Fw: XMRV & Treatments -Update Dr. AzRa MaEl, MD

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From: Al Melillo <melillo3@...>Subject: XMRV & Treatments -Update Dr. AzRa MaEl, MDDate: Monday, February 21, 2011, 10:43 AM

http://bit.ly/e4fmP5GORDON MEDICALInnovative Healthcare3471 Regional ParkwaySanta , CA 95403707.575.5180Greetings!This Update on XMRVis by Dr. AzRa Mael, MD:What is XMRV (aka XenotropicMurine Leukemia Virus-RelatedVirus)? Does it cause ChronicFatigue Syndrome? What otherillnesses might it be associatedwith? How can it be treated?XMRV is the current name given to this recentlydiscovered group of retroviruses that infectshumans.It is a member of the third known family of humanretroviruses, a Human Gamma Retrovirus (HGRV),and in time these viruses may be renamed HGRV.Human Immunodeficiency Virus (HIV) and HumanT-Lymphotropic Virus (HTLV) are the other 2 familiesof human retroviruses that may be more familiar

tosome.XMRV was first discovered in association withprostate cancer in 1996. Only recently (2009) wasthe virus found to be strongly associated withChronic Fatigue Syndrome by a group of collaboratinglabs, including Dr. Mikovits's lab at the Whittemore Institute (WPI).The presence of other closely related viruses(murine leukemia virus related-viruses or MLV-relatedviruses) was then independently and robustlyconfirmed by the Harvard / NIH / FDA collaborativeeffort headed by Dr.'s Lo and Alter in 2010.The family of viruses consists of multiple closelyrelated viral mutations, which is typical ofretroviruses. In studies, approximately 80-90%(perhaps more) of people with CFS have XMRV andclosely related viruses, compared to 4-7% ofcontrols.The strength of this association has led to thehypothesis that XMRV causes

CFS.However, it is more complicated than that. Inunpublished studies from Dr. Cheney andGordon Medical patients, approximately 40-50% ofhealthy family members and close contacts of peoplewith CFS are infected with XMRV.XMRV alone may not be sufficient to cause CFS in allpeople, but it appears it may be a necessarycontributing factor, possibly in combination withanother undetected retrovirus, another infection, or agenetic susceptibility to XMRV.It is possible not everyone infected will developdisease in response to XMRV. In the case of HTLV,another human retrovirus, we see a similar pattern inthat only 10% of infected patients develop clinicalillness.Since the original CFS paper published in Sciencemagazine in 2009, several research teams havequestioned the research of Mikovits, Lo, and Alter,perhaps due to concern about the

consequences ofthe presence of XMRV in the nation's blood supply,and the high cost of screening our blood banks.A recent flurry of papers attempted todebunk the XMRV research using theissue of possible mouse DNA contamination.The contamination concerns are generallyvalid, but the research done by the groupfor the Science paper, and the later paperby Lo and Alter had already taken steps totest for such contamination issues.The contamination arguments, claiming the positiveresults are due to mouse DNA, cannot explain whypositive samples show an immune response toXMRV, or why XMRV can be cultured from samples.In addition, the samples were tested specifically formouse DNA, in order to ensure there would be nocontamination.The contamination papers are not relavant to themost important studies indicating the finding ofXMRV in Chronic Fatigue Syndrome, and

theexistence of XRMV still stands firm.As of December 2010, the American Red Cross andinternational blood banks began banning blooddonation from people with CFS. The government iscurrently working to develop a fast and accurate testfor XMRV in order to protect the blood supply.In unpublished research XMRV has been foundassociated with multiple other illnesses, includingchronic Lyme disease.It is associated with lymphoma, prostate cancer,inflammatory breast cancer, fibromyalgia, autism,Parkinson's, and Multiple Sclerosis, among otherinflammatory conditions.There is no proof yet that it is causative, but it isbeing found in higher numbers than would otherwisebe expected.``````XMRV TestingTesting for XMRV has not proven easy. The Lo/Alterpaper has shown there are many strains (mutations)of XMRV and

