cytokine panel

Been having this inflammatory enthesitis/arthritis still, so my rheum ordered a cytokine panel.

Much to my surprise, the whole panel is negative, except for IL-10, which is generally thought to be anti-inflammatory. I've been forced to rely on hyperthermia, in addition to nsaids and prednisone, to get the inflammation down.

So I dont understand how my panel can be negative. I thought that w/ inflammatory arthritises, even when all antibodies and sed rate/crp are negative, the cytokine panel is usually positive, but I could be wrong.

https://ibb.co/9y0x1xl

When I google IL-10 it seems like all of the hits I'm seeing are with respect to it's role in infection. Saw one paper saying that gram-negative bacteria release LPS which stimulate IL-10.

This paper discusses it's role in different infections. Maybe a clue that I've got some background pathogen stimulating me. Was curious if anyone else had a cytokine panel run and what did it show?

https://www.jimmunol.org/content/jimmunol/180/9/5771.full.pdf

this is an interesting result

its a while since i went deep into the various cytokines - but my recollection is also that IL-10's main role is an anti-inflammatory one - important in acute infections - for quelling the inflammation after an infection has been largely dealt with by the immune system and the peak in inflammation from when the immune system responded to the threat now needs to be turned down.

one thought i had on the test result was to try to understand if it is a mainstream cytokine panel used by conventional doctors - or a functional medicine test - used by functional medicine doctors
reason i ask is that conventional tests tend to have very wide "normal ranges" and tend to report normal even for sick patients - but have good specificity ( ie if your result breaches these relatively wide limits then something serious is off ) - designed to suit health systems and insurance companies interests.
whereas functional medicine tests often have the opposite problem - different terminology / stance of tests - "ideal range" vs "normal range" and in general more narrow ranges - such almost everyone will have results outside ideal range - and interpretation starts to be more of an issue. designed more to meet the needs and expectations of functional practitioners and their patients

- Rainy's posts on bartonella are interesting - the research around bartonella shows it has some very special properties that allow it to exist in the hosts blood without driving the normal reaction that other bacteria in the blood in the same quantities would normally cause - eg fever, septicaemia, inflammation, coagulation.
in fact, often general markers of inflammation like C-Reactive protein and ESR can be normal or even low in at least 50% of chronically infected patients, despite positive testing via PCR or culture.
so bartonella has some powerful immune modulating properties - which could involve anti-inflammatory cytokines like IL-10

- IL-10s role in chronic illness might well be more complex - would have to look into that - sometimes you get both inflammatory and anti-inflammatory signalling pathways both active and kind of locked in a status quo.

That document is fantastic, Garzie! Thanks for sharing.

Wow that's very impressive Garzie.

You're not one those people who writes those giant well thought-out plans on their walls are you? You know like in crime movies haha (just kidding).

🤣🤣🤣

will email it to you now dcd

the way this came about was after going through the gamut of many GP's and infectious disease so called experts and then functional medicine gut testing and treatments, and then NHS Lyme tests - all without finding a smoking gun - so i resolved to cast the net as wide as possible to try to capture all pathogens that could cause the symptoms my partner on the basis that we both became ill at the same time, then try to narrow that list down by a process of elimination.

another large spreadsheet was born to try to filter those down by those that one or both of of us could have exposure to and try to asses how close to our symptoms it might present with.
I had travelled widely and to some pretty far flung places - my partner less so.
The pathogens in the sheet the snapshot is from are those that were shortlisted from that process.

most of the credit for the research has to go to Buhner - as i used his lyme, bartonella and viruses books as the source for most of it - and then filled in any blanks with independent research on pubmed / google scholler etc.

i need to do some more microscopy to repeat the slides that were messed up - but if i get time i will look up some of buhners references on IL-10.

from memory many acute infections will trigger it at some point in the infection cycle - but fewer infections will trigger it to high levels long term in chronic phase. i seem to recall Buhner saying something about intracellular bacteria can increase IL-10 levels to prevent the body forming granulomas, a process by which the body walls off infected cells as a way of dealing with intracellular infections - but would have to check that.

i realise that while my sheet made sense to me at the time - it may not be clear to other what approach i was following or how to interpret it

dcd had some good questions regarding interpreting the sheet that i thought would be helpful to anyone else trying to use it so i will post those and my answers below in the hope that it might help clarify

question: So I assume a 1 and a 2 are just positive and strong positive. What does a -1 mean?
yep - in the pathogens section a 1 is raised and 2 is strongly raised

question: For example, if i have a specific pathogen and an herb and that combo is -1? It's contraindicated?
in the herbs section -1 means it lowers that particular cytokine -2 means it strongly lowers that particular cytokine
so actually - following buhners approach we would target the herbs that have negative numbers for pathogens that have positive ones for the same cytokine - or at least that was the rationale of the sheet

the concept being that ( based on buhners approach) the goal is to lower those cytokines that are artificially raised by the target pathogen - in order to restore immune balance and function in favour of the host homeostasis

question: Also, what do the herbs listed as 1s for IL-10 mean? Does that mean it suppresses them? Licorice for example? It's not clear to me if i want to suppress it, or if its anti-inflammatory due to something else.
The sheet mainly focuses on the cytokines that are raised and which herbs help with them.
The items in the rows below the thick black bar were an attempt to capture the action of the anti-inflammatory cytokines.
a positive number in the pathogen section means that that cytokine is raised in those conditions
a negative number in the herbs section - follows the rule above - signifying that this herb is expected to lower this cytokine - and a positive number here would signify that it's expected to raise it.

I think that because in general anti-inflammatory cytokines are thought of as "good" in buhner's general approach - then the focus in the sheet is on things that should raise anti-inflammatory cytokines - and as such it lists only positive numbers in the herb section.

it should be noted that in reality many of the cytokines have different actions in the body in different contexts of other cytokine levels, such is the level of complexity and interconnectedness of the system.
in general as we go through acute illnesses and then recovery there is a surge of inflammatory cytokines that call immune cells to the area - open up tissues so they can access infected cells and break them down - then after the majority of the infection is cleared anti-inflammatory cytokines are released that start to calm down the system, promote healing and allow tissue repair.
in chronic infection this process gets interrupted and stuck part way and the situation becomes more complex and as a result its a bit harder to apply.

also some herbs - astragalus and salvia miltiorrhiza come to mind - are thought to have immune modulatory effects - where they lower or raise cytokines dependent on their starting levels - lowering if high and rising if low - (though i have not checked if these are active for IL-10 )

Post Edited (Garzie) : 1/24/2022 5:14:36 AM (GMT-7)