New Immune Factors May Determine Susceptibility to Aids
Research conducted by Sid Tracey
Acquired Immunodeficiency Syndrome (AIDS) is perhaps the most devastating disease known to medical science. The degenerative effects of this disease are characterized by a high incidence of Kaposi's sarcoma and a wide spectrum of opportunistic infections that overwhelm a weakened immune system.1 The progression of the disease is relentless, and the prospects for survival are bleak.
AIDS-related complex or ARC is a less severe form of AIDS.2 Estimates indicate that for every confirmed AIDS patient, there are ten who suffer from ARC. The symptoms associated with ARC patients tend to be similar, although less virulent than those diagnosed with AIDS. While AIDS is usually a fatal condition, ARC mortality is far less, but is characterized by recurring symptomatic illness such as fever, lethargy, diarrhea, malaise, lymphadenopathy, respiratory problems and abnormal responses to the immune system.
Both AIDS and ARC are caused by the same virus, HTLV-III, yet the severity of the disease in exposed individuals is vastly different. Furthermore, while millions of people have been exposed to the AIDS virus, to date the vast majority of exposed individuals have not exhibited the symptoms of AIDS or ARC.3 Why?
An important key to this puzzling dilemma comes from recent advances in understanding the role of new immune factors and their control of immune response. However, to better understand how those factors control the function of the immune system, one must first understand the basic molecular biology of AIDS.
The first indication that an individual has been exposed to the HTLV-III virus is the detection of antibodies to HTLV-III in the bloodstream. The presence of antibodies does not indicate that an individual will contract AIDS, but their presence indicates exposure to the HTLV-III virus. Unlike many viruses, the HTLV-III virus can "hide" like a ticking bomb during a latency period lasting for years within various body sites like the brain, bone marrow and macrophages. One of the primary sites where the HTLV-III virus flourishes is within a subclass of T-lymphocytes called T-helper (TH) cells.4 Once the HTLV-III virus becomes active, it multiplies rapidly and makes thousands of new copies of itself in the TH cells. Eventually, the infected TH cells are broken apart and destroyed in a process called cell lysis. As the infected TH cells are destroyed, new HTLV-III virus particles are released to infect other TH cells, and are also carried to other parts of the body, such as the semen, blood, tears and saliva, where it can be transmitted to others.
As a result of cell lysis, the clinical manifestation of AIDS is initially characterized by depression of TH cell activity in the body.5 Furthermore, infected TH cells lack the "helper" ability by which they normally aid other components of the immune system, primarily macrophages, that seek out and destroy invading opportunistic organisms.6 In the final analysis, the AIDS patient does not die from AIDS, but from the body's inability to fight off the opportunistic infections that constantly invade the body, but which are no longer aggressively attacked by the immune system.
The difference in severity after exposure to the HTLV-III virus range from AIDS, to less severe ARC, or to individuals who are potential carriers of the virus with no symptoms whatsoever. It is quite clear these differences are totally dependent on the quality of the exposed individual's immune system. This is where we feel a new preventative and treatment strategy should be focused - the stimulation and enhancement of the immune system, using a non-toxic intervention.
This goal has become more likely with the increased scientific knowledge that one of the primary factors controlling the immune system is a class of hormones called prostaglandins.
In the thirties, U.S. von Euler, a Swedish scientist, made the discovery of Prostaglandin, but their critical importance for the molecular control of virtually all body systems, and especially the immune system, went unrecognized until the late 1970's. This is because prostaglandins are made, act and self-destruct within seconds and work at incredibly low concentrations in the body. During the late 1970's, medical instrumentations were developed that could study these powerful, yet naturally-occurring compounds, and their impact on body function.
Now that prostaglandins can be studied, for the first time a realistic strategy for enhancing the immune system emerges. This approach may be the only viable alternative to treating AIDS, for it appears that the HTLV-III virus mutates far too rapidly to allow the production of a suitable vaccine7 and all drug treatments to date offer little real hope. Even the newest drug breakthrough, AZT, acts more to prevent further virus replication than to repair an already damaged immune system. What is needed is a method for enhancing and restoring immune function via prostaglandin modulation.
To maximize the production of the specific prostaglandin classes that can enhance the immune system one must understand that the critical "building blocks" required for prostaglandin synthesis cannot be made by the body, and must enter into the body via diet. What are these building blocks? They are the essential fatty acids, and although there are eight essential fatty acids, the two which have the greatest potential for modulating and stimulating the immune system are the metabolically activated essential fatty acids, gamma linolenic acid, or GLA (Omega 6), and eicosapentaenoic acid, or EPA (Omega 3).
We classify EPA and GLA as metabolically activated in that the body must convert the less active forms of essential fatty acids (Linoleic Acid and Alpha-Linolenic Acid) into GLA and EPA.
GLA is only found in rare plant seeds such as evening primrose and borage and EPA is found in specific fish oils. Although the body should be able to manufacture GLA and EPA, just as it should be able to manufacture sufficient interlukin-2 and other lymphokines, there are a number of reasons why the normal production of GLA and EPA is disrupted. One primary reason is that key enzymes are under the profound control of external factors such as alcohol, saturated fats, sugar and low levels of essential nutrients, which can dramatically reduce their activity. If the activity of those enzymes, critical for the synthesis of GLA and EPA is sufficiently decreased, then the body's production of prostaglandins that act as immune factors also decrease.
