Saturday

INFORMATION ABOUT COVID- 19 for those with AUTOIMMUNE DISEASE and other chronic illnesses

The spread of the coronavirus, now called COVID-19, is causing alarm worldwide.
The World Health Organization has declared a global health emergency, and many countries have a rise in confirmed cases.
In the US, the Centers for Disease Control and Prevention (CDC) is advising people to be prepared for disruptions to daily life that will be necessary if the coronavirus spreads within communities.
information about COVID-19 for those with autoimmune disease

As Wuhan has seen the highest number of infections their numbers have been analyzed showing:
  • people over 60 are more at risk.
  • people with other chronic illnesses are more at risk.
Those with other chronic illnesses do worse: There have been approximately 5,000 cases where individuals have reported a known co-morbid medical condition, such as high blood pressure, diabetes, heart disease, chronic lung disease, or cancer. The average mortality rate in these groups is in the 5-10% range, whereas of the 15,000 individuals who reported no other medical conditions, the mortality rate to date has been less than 1%. FORBES
While less than 1 percent of people who were otherwise healthy died from the disease, the fatality rate for people with cardiovascular disease was 10.5 percent. That figure was 7.3 percent for diabetes patients and around 6 percent for those with chronic respiratory disease, hypertension, or cancer.  THE SCIENTIST
It is hard to know the facts in these early days of the conronavirus about the long term prognosis for people with autoimmune disease. My concerns are that many people with autoimmune disease take immunosuppressant medications to manage their symptoms and these can make them more vulnerable to infection generally. Also our bodies are working so hard already, are they going to fight off the coronavirus?

THE SYMPTOMS

Common corona virus symptoms include:
  • fever 
  • dry cough
  • fatigue
Some people also get:
  • sore throat
  • congested nose
  • nausea and gastrointestinal symptoms
  • shortness of breath
  • flu like aches and pains
THE MAIN PROBLEM WITH THE CORONAVIRUS is that you are contagious when you do not have symptoms. These symptoms generally appear three to four days after exposure but can be up to 27 days later!

GENERAL PRECAUTIONS
According to the WHO, coronaviruses may survive on surfaces for just a few hours or several days, although many factors will influence this, including surface material and weather.
That’s why personal preventive steps like frequently washing hands with soap and water or an alcohol-based hand sanitizer, and wiping down often-touched surfaces with disinfectants or a household cleaning spray, are a good idea. HARVARD HEALTH 
WHAT WE CAN DO IF WE HAVE AN AUTOIMMUNE DISEASE:

"If you’re sick or you are immune-compromised, avoid places with large numbers of people." UCHealth.

In Australia we have been told by the Health Minister to stop shaking hands when we great people. In France they have been told to stop kissing on the cheek. This is because this disease is so transmissible. The only way to avoid it is to not have any contact with anybody!

Keep up to date on your local health warnings and advice. The main advice at the moment seems to be to wash our hands often, for 20 seconds or more, with soap and water.

CDC provides recommendations on postponing or cancelling travel to certain countries only, at this stage. These travel notices are based on assessment of the potential health risks involved with traveling to a certain area. Their list of travel notices is available here.

Smart Traveller, by the Australian government, provides travel updates on countries and recommendations.

The Institute of Public Health in Norway, says "To prevent infection, people should keep at least one metre away from people with respiratory symptoms and those who are ill should avoid coughing or sneezing directly onto others."
TREATMENT
  • Avoid infection by not traveling to epidemic areas. 
  • Infected people should use mouthwash. 
  • Frequent and thorough hand washing and good general hygiene are recommended. 
  • Preventive measures are especially important for people with weakened immune systems. 
  • Immunosuppressants should be considered discontinued among those infected until the infection is over. A vaccine against covid-19 has not yet been developed (as of March 2020). Antibiotics (against bacteria) do not work against viruses. Anti-viral drugs especially for coronavirus are not available (as of March 2020). 
  • In cases where covid-19 causes pneumonia, hospital treatment will often be necessary. Oxygen supplementation and breathing aid, including the use of a respirator may be necessary.
  • People who use immunosuppressive drugs and have no symptoms of infection should continue with their usual treatment during an epidemic. 
  • If signs of infection with fever and other influenza symptoms should occur, a 1-2 week treatment break with the immunosuppressive therapy may be appropriate. However, it assumes that one is not completely dependent on the treatment. Prednisolone and other cortisone preparations should not be terminated abruptly.  Physician and specialist in rheumatic diseases PhD Øyvind Palm 

coronavirus and autoimmune diseases

WHAT I WILL BE DOING:

I personally have 3 autoimmune diseases and other health issues.

