Hepatitis Researcher importance of TH1 response

[St. George]

I aked you before in a previous post what, if any, your thoughts were in regards to SVR and a vigorous TH1 favored immune response.  I'm started to beleive that it is exactly this shift from the dominating Th2 response to a more 'viral hungry" TH1 response which determines svr at the end of treatment.  In other words, people who acheive svr are also maintaining a strong Th1 response at the end of treatment which in turn may be keeping any viral remnants in check.  People who fail to acheive svr maybe reverting back to the old virally favorable TH2 arm of the immune system when the drugs are removed from their systems.  Do you think my hypothesis is credible?

[jmjm530]

The preceding was supposed to be an apology but on re-reading it ddin't come off that way :) As you can tell I'm not a fan of combo treatment as it currently exists. Hopefully, VX-950 or some other agent(s) can soon significantly cut down the exposure time to interferon and eventually eliminate it from the mix.

[Hepatitis Researcher]

Interferon is a class of substances that we are naturally producing all the time in small amounts and in larger amounts during infections. I am toying with the thought, stemming from my understanding of antiviral effectiveness at low doses, that even very very low amounts of Pegasys, too low to cause more than minor discomfort, might be capable of holding down small amounts of virus capable of reactivation.

The TCM issue fits well with the above mentioned balancing act of the immune system, but because in itself is an ill defined term/entity, it can be easier discussed in a call/conference call that we might have re some of these issues. The need for dialog and the sheer volume of background concepts  that underlie any valid "opinion" and need to be brought up to explain any position one might have, forbids a meaningful treatment in this restricted format.

[jmjm530]

HR: I am toying with the thought, stemming from my understanding of antiviral effectiveness at low doses, that even very very low amounts of Pegasys, too low to cause more than minor discomfort, might be capable of holding down small amounts of virus capable of reactivation.
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This seems consistent with the approach I believe being taken by Mike Simon's transplant team. Mike has been post transplant serum negative via Heptimax for a number of years. A recent biopsy preceded by a raise in liver enzymes showed HCV virus in liver tissue but not serum. He was and still is on a low dose of Pegasys and I believe 200 mg of riba a day. Hopefully, I got this correct and I'm sure Mike will clarify if he's around.

Interesting your take on TCM. The cunondrum as I see it -- be it TCM or drugs -- is that on one hand it may keep the virus in check by enhancing the immune response, but on the other hand, an enhanced immune response seems to be the culprit in so many post treatment issues. Given the durability of SVR, doesn't it seem that any benefits of charging up the immune system with low doses of Pegasys would be outweighed by the risks -- or are you trying to find some minimal dose that minimizes the risks? I certainly see the logic in special circumstances, like with Mike Simons, but on a personal level, the thought of more interferon is unsettling. Sounds like a real balancing act.

I do agree about acknowledging the restrictions of this format and appreciated your response.  

-- Jim

[jmjm530]

Probably should mentioned that the above remarks were directed mainly to geno 1's because of the lower tx response rate. Not as clear cut with geno 2's and 3's who have little or no liver damage, because they have a significantly better chance of SVR with half the treatment time.

[cuteus]

well, it looks like in your case your body is already doing a good balancing act.  Maybe the tx will throw that into havoc?  But from what I have heard and read from others it is not going that way.
  For some people, the "cold" as it was called, is not a benign issue. It turns into bronchitis and severe sinus conditions that warrant antibiotics for secondary infections. I am too familiar with the path this "benign" cold virus takes in susceptible individuals.  I think  that for them, they would rather deal with skin issues than with needing albuterol and other things to help them breathe.  Yes, I think breathing is more pressing for them.  Any state that keeps those things under control, I welcome.  And then, you get folks with pulmonary conditions that get aggravated with this tx.  Such a complex mechanism, our immune system is!

When a scientist sees the intricacies of the human body, how can they truly think that it was  chance and coincidence that produced such machinery?  I am agnostic, with catholic upbringing, and it is reading things posted in immunology that tilts things in the upbringing direction a bit. Funny, that a scientific article produces that effect!
Maybe you have mastered the immune system balancing through years of supplementation and diets?  how was it before you started on the healthier route?

I had not being taking anything post tx, now that I added all the stuff like ginko biloba, alpha lipoic, etc., that is going to be expiring in my cupboards soon, I wonder if I might be altering things and loose the present balance thus making my system vulnerable? not by the substances themselves, but by the possible alteration they might exert, before it becomes part of the functioning immune system.  
Well, I wondered if the hand surgery and the epidural were going to bring back HCV, so why not worry that the supplements will take away the 'protection' the tx brought?
I like worrying sometimes.
Angie, you are not really going to treat, are you?  Geesh! I remember you talking about it at OOB also, and that was a few yrs ago, might as well wait for the newer stuff now.

Ok, back to the mundane task of house decluttering...this is when miracles would come in handy...
take care

[cuteus]

for those with the interest of immunology as it pertains to hcv:

http://hcv.lanl.gov/content/immuno/ctl_search?action=results;cite=Sreenarasimhaiah2003

this is from 2001, perhaps the preparatory stage leading to today's new treating substances, a bit too technical for me:
http://www.blackwell-synergy.com/doi/full/10.1046/j.1365-2567.2001.01209.x