Going Deep Into Autoimmune Factors: Viruses, Complement & - PowerPoint PPT Presentation

Going Deep Into Autoimmune Factors: Viruses, Complement & Vitamin D Metabolism Michael McEvoy MetabolicHealing.com

About me • Founder MetabolicHealing.com & TrueReport - • Consulting Programs • 5 Clinical Training Courses • TrueReport - • Client Management • Blood Chemistry Analysis • Symptoms & Tracking • Genetics Analysis from 23andme • Research & Writing - authored 500+ articles over past 8 years

Essential Steps: Working with Clients Who Have Autoimmune Conditions Dietary Refinement & Remediation - • Identify & remove all antigenic foods & triggers • Optimize organic, whole food nutrition • Identify & Remove as Many Environmental Triggers as Possible - • Toxins in the immediate environment: mold, chemical exposure, toxic metals, water, drugs, cosmetics, • pesticides Create a Strong Foundation - • Hydration, sleep/circadian biology, diet, exercise • Optimize: • Digestion & absorption • GI microbiome • Liver & detoxification • Hormones & Endocrine balance • Identify & Address Infections: • Viral • Bacterial • Parasitic • Fungal •

Viruses & The Immune System - The Oldest Cat & Mouse Game

Epstein Barr Virus (EBV): Linked to 7 Autoimmune Diseases Systemic lupus (SLE), multiple sclerosis (MS), rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA), inflammatory bowel disease (IBD), celiac disease and type 1 diabetes

Type 1 Diabetes

Lupus: EBV, Parovirus, CMV

EBV & Hashimoto’s

Autoimmune Susceptibility Loss of self tolerance • Typically involves elevations in antibody to self tissues • Genetic Predispositions - HLA 1-3 regions (examples) • HLA B27 (AS, psoriasis, Crohn’s) • C4, C4a, C4b, RCCX (Lupus, RA, T1D, MS, Grave’s, Crohn’s, • Hashimoto’s, Celiac, Autism) C2 (Lupus) • Factor B (Celiac) • SKIV2L & TREX1 (Lupus) • C1q (Lupus, Hashimoto’s, Graves) • Viral & other infections • Dysbiotic terrain: loss of tight junctions in gut, food antigens, infections, • toxins (glyphosate, Hg, AI, Cd, etc) Joint hypermobility ??? Inflammasome/TLR’s •

The Innate Immune System

The Innate Immune System • Early responders to the threat of danger (viral, pathogenic, toxin, ECM collagen tissues) • Complement pathways: Lectin pathway, Alternative, Classical • Inflammasome: TLRs, PAMP’s, DAMP’s • Epithelial & mucosal barriers • NK cells • Dendritic cells (APCs) • Mitochondria

Inflammasome Activation & Cell Danger Signaling: Mechanisms of Inflammation, Anti-Viral Activity & Autoimmune Danger signaling protein complex • Modulates production of pro-inflammatory • cytokines IL1ß, IL18 IL18 - Interferon gamma activation (most • notable anti-viral cytokine) IL1ß - Pain & COX-2 activation • Inflammasome strongly linked to • autoimmune disease

Possible Indicators of Inflammasome Activation Active autoimmune disease • Hashimoto’s, Lupus, T1D, Grave’s, RA, MS - IL18 • Sudden onset of hypermobile joints (breakdown of collagen leads to DAMPs • which stimulate TLRs) MCAS - mast cell activation syndrome is IL1ß dependent • High pathogenic load • Fever - IL-1 • Toxins that stimulate TLR’s - AI, Hg, Cd, silicon, asbestos •

Modulation of Inflammasome Inhibition of Inflammasome AMPK activation • Fasting • Calorie restriction • Exercise • Cold exposure • Berberine, Bitter melon, Lipoic acid, L-Carnitine, • Astragalus, Resveratrol Ketosis • ß-hydroxybutyrate • Autophagy Activation • Fasting • Ketosis • Resveratrol, green tea, coconut oil & MCTs, Reishi, • sulphoraphane

The Complement Immune System

Complement Immune Response • Innate Immune System Pathways: • Alternative pathway • Lectin pathway • Classical pathway Series of circulating “pre-proteins” produced by: liver, macrophages, epithelial cells (urinary • tract, GI tract) - C4, C3, C2, C1q etc. Create “adhesive bonds” (polysaccharides & ficolin) directly to: bacteria, fungi, viruses, • parasites, mold/mycotoxins Classical pathway uses antibodies but not lectin or alternative pathway • Goals of Complement Pathways: Opsonization, antibody binding •

The Complement Immune System Common Complements C4 • C4a, C4b • C3 • C3a • C1q, C1R, C1S • C2 •

Complement Immune Deficiencies & Autoimmune Disease Deficiencies of Complement - Among the most common immune deficiencies worldwide - Lupus - C4, C1Q, C1r, C1s, C2 • MS - C4 deficiency in cerebrospinal fluid, but other complements in CNS of MS are high! • RA - Deficiencies of C4, C4b, C1Q, C1R, C1S • Celiac - Deficiency of C4, C3 - significantly lower C4 protein levels • Type 1 Diabetes - C1Q, C4 & C3 protein deficiency common • Mice bred to be deficient in C4 were shown to have decreased frequencies of TREGs cells • • Hashimoto’s & Grave’s - Thyroid tissue features an increased expression of C4 The significance of complement immune deficiencies indicates an impaired innate immune response to resolving the threat of danger.

