Vitamin C Plays Many Roles
In May 1953, Fred R. Klenner, a North Carolina medical doctor, presented his paper "The Use of Vitamin C as an Antibiotic" at an AAN convention. Most medical doctors nowadays would cast the paper aside without bothering to read it, calling it hogwash, quackery, and stupidity. As infections become more persistent and virulent, it might be wise for doctors to look at vitamin C with open minds.
As he relates in his presentation, Klenner came upon vitamin C's antibiotic properties purely by chance. Sometime in the early 1940s, he made a home visit to provide symptomatic relief to a man with viral pneumonia who had suddenly developed cyanosis. Since the man did not want to go to the hospital for oxygen therapy, Klenner gave him an intramuscular injection of vitamin C (2 g) to improve cellular respiration. Because this was "an old idea," Klenner was not surprised that "the characteristic breathing and slate-like color had cleared" within 30 minutes. What did surprise him, however, was the patient's condition 6 hours later, when he paid the man a second visit at 8 p.m. The patient was sitting on the edge of his bed, enjoying dinner. His temperature had decreased by 3°. This time, Klenner gave him a 1 g injection of vitamin C and continued doing so at 6-hour intervals for the next three days. "This patient was clinically well after 36 hours of chemotherapy [with C]."
Excited that ascorbic acid may give a new way to deal with viral infections, Klenner used it (oral doses, IM injections, and intravenous administration) on pediatric diseases like measles, chicken pox, mumps, encephalitis, and poliomyelitis. He found that "… definite clinical response is made evident by a climbing white blood count, drop in fever, and general all around improvement" with injections of a large-enough dose of ascorbic acid. Effective dosage depends upon the type and severity of the disease and body weight. Symptoms do not dissipate with too low a dose. Discontinuing C prematurely will cause a regression. Andrew W. Saul, PhD, editor-in-chief of Orthomolecular Medicine News Service, says: "For those unable to obtain intravenous vitamin C [the preferred route], it is essential to pay special attention to one of the most important aspects of vitamin C therapy, dividing the dosage improves absorption and retention of vitamin C." (his emphasis)
"Studies of ascorbic acid at the molecular, cellular, and clinical levels conducted by a host of scientists from a variety of disciplines have revealed that ascorbic acid plays multiple biochemical roles," explain public health scientists Fred and Alice Ottoboni in their 2005 article for the Journal of Orthomolecular Medicine. Ascorbic acid is more than an antioxidant. It stimulates the hexose monophosphate (HMP) shunt, a series of biochemical reactions that convert 6-carbon sugar (glucose) into 5-carbon sugars (ribose and deoxyribose). These sugars are needed to make RNA and DNA, necessary for creating new cells. Readily available RNA and DNA allow the body to quickly make phagocytic leukocytes, "the first line in host defence against pathogens." Leukocytes have an ascorbic acid content up to 80 times greater than the content of plasma. Another function of the HMP shunt is to produce NADPH, which is used by phagocytes to make superoxide, their weapon against invading pathogens. Glucose competes with ascorbic acid for insulin transport into cells (including leukocytes). Glucose also inhibits the HMP shunt. Consequently, the Ottobonis advise restricting sugar and carbohydrate consumption to get the most benefit from ascorbic acid supplementation.
Ascorbic acid is a necessary biochemical compound. Most animal species make their own from glucose. In humans, however, an enzyme necessary to make the conversion is inactive. Based on ascorbic production in other animals, scientists believe that humans would normally produce 2 to 4 g of ascorbic acid per day and "at least 15 grams per day under stress."
"Vitamin C, in very high doses, has been used to successfully treat several dozen illness[es], with a published, peer-reviewed literature spanning the last 60 years," writes Saul. "… I never cease to be amazed at the number of persons who remain unaware that vitamin C is the best broad-spectrum antibiotic, antihistamine, antitoxic and antiviral substance there is."
Klenner FR. The use of vitamin C as an antibiotic. Paper presented at: AAN Convention; May 1953; Pasadena, California. Available at: www.whale.to/v/c/klenner1.html. Accessed April 20, 2010.
