th1/th2 cytokine test

[SwanRonson]

Has anyone had a test like this:

http://www.truehealthlabs.com/TH1-TH2-Balance-Panel-Basic-p/LC_815250.htm

Any thoughts on whether it's worth the money?

 

[Gingergrrl]

I have not had the test although I have read the thyroid book it references (a few years ago when first diagnosed with Hashimotos).

I think that test would only have value if you had a doctor or really skilled clinician who knew what to do with the results.

My own understanding is that my immune system is screwed up on both sides with viral reactivation of several viruses and on the flip side, autoimmune/MCAS and that this is common in our population. What you do to fix it, I have no idea!

 

[Jonathan Edwards]

Has anyone had a test like this:

http://www.truehealthlabs.com/TH1-TH2-Balance-Panel-Basic-p/LC_815250.htm

Any thoughts on whether it's worth the money?

A complete waste of time (and money) SwanRonson). The immune system does not work like a see-saw (their terminology). There is no such thing as Th1/Th2 balance except in genetically modified mice maybe. There are no immune disease due to such an imbalance that I know of, although the immunology literature might make one think that. Any lab that is selling this is conning people and I would steer well clear of them.

 

[msf]

The Lipkin group seem to think it might be relevant to ME: http://www.ncbi.nlm.nih.gov/pubmed/25824300

Has the test been ordered by a doctor? I don´t think there would be much point in getting it done on your own.

 

[minkeygirl]

Also note per JE that NP's and supplements are also scams and wastes of money.

 

[minkeygirl]

There is no such thing as Th1/Th2 balance except in genetically modified mice maybe. There are no immune disease due to such an imbalance that I know of, although the immunology literature might make one think that.

The operative words being "that you know of".

 

[drob31]

I think this is where conventional medicine and alternative medicine (allopath versus integrative/naturopath) seem to disagree big time. Many integrative practicioners believe in a TH1/TH2/TH17 imbalance (over/underactive).

 

[Ema]

I have actually done this test and have some positive and negative things to say about it.

Prior to taking this test, I was working under the impression that my immune system was underreactive. I was a patient of Dr Lerner's and had been diagnosed with EBV/CMV/HHV6. I'd also been diagnosed with Lyme.

Everything I did was aimed towards eradicating these infections and stimulating my immune system.

When I did this test, it came back that my immune system was over-stimulated and I had very high levels of both Th1 and Th2 cytokines. So it changed my treatment strategy from a "stimulate the immune system" one to a "modulate the immune system" one.

The negative is that I can't seem to replicate their findings with regards to elevated cytokine levels through any of the mainstream lab testing. I'm not sure if that is because the Labcorp tests aren't sensitive enough or if the Neuroscience testing is the problem. And Neuroscience is the least customer friendly company. Well, perhaps Comcast is worse...but NS is bad when you want to get some answers.

I also agree that the Th1/Th2 model is overly simplistic but I don't think that means it has no value whatsoever. Many models are simplified because we don't know all the details and including them all would make the model so messy and overwhelming as to lose value.

So, overall I don't regret doing the testing because the results led to actionable changes in my treatment plan. I do wish that I could have found some supporting evidence for the results though.

 

[Gingergrrl]

I think this is where conventional medicine and alternative medicine (allopath versus integrative/naturopath) seem to disagree big time. Many integrative practicioners believe in a TH1/TH2/TH17 imbalance (over/underactive).

@drob31 or @Ema, Sorry if I have asked this before but I have no memory of the answer. What does TH17 mean?

 

[Gingergrrl]

When I did this test, it came back that my immune system was over-stimulated and I had very high levels of both Th1 and Th2 cytokines. So it changed my treatment strategy from a "stimulate the immune system" one to a "modulate the immune system" one.

@Ema, since I also test highly positive for multiple viruses (minus Lyme) my treatment had been anti virals as you know. Can you remind me (and PM okay if you prefer) how Dr. Lerner shifted your treatment to modulate the immune system vs. stimulate it? I suspect mine would show both kinds of cytokines to be high if I were to do this test.

 

[Ema]

@drob31 or @Ema, Sorry if I have asked this before but I have no memory of the answer. What does TH17 mean?

"Functionally, Th17 cells play a role in host defense against extracellular pathogens by mediating the recruitment of neutrophils and macrophages to infected tissues.

Moreover, it has become evident that aberrant regulation of Th17 cells may play a significant role in the pathogenesis of multiple inflammatory and autoimmune disorders."

http://www.ebioscience.com/knowledge-center/cell-type/th17-cells.htm

 

[Ema]

@Ema, since I also test highly positive for multiple viruses (minus Lyme) my treatment had been anti virals as you know. Can you remind me (and PM okay if you prefer) how Dr. Lerner shifted your treatment to modulate the immune system vs. stimulate it? I suspect mine would show both kinds of cytokines to be high if I were to do this test.

This was all post Dr Lerner. In a nutshell, I was taking a few supplements to stimulate interferon gamma production which would activate the Th1 side. I stopped those and picked supplements that were immunomodulatory (ie raise if low, lower if too high) instead and also focused more on lowering systemic inflammation in general rather than trying to target infections specifically.

 

[Jonathan Edwards]

The operative words being "that you know of".

Meaning that you know of one? Please let me know the reference.

 

[Jonathan Edwards]

I think this is where conventional medicine and alternative medicine (allopath versus integrative/naturopath) seem to disagree big time. Many integrative practicioners believe in a TH1/TH2/TH17 imbalance (over/underactive).

I don;t think so. I am not an allopath. I just look carefully at the evidence. The TH balance story comes from conventional immunological speculation and you will see it all over conventional immunological review articles, but based on a lot of muddled thinking and transgenic mice. Integrative practitioners believe in it because they like picking up academic fag ends that sound slick - as do conventional doctors - there ain't much difference I suspect.