Therefore, the only way to ensure the dietary intake of these critical prostaglandin "building blocks" is by direct dietary supplementation with GLA and EPA. Without adequate levels of GLA and EPA, prostaglandins cannot be made. The reason the body requires both GLA and EPA is that each makes different and unique classes of prostaglandins that complement each other and maximize immune response.
Let's look at the scientific evidence on the positive effects of GLA and EPA on the immune system. Cancer can be considered an immune-deficiency disease of the highest order. Clinical trials have shown that high doses of GLA have a dramatic effect for increasing survival rates of individuals with inoperable tumors, such as primary liver tumors and various brain tumours.9 The primary cause of this effect appears related to the formation of PGE1, a prostaglandin derived from GLA, and its stimulation and regulation of T-lymphocytes.10 On the other hand, EPA has a different physiological effect by decreasing the formation of prostaglandins, such as PGE2, which are strong immunosuppressive agents.11 As an example, EPA supplementation protects test animals from implanted tumors, probably by decreasing the formation of immunosuppressing prostaglandins.11-13
In specially-bred animals, a form of human lupus erythematosus occurs. These animals are characterized by depressed T-cell activity, and die of a variety of immune disorders. Supplementation with EPA in these animals leads to virtually complete survival of the EPA treated animals compared to complete fatality of those animals which had no EPA supplementation.14 In similar animals it was found that PGE1, produced from GLA, produced equally impressive survival rates.15,16
The obvious implication is that any immune disorder my respond more dramatically to the combination of EPA and GLA, than to either essential fatty acid alone. This is because the prostaglandins synthesized from GLA are immunostimulating, primarily through the activation of T-lymphocytes, and the prostaglandins derived from EPA tend to reduce the production of immunosuppressing prostaglandins.
It should be noted that male semen contains concentrated amounts of PGE2, a very powerful immunosuppressing agent. New data indicates that the presence of PGE2 aids the replication of the HTLV-III virus under 'in vitro' conditions.17 The importance of this observation is that the dietary intake of both GLA and EPA decrease the production of PGE2.
By understanding the critical function of prostaglandins as key immune factors and their effect on the immune system, one can begin to understand why exposure to the HTLV-III virus produces a wide clinical response. The predisposing factor that determines the severity of exposure to the virus may ultimately be determined by the amount of GLA and EPA in one's diet18 and their ability to be synthesized into prostaglandins that stimulate and enhance the immune system.19 Therefore, the ultimate insurance policy against AIDS for any individual exposed to the HTLV-III virus may be GLA and EPA/DHA supplementation on a daily basis. Since GLA and EPA/DHA are natural materials and have never demonstrated any toxicity, even under exceptionally high daily dosages, this dietary strategy is one that makes excellent scientific sense.
The Balance between the Omega 6 and Omega 3 Essential Fatty Acids20
In our dietary goal to provide these Essential Fatty Acids during growth, pregnancy, lactation, or for therapeutic approach to the management of specific disease conditions, a balance of the Omega 6 and Omega 3 fatty acids should be ensured. This correct balance is important to maintain cellular and other functions.
The ratio of Omega 6 and Omega 3 fatty acids in all cellular lipids, is approximately 4:1, except in the central nervous system, where the ratio is nearer 1:1. Human milk samples from nine different countries showed a remarkable uniformity in the ratio of 5:1 in favor of the Omega 6 fatty acids in the milk lipids in spite of the wide variations in the mother's diet in the different countries. Human red blood cells membranes also show much the same ratio.
While there is yet no clear-cut answer to what the correct balance should be, we can look at Nature to obtain guidelines on this important question. All the comparative data from various studies show a predominance of the Omega 6 fatty acids over the Omega 3. Since the Omega 3 fatty acids are preferentially metabolized in the body, a ratio of 4:1, in favor of the Omega 6 fatty acids will ensure a balanced composition at the cellular level. Such a ratio would be applicable when the parent acids, Linoleic and Alpha-Linolenic, are the predominant constituents in the diet.
On the other hand, the longer chain derivatives such as Gamma-Linolenic Acid (GLA), Dihomo-Gamma-Linolenic Acid (DGLA), Arachidonic Acid (AA), Eicosapentaenoic Acid (EPA) and Docosahexaenoic acid (DHA) are biologically more active and are incorporated into cell structures more efficiently. Also, the Omega 3 Fatty Acid, EPA, is preferentially incorporated into cell membrane at the expense of Arachidonic Acid. In situations where these longer chain polyunsaturated fatty acids are provided in the diet in larger amounts, a ratio of 1:1 between GLA and EPA/DHA would be desirable to ensure a correct balance at the cellular level. Obtaining these balanced levels of GLA and EPA/DHA from supplementation can be accomplished as follows:
The majority of the research carried out world-wide shows that the ideal level to be 240 mg of GLA and 240 mg of EPA/DHA daily to maintain optimum prostaglandin production in the average healthy person. This can be supplied by:
However, therapeutic doses several times the normal levels may be necessary to effect positive changes in cases of weakened immune function. Daily dosages of eight Omega 3-6 capsules (two capsules, four times a day) have been used with some success in Aids cases 21.