Immunological Perspectives

LETTER TO PATIENT

"............I am requesting two additional tests. You may not have heard of them. I would like a comprehensive diagnostic stool assessment (CDSA) from Great Smokies Laboratory. They will mail you a kit and instructional video; this is an extremely detailed, state of the art stool assessment and not to be confused with ordinary stool assessments done by most laboratories. Also, we are ordering an ION panel from Metametrix laboratory. These tests are for short term and long term patient planning, The ION panel covers 150 different analytes, solutes and metabolites and is very much an advanced clinical chemistry with a thirty (30) page report for the patient as well. This represents PATTERN RECOGNITION ANALYSIS, a new approach in clinical assessment reflected in the growing field of molecular pathology, now more commonly called molecular diagnostics."

ALTERED STATES OF METABOLISM

The basic notion is to identify and profile altered states of metabolism in the patient, a functional approach, rather than identification and classification under ICD-9-CM (International Classification of Diseases, 9th Revision, Clinical Modification Codes). Using advanced molecular diagnostics, beyond morphology, structure and function, analyte, solute and metabolite patterns are examined so that a management protocol may fit the patient like pieces of a puzzle. New capabilities have been created by molecular biology, novel instrumentation and information technologies that may now be brought together to allow a better understanding of this patient's white blood cell system at molecular and cellular levels. In this way, we may better characterize her immune system structures, functional units and metabolic pathways to upregulate or improve existing levels of function.

There are hundreds of biochemical reactions and dozens of metabolic pathways,circuits and loops that mediate the immunohistochemical reserves, capacities and capabilities of this patient. A comprehensive approach is to reach clinical thresholds by finding the right combination to activate DNA-RNA pathways to code both for the production and proliferation of all necessary white blood cell subsets. The rate of tumor progression, and or precancerous lesions is affected by the immunohistochemical reserves, capacities and capabilities of the patient at any given time; it is not fixed and immutable. The requested tests are designed to identify and profile existing biochemical pathways within this patient so that an individualized protocol may be developed consistent with this patient's existing biochemistry, not wishful thinking or cookbook medicine approaches.

GLUTATHIONE LEVELS MEDIATING IMMUNE RESPONSES

For example, functional plasma glutathione levels may be a critical factor in the immunohistochemical responses of the patient. Glutathione (GSH) is a central player in the antioxidant defense system. It is a tripeptide (3-ammino-acid protein) made from glutamate, cysteine and glycine. The active site on the glutathione molecule is the sulfhydryl (SH) group on the cysteine part of the glutathione (which is where the "SH" comes from in the GSH. The sulhydryl group (sometimes called a thiol group) interacts with a free radical to form a glutathione radical, which dimerizes (pairs up with another glutathione radical) to form oxidized glutathione (GSSG). The oxidized glutathione is then recycled back to glutathione for reuse. The maintenance of reduced glutathione appears to be especially critical for basic health and vitality. Glutathione levels are measured as a key organic acid within the ION panel by Metametrix Laboratory. The ION Panel is an advanced clinical biochemistry that profiles amino acid analysis, fatty acids, mineral analysis, organic acid metabolites, vitamin chemistry and lipid peroxides (TBARS). The glutathione family includes glutathione peroxidases, disulphides and reductases that provide us with vitally important intracellular defenses against a wide variety of pathogens and chemical toxins. Thiol based compounds, acting with the necessary accessory nutrients, serve as precursors to glutathione formation or glutathione, itself, may fight off free radicals, neutralize toxins and may serve to slow down, reverse or stop mutagenic changes that occur in this patient. Thiol compound support of this patient may enhance existing biochemical detoxication pathways such as acetylation, acylation, peptide conjugation, sulphur conjugation, methylation. Appropriate dose-response curves for this patient to enhance sulphur amino acid metabolism to upregulate immunohistochemical status (upgrade!!!) for individualized management cannot be developed without establishing baseline studies through advanced clinical chemistries. These advanced clinical chemistries are intended to provide additional detailed databasing (information gathering) for advanced, safe management of this patient.

BEYOND DISEASES CLASSIFICATION: UNDERLYING BIOCHEMICAL PATHWAYS

The questions that need to be asked, beyond classification under ICD-9-CM (International Classification of Diseases, 9th Revision, Clinical Modification Codes) are

1. What is the internal environment of this patient? What is the character and cellular architecture of any lesions, if present?

2. What co-factors are needed to upregulate (upgrade) the patient's immunohistochemical reserves, capacities and capabilities (persistent cough, etc)?

