Rituximab: a promising therapy in systemic lupus erythematosus

[RedOnce]

Jan. 5, 2006
Several trials of new immunologic agents in systemic lupus erythematosus (SLE) have recently been undertaken. Rituximab, a chimeric antibody directed against CD20 on B lymphocytes, has emerged as a promising therapy. Based upon preliminary data, clinical efficacy of rituximab has been documented in both pediatric and adult-onset SLE patients. The specific manifestations reported to be beneficially affected include lupus nephritis, arthralgia/arthritis, serositis, cutaneous vasculitis, mucositis, rashes, fatigue and neurologic symptoms.

Good tolerability of rituximab is reported with rare serious side effects. The positive response to rituximab verifies a central role for B cells in SLE. This article highlights the clinical experience of rituximab therapy in both pediatric and adult-onset SLE. These data suggest a promising role for rituximab in the treatment of SLE. Further controlled trials and long-term outcome studies are imperative to further define its clinical application and to improve the care of patients.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16338207&query_hl=3&itool=pubmed_DocSum

Rituximab (pronounced ri tucks i mab) belongs to a group of cancer drugs known as monoclonal antibodies. It is normally used to treat several types of non-Hodgkin’s lymphoma. Monoclonal antibodies are typically used to try to destroy some types of cancer cells while causing little harm to normal cells. They recognise certain proteins that are found on the surface of particular cancer cells. The monoclonal antibody recognises the protein and ‘locks’ on to it (like a key in a lock). This may then trigger the body’s immune system to attack the cancer cells and can sometimes cause the cells to destroy themselves. Rituximab is given as a drip (infusion) through a fine tube (cannula) inserted into the vein.

http://www.cancerbacup.org.uk/Treatments/Biologicaltherapies/Monoclonalantibodies/Rituximab

[philb]

1. Lupus(& MS) are autoimmune conditions & testable and curable usually

Autoimmune conditions are where the body has a chronic toxic exposure and the immune system is activated to fight the
(foreign) invader but can't win, so the immune system is in constant battle and harms the body rather than toxic substances
that it can't win against and are continuously being introduced into the body.

There are tests these days to determine what the immune system is reacting to and also what metabolic processes are blocked by what toxics.
For immune reactivity there are blood lymphocute immune reactivity tests such as MELISA (www.melisa.org
to determine what the immune system is having to fight.
(there are also tests for body burden of toxics like hair element test,etc.)

A good test for metabolic blockages caused by toxic exposures is the 24 hour urine fractionated porphyrin test.
Body processes at the cellular level take nutrients and convert them to whats needed by the body. Toxic exposures block these
enzymatic processes, and result in waste porphyrins rather than what the body needs like (ATP) energy and blood heme being manufactured. By looking at the level and pattern of waste porphyrins in the urine you can tell the extent of the metabolic blockages and also the likely cause- different toxics cause different patterns of blockages. Body burden tests and interview can also follow up on this.
In the case of Lupus, the porphyrin that shows up most commonly in the Urine is Uriporphyrin. Which tells the doctor what processes are blocked and an indication of the toxic responsible. Nickel and Mercury are the 2 most common causes of Lupus and
usually show up in the immune reactivity test and the porphyrin test.
And its documented by clinical experience, that when you find the cause in one of these tests, removing the chronic exposure
(usually mercury fillings or nickel crown or braces or etc.) brings about significant improvement.


Another good test for such conditions is the Great Smokies Diagnostic Lab(www.gsdl.com) Comprehensive Liver Detox test.
The liver is the body's detox organ and virtually always has been adversely affected when a person has a chronic condition- it is unable to eliminate the toxin effectively. But this also is measureable. The test includes a blood test, urine test, and saliva test. Again it determines metabolic blockages and problems with liver function.
In the case of Lupus( or other similar conditions), what you will find from this test is that the person's sulfur processing system is blocked- there will be high level of free cysteine in the blood commonly; and the Phase 1 and/or Phase 2 liver detox systems will be blocked or damaged.