Ottoboni F, Ottoboni A. Ascorbic acid and the immune system. J Orthomol Med. 2005;20(3):179–183. Available at: www.orthomolecular.org/library/jom/2005/pdf/2005-v20n03-p179.pdf.
Saul AW. Putting the "C" in Cure: quantity and frequency are the keys to ascorbate therapy. Orthomolecular Medicine News Service. December 15, 2009. www.orthomolecular.org/resources/omns/v05n11.shtml. Accessed December 15, 2009.
Book Advises on Preventing Food Poisoning
Several common food-borne microbes cause food poisoning. Symptoms, most notably vomiting and diarrhea, can be mild or severe; but the symptoms usually end quickly. Most food-borne pathogens are not lethal. Sometimes, however, these infectious bacteria leave the gastrointestinal tract and travel in the bloodstream to other areas in the body, where they cause more serious and long-term health problems. For example, strains of Campylobacter, a bacterium found in the intestinal tracts of many animals (particularly birds), can cause pneumonia, urinary tract infections, arthritis, endocarditis, cholecystitis, meningitis, pancreatitis, and other organ inflammations. The link between food-borne pathogens and how to prevent these infections is the subject of Beatrice Trum Hunter's latest book, Infectious Connections.
Preventing food-borne disease is not high-tech, but it does require diligence. Frequent and thorough hand-washing with plain soap and hot running water cannot be overemphasized. In addition to hand-washing, cleanliness during food preparation includes cleaning cutting boards and utensils so that bacteria in raw animal foods do not contaminate vegetables or ready-to-eat foods. Many of the pathogens thrive at lower temperatures, so thoroughly cooking meat, fish, and poultry – the most common sources of food-borne pathogens – is a must. Even after cooking, bacteria will multiply if the temperature is right (between 40 ºF and 140 ºF), so leftover perishable foods need to be refrigerated soon after the meal. "The CDC rates poor personal hygiene of food handlers and preparers along with improper temperature control as the two most significant factors leading to food-borne illness," Hunter writes.
Beatrice Trum Hunter is an award-winning author of more than 30 books on food issues and health. Infectious Connections is a well-researched and comprehensive look at food-borne infections and how to prevent them. The book, published by Basic Health Publications, costs $18.95 (ISBN 978-1-59120-244-8).
Lyme Guidelines Still Unchanged
The 2006 Infectious Diseases Society of America (IDSA) guidelines for the treatment of Lyme disease "require no revision," according to a review panel's announcement on April 22, 2010. The IDSA set up the review panel, under the guidance of an independent medical ethicist, as part of a 2007 antitrust settlement with Connecticut's Attorney General Richard Blumenthal. The 2006 IDSA guidelines do not recognize the existence of chronic Lyme disease. Rather, the IDSA asserts that Borrelia burgdorferi, a bacterium transmitted to humans via tick bites, is readily cured with short-term antibiotic therapy (of less than one month). The International Lyme and Associated Diseases Society (ILADS), made up primarily of physicians who treat people with chronic Lyme, vehemently disagrees.
In assembling the 2006 Lyme guidelines, the IDSA "suppressed scientific evidence and … excluded opposing views from [its] panel" according to the attorney general's findings, which led to the settlement. Panel members held commercial interests in diagnostic tests, vaccines, and insurance. The exclusion of ILADS's viewpoint left its doctors and their patients in no-man's-land. Long-term antibiotic protocols and other treatments that do not follow IDSA guidelines are denied by insurers, and doctors who do not follow the guidelines are vulnerable to medical board censure. As a result, Attorney General Blumenthal threatened the IDSA with an antitrust suit.
The IDSA looks at the review panel decision as validation that chronic Lyme disease does not exist, but the controversy is bound to continue. The review panel "'found that each [of the IDSA's 69 recommendations stated in its guidelines] was medically and scientifically justified in light of all the evidence and information and required no revision,'" according to panel chair Dr. Carol J. Baker. The votes for each recommendation were unanimous for all but one item.