I will be avoiding all non essential travel and have sadly postponed an overseas holiday to Asia.

I will be avoiding all large events and gathering places such as universities, the library and the shopping mall.

If I was still working I would be asking to work from home due to my compromised immune system.

I am trying to be my healthiest self by eating well and exercising. I have already added magnesium and Vitamin D supplements to my diet and will now add a daily multivitamin as well and garlic tablets. It can't hurt and it may help fight off infection.

Eating garlic appears to offer the best of both worlds, dampening the over-reactive face of the immune system by suppressing inflammation while boosting protective immunity, for example natural killer cell activity, which our body uses to purge cells that have been stricken by viruses or cancer. In World War II garlic was evidently dubbed ‘Russian Penicillin’ because, after running out of antibiotics, that’s what the Soviet government turned to. Dr Michael Greger at Nutrition Facts
I have asked my doctor for extra scripts of my medications so I can have an adequate supply.

I have put in place a plan with my family regarding what we will be doing if more cases come to our area.

We have checked our medicine chest to make sure all painkillers etc are in supply and not out of date.

We are checking our pantry and making sure we have all our normal food supplies and a few extra so that we do not have to go to the shops as often. Our list includes extra toilet paper, canned food and dry goods such as rice and pasta.
For food, you can just buy two or three weeks’ worth of shelf-stable food that you would eat anyway, and be done; this could include canned food like beans and vegetables, pasta, rice, cereals or oats, oils/fats, nuts and dried fruits. It’s really not that hard because we’re talking two-three weeks, so whatever you get is fine. Zeynep Tufekci is an associate professor at the University of North Carolina School of Information and Library Science, her coronavirus article is at Scientific American.  

I will be updating this page with suggestions as I research them.

I have no medical background but use reliable sources when providing you information and when doing research. Best wishes from Lee Good.

You can check out my website on Autoimmune Disease here.

If you are interested in the autoimmune updates that I send out you can sign up here


Sunday

Diet Can Slow Onset of Autoimmune Disease


This study finds a common amino acid can that can dampen the immune response.
Diet Can Slow Onset of Autoimmune Disease
SUMMARY 
  • Significantly reducing dietary levels of the amino acid methionine could slow onset and progression of inflammatory and autoimmune disorders 
  • The research was published in the journal Cell Metabolism. 
  • Researchers found that mice eating less methionine had a slower onset and progression of disease in the diets of mouse models of multiple sclerosis.
“These findings provide further basis for dietary interventions as future treatments for these disorders.” said Russell Jones, Ph.D., the study’s senior author and program leader of Van Andel Institute’s Metabolic and Nutritional Programming group. 
 MORE DETAIL
  •  Methionine restriction limits the expansion of inflammatory Th17 cells.
  • Many cell types in the body produce methionine, but the T cells responsible for responding to threats like pathogens do not. 
  • The methionine that fuels these T cells, must be eaten.
  • Methionine is found in most foods, but animal products such as meat and eggs contain particularly high levels.
  • Methionine is critical for a healthy immune system. 
  • These results suggest, for people predisposed to inflammatory and autoimmune disorders, reducing methionine intake can actually dampen the immune cells that cause disease.
  • During an immune response, T cells flood the affected area to help the body fend off pathogens. 
  • Methionine fuels this process by helping “reprogram” T cells to respond to the threat by more quickly replicating and differentiating into specialized subtypes. 
  • Some of these reprogrammed T cells cause inflammation, which is a normal part of an immune response but can cause damage if it lingers, such as the nerve damage that occurs in multiple sclerosis.
  • Researchers found that significantly reducing methionine in the diets of mouse models of multiple sclerosis altered the reprogramming of T cells, limiting their ability to cause inflammation in the brain and spinal cord. The result was a delay in the disease’s onset and slowed progression.
“By restricting methionine in the diet, you’re essentially removing the fuel for this over-active inflammatory response without compromising the rest of the immune system,” Russell Jones said.
He cautions that the findings must be verified in humans before dietary guidelines can be developed. 
The team also plans to investigate whether new medications can be designed that target methionine metabolism.
FOOD HIGH IN METHIONINE:
Amounts listed above are estimates of methionine content.
(SOURCE: USDA Nutrient Database Release 28)