3. What is the patient's altered state of metabolism, if any?

Immune system compromise and assessment of immunohistochemical reserves in a given patient cuts across most diagnostic ICD-9-CM Code classifications. The current approach to infectious, neoplastic and autoimmunologic disease management emphasizes chemotherapy with the usual potential for adverse drug reactions, side effects, drug tolerances and other limitations. The emergence of antibiotic-resistant strains of bacteria, as well as difficult to treat new viral and zoonotic diseases and other pathogens known as "stealth pathogens" that pass "underneath the body's radar defense systems" argues for a reassessment of current therapies and the development and transfer of new biotechnologies into mainstream clinical practice. Clinical assessment should include effective, practical and even less expensive and less hi-tech treatment options that are far beyond the current system of practitioners many of whom may be locked into limited clinical practice guidelines and treatment choices largely confined to a pharmaceutical treatment paradigm.

The program objectives when a live patient faces us is to identify and review a wide range of factors that impact the patient's immune system performance, with a view toward effective and practical intervention strategies. Special attention should be given to (1) the role of nutrition in immune system modulation; (2) adjunctive strategies for treatment of refractory diseases like Chronic Fatigue Syndrome, Cancer, Lyme Disease and AIDS; (3) Open minded and novel prospectives in antimicrobial therapy such as for use in autoimmune disease; (4) the role of biobotanical or phytonutrients as immune system modulators; (5) the psychoneuroimmunology dimensions and depths of disease; (6) the techniques of assessing the immune system; (7) innovative methods for biological response modification with appropriate biobehavioral modification; (8) the role of screening for environmental toxins on the immune system and techniques of mitigating their effect; and (9) the identification of increasingly new "stealth pathogens" that may be responsible for illness and innovative, individualized strategies for their elimination.

THE ROLE OF TOXINS

Toxins are a major factor in the increase of degenerative conditions and diseases; pollutants and toxins accelerate the aging process. Basic concepts must be understood by the patient in treating toxic states. A toxin has been defined as any class of more or less unstable poisonous compounds elaborated by animal, vegetable or bacterial organisms and acting as causative agents in many diseases, usually after an incubation period; its action may be subclinical and give rise to compromises in healthy function prior to formal onset of disease. Immunotoxicology is the science of the delicate and precise relationship between levels of immune function and the origins, nature, properties and effects of poisons, of their detection in the organs or tissues, of their antidotes and removal in the treatment of subclinical conditions and diseases due to poisoning.

Most people are unaware that toxins, chemicals and pollutants that infect our internal environment are behind the massive increase in cancer, especially breast cancer. A study involving the analysis of a great number of frozen lumps from a "lumpectomy" surgical center showed that these lumps were a veritable waste dump of highly toxic pollutants. The women had been exposed to these chemical slow acting poisons unwittingly, years before the onset of symptoms. The toxins were stored in fatty tissues in a futile effort by the body to wall off the poisons, and then breast cancer developed. Mainstream, crisis oriented medicine then deals with the malignant tumor with a radiation accelerator machine. This adds even more toxins to the body in the form of intravenous chemotherapy.

The storage of toxins in human tissue is like a time bomb waiting to go off. Most human cancers develop through a process of evolution within the tissue microenvironment. In tumor dormancy, sometimes called "the quiet before the storm," the tumors may maintain their size over many years or even decades, without additional growth; then suddenly, they "awaken" followed by rapid tumor growth and proliferation called the "cancer cascade." Intake of dietary fat and many other factors may modulate tumor angiogenesis by influencing tumor dormancy. Responsible clinical practice involves the identification of immediate "triggers" and "mediators" as well as "antecedent conditions," genetic or otherwise, in the patient's life that may influence tumor dormancy. A tumor either stays the same, shrinks or goes wild in the cancer cascade. Every patient passing through Dr. Keys's office is a special person who is screened for immunotoxicological insult for the presence of toxic signs, symptoms or tissue pathology. A program of biobehavioral modification and more integrated health and medical care is developed to change the person's life because there is a delicate balance between tumor and host, with diet and other literally dozens of possible, individual risk factors being the unbalancing factor(s) that may promote the awakening of tumor dormancy and the devastating cancer cascade. Dr. Keys strives to induce tumor regression and, or dormancy by looking at many different levels of treatment options.

AN INTEGRATED APPROACH

This integrated approach is compared with the seductive and simple-mindedness of hi-tech gadgetry in clinical medicine; expansion of intellectual and conceptual approaches is necessary for cancer and other immune related illnesses. There is the standard acceptance and use of highly impressive looking pieces of medical equipment; frequently, this technology is so impressive looking that the clinician stops asking basic and fundamental questions. (1) Should this machine be used? (2) If so, for whom? (3) If so, for how long? (4) And at what cost, both from a cytoxoic (cell-destroying) as well as economic, cost-benefit prospective? Instead, the clinician only asks, "How do I hook it up?" logo

Contact Dr. Ronald B. Keys at (718) 460-3966 or e-mail at rkeysphd@brainlink.com.
After all, it's only your life.