The unanimity was a red flag for ILADS supporters. "'How can there be such total consensus with any scientific issue? It's beyond comprehension,'" says Dr. Robert Bransfield, president of ILADS. The unanimity could be the result of the question that panel members were asked. A letter from Attorney General Blumenthal, dated Feb. 1, 2010, accused the IDSA of "improper voting procedure." Instead of voting on whether each 2006 Lyme treatment recommendation was "medically and scientifically justified in light of the evidence presented at [the July 30, 2009] hearing," (my emphasis) the group merely voted on whether the guidelines should be revised, rewritten, or left unchanged. During the July hearing, the review panel listened to eight hours of testimony from 18 presenters, who represented diverse viewpoints about the diagnosis and treatment of Lyme disease.
After the review panel's decision, Attorney General Blumenthal's office released the following: "My office is reviewing the IDSA's reassessment of its 2006 Lyme disease guidelines mandated by its agreement with my office. … We will carefully and comprehensively assess the final report and the review process leading to that report to determine whether the IDSA fulfilled the requirements of our settlement."
Chamoff L. AG chides Lyme panel for not following settlement agreement. Greenwich Time. February 10, 2010. Available at: www.greenwichtime.com/local/article/AG-chides-Lyme-panel-for-not-following-settlement-360055.php. Accessed April 21, 2010.
Connecticut Attorney General's Office. Attorney general statement on IDSA guidelines review panel report [press release]. April 22, 2010. Available at: http://www.ct.gov/ag/cwp/view.asp?A=2341&Q=459296. Accessed April 24, 2010.
Newby K. A summary of the IDSA Lyme evidence hearing [Web article]. Under Our Skin. August 5, 2009. Available at: http://underourskin.com/blog/?p=250. Accessed April 21, 2010.
Reinberg S. Review Panel leaves controversial Lyme disease guidelines unchanged [Web article]. HealthDay News. April 22, 2010. www.healthday.com/Article.asp?AID=638398. Accessed April 23, 2010.
NIH Launches Human Microbiome Project
On December 19, 2007, the National Institutes of Health officially commenced the Human Microbiome Project. After decades of focusing on how to kill disease-causing organisms, NIH is now taking a more ecological approach and is looking at the genetic makeup of the trillions of microorganisms living in or on the human body. "Our goal is to discover what microbial communities exist in different parts of the human body and to explore how these communities change in the presence of health or disease," said Francis S. Collins, MD, PhD, director of the National Human Genome Research Institute.
Microorganisms outnumber the body's cells by a ratio of 10 to 1. Some microbes have a symbiotic relationship that actively supports our health. Others provide benefits that are unrecognized until their absence produces negative effects. For example, the pneumococcal vaccine has reduced the number of pneumonia cases caused by Streptococcus pneumoniae, but decimating the population of this bacteria that is commonly found in healthy people "has opened space for different and potentially more harmful pathogens," according to Scientific American. S. pneumoniae competes with Staphylococcus aureus, a common bacterium that has developed resistance to the antibiotic methicillin (i.e., MRSA).
At this point, the Human Microbiome Project has three goals. After sequencing more 600 microbial genomes to complete its collection of 1,000, researchers will begin to "characterize the microbial communities present in samples taken from healthy human volunteers." These samples will come from the digestive tract, mouth, skin, nose, and female urogenital tract. (The NIH news report does not say how researchers will recruit these healthy subjects. It's possible that "healthy" people who eat a typical American diet will have different microbial communities than people living on a whole-foods diet.) After deciphering microbial communities in healthy people, researchers will study samples taken from people with specific diseases to identify changes. This research is just in its infancy and is long overdue. More information about the Human Microbiome Project can be found at http://nihroadmap.nih.gov/hmp.
National Institutes of Health. NIH launches Human Microbiome Project [press release]. December 19, 2007. http://www.nih.gov/news/pr/dec2007/od-19.htm. Accessed April 27, 2010.
Harmon K. Bugs inside: what happens when the microbes that keep us healthy disappear? Sci Am. December 16, 2009. Available at: www.scientificamerican.com/article.cfm?id=human-microbiome-change. Accessed April 20, 2010.
