N Engl J Med. 1996 Aug 1;335(5):311-5. Related Articles, Links
Comment in:
* N Engl J Med. 1996 Aug 1;335(5):347-8.
Prevention of Jarisch-Herxheimer reactions by treatment with antibodies against tumor necrosis factor alpha.
Fekade D, Knox K, Hussein K, Melka A, Lalloo DG, Coxon RE, Warrell DA.
Department of Internal Medicine, Black Lion Hospital, Addis Ababa, Ethiopia.
BACKGROUND: In patients with louse-borne relapsing fever (Borrelia recurrentis infection), antimicrobial treatment is often followed by sudden fever, rigors, and persistent hypotension (Jarisch-Herxheimer reactions) that are associated with increases in plasma concentrations of tumor necrosis factor alpha (TNF-alpha), interleukin-6, and interleukin-8. We attempted to determine whether sheep polyclonal Fab antibody fragments against TNF-alpha (anti-TNF-alpha Fab) could suppress the Jarisch-Herxheimer reaction. METHODS: We conducted a randomized, double-blind, placebo-controlled trial in 49 patients with proven louse-borne relapsing fever. Immediately before the intramuscular injection of penicillin, the patients received an intravenous infusion of either anti-TNF-alpha Fab or a control solution. RESULTS: Ten of the 20 patients given anti-TNF-alpha Fab had Jarisch-Herxheimer reactions with rigors, as compared with 26 of the 29 control patients (P = 0.006). The controls had significantly greater mean maximal increases in temperature (1.5 vs. 0.8 degrees C, P < 0.001), pulse rate (31 vs. 13 per minute, P < 0.001), and systolic blood pressure (25 vs. 15 mm Hg, P < 0.003), as well as higher mean peak plasma concentrations of interleukin-6 (50 vs. 17 micrograms per liter) and interleukin-8 (2000 vs 205 ng per liter) (P < 0.001 for both comparisons). Levels of TNF-alpha were undetectable after treatment with anti-TNF-alpha Fab. CONCLUSIONS: Pretreatment with sheep anti-TNF-alpha Fab suppresses Jarisch-Herxheimer reactions that occur after penicillin treatment for louse-borne relapsing fever, reduces the associated increases in plasma concentrations of interleukin-6 and interleukin-8, and may be useful in other forms of sepsis.
Please send me 16 cases of sheep anti-TNF-alpha Fab. I am herxing and could use some help!
I had not seen this info. Is the sheep anti-TNF-alpha Fab close to the Actos that is prescribed along with the cholestrymine protocol for neurotoxins?
Interesting!!
Thanks for sharing. I will be interested to see other comments about this subject.
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If you get the choice to sit it out or dance...
TNF alpha has many "benefits"...yes, I know...ouch, but don't BLOCK it.
From my Updated Nutshell post:
Benefits of TNF alpha:
1. ``as more people are treated with TNF inhibitors over longer periods of time, tumor risk may become more pronounced.''
(May protect us from tumors.)
www.Hopkins-arthritis.som.jhmi.edu/edu/acr2003/ra-treatments.html
2. ``TNF-alpha is potentially an important mediator of protein wasting in chronically uremic patients.''
www.dscmt.univ.trieste.it/text/curriculum/containerbiblio.htm
3. ``one mechanism of action of TNF-alpha ...on thyroid FRTL-5 cells is to inhibit calcium entry.''
PMID: 10092616
4. ``is actually a potent modulator of neurotransmitter interaction.''
hdlighthouse.org/see/immune/tnf.htm
5. ``the body does use tumor necrosis factor-alpha (TNF-alpha) to acutely fight infections. If patients
are showing any sign of infectious disease, drugs such as Enbrel (that inhibit the effects of TNF-alpha) are temporarily discontinued.''
www.lef.org/protocols/prtcl-128a.shtml
6. ``After noticing that exposure to the naturally occurring compound TNF-alpha (Tumor Necrosis
Factor-alpha) killed malfunctioning immune cells...''
www.diabetesincontrol.com/issue166/item1.shtml
7. ``generally the level of TNF increases with aging. Lactic acid and unsaturated fats and hypoxia
stimulate increased formation of TNF. Estrogen increases production of nitric oxide systemically, and nitric oxide can stimulate TNF formation. When oxygen and the correct nutrients are available, the hypermetabolism produced by TNF could be reparative (K. Fukushima, et al., 1999), rather than destructive.''
http://www.ferlowbrothers.com/estrogen_osteoporosis.htm
(Original website would not link. Above website says the same.)
8. ``TNF-a is a molecule responsible for activating and proliferating cells of the immune system as
well as protecting the body from abnormal cell growth.''
(same source as #7)
9. ``Activity of TNF-a is associated with inflammation, cytotoxicity (destruction of abnormal cells)
antiviral activity, and the proliferation of immune cells.''
(same source as #7)
10. ``modulate cell proliferation and cellular calcium homeostasis.''
http://www.cell-research.com/991/991-syf1.html
(If you go to the above website, please note the mention of spingolipid metabolites and keep this in mind: syhingomyelinase is Mg dependent)
PMID: 9195931
11. ``the level of TNF-alpha directly or indirectly regulates the production of borreliacidal antibody''
PMID: 12522038
12. ``The increased bone resorption may be due to an increase in TNF-alpha''
PMID: 14704297
13. ``no detrimental effects on normal neurons and can protect neurons when present in neuronal cultures during in vitro ischaemia...Once TNF's removed, neuroprotection is lost.''
www.anri.uwa.edu.au/teams/teamcvdl/cvdl.htm
14. ``TNF- a also causes production of sphingosine which can directly block the release of calcium
from the sarcoplasmic reticulum and therefore depress cardiac contraction.''
www.saem.org/download/01kline.pdf
15. ``suppression of insulin action in the liver resulting from TNF-alpha mediated suppression of
tyrosine phosphorylation''
Gastroenterology 2004; 126: 840-848,917-919
(Keep in mind insulin ACTIVATES PFK which Bb is dependent on.)
16. ``Total elimination of the TNF-a cytokine apparently creates a less hostile immune environment...Although `Chronic-lyme' is a lympopenic disease, chronic lyme patients do not usually form sarcoid granuloma. Borrelia burgdorferi appears to be a pathogen with insufficient lympopenic activity to proliferate sarcoid granulomas on its own. However, together with other pathogens, it is frequently found as a component of sarcoid inflammation.''
www.joimr.org/phorum/read.php?f=2&I=38&t=38
17. ``the level of TNF-alpha directly or indirectly regulates the production of borreliacidal antibody''
PMID: 12522038
18. ``Polymerase chain reaction analysis indicated a protection rate of 95% in mice receiving tumor
necrosis factor (TNF)-alpha.''
PMID: 8537658
19. These results are in line with previous experiments using cells of the adaptive immune response, indicating that strong T helper type 1 (Th1) proinflammatory responses might be associated with a
successful resolution
of Lyme disease.
PMID: 15958074
Unfortunately, a review I just read showed that nothing studied so far has ameliorated a herxheimer reaction EXCEPT tnf-a antibodies. sigh. guess there's no way out but through.
KLP