led them to the diagnosis of temporal arteritis.

Tianna, I have also been told, and read as well, that if you have an autoimmune disorder you are predisposed to other autoimmune issues as well.

Off to learn more about biochemistry and neuroscience!
I never would have thought a TOPICAL corticosteroid would be so potentially dangerous.

Cat

Title: Re: Autoimmune connection?
Post by Tiannia on Mar 12^th, 2004, 6:00pm

on 03/12/04 at 15:16:59, Tiannia wrote:

I will check out the Auto-immune Association website and see if they make any comment regarding it.

Here is the website for American Autoimuune and related Disease Association

http://www.aarda.org

Title: Re: Autoimmune connection?
Post by floridian on Mar 12^th, 2004, 11:32pm

Quote:

I never would have thought a TOPICAL corticosteroid would be so potentially dangerous.

I'm not sure that the topical steroid caused the problems - it could have been a factor, but we don't really know. Could just be that one immune dysfunction makes us more susceptible to a second one. Too much cortisone or prednisone definitely has risks, but I managed to get both diseases without taking much topical steroids in my life - only on ocassion, for a day or two. Yes, the doc said psoriasis tonight - not a surprise, though. The elbows were a pretty strong clue - reminds me of a tweed jacket with patches on the sleeves >:(

Lithium is one of several drugs that can induce or aggravate psoriasis. I think that is more from the toxicity of lithium than from its therapeutic action - lithium is another drug like the steroids - it does a few things you want, and lots of other things that aren't so good. Not everyone has side effets, and for some situations, it is worth the risk.

Yes, the biological response modifiers you mentioned include the alphabet soup I spilled all over this page. They have lots of potential for treating infectious disease, cancer, inflammatory and rheumatic disease. They are more specific than many older medicines, but still have side effects (IL-1 can cause anxiety, for example).

Will look for some stuff on the HPA axis - it is involved in clusters, depression, stress, lots of other things. My depressive episodes were usually stress induced. Not day to day stress, only when feeling powerless, between a rock and a hard place, or screwed by the system.

Title: Re: Autoimmune connection?
Post by cootie on Mar 13^th, 2004, 12:37am

I have a freind that has psoriasis real bad and he was useing ultra violet light like in a tanning bed I think ? Siad it cleared it up FAST but there was some sorta threat with doin that too...fergot what it was.....been a while since he was tellin me all about it. I was jus reading about that psoriatic arthritis today on a health MB......they were discussing what they were prescribed for it and first I had ever heard of it. My vet kept me more inform'd then the docs on medical issues......think I'll become a horse Pam

Title: Re: Autoimmune connection?
Post by catlind on Mar 13^th, 2004, 9:06am

Sorry to hear that Floridian :( Dovonex is a good ointment for maintaining, it's a vitamin D derivative. I do think I'm going to try some garlic though :)

So lithium can aggravate huh? I never knew that one either, wonder if that has anything to do with why my levels were all whacked out 2 weeks after starting lithium?

There are just too many possible links and connections for so many of us. Will we ever figure out what exactly is going on?

I'm glad you are as intelligent as you are floridian, because I don't know that I would be able to find all that information. It's going to take me some time just to research it all so I can fully understand it.

Thanks for all you do!

Cat