Zithromax long term benefits

[Guest guest]

Speaking of this theory, I believe they have shown that long term

zithromax use prevents heart disease due to a similar reasoning.

> > Immunology is a large and complicated area of medicine that

> > interrelates with many other areas. So it's not surprising that a

> > number of immune-mediate (where the immune system contributes to

> the

> > disease) and infectious (where the immune system helps fight an

> anti-

> > microbial invasion) disorders were brought up under the

immunology

> > umbrella. I think we're more likely to understand rosacea by

> > understanding immune-mediated activity rather than post-

infectious

> > conditions, but I'll tell you what I know about both in relation

to

> > local inflammation conditions like rosacea.

> >

> > Regarding immune-mediated, one type is autoimmune disorders.

> > Autoimmunity is an immune response directed against an antigen

> within

> > the body. It is similar to an allergy, which is also an immune

> > response, but in allergies the antigen is foreign to the body and

> an

> > allergy only involves part of the immune system, the T-cells or B-

> > cells. One common misunderstanding and a key point: naturally

> > occurring autoantibodies are common in all healthy people, so the

> > mere presence of certain autoantibodies does not mean the person

is

> > sick or has a disease. Even if a condition is diagnosed from

blood

> > tests, it doesn't establish a cause-and-effect relationship,

since

> > the autoantibodies may be the result, not the cause, of the

disease

> > process.

> >

> > I don't believe rosacea is an autoimmune disorder like some types

> of

> > thyroid disease, multiple sclerosis, or lupus but it seems to be

> > associated with other autoimmune disorders. The reason for the

> > association is not clear, but I think it's an important

association

> > because it brings rosacea into the large family of immune-

mediated

> > disorders.

> >

> > Again regarding immune-mediated disorders, a large number of

> > compounds in the body stimulate or inhibit immune reactions. One

> > important group, cytokines, are proteins that help cells

> communicate

> > with one another and also sometimes regulate the immune system. A

> > complex cytokine network is involved in normal immune function,

and

> > this network is comprised of positive and negative feedback loops

> > that enhance or suppress the immune (in this case, frequently

> > inflammatory) response. Many immune-mediated diseases (especially

> > connective tissue/rheumatic diseases) involve the abnormal

> regulation

> > of cytokines. Understanding how cytokines interact is a hot area

> for

> > reseach, and since they are often related to local inflammation

may

> > ultimately prove helpful to rosaceans.

> >

> > In particular, cytokines are in large part responsible for

> regulating

> > the production of groups of small molecule mediators of

> inflammation,

> > such as prostaglandins and leukotrienes. Understanding these

small

> > immune-mediator molecules and how they relate with cytokinesis is

> > also a very active area of research. For example, we already know

> > that manipulation of prostaglandins are loosely associated with

> > exacerbations and remissions in some people's rosacea; for

example,

> > it may be one of the mechanisms through which hormones affect

> rosacea

> > (although I would bet there are others).

> >

> > There are also interactions between the immune system and the

> > neuropeptides such as NO and CRPG and all the rest that play a

role

> > in vasodilation and pain perception. So there are ways to tie in

> the

> > vascular and pain components of rosacea, and research in those

> areas

> > may prove helpful as well.

> >

> > Someone brought up scleroderma, and the unfortunate death of

their

> > parent and concerns about having the condition themselves.

> > Scleroderma does show patterns of inheritance but in a very

> > complicated manner. Essentially, scleroderma is a multi-system

> > disorder involving immune activation, vascular damage, and

> excessive

> > synthesis of collagen. The cause of scleroderma seems to involve

> the

> > interplay between early immunological events and vascular

changes,

> > inducing a population of activated fibrogenic fibroblasts that

> > produce the characteristic skin and inner organ changes. It's

> > enticing to speculate whether there are similar immunologic

events

> in

> > rosacea, but they are certainly not the same vascular changes or

> skin

> > changes, and rosacea is not associated with inner organ changes,

so

> > it's not that close a fit.

> >

> > Raynaud's phenomenon is associated with scleroderma and other

> > connective tissue diseases, occlusive vascular disease, and some

> drug

> > effects, but as an isolated phenomenon Raynaud's is pretty

common,

> so

> > most people don't have associated disorders. Raynaud's is an

> > exaggerated vascular response to cold temperature or emotional

> stress

> > manifest clinically by sharply demarcated color changes of the

skin

> > of the digits, usually the fingers. As an isolated phenomenon,

the

> > cause is abnormal local vasoconstriction regulated by the

autonomic

> > nervous system -- so it's not immunologic-based. However, there

is

> an

> > immune-mediated connection in that some people with Raynauds have

> > specific autoantibodies, which may or may not be related to the

> kinds

> > of immune activities found in connective tissue diseases.

> >

> > All the above is pretty much distinct from the immune system's

> > involvement in combating infection disease. It's true that a post-

> > viral syndrome is often evoked to explain ongoing activity of

some

> > part of the immune system immediately after fighting off a virus,

> but

> > most of those syndromes are very cleanly defined and have classic

> > symptoms. That doesn't entirely rule out other post-viral

> conditions,

> > of course, but nowadays that's a grab-bag theory that can explain

> any

> > disease or disorder. So rosacea may be a post-viral syndrome,

but

> > from a practical perspective right now that doesn't help us

> > understand rosacea or anticipate a treatment plan. We need to

learn

> > more about post-viral syndromes in general before we can relate

it

> to

> > rosacea. Plus, the relationship may also be time coincidence, or

it

> > may have to do with some other aspect of the infection unrelated

to

> > the immune system.

> >

> > I don't know what " glandular fever " refers to. I assume ME refers

> to

> > myalgic encephalitis, which historically was thought to be what

> they

> > called chronic fatigue syndrome (CFS) in the early part of the

20th

> > century. There is evidence of immune differences in patients with

> CFS

> > compared to healthy controls, but the importance of these changes

> is

> > unclear. These observations raise the possibility that some cases

> of

> > CFS are associated with a chronic inflammatory process (rosacea

is

> a

> > chronic inflammatory condition), but the actual studies

supporting

> > this are very inconsistent, and even when present are relatively

> > mild. Intuitively, I don't think that mainstream rosacea fits in

> well

> > here.

> >

> > The NIH relates CFS and fibromyalgia, a common cause of chronic

> > musculoskeletal pain. Fibromyalgia is one of a group of soft

tissue

> > pain disorders that affect muscles and soft tissues such as

tendons