An article on Morgellons; a link, and a comment I added re keratinocytes

Morgellons, chapter from a book, skeptic busting or quack busting, but open-minded regarding the sufferers having a real itch problem rather than a delusional psychiatric disorder as the mainstream medical world is treating the condition. Sufferers have lost jobs due to a condition that has no physical diagnosis:[https://medium.com/matter/the-itch-nobody-can-scratch-4d980e3ac519#.tcwvu9neq]

It is horrible to have physical symptoms that are dismissed as “all in your head,” — that is no help if there is pain in your skin or under your skin.

I added a comment, slightly edited here:

Maybe they have overactive keratinocytes that produce Substance P and causes itch and neuropathic pain. Magnesium deficiency can lead to increased production of Substance P.

“Keratinocytes are able to detect itch-associated signals by expression of protease-activated receptor-2,[11] opioid,[12] cannabinoid[13] and histamine H4 receptors.[14] By responding to these signals, keratinocytes can modulate itch in many ways. For example, keratinocytes can release neurotrophins including NGF[15,16] and neurotrophin-4[17] (Fig. 1), lipid mediators[18] or endothelin-1,[19] which can either directly activate itch fibres in the skin or activate mast cells to release pruritogenic mediators. In addition, neuropeptides including substance P have been shown to significantly increase the release and production of NGF of human cultured keratinocytes, indicating a neuroimmune interaction mechanism between sensory nerves and keratinocytes[20] (Fig. 1). Interestingly, keratinocytes can also inhibit itch through the release of endocannabinoids, which bind directly to inhibitory receptors on sensory nerves.”

— so maybe the Morgellons sufferers have a defect or insufficiency in endocannabinoids. Epsom Salt baths for magnesium in case gastrointestinal absorption of magnesium is a problem might help, and supplements with phospholipids like phosphatidylcholine or phosphatidylserine might help if endocannabinoid deficiency is a problem — or chocolate, rosemary and nutmeg are food sources.

Excerpt from: “Pathophysiology of Itch and New Treatments,” Ulrike Raap; Sonja Ständer; Martin Metz, Curr Opin Allergy Clin Immunol. 2011;11(5):420–427. [http://www.medscape.com/viewarticle/749608_2]

/Disclaimer: Opinions are my own and  the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./

Links about magnesium deficiency and Substance P, a neuropeptide associated with inflammation

Magnesium is Essential for Preventing Substance P Overload , May 24, 2011, by Byron J. Richards, Board Certified Clinical Nutritionist , “Substance P is a neuropeptide that is typically ”over-heated” in situations of anxiety, depression, digestive bloating, insomnia, fibromyalgia, PTSD, and cardiovascular deterioration. New research shows that one of the first signs of magnesium deficiency1 is that it enables the over-production of substance P.” Read More:  [http://www.wellnessresources.com/health/articles/magnesium_is_essential_for_preventing_substance_p_overload/]

Raw shelled pumpkin seeds are a good source of magnesium, zinc, B vitamins and essential fatty acids. A few prenatal clients that I have worked with in the past, who were high risk due to a history of high blood pressure or pre-eclampsia during their first pregnancy, did report that the raw shelled pumpkin seeds that I had recommended they try adding to their diet during their second pregnancy did seem helpful for preventing high blood pressure or pre-eclampsia from reoccurring.  So it is also possible that raw unsalted pumpkin seeds may be a beneficial food for use during the perinatal stage for women who hope to prevent autism from developing in their infant during conception or the early weeks of pregnancy. [http://transcendingsquare.com/2014/07/24/magnesium-might-help-protect-against-beta-amyloid-placques/]

/Disclosure: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./

Additional notes to think more about later:

