Kickas.org Forums Treatments, Drugs and Alternatives NSD and diet-related; HOWTO LSD in a stickey post

Ken,

Nope, I did not feel "attacked" regarding the discussion about Leaky Gut Syndrome. I did when I made an observation about aortic insufficiency.

As a matter of fact, I was at first critical of the LGS concept. The concept seemed to lack scientific validity, then I learned to translate the phrase into the term "intestinal permeability" and Bingo!

I just finished replying to a post to Tim where I agreed that LGS is part of solving the AS mystery. I learned from that discussion that took place about Probiotics.

P.S. I don't think I said anything about "Yo Momma," did I?

Best regards,

jcwinnie

Notice, please, Dear Reader, that chapter and verse are still missing.

jc,

glad there was no misunderstanding and that we all benefitted from the probiotic discussion. thats what is great about this place, helping others help themselves by sharing info.

you did not insult my mother and anyone who does will reap the consequences. i dont know what is worse, my suffering with AS or seeing my mother saddened at witnessing her only son degenerate with this crappy disease.

-ken

Ken,

In reply to:

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lastly, continue the debate, but quit the bickering. we all must find out our way thru this maze whether it is diet, drugs, supplements, exercise, meditation or a combination of all. as the buddha said, "seek your own salvation with great diligence"

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Hear! Hear!

You have given some thought to and contributed to a discussion.

Regarding point #2:

Many of the 5-ASA preparations for IBD are just that, they contain no sulfa, as does sulfasalazine, so I think that practitioners perceive the active ingredient to be 5-ASA. I don't know that I have seen any head-to-head comparisons; certainly the remission rates for mesalamine and sulfasalazine are similar.

Regarding point #3:

I don't know if you will understand this comment; it may be culturally irrelevant. Nonetheless, in "The Graduate" a character comes up to Dustin Hoffman and says, "Plastics!" Well, in this case, I would say to you Peyer's Patches.

Best regards,

jcwinnie

Gerard,

Some good points!

In reply to:

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Is it really important if it are the IgA, IgM or IgG antibodies that play a role?

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I would say, "Yes," whether or not the Klebsiella hypothesis holds. These antibodies are indicators of the disease process, the "smoking gun" afterall has been fired.

In reply to:

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There is no absolute truth to find yet.

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Perhaps, there are some relative truths that need to be discerned.

In reply to:

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Critical views are essential for this group for not becoming a bunch of diet cult followers but becoming a group of critical persons that try to enbetter there situation in a sensible way.

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I quite agree with you, especially when theories are being promulgated.

Best regards,

jcwinnie



"Are we KickASsers, or are we guinea pigs!"

Ken,

In reply to:

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We are all here with the common goal to help each other in our quest for health and well being.

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Excellent point!

I am doing research because I want to feel better. This research includes exploring the possibility that, if the Klebsiella Konspiracy does not full explain things, then why does a reduced carbohyrdate diet seem to help?

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Rueda and Gill note:

"The development and the functional mechanisms of the regional immune system in the gastrointestinal tract are relatively independent of systemic immunity. The interaction of different factors, such as intestinal microflora and nutrients at the local level may influence the inner regulatory mechanisms of the intestinal immune function."

Source: Rueda, R. & Gil, A. Influence of dietary components on intestinal immunity. h0.web.u-psud.fr/microfun/ch8.html

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Then, recently, when following some inquiries on lipopolysaccharides, I saw the following statement regarding nutrition, cytokines and sepsis:

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"A model has been developed in our laboratory which involves implantation of a mini-osmotic pump filled with bacteria into the peritoneal cavity of rats or guinea pigs. This seven day osmotic pump causes the extrusion of bacteria into the peritoneal cavity with a persistent active and ultimately fatal peritonitis where the animals die between 10-28 days. (Poor little guys!) This allows the evaluation of nutritional formulations to alter the outcome in sepsis. Surprisingly, very low protein content diets and diets low in overall energy had beneficial effects. It was found that these beneficial effects were achieved by down regulation of the counter regulatory cytokines produced by the gut and a decrease in translocation from the intestine."(My emphasis)

Source: Research Programs -- Transplant
http://surgery.uc.edu/research/transplant.htm

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I don't know if the transplant researchers put the guinea pigs on a Cayce Three Day Apple Diet or not, but reducing carbohydrates, the main fuel source, would seem to have an effect on those nasty cytokines.

Needless to say, I want to do some more digging into what strategies help with transplantation, following the above clue and the fact that immunosuppressives are used to treat AS and IBD.

Best regards,

jcwinnie


"I wonder what they would think if I yelled 'food fight'?"