 

[Jonathan Edwards]

"Functionally, Th17 cells play a role in host defense against extracellular pathogens by mediating the recruitment of neutrophils and macrophages to infected tissues.

Moreover, it has become evident that aberrant regulation of Th17 cells may play a significant role in the pathogenesis of multiple inflammatory and autoimmune disorders."

http://www.ebioscience.com/knowledge-center/cell-type/th17-cells.htm

Trouble is the first sentence applies to all T cells - just using different cytokines. And the second sentence is a bit of a wimp out - has become evident that ... may play a significant role. Er yes well, it is evident that they may but it would nice to be specific. The specifics are that blockade of IL-17 from TH17 cells seems good treatment for autoinflammatory conditions like psoriasis but not for autoimmune conditions as far as I know (like RA).

If anyone can actually explain to me what the evidence for a 'Th1/Th2 balance' is and how an imbalance causes a disease I would be interested to know. I have been sitting in seminars given by colleagues who say things like this since about 1990 and nobody has ever explained why this is a 'balance' rather than just two sets of cells doing their different jobs. Immunobabble to my mind.

 

[drob31]

Meaning that you know of one? Please let me know the reference.

Dr. Kharazian talks about it in his book:

http://www.amazon.com/Still-Thyroid...=sr_1_1?ie=UTF8&s=books&qid=1283040524&sr=8-1

Also, a Kresser article:

http://chriskresser.com/basics-of-immune-balancing-for-hashimotos/


Here's the selfhacked article, that contains links to sources:

http://selfhacked.com/2014/06/16/supplements-foods-exercise-right-type-th1-vs-th2-dominance/

RA:
http://www.ncbi.nlm.nih.gov/pubmed/11812015
Hashimotos:
http://www.ncbi.nlm.nih.gov/pubmed/15249726
Lupus:
http://www.ncbi.nlm.nih.gov/pubmed/21484768

 

[Jonathan Edwards]

Dr. Kharazian talks about it in his book:

http://www.amazon.com/Still-Thyroid...=sr_1_1?ie=UTF8&s=books&qid=1283040524&sr=8-1

Also, a Kresser article:

http://chriskresser.com/basics-of-immune-balancing-for-hashimotos/


Here's the selfhacked article, that contains links to sources:

http://selfhacked.com/2014/06/16/supplements-foods-exercise-right-type-th1-vs-th2-dominance/

RA:
http://www.ncbi.nlm.nih.gov/pubmed/11812015
Hashimotos:
http://www.ncbi.nlm.nih.gov/pubmed/15249726
Lupus:
http://www.ncbi.nlm.nih.gov/pubmed/21484768

The first two are just second hand fag end stuff from popular authors I am afriad. I didn't see any evidence presented.
The other articles just repeat fashionable speculation. The one on RA is by an old friend of mine Jochem Kalden, who was one of the few colleagues prepared to admit that everyone had got things wrong when I showed that rituximab worked after all (in 2001, just after that article was published). He was a great handle turner on the fashionable stories but there is no evidence there - just a sort of rheumatological astrology - if you are Th1 Taurus you will get sore knees - that sort of level to my mind.

I would need to see some actual evidence to take this seriously - after all nobody in rheumatology takes Th1/Th2 seriously any more because they have moved on past Th17 to some other new fashion.

 

[Gijs]

Some doctors calls Th17 Th3

Professor Edwards what do you think about the reliability of the Lymphocyte transformation test (LTT) for detecting Borrelia?

The test principle is based on bringing together of the patients blood with specific recombinants Borrelia antigens (Osp A) in order to establish a reaction with the T-lymphocytes. T-lymphocytes have a memory function, and if these were exposed to the Borrelia then they will have stored in the memory in front of which, that were not exposed. I know that about more then 90% of ME/CFS patiënts test positive. I don't believe it is due to Borrelia infection but this strange immunologial reaction looks very interesting too me.

And what does a low count of CD3 en CD57 means?

 

[Gingergrrl]

Integrative practitioners believe in it because they like picking up academic fag ends

The first two are just second hand fag end stuff

What does this mean?!! It sounds very offensive but must have a different meaning to doctors in the UK?!!!

 

[Jonathan Edwards]

Some doctors calls Th17 Th3

Professor Edwards what do you think about the reliability of the Lymphocyte transformation test (LTT) for detecting Borrelia?

The test principle is based on bringing together of the patients blood with specific recombinants Borrelia antigens (Osp A) in order to establish a reaction with the T-lymphocytes. T-lymphocytes have a memory function, and if these were exposed to the Borrelia then they will have stored in the memory in front of which, that were not exposed. I know that about more then 90% of ME/CFS patiënts test positive. I don't believe it is due to Borrelia infection but this strange immunologial reaction looks very interesting too me.

And what does a low count of CD3 en CD57 means?

The problem with T cell response tests (transformation) is that T cells are not that fussy about what they respond to - so the result depends entirely on how long you 'cook' the test and what concentrations you use etc. You can get any T cells to respond to anything if you try hard enough. The T cells themselves do not 'remember' things. Memory is due to selection of T cells born with a higher affinity for the antigen in question. Memory is actually the wrong word, although it sort of works.

So 90% of ME patients will test positive if the lab wants to sell that. This is the problem and it makes me very wary of these tests if they are being sold commercially. I would not trust a transformation test unless it was done by a university hospital lab that no financial interest in whether it got positive or negative results. I am afraid that medical commerce is a sleazy place.

Lowish CD3 or CD57 probably mean nothing much. Lymphocyte counts vary widely because they just measure how many cells happen to be taking bus rides through the blood stream at that point in time. If they are way out of range that is different. If they were the person would be given a formal immunodeficiency diagnosis, not ME.