related MLV viruses (such as PMRV).Different strains of the virus can only be detectedusing the most sensitive PCR probes and underexacting conditions, often requiring culturing of theblood sample for several weeks to increase the viralnumbers to detectable levels.Testing is also complicated by the fact that XMRVcan be undetectable in the blood, but may be foundinstead in organs such as the spleen, lymph nodes,and others.Additionally, as in some other chronic infections, noteveryone who is infected with XMRV producesantibodies, so tests that rely on measuringantibodies can produce *false negative* results.Patients who are negative by PCR, may be positiveby culture or serology/antibody, and vice versa.Dr. Mikovits is currently working on a way to detectmore of the strains of the MLV viruses in the XMRVfamily, as well as faster and more sensitive tests

forboth antibody and DNA of the entire family ofretroviruses.Patients who have tested negative forXMRV should realize that it is stillpossible they are infected, but it wasnot possible to find the infection in thatsample on that day. Retesting on anotherday, or by another type of test, may givedifferent results.Samples from Gordon Medical patients whoparticipated in the XMRV study through WPI arebeing used to help in the development of these newtests.Dr. Mikovits is continuing to actively test anynegative samples to ensure that any infections arefound if evidence is present in the sample.When viral evidence is found, WPI is sequencing thegenetics to discover whether it is in this new familyof retroviruses.Dr. Mikovits stated that she expects to have a new,commercially viable test available by June of

2011.``````Treatment Possibilitiesfor the New HumanRetrovirusesAre there treatments for XMRV? Will theyhelp people with CFS, cancer, or otherillnesses?This is the hot topic that is still under investigation.Doctors at Gordon Medical, the Whittemore-Institute, and a handful of other centers across theworld are actively looking at possibilities.At the time of writing, we know of approximately 65CFS patients with XMRV who have tried variouscombinations of three anti-retroviral (ARV)medications originally designed for HIV: tenofovir,zidovudine and raltegravir.Each drug has been proven to inhibit XMRV viralreplication in in vitro (test tube) studies, and theyare synergistic when any two drugs are combined.Dr. ph Brewer is one of the primary cliniciansdoing trials with these medications. Dr. Brewer

andother CFS doctors report that after 6 months of use,approximately 20-30% of patients on ARV's havenoticed mild to moderate improvements.Though these medications help some people, theyare clearly not a complete solution for CFS andXMRV.There is still a lot to learn about what doses, whatcombinations, and what supportive therapies mightmake them more useful for more patients.Gordon Medical doctors, along withseveral other centers around the worldare now looking at working withimmunomodulating treatments such asGc-MAF, stem cells, Peptide T and othersthat boost immune system function againstviruses and cancers.Dr. Cheney is one of the pioneers of umbilicalcord stem cells in the treatment of CFS and XMRV.Based on 18 - 24 months of his experience with justover 30 patients, it is clear that stem cells producedramatic

improvements in most people under the ageof 36, moderate results in the 36 - 60 year age groupand mild improvements in those over 60 years ofage.Unfortunately, the good results are only temporary,lasting approximately 6 - 18 months before patientsregress partially or completely.Doctors at GMA are now investigating a technologyrelated to stem cells called Platelet Poor ParticleRich Plasma that has proven beneficial to severalhundred patients, some with conditions related toCFS, and will hopefully will have longer lastingeffects than umbilical cord stem cells.Another promising immune therapyis Gc-MAF (Gc protein-MacrophageActivating Factor).Gc-MAF activates macrophages, whichare immune system cells that areimportant in eliminating infection andcancer.Unfortunately, many cancers and viruses cause thesecretion of an enzyme called nagalase that

digestsnaturally occurring MAF in our bodies.Gc-MAF has a similar effect to that of our naturallyoccurring MAF, but Gc-MAF is not degraded bynagalase.Administration of Gc-MAF via intra-muscular injectionresults in the reactivation of previously suppressedmacrophages.Gc-MAF was first used by Dr. Yamamoto in thetreatment of HIV and cancer. Recently,approximately 80 XMRV positive CFS patients inBelgium and the U.S. have received Gc-MAF with verypromising initial results.Patients who are considering this therapy can betested for nagalase levels as well as vitamin Dreceptor mutations, which may influence the outcomeof Gc-MAF treatment.Dr. Mikovits warns that it may be importantto use an anti-viral strategy in addition toimmunologic treatments that couldpotentially activate a reservoir in the bodyto express more virus. In addition to