Documentation on causes and successful treatments of Lupus(and MS) at:
http://www.home.earthlink.net/~berniew1/ms.html

and the 2 medical lab web sites I referenced.

there are also other medical labs with reasonable tests, I could list some others


I might also note that when a person has a significant toxic exposure and weakened immune system(resulting in chronic condition)
the immune system can't fight off the parasites, viruses, bacteria, and mycoplasmas that everyone is exposed to pretty continuously.
In this case, most people with chronic conditions also have parasites or bacteria or etc. that need to be determined and treated.

[RedOnce]

2. From what I have read, Lupus is...

a multi-genic disease, meaning that it is caused by defects in multiple genes. If enough of these genetic defects accumulate in the same person, the disease may develop. However, Whether or not these genes are expressed, and to what degree, relies on external and internal triggers. These triggers seem to include stress, antioxidant levels, exposure to toxic chemicals and infections such as Epstein-Barr virus.

So, in the case of Lupus are saying Nickel and Mercury are frequently the trigger?

[trotsky]

3. Lupus and MS can be cured?

Might want to let the Lupus Society know about that.

http://www.lupus.org/education/faq.html#33

And the National Multiple Sclerosis Society:
http://www.nationalmssociety.org/What%20is%20MS.asp

Please don't make such wild, unsupported claims.

[Warpy]

4. The collagen vascular diseases like lupus are NOT curable

although the symptoms can be controlled to the point that a normal lifespan is possible. Lupus used to carry a life expectancy of an average of seven years after diagnosis.

There is a difference between treatment and cure.

None of the quackery about diet or chelation or any of the other stuff the medical phobes are coming up with constitutes a treatment, let alone a cure. The collagen vascular diseases have a typical course of exacerbation and remission, making them wide open to claims of quack cures. It is simply not the case.

If you want to do this stuff along with standard treatment, then it may help you feel better. The placebo effect is real and it is a powerful one. However, recommending any of this stuff as a complete alternative to standard care will push lupus patients right back to that seven year life expectancy.

[RedOnce]

5. Medline - Mercury and autoimmunity:

Mercury and autoimmunity: implications for occupational and environmental health.

2005 Sep 1;207(2 Suppl):282-92.
Silbergeld EK, Silva IA, Nyland JF.

Department of Environmental Health Sciences, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA.

Mercury (Hg) has long been recognized as a neurotoxicant; however, recent work in animal models has implicated Hg as an immunotoxicant. In particular, Hg has been shown to induce autoimmune disease in susceptible animals with effects including overproduction of specific autoantibodies and pathophysiologic signs of lupus-like disease. However, these effects are only observed at high doses of Hg that are above the levels to which humans would be exposed through contaminated fish consumption. While there is presently no evidence to suggest that Hg induces frank autoimmune disease in humans, a recent epidemiological study has demonstrated a link between occupational Hg exposure and lupus. In our studies, we have tested the hypothesis that Hg does not cause autoimmune disease directly, but rather that it may interact with triggering events, such as genetic predisposition, exposure to antigens, or infection, to exacerbate disease. Treatment of mice that are not susceptible to Hg-induced autoimmune disease with very low doses and short term exposures of inorganic Hg (20-200 mug/kg) exacerbates disease and accelerates mortality in the graft versus host disease model of chronic lupus in C57Bl/6 x DBA/2 mice. Furthermore, low dose Hg exposure increases the severity and prevalence of experimental autoimmune myocarditis (induced by immunization with cardiac myosin peptide in adjuvant) in A/J mice. To test our hypothesis further, we examined sera from Amazonian populations exposed to Hg through small-scale gold mining, with and without current or past malaria infection. We found significantly increased prevalence of antinuclear and antinucleolar antibodies and a positive interaction between Hg and malaria. These results suggest a new model for Hg immunotoxicity, as a co-factor in autoimmune disease, increasing the risks and severity of clinical disease in the presence of other triggering events, either genetic or acquired.

PMID: 16023690

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16023690&query_hl=3&itool=pubmed_docsum