Gee, I hadn't looked at this thread but what have I been missing - heaps it seems. After going thru the posts, I must say I like Ken's comments and think them quite sensible. We seem to know that some type of bacteria (or fungus) that has invaded or overgrown the intestinal tract is probably the most likely trigger for AS. I don't know if the Kleb. theory can be talked about as being 100% the offending agent but there certainly seems up there with others. I had always theorised that candida was the culprit (an overgrowth of).

It is interesting to note that the only antibiotics that I found beneficial were sulfa based (being erythromycin). Apart from this drug I have also over the years found salazapyrine beneficial (although i don't like the immunosuppressive nature of this) and have also found garlic VERY beneficial. All three have a high sulfa content. I have read somewhere J.C. that the active ingredient in Salaz. has in many cases been shown to be the sulfa component.

Interestingly, sulfur (sulfa, sulphur, whatever) is very effective against candida. So too is a low carb. diet so the NSD/LSD may be working as a result of this. Maybe the kleb. levels are elevated because candida allows other bacteria to proliferate?????

Whatever the trigger is most of us seem to agree that the NSD/LSD is beneficial. I don't think we can possibly work out the trigger for ouselves (i.e. is it kleb. candida or some other bacteria) but we can modify the diet and help others with it. Why don't we stop the b/[####] and just get on with that.

Don't think you can - KNOW YOU CAN

i have read studies which are conflicting regarding the active moiety of sulfasalazine (ssz).

1. i saw one report stating that people with AS responded to asacol (5-ASA) treatment. this was a test of asacol only. i can say from my experience, asacol did nothing for me. i believe strutsys (jeanna) found it useless too.

2. i saw another report where 5-asa was tested against the sulfa alone, essentially testing the two halves of ssz for AS patients. they found the sulfa was the active component, but ssz was slightly better than sulfa alone.

3. one can go to http://www.asacol.com and read the clinical trials of asacol against ssz. this is strictly from an IBD standpoint. if i recall, my interpretation was that asacol and ssz are practically equally effective for IBD at optimal dosages. the benefit of asacol was that it had less sideffects (male infertility etc) and could therefore be given at a higher dose. interesting to note is that with ssz, only 30% of the 5-asa is absorbed systematically. the rest stays in the intestines. if you think about this closely, it raises some interesting questions for AS people taking ssz which im too disorganized to type out here.

now questions for everyone

1. ozlion mentioned the connection between ssz and candida. i always felt that since sulfa is an antibiotic, ssz would actually promote growth of candida. all other broad spectrum antibiotics (cipro, flagyl, tetra etc) promote candida growth by wiping out all flora, good and bad, which allows the fungus to grow. plus ssz may have some immunosuppresive action which also will proliferate candida (it is known that immunosuppressives like mtx and prednisone will promote candida overgrowth). i am concerned about long term ssz use because of candida which can make things worse. is it documented that ssz is effective against candida?

-ken

ps. for ozlion...if you suspect candida, you can get a blood test to check for candida antibodies and a stool test to check for fungus in the USA. not too sure about australia though. sadly, most allopathic doctors in the USA dont believe in candida unless you have oral thrush, AIDS or a vaginal infection so they wont test/treat for it. the heresy in this is that they say the immunosuppressed can get candida (ie AIDS patients) and test/treat them, but many rheumatic patients are also immunocompromised and are taking immunosuppresive drugs on top of that. i asked my GI doctor about candida and he said only the immunosuppresed can get intestinal candida overgrowth. im sure he written more than enough prescriptions for prednisone, mtx without even thinking about the connection.




made link active--John

Edited by DragonSlayer on 07/26/02 10:12 PM (server time).

Ken,

Yes the Salazapyrine is a tricky one re. candida I feel in that it probably suppresses the immune system (but perhaps not as much as MTX or pred.) and thus increase chances of candida promotion but the sulfa content may be more powerful as to offset this. I really have not seen any info. that links Salazapyrine to reducing candida - it was really just my own thoughts as to the sulfa action on candida.

I know you can get tests for candida but the prob. is that candida is a normal part of our flora and is only a prob. when it "overgrows". You see I was on many antibiotics and also MTX and pred. for a couple of years and then I discovered quite by accident that fresh garlic seemed to make my symptoms decrease (I'm talking within 12 hrs) and so I decided to come off all drugs and go the natural route. Well I'm sure that those years of immunosuppression really allowed whatever triggered my AS (be it kleb, candida or other) to proliferate because I was heaps worse just a week after coming off the drugs. Slowly I have been able to pull back some of my increased inflammation due to garlic and the NSD.