Sugars: Powerful Immune Weapons Modulating the Complement Immune Response Polysaccharides & Other Sugars: Immune Glycosylation • Beta 1,3 glucans: mushrooms (reishi, maitake, Lion’s mane, agaricus blazei, etc) • Polymannan, mannose: Aloe vera • Sulfated polysaccharides, Fucoidans: Marine red & brown algae, bladderwrack, kombu, • seaweeds Glucomannan - Konjac • Arabinogalactan - Larch bark • D-Mannose • Manuka honey • Glycosylation & Immune Cells - Adhesive binding to pathogens Almost all of the key immune molecules of the innate & adaptive immune systems are glycoproteins

EBV Testing

Testing Epstein Barr Virus (EBV) • Most people have been exposed to EBV in their lifetimes and will show IgG antibodies • The only 2 antibodies that are relevant for active EBV infection are: • Early Antigen (EA) IgG • IgM • Armin Labs (Germany) - T-cell Elispot for EBV • T-cell Lymphocyte reactivity test

Testing Epstein Barr Virus (EBV) Active EBV: Active EBV: EA IgG Armin Labs T-cell Elispot

Testing Epstein Barr Virus (EBV) Active EBV: VCA IgM

Key Anti-Virals

Key Anti-Virals Product Dosage Effect IV - 30-50 grams 1X weekly; Liposomal Na Vitamin C (high dose) Potent ascorbate 2-3 grams minimum Bravo Yogurt (source of GcMAF & 1 teaspoon - 4 ounces daily Strong. Occasional intolerance Immunomodulatory peptides) Baicalin from Chinese Skullcap 250-1,500mg with fat Strong. Taken orally or topically Strong. Fast acting in cases of HSV-1&2, BHT (butylated hydroxytoluene) 250-1,000mg CMV Tincture (1/2 dropper 3X daily); Good. Pairs well with: Licorice, Isatis, Andrographis paniculata Capsules 500mg X3 Goldenseal Bitter Melon 500mg X3 Good Foundational: Selenium, Zinc, Vitamin A, Vitamin E Other herbals worth noting: Monolaurin, Licorice, Astragalus, Isatis, Berberine, Olive Leaf

Case Study Female Age 60 Current Regimen Celiac • • Selenium - 200mcg Hashimoto’s • • Diet - paleo, low • L-Lysine - 1,000mg History of viral (HSV-2, EBV) • FODMAPS • Omega 3 • NatureThyroid - • Liposomal C - Additional Symptoms: 32.5mg 2,000mg • Nacent Iodine - Joint hypermobility • • Antrantil - 9 daily 400mcg Pain • • Betaine HCL - 600mg • LDN - 4.5mg Extreme fatigue • w/food • CoQ10 300mg Poor stress tolerance • Digestive enzymes • • Vitamin D3 - 5,000IU SIBO-like bloating • • Vitamin K2 - 120mcg

Case Study Female Age 60

Female Age 60 - Initial Protocol • Improve hydration - Add electrolytes to drinking water Viral Support Protocol - titrate slowly over 10-14 days • Pure Vida CBD oil - 10-20 mg daily or as needed • Monolaurin Lauricidin - 1/4-1/2 teaspoon daily • Enzymedica Serrapeptase - 1 capsule 2X daily • Baicalin - Start with 250mg (1 scoop). Titrate unto 4 scoops (1,000mg) • Add later: BHT (butylated hydroxytoluene) Updates after 2 weeks: CBD improves pain & fatigue Updates after 6 weeks: Fatigue has gone from an 8 to a 3

Female Age 60 - Follow-up Protocol: 3 months New Protocol Additions Instructions Dosing Functional Effects Increase water & salt intake 3-4 tablespoons salt in 1 gallon of • Acting on ECM electrolyte gradient water and daily use 2 teaspoons 3X • Acting on salt lost though daily in drinking water aldosterone deficient due to CYP21a2 Autoimmune-X Digestaqure Start with 4 capsules daily. After 3-5 • Acting on Complement C4 to yield days, workup to 8 capsules daily. The lectin pathway activation ceiling dosage is 12 capsules daily. • Acting on growth factors by (initial symptoms of gas, nausea has modulating ECM been reported by some people. Titrate up and down accordingly) Megasporebiotic 2 daily Immunomodulatory, Histamine Himalaya Ashwagandha 1X2 Attenuating CYP21a2 Modulating thyroid axis Berberine 500mg - experimental dosage to May be useful for reducing determine physiological effects. progesterone bottleneck, increasing tight junctions in gut, improving circulation Collagen Supplement Daily as needed Improving collagen structure & ECM Immunomodulatory/Anti-Viral Pure Vida CBD 10-20 mg Baicalin 1,000 mg BHT 500-1,000 mg

Follow-Up Blood Work - 6-Months