FURTHER READING:

The low-methionine content of vegan diets may make methionine restriction feasible as a life extension strategy

Thursday

Researchers discover technique to alter a patient's DNA that could cut chronic agony for sufferers

Hope for millions as scientists learn how to 'edit out' PAIN

scientists learn how to 'edit out' PAIN

  • Studies on mice showed that altering DNA can stop pain signals being sent
  • Treatment made by San Diego-based company may be available in five years
  • It could help sufferers of chronic pain or with long-term pain problems
Scientists have discovered how to switch off a key ‘pain gene’, dramatically raising hopes of a long-term treatment to relieve the agony of serious illness for millions.
The revolutionary technique alters a patient’s DNA, silencing a gene that transmits pain signals up the spine.
Preliminary studies on mice have already proven successful and US researchers plan to start human trials next year, potentially offering terminally-ill patients and those with chronic conditions the prospect of pain-free care.

  • The treatment, devised by start-up firm Navega Therapeutics in San Diego,California, could be approved for use in five years’ time
  • their new approach to pain is not addictive
  • uses the new high-precision gene-editing technique called CRISPR
  • researchers have reversed a patient’s sickle cell anaemia using this method.
  • Navega is using a CRISPR technique called ‘epi-genome editing’ which silences rather than replaces the gene. 
  • Using CRISPR to edit away pain is discussed in a new documentary about the technique, Human Nature, recently given its UK premiere at the Science Museum.


You may also be interested in other articles on this site:

Tuesday

FDA approves Fiasp for treatment of children with diabetes type 1

new treatment of children with diabetes type 1


PLAINSBORO, N.J.Jan. 6, 2020 /PRNewswire/ -- Novo Nordisk today announced that the U.S. Food and Drug Administration (FDA) has approved Fiasp® (insulin aspart injection) 100 u/mL for use as a new mealtime insulin option for children with diabetes.1 Fiasp® is the first and only fast-acting mealtime insulin injection that does not have a pre-meal dosing recommendation. Fiasp® is now available for use in children and adults in three different dosing options: multiple daily injections (MDI), continuous subcutaneous insulin infusion pumps and intravenous infusion under supervision by a healthcare professional.

READ FULL ARTICLE

Novel Paradigm Connecting MS to Hygiene Hypothesis, Microbiome



Thursday

Relapse recovery: The forgotten variable in multiple sclerosis clinical trials

In patients with MS presenting without good recovery after the initial relapse, immediate DMT initiation favorably influences the likelihood of more ambulatory-benign disease akin to patients with good recovery after the initial relapse.

Multiple Sclerosis attacks the central nervous system - brain and spinal cord -  interfering with the nervous system signals and causing neurological symptoms. 
It can follow an unpredictable course.  
You may experience only some of the symptoms and never have others. Symptoms may include numbness, tingling, pain, burning, and visual disturbances, tremor, difficulty walking, lack of coordination and constipation.

READ FULL REPORT HERE

Friday

Psoriasis and the role of fibroblast growth factors in metabolic pathways.

Psoriasis is a common and chronic inflammatory skin disease whose exact pathogenesis remains uncertain and continues to be a topic of extensive research. Nowadays, research focuses not only on understanding the genesis of skin lesions but especially on the explanation of systemic disorders associated with psoriasis.

This is the first prospective study assessing serum concentrations of FGF21 and FGF23 in psoriatic patients and adds value by evaluating the relationships with systemic medications such as acitretin or methotrexate.

READ FULL REPORT HERE

Monday

Gut bacteria and dry eyes in Sjogren's syndrome

Find out what the connection is with Sjogren's syndrome and our gut bacteria in this study...