My regime of garlic and the NSD (plus I take 2gms of Vit C/day plus Omega 3 and 6) would benefit either a kleb. or candida (or even the possibility of both being the prob.). I don't know which it is because they are both present anyhow in our intestines but I know in myself I'm slowly winning the war.



Don't think you can - KNOW YOU CAN

Ken,

In reply to:

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I saw another report where 5-asa was tested against the sulfa alone, essentially testing the two halves of ssz for AS patients. they found the sulfa was the active component, but ssz was slightly better than sulfa alone.

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I would like to see that information; I have yet seen anything that argues for the antibiotic property of sulfasalazine except Bilko's Klebsiella Konspiracy posts on this drug topic in the AS Pharmacy Forum. I would agree that sulfa has antibiotic properties.

On the other hand, I have information that argues that 5-ASA is the active ingredient and why.

Repeating information from previous posts on Sulfasalazine, this one from me:

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In their article, "Sulfasalazine: a potent and specific inhibitor of nuclear factor kappa B," Wahl, et al, provide some evidence as to why sulfasalazine may be helpful:

"Transcription factors of the NF-kappaB/Rel family are critical for inducible expression of multiple genes involved in inflammatory responses. Sulfasalazine and its salicylate moiety 5-aminosalicylic acid are among the most effective agents for treating inflammatory bowel disease and rheumatoid arthritis. However, the mode of action of these drugs remains unclear. Here we provide evidence that the transcription factor NF-kappaB is a target of sulfasalazine-mediated immunosuppression. Treatment of SW620 colon cells with sulfasalazine inhibited TNFalpha-, LPS-, or phorbol ester- induced NF-kappaB activation. NF-kappaB-dependent transcription was inhibited by sulfasalazine at micro- to millimolar concentrations. In contrast, 5-aminosalicylic acid or sulfapyridine did not block NF-kappaB activation at all doses tested. TNFalpha-induced nuclear translocation of NF-kappaB was prevented by sulfasalazine through inhibition of IkappaBalpha degradation. When blocking proteasome-mediated degradation of IkappaBalpha, we could demonstrate that sulfasalazine interfered with IkappaBalpha phosphorylation, suggesting a direct effect on an IkappaBalpha kinase or on an upstream signal. Inhibition of NF-kappaB activation seems to be specific since other DNA-binding activities such as AP1 were not affected. These results demonstrate that sulfasalazine is a potent and specific inhibitor of NF-kappaB activation, and thus may explain some of the known biological properties of sulfasalazine."

PMID: 9486988 [PubMed - indexed for MEDLINE]
J Clin Invest 1998 Mar 1;101(5):1163-74

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And, this one from Evelyn:

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Dekker-Saeys BJ, Dijkmans BA, Tytgat GN.Treatment of spondyloarthropathy with 5-aminosalicylic acid (mesalazine): an open trial. J Rheumatol. 2000 Mar;27(3):723-6.
[PubMed - indexed for MEDLINE]
PMID: 10743816
"Ankylosing spondylitis (AS) and spondyloarthropathy (SpA) are inflammatory diseases of unknown etiology. Various exogenous and endogenous (inherited) factors play a role in their development. Sulfasalazine (SSZ) is generally accepted as a disease modifying drug in the treatment of AS and SpA. Which part of SSZ, 5-acetylsalicylic acid (5-ASA, mesalazine) or sulfapyridine (SP), is the effective moiety is unknown. As the bowel, colon, and the ileum play an important role in the development of AS and SpA, it may be possible that 5-ASA is the effective moiety, with a similar mode of action as in the treatment of inflammatory bowel disease. To determine the efficacy of 5-ASA an open pilot study was done in 2 groups of patients with SpA. METHODS: Twenty patients with SpA, who were taking SSZ, were switched to 5-ASA (Pentasa), and 19 patients with active SpA were treated with 5-ASA without previous administration of SSZ. RESULTS: In the first group, 17 (85%) patients responded with respect to the physician global clinical assessment compared to the previous SSZ treatment period; whereas in the second patient group a statistically significant improvement was obtained in erythrocyte sedimentation rate. CONCLUSION: The results support our hypothesis that 5-ASA might be the active moiety of SSZ in the treatment of SpA."

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That's not to say that sulphur doesn't have a role in this play. See, for instance, previous discussions about MSM (methyl-sulfonyl-methane). My sense is that there is a balance required with sulfur, i.e., there are side effects to too much. I wish I knew more as to how sulphur has a role in intestinal permeability. An inkling is that the amino acid cysteine contains sulfur.

Best regards,

jcwinnie