  1. Gehan A Mostafa; Laila Y AL-Ayadhi, The Possible Link Between the Elevated Serum Levels of Neurokinin A and Anti-ribosomal P Protein Antibodies in Children with Autism, J Neuroinflammation. 2011;8(180) Excerpt from the background section: “Neurogenic inflammation is orchestrated by a large number of neuropeptides. Tachykinins (substance P, neurokinin A and neurokinin B) are pro-inflammatory neuropeptides that may play an important role in some autoimmune neuroinflammatory diseases. Autoimmunity may have a role in the pathogenesis of autism in some patients.” And an excerpt from the discussion section: “In our series, increased serum levels of anti-ribosomal P protein antibodies were found in 44.3% of autistic patients. This study was the first to investigate serum levels of anti-ribosomal P protein antibodies in autistic children.” [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3261830/]
  2. Julio Hernandez, et. al., Substance P Is Responsible for Physiological Alterations Such as Increased Chloride Ion Secretion and Glucose Malabsorption in CryptosporidiosisInfect. Immun. March 2007 vol. 75 no. 3 1137-1143
    [http://iai.asm.org/content/75/3/1137.full] *Cryptosporidiosis is a parasitic infection that can be more of a risk for AIDS patients than for average people — reason unknown — The reason speculatively might be that there is a magnesium deficiency or an elevated calcium level resulting from elevated hormone D levels underlying the increased risk for crypotosporidiosis in AIDS patients.
  3. Sylke Müller1 and Barbara Kappes, Vitamin and co-factor biosynthesis pathways in Plasmodium and other apicomplexan parasitesTrends Parasitol. 2007 Mar; 23(3): 112–121.
    This article is primarily about a few B vitamins and protozoan parasites but one section addresses vitamin D, Excerpt: “One way in which vitamin D3 might affect Plasmodium is through its involvement in phospholipid metabolism and signalling pathways 60. Vitamin D3 and analogues have pronounced inhibitory effects on P. falciparum erythrocytic late stage development possibly because the phospholipid biosynthesis pathways of the parasite is affected by these compounds 61. Inhibition of phospholipid biosynthesis by other classes of inhibitors (for instance choline analogues) has been followed up extensively 62, 63 and it is likely that these inhibitors will be developed as new drugs against malaria in the near future 64. Thus the activity of vitamin D3 analogues merits further attention.” [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2330093/]
  4. 60. Boyan BD, et al. 1,25-(OH)2D3 modulates growth plate chondrocytes via membrane receptor-mediated protein kinase C by a mechanism that involves changes in phospholipid metabolism and the action of arachidonic acid and PGE2. Steroids. 1999;64:129–136. [PubMed] *Roughly this title could be translated into: Hormone D affects growth plate cartilage cells by affecting the endogenous cannabinoid system, — arachidonic acid and PGE2 can be formed from cannabinoids that are released from storage within cell membranes. Elevated levels of calcium intracellularly can be a trigger signalling the release of endogenous cannbinoids from the membranes.
  5. 7. Regulation of growth plate chondrocytes and bone cells,                                        Excerpt: “In recent years it has been demonstrated that a large number of growth factors and cytokines regulate the proliferation and differentiation of bone and cartilage cells in vitro and in vivo (Table 2). This subject has been extensively reviewed (Goldring & Goldring, 1990; Canalis, McCarthy & Centrella, 1988a; Price & Russell, 1992; Martin, 1989). There is also increasing evidence that abnormal production of cytokines in diseases such as rheumatoid arthritis, osteoarthritis and osteoporosis may result in inappropriate responses by bone and cartilage cells. Those cytokines and growth factors considered to be of particular importance during bone development and growth include the IGFs, TGF a and b, bone morphogenetic proteins (BMPs), FGF, PDGF and epidermal growth factor (EGF). Many of the cell types present in the microenvironment of growing bone contribute to the local synthesis of cytokines and growth factors including the resident endothelial cells, marrow stromal cells, osteoblasts, periosteal cells and chondrocytes. The haemopoetic cells present in bone marrow include circulating monocytes, macrophages and T cells; these are another potential source of cytokines. In fact, several lines of evidence point to there being a close relationship between bone cells and cells of the immune system (Skjodt & Russell, 1993).”

    7.12. Parathyroid hormone related peptide (PTHrP)

    “PTHrP is a peptide closely related to PTH that is produced by normal tissues, with similar effects to PTH on bone. It has been established as having an important role in regulating the hypercalcaemia that is associated with some malignancies (Webb et al., 1988). PTHrP has also been identified as a fetal hormone which may regulate placental calcium (Ca2+) flux (Orloff, 1989). This peptide may also have an important role in skeletal development, having been localised in embryonic bone, and a recent study has shown that mice with a defective PTHrP gene have multiple skeletal abnormalities (Karaplis et al., 1992).” [http://archive.unu.edu/unupress/food2/UID06E/UID06E0V.HTM]

  6. Arnold J. Felsenfeld, et. al., Dynamics of Parathyroid Hormone Secretion in Health and Secondary HyperparathyroidismCJASN November 2007 vol. 2no. 6 1283-1305 [http://cjasn.asnjournals.org/content/2/6/1283.full]

  7. S. C. Kukreja, et. al., Antibodies to parathyroid hormone-related protein lower serum calcium in athymic mouse models of malignancy-associated hypercalcemia due to human tumors. J Clin Invest. 1988 Nov; 82(5): 1798–1802 [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC442751/] Abstract: “A parathyroid hormone-related protein (PTHrP) has recently been isolated from tumors associated with hypercalcemia. In the present study, we tested the effects of neutralizing antisera to the PTHrP on serum calcium and urine cAMP in two animal models of malignancy-associated hypercalcemia. The animal models consisted of (a) a human squamous cell lung cancer and (b) a human laryngeal cancer, both serially carried in athymic mice. The antisera specifically reduced the elevated serum calcium and urinary cAMP levels in the tumor-bearing animals. We conclude that PTHrP plays a major role in the pathogenesis of malignancy-associated hypercalcemia.”