Gut microbial dysbiosis in individuals with Sjögren’s disease

Roberto MendezArjun WataneMonika FarhangiKara M. Cavuoto
Tom Leith Shrish Budree, Anat GalorSantanu Banerjee

Thursday

Dupuytren contracture

Dupuytren contracture

Dupuytren contracture is characterized by a deformity of the hand in which the joints of one or more fingers cannot be fully straightened (extended); their mobility is limited to a range of bent (flexed) positions.
Dupuytren contracture
IMAGE from British Dupuytren's Society

The condition is a disorder of connective tissue, which supports the body's muscles, joints, organs, and skin and provides strength and flexibility to structures throughout the body. In particular, Dupuytren contracture results from shortening and thickening of connective tissues in the hand, including fat and bands of fibrous tissue called fascia; the skin is also involved.
In men, Dupuytren contracture most often occurs after age 50. In women, it tends to appear later and be less severe. However, Dupuytren contracture can occur at any time of life, including childhood. The disorder can make it more difficult or impossible for affected individuals to perform manual tasks such as preparing food, writing, or playing musical instruments.
Dupuytren contracture often first occurs in only one hand, affecting the right hand twice as often as the left. About 80 percent of affected individuals eventually develop features of the condition in both hands.
Dupuytren contracture typically first appears as one or more small hard nodules that can be seen and felt under the skin of the palm. In some affected individuals the nodules remain the only sign of the disorder, and occasionally even go away without treatment, but in most cases the condition gradually gets worse. Over months or years, tight bands of tissue called cords develop. These cords gradually draw the affected fingers downward so that they curl toward the palm. As the condition worsens, it becomes difficult or impossible to extend the affected fingers. The fourth (ring) finger is most often involved, followed by the fifth (little), third (middle), and second (index) fingers. Occasionally the thumb isinvolved. The condition is also known as Dupuytren disease, and "Dupuytren contracture" most accurately refers to later stages when finger mobility is affected; however, the term is also commonly used as a general name for the condition.
About one-quarter of people with Dupuytren contracture experience uncomfortable inflammation or sensations of tenderness, burning, or itching in the affected hand. They may also feel pressure or tension, especially when attempting to straighten affected joints.
People with Dupuytren contracture are at increased risk of developing other disorders in which similar connective tissue abnormalities affect other parts of the body. These include Garrod pads, which are nodules that develop on the knuckles; Ledderhose disease, also called plantar fibromatosis, which affects the feet; scar tissue in the shoulder that causes pain and stiffness (adhesive capsulitis or frozen shoulder); and, in males, Peyronie disease, which causes abnormal curvature of the penis.
Interesting video Bringing awareness to Dupuytren's disease: 3 minutes 
FREQUENCY
Dupuytren contracture occurs in about 5 percent of people in the United States. The condition is 3 to 10 times more common in people of European descent than in those of non-European descent.
CAUSES
While the cause of Dupuytren contracture is unknown, changes in one or more genes are thought to affect the risk of developing this disorder. Some of the genes associated with the disorder are involved in a biological process called the Wnt signaling pathway. This pathway promotes the growth and division (proliferation) of cells and is involved in determining the specialized functions a cell will have (differentiation).
Abnormal proliferation and differentiation of connective tissue cells called fibroblasts are important in the development of Dupuytren contracture. The fascia of people with this disorder has an excess of myofibroblasts, which are a type of fibroblast containing protein strands called myofibrils. Myofibrils normally form the basic unit of muscle fibers, allowing them to contract. The increased number of myofibroblasts in this disorder cause abnormal contraction of the fascia and produce excess amounts of a connective tissue protein called type III collagen. The combination of abnormal contraction and excess type III collagen likely results in the changes in connective tissue that occurs in Dupuytren contracture. However, it is unknown how changes in genes that affect the Wnt signaling pathway are related to these abnormalities and how they contribute to the risk of developing this disorder.
Other risk factors for developing Dupuytren contracture may include smoking; extreme alcohol use; liver disease; diabetes; high cholesterol; thyroidproblems; certain medications, such as those used to treat epilepsy (anticonvulsants); and previous injury to the hand.
INHERITANCE PATTERN
Dupuytren contracture is usually passed down through generations in families and is the most common inherited disorder of connective tissue. The inheritance pattern is often unclear. Some people who inherit gene changes associated with Dupuytren contracture never develop the condition.
In some cases, Dupuytren contracture is not inherited and occurs in people with no history of the condition in their family. These sporadic cases tend to begin later and be less severe than familial cases.

TREATMENT
Physiotherapy, massage and exercise at British Dupuytren's Society
Needle Aponeurotomy 
Steroid injections
Surgery
DIAGNOSIS and TREATMENT LINKS

SOURCES FOR THIS PAGE
NIH 
National Library of Medicine (NLM)
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