ARVpharmaceuticals, agents such as artesunate,nexavir and others have antiviral and anti-inflammatory properties that retard thegrowth of viruses.Other factors that studies show may inhibit XMRVreplication are restoring healthy glutathione levels,reducing oxidative stress, reducing inflammation, andnormalizing methylation.Few people realize that our body can naturallysilence viral infections, including retroviruses such asHIV and XMRV, through methylating viral DNA.Conversely, if viral DNA is not properly methylated,viruses will continue to reproduce and grow in ourbodies.We know that almost everyone withCFS has a methylation cycle abnormalitythat can be improved by taking methylationenhancing nutritional supplements.The study that proved this concept was co-written byGMA's very own Neil , MD. Most people withCFS have mild to moderate

improvement insymptoms when on methylating factors.Some very sensitive patients find that startingmethylation supplements can exacerbate symptoms,so as with all treatments, it is important to do thesein close consultation with your physician.Viruses replicate more quickly in environments ofoxidative stress and inflammation. They also growmore easily in low-glutathione environments.As an adaptive mechanism viruses actually causeoxidative stress, inflammation, and low glutathionelevels in our bodies that favors their survival.By replenishing glutathione levels and reducingoxidative stress and inflammation, we may inhibitviral growth.Many natural compounds haveanti-inflammatory properties. Onegroup of compounds that has provento inhibit both the herpes viruses andthe NF-kB inflammatory pathway isartesunate and related

artemisininderivatives.Dr. Mikovits and the doctors at Gordon Medicalbelieve it will be important to diagnose and treatco-infections in patients infected with XMRV, just asit is with HIV.In the Gordon Medical cohort so far approximatelyhalf of the patients who are positive for XMRV alsohave Lyme disease. Many also have EBV, HHV-6 andCMV, and other infections.Some patients who are diagnosed with *CFS*respond partially or completely after treating theLyme disease.Other patients experience benefits by taking valtrex,valcyte or other antiviral medications active againstherpes-viruses. Though valtrex and valcyte do notusually cure CFS, they can help people feel better byreducing the immune system load imparted by viralco-infections.Studies have shown that hormonessuch as cortisol, testosterone andestrogen can promote XMRV

replication.Each of these hormones performs critical functions inour body, so some amount is needed, but in excess,or out of balance, they may be harmful.Cortisol is produced in response to stress, andmost people with CFS are familiar with howstress impacts their symptoms.Estrogen, progesterone, testosteroneand DHEA are often low or out-of-balancein CFS. Some patients feel better onlow-level supplementation of thesehormones, but some worsen. It isimportant to pay close attention howone's body responds to hormonal shiftsin order to stay in balance.The good news is that with every passing year, ourunderstanding of CFS is getting better and better.Though CFS is still a challenging illness to treat,recently discovered treatments have resulted inmarked improvements in a growing percentage ofpatients with CFS, which represents a significantadvance

compared to years past.It is important to rememberthat each of the therapiesmentioned in this newsletterare experimental.There are no publishedclinical trials yet, only informalobservations made by groupsof astute doctors and patients.The practitioners and staff at GMA thank you for yourtime and interest.We will continue to collaboratewith the Whittemore- Institute and sharethe latest advances in CFS and XMRV research.We would also like to extend our appreciation andgratitude to the courageous patients dealing withCFS, XMRV, chronic Lyme disease and relatedillnesses who have maintained hope, raisedawareness and pushed us forward.Dr. AzRa MaEl, MDIf you have questions about XMRV, the lecture, orour studies, please contact: FriedlResearch CoordinatorGordon Medical Associatessusan@...707.396.5835