  8. Moniz C., et. al., Parathyroid hormone-related peptide in normal human fetal development., J Mol Endocrinol. 1990 Dec;5(3):259-66. [http://www.ncbi.nlm.nih.gov/pubmed/2288637Abstract:

    “Parathyroid hormone-related peptide (PTHrP) has been detected in fetal serum and amniotic fluid. Using a combination of immunocytochemistry and molecular biology we have detected the peptide and its mRNA in a variety of fetal tissues throughout gestation. Tissue-specific mRNA isoforms were observed, the pattern of hybridization of which changed throughout gestation. In addition, the intensity and pattern of immunocytochemical localization of the peptide was found to vary over the time-period studied (8-30 weeks). PTHrP is expressed by a variety of tumours associated with the syndrome of humoral hypercalcaemia of malignancy and probably accounts for the hypercalcaemia by virtue of its limited amino acid homology with parathyroid hormone. These data demonstrate for the first time that PTHrP, a tumour-related peptide, is expressed during normal human fetal development, and suggest the possibility that it may function to regulate fetal calcium balance and growth in utero.”

     

  9. “Parathyroid hormone-related peptide (PTHrP) can be elevated in pregnant and lactating women and in newborn infants. Nonmalignant conditions that have been described in association with elevated plasma PTHrP levels include systemic lupus erythematosus, HIV-associated lymphadenopathy, lymphedema of chest or pleural cavities, and with benign tumors of the ovary, kidney and the neuroendocrine system.” [http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/81774]
  10. Shane T. Mortimer, David A. Hanley, William K. Stell, Immunohistochemical identification of calcitonin gene-related peptide and substance P in nerves of the bovine parathyroid gland., Cell and Tissue Research
    , Volume 261, Issue 2, pp 339-345, [http://link.springer.com/article/10.1007/BF00318675Summary:

    “Although peptide neurotransmitters have been shown to modulate hormone secretion in many glands, there are very few studies of neurotransmitters in the parathyroid gland. Bovine parathyroid glands were collected at a local abattoir, fixed with paraformaldehyde, sectioned using a cryostat, and stained by indirect immunohistochemistry for calcitonin gene-related peptide and substance P. We were able to positively identify both neuropeptides. Nerve fibres containing calcitonin gene-related peptide and substance P were identified in contact with the tunica media of arteries and arterioles and dispersed throughout the stroma of the gland. While many of the fibres encircled parenchymal lobules, no intimate contact with the peripheral chief cells was observed. All immunoreactive fibres were found to contain both neuropeptides. Since calcitonin gene-related peptide and substance P are vasodilators, they may increase blood flow within the gland. In addition, the neuropeptides may diffuse from perilobular nerve fibres into the parenchyma, thereby modulating secretion of parathyroid hormone.”

  11. And for the swish and score — calcitonin gene-related peptide is associated with migraine attacks — hmmmmm — health is a miracle when it works. [https://migraine.com/blog/what-is-calcitonin-gene-related-peptide-cgrp/]

Kidney dialysis may be a side effect of sugarcane production in Nicaragua; a link

Chronic kidney disease has become a problem for almost half of the adult men in Chichigalpa, Nicaragua. The disease seems to the linked to the men’s work cutting sugar cane. The exact cause of the problem is unknown but it is suspected that dehydration is a factor due to the hot working conditions with limited time for breaks. Read more: [1] Chronic kidney disease might be less of a risk associated with their jobs if sugarcane workers were allowed enough time to take breaks to prevent dehydration from occurring, as dehydration itself can cause long term harm to the kidneys. [2]

As a consumer of sugarcane products I care about whether sugarcane workers are allowed their right to protect their health during their workday. As a human I care about the worker’s pain and shortened lifespans and about their families. Chronic kidney disease and kidney dialysis treatment require the patient to follow a very restrictive diet and the treatment requires the patient to stay attached to the dialysis machine for hours every few days.  Providing adequate breaks to the workers now seems like an easier strategy in the long run, to me.