Homeopathy Prevents Leptospira Epidemic
For years, Cuba's Carlos J. Finlay Institute has made and distributed a Leptospira vaccine to prevent leptospirosis among children, pregnant women, and the elderly during hurricane season. (The high cost of making the allopathic vaccine has prevented the government from vaccinating everyone in affected areas.) Heavy rainfalls, flooding, and damage to sanitary systems provide an ideal environment for the bacterium that affects animals and humans.It produces severe headache, high fever, chills, muscle aches, and vomiting. Jaundice, red eyes, abdominal pain, diarrhea, and a rash are also possible symptoms. Infection can lead to kidney damage, meningitis, liver failure, respiratory distress, and death. Despite the Cuban government's efforts, this vaccine program had been unable to keep the numbers of infected people from rising from year to year.
During late summer in 2007, Finlay Institute began producing a Leptospira homeopathic nosode using four circulating strains in accordance with international manufacturing standards. Cuba's "outcast" status has caused the country to develop its own resources for affordable and effective health care. Homeopathic medicine is one of the country's accepted therapies. In fall 2007, yet another outbreak of leptospirosis threatened about 2 million people after heavy rains and flooding overwhelmed three Cuban provinces. Finlay Institute sent a team to dispense two doses of the nosode (7 to 9 days apart) as preventive treatment to all the inhabitants, about 2.4 million people.
"The epidemiology surveillance after the intervention showed a dramatic decrease of morbidity two weeks after and a reduction to [zero] of mortality of hospitalized patients. The number of confirmed leptospirosis cases remains at low levels and below the expected levels according with the treads and rain regimens," according to the researchers' summary (January 17, 2009): decrease in the number of sick and no deaths. The nosode preventive treatment cost about US $200,000, a fraction of the US $3,000,000 allopathic vaccine program that treated only at-risk populations.
This study was reported at NOSODES 2008, an international meeting on homeoprophilaxis, homeopathic immunization, and nosodes against epidemics (Havana, Cuba; 10–12 December 2008). Homeopaths from Cuba, South America, Canada, Australia, the UK, and Kenya presented their findings on the use of homeopathics, particularly nosodes, to prevent contagious diseases, including tuberculosis, Chagas disease, hepatitis, and malaria.
Campa C, Varela LE, Gilling E, et al. Summary of Cuban experiences on leptospirosis prevention from the authors (a preliminary report). January 17, 2009. Available at www.homeopathyresource.com. Accessed April 20, 2010.
Successful use of homeopathy in over 2.5 million people reported from Cuba. January 1, 2009. Available at www.homeopathyresource.com. Accessed April 20, 2010.
Borrelia Defeats Antibiotics
The Infectious Diseases Society of America (IDSA) asserts that Borrelia burgdorferi (the tick-transmitted spirochete that causes Lyme disease) readily succumbs to antibiotic treatment. Microbiologists who have studied the organism disagree. It survives assaults from drugs and the immune system by hiding in biofilms and by changing form (See Townsend Letter, July 2009; 312:30–31). Norwegian researchers øystein Brorson and Sverre-Henning Brorson say: "B.burgdorferi has the ability to convert (and reconvert) to cystic forms both in vivo and in vitro" when exposed to the antibiotics ceftriaxone, doxycyclin, ciprofloxacin, and vancomycin. When the environment is safe for growth, the bacteria returns to its motile form.
Recent studies involving the use of the new antibiotic tigecycline show the difficulty of finding a treatment for Borrelia. In vitrolaboratory tests found that tigecycline inhibited and destroyed the cyst and motile forms of B. burgdorferi. Unfortunately, in vitroresearch does not always match the results of in vivo research. Researchers at University of California-Davis tested this antibiotic on mice with different stages of Borrelia infection (1 week, 3 weeks, or 4 months) in a controlled study. Three months after treatment, infection status was evaluated by culture, quantitative OspA (outer surface protein A) real-time polymerase chain reaction (PCR), and subcutaneous transplantation of joint and heart tissue into other mice. Not surprisingly, tissue from the saline-treated control mice were culture- and PCR-positive for Borrelia. Some tissues from the antibiotic-treated mice were also PCR-positive, although the DNA markers were greatly reduced compared with the controls. Antibiotic treatment at the 1-week stage appeared to be more effective than treatment that began at the later stages.
All of the antibiotic-treated mice were culture-negative. Even though the spirochetes could not be cultured, mice that received transplants from the antibiotic-treated mice developed spirochetal DNA in multiple tissues. Moreover, ticks that fed on the antibiotic-treated mice acquired Borrelia and were then able to transmit the infection to other mice. Clearly, negative cultures do not mean that Borrelia is absent. The researchers conclude: "… antibiotic treatment [with tigecycline] is unable to clear persisting spirochetes, which remain viable and infectious, but are nondividing or slowly dividing."
Unfortunately, tigecycline is not the only failure. The UC-Davis researchers state: "Treatment failures have been documented with nearly every type of antimicrobial drug, based upon clinical relapse, culture, or PCR." Studies such as this one support the view that the IDSA's treatment guidelines are inadequate. They also show how challenging this infection is.
Barthold SW, Hodzic E, Imai DM, Feng S, et al. Ineffectiveness of tigecycline against persistent Borrelia burgdorferi [abstract]. Antimicrob Agents Chemother. February 2010;54(2):643–651.Available at: www.ncbi.nlm.nih.gov/pubmed/19995919.
Brorson ø, Brorson S-H. An in vitro study of the susceptibility of mobile and cystic forms of Borrelia burgdorferi to tinidazole. Int Microbiol. 2004;7:139–142. Available at www.im.microbios.org. Accessed April 21, 2010.
Brorson ø, Brorson SH, Scythes J, MacAllister J, et al. Destruction of spirochete Borrelia burgdorferi round-body propagules (RBs) by the antibiotic tigecycline [abstract]. Proc Natl Acad Sci U.S.A. November 3, 2009;106(44):18656-61. Available at: www.ncbi.nlm.nih.gov/pubmed/19843691. Accessed April 21, 2010.
Johnson L. LYMEPOLICYWONK: Barthold and Luft – persistence and integrity in science [blog]. December 15, 2009. www.lymedisease.org/news/lymepolicywonk/290.html. Accessed April 27, 2010.
Antibiotics as an Evolutionary Force
"Antibiotics may be the most powerful evolutionary force seen on this planet in billions of years," according to microbiologist Stuart Levy. Is he exaggerating? Maybe not. Unlike the healthy immune system, which identifies and destroys specific threats, antibiotics kill any microbes that share targeted characteristics with the pathogen, including beneficial ones. Pathogens strong enough to withstand antibiotic assault (and some always withstand treatment) flourish as the drugs destroy competing microbes. In addition, these resistant pathogens pass their resistance on to the next generation and even share resistant genes with other species.
Antimicrobial compounds and DNA that provides resistance to microbes are not new factors in the environment. Most manmade antibiotics come from soil microorganisms that produce their own antibiotics. In the case of Streptomyces toyocaensis, the bacterium's DNA contains three resistance genes that take part in the microbe's production of its antibiotic teicoplanin. Those resistance-genes are "nearly identical to the resistance genes in vancomycin-resistant enterococcus (VRE)," according to Dr. Gerry Wright. Wright heads McMaster University's antibiotic research center (Hamilton, Ontario, Canada). In fact, about one-third of the DNA in VRE is foreign; it was acquired from the environment or from other species.
In addition to promoting drug resistance, manmade antibiotics affect microorganisms' genetic expression. J. F. Linares and colleagues found that low levels of three different antibiotics – tobramycin, ciprofloxacin, and tetracycline – increase the expression of genes that affect virulence in the bacterium Pseudomonas aeruginosa. The organism's swimming and swarming activity increased, and more biofilms formed. Also, tetracycline increased the bacterium's toxicity.
As scientists learn more about microbial community response to antibiotics, the importance of avoiding unnecessary use of the drugs becomes very clear. Unfortunately, unnecessary antibiotic use continues to be widespread. Conventional livestock farms primarily use antibiotics to promote growth and to prevent, not treat, disease. Soil bacteria surrounding conventional pig farms "carry 100 to 1,000 times more resistance genes than do the same bacteria around organic farms," according to a study by microbiologist Roderick Mackie. These genes end up in groundwater and wells that provide drinking water for humans and other animals. Antibiotic use in humans for nonresponsive conditions, such as childhood ear infections, also adds resistant genes to the environment.
Waste treatment plants remove solid matter, but they are not designed to remove pharmaceutical chemicals or free-floating DNA. Instead, these plants add to the antibiotic problem by selling the bacteria-rich slurry as fertilizers, most of which are sprayed on cropland. Alternative methods of processing sewage can reduce the amount of antibiotic-resistant bacteria in the slurry, but these methods cost more, so few plants bother. Waste water deemed safe (complete with pharmaceutical chemicals and bacterial DNA) is released into rivers and other water bodies. Drinking-water plants treat surface water and groundwater to kill bacteria, but killing bacteria does not destroy resistant DNA.
It's a continual cycle. Antibiotics ingested by animals and people change the microbes and ecology within. Then, excreted antibiotic compounds and resistant DNA are dumped in waterways or sprayed on cropland; and the animal kingdom gets to ingest these evolutionary modifiers all over again. Reducing antibiotic use is the only tactic we have right now for slowing these evolutionary shifts and their unknown consequences.
Linares JF, Gustafsson I, Baquero F, Martinez JL. Antibiotics as intermicrobial signaling agents instead of weapons. PNAS. December 19, 2006;103(51);19484–19489. Available at www.pnas.org. Accessed April 21, 2010.
Sachs JS. DNA pollution may be spawning killer microbes. Discover. February 14, 2008. Available at: www.discovermagazine.com/2008/mar/14-dna-pollution-may-be-spawning-killer-microbes/?searchterm=antibiotic%20resistance. Accessed April 21, 2010.
Anyone who has read Dancing Naked in the Mind Field knows that Kary Mullis is a creative scientist born to investigate and test whatever interests him. Mullis won the 1993 Nobel Prize in chemistry for discovering polymerase chain reaction (PCR), a technique that lets scientists take one molecule of DNA and quickly produce billions of similar molecules. During the past 10 years, Mullis has turned his attention to immunology and antibiotic-resistant microbes, subjects that have a personal attraction for him. "I don't care to see my offspring come to an untimely end before my eyes," he says. "Infectious disease is therefore something I think about." Antibiotic-resistant infection killed a friend of his in 2008. These years of investigation and thought have led him to the concept of "chemically programmable immunity," which he calls Altermune.
Mobilizing an immune response against a new pathogen takes the body some time – time that a quick, aggressive pathogen uses to its own advantage. Mullis came up with the idea of using an "old" immune response, common to all people, and "refitting" it to fight new threats. All humans have antibodies to alpha-1,3-galactosyl-galactose bonds. Altermune chemically links an alpha-Gal epitope (where an antibody attaches) to a DNA aptamer. This aptamer is designed to bind to and hold a specific pathogen until a macrophage can destroy it. Altermune is administered with a nasal spray. "'Nothing in nature is similar to the Altermune linkers,'" says Mullis. "'It will be hard for bacteria and the flu to deal with them. It really has great potential but it's going slow. We are not part of a huge drug company.'"
Unlike in his development of PCR, "a solo effort," Mullis is collaborating with Ron Cook of Biosearch (Novato, California) and a team of organic chemists, immunologists, and influenza and poultry specialists. An early test of Altermune involved mice exposed to anthrax; the mice survived and showed no sign of anthrax post-mortem, according to a February 2009 lecture (posted on www.ted.com). Mullis's team is presently performing animal experiments involving influenza A. Mullis was awarded a patent for Altermune on January 12, 2010.
Mullis KB. Altermune [Web article]. Dr. Kary Banks Mullis. www.karymullis.com/altermune.shtml. Accessed April 23, 2010.
———. Kary Mullis' next-gen cure for killer infections [online video]. TED. www.ted.com/talks/kary_mullis_next_gen_cure_for_killer_infections.html. Accessed April 23, 2010.
Puppe J. Groundbreaking discoveries of the past and the future [Web article]. Dr. Kary Banks Mullis. www.karymullis.com/pdf/jpuppe.pdf. Accessed April 23, 2010.