There is also a question of gender representation — Why aren’t half of the women suffering from chronic kidney failure too? If the disease was caused by something in the environment it would show up in a more even distribution, men and women would be sick in equal numbers. If the disease is associated with cutting sugarcane then maybe women aren’t getting it because more men then women are working as sugarcane cutters. Likely cutting sugarcane is very physically demanding work and male skeletal structure and muscle mass on average simply is stronger and larger than female anatomy. Machines able to navigate sugarcane fields might be invented to do the job but that solution would be taking away yet more jobs from humans and a risky job, unfortunately, is better than no job for many people because, unlike corporations, people have to eat to survive.

Working in hot conditions causes a loss of fluid and electrolytes contained in sweat and overheating may further increase the amount of sweat that is produced. Evaporation of sweat can have a cooling effect on the body. Intense physical exercise in hot and humid conditions may cause losses of up to three liters of sweat which is almost equivalent to the water content of the body’s blood supply.  [3] Workers need to have enough time to drink, eat and cool down to help prevent the risk of acute dehydration and the risk of it causing lasting damage to the kidneys.

Allowing workers frequent breaks in the shade might give their bodies time to cool down and slow down the loss of nutrients caused by excessive sweating, and allow them enough time to drink water and have a salty magnesium rich snack to replace the nutrients that were lost in sweat or used by the kidneys. The water and potassium in a piece of fruit and a salty magnesium rich snack like tortilla chips would help replace the water, sodium, potassium, and magnesium that are essential for the kidneys function. [4] The kidneys have to have enough nutrients to be able to filter out the toxins that are produced daily as a normal part of physiology and any extra toxins created by a job with hard physical labor and then still have enough nutrients to filter out any additional toxins that may have been absorbed from working around the agricultural chemicals.

4/18/2017, Update: dehydration is still suspected to be involved in the increased incidence of chronic kidney disease in agricultural workers. The problem is more widespread however than just Nicaragua. Pesticides from agriculture or silica from contaminated ground water is suspected to be involved. Use of painkillers and alcohol in the evenings combined with the limited access of water during the work day is also suspected to add to the risk of chronic kidney damage occurring.  [5]

Associations were reported with agricultural work, agrochemical exposure, dehydration, hypertension, homemade alcohol use and family history of chronic kidney disease. There is no strong evidence for a single cause, and multiple environmental, occupational and social factors are probably involved.” [6]

Part of the problem is that symptoms don’t occur until fairly serious permanent damage has developed. Earlier diagnosis by use of more frequent screening of certain lab tests may help but families need to eat and someone needs to work. Young adult sons take over when their father is no longer able to work. The disabled men are a financial and physical burden for the family and the number of widows has increased in many of the areas that have been experiencing an increase in the number of adult workers with severe chronic kidney disease. A sense of futility in the men may be part of the problem too – you can’t prevent what you don’t feel you have any control over. [5]

Preventative health care can help prevent damaging chemicals from collecting in the kidneys. And having adequate magnesium and water throughout the day and evening can help the kidneys detoxify and remove the chemicals before damage develops. Having water and some salty snacks or peanuts along with alcoholic beverages in the evening can help the body detoxify and remove the toxic effect of alcohol before it has a chance to cause damage to the kidneys either.

Agricultural companies might save money on employee turnover and sick days if they provided filtered water [8] and adequate work breaks, especially during the hottest part of the day.

A video about the condition and research regarding the increased incidence in El Salvador is available with subtitles in English, Enfermedad Renal Crónica: NefroSalva Clínico (El Salvador): [7]

/Disclosure: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./

  1. http://news.nationalgeographic.com/news/2015/01/150129-sugarcane-workers-kidney-disease-nicaragua-health-ngfood/
  2. http://www.kidneyfailureweb.com/causes-others/767.html
  3. http://www.texasheart.org/hic/topics/hsmart/hydrate.cfm
  4. http://transcendingsquare.com/?p=967
  5.  http://www.sciencemag.org/news/2016/03/mysterious-kidney-disease-goes-global
  6. Associations were reported with agricultural work, agrochemical exposure, dehydration, hypertension, homemade alcohol use and family history of chronic kidney disease. There is no strong evidence for a single cause, and multiple environmental, occupational and social factors are probably involved.” https://www.ncbi.nlm.nih.gov/pubmed/24878644
  7. Enfermedad Renal Crónica: NefroSalva Clínico (El Salvador), a video from El Salvador: https://www.youtube.com/watch?v=Tk9wcMyRG1E&feature=youtu.be
  8. 6 types of water filtering devices designed for developing nations: http://inhabitat.com/6-water-purifying-devices-for-clean-drinking-water-in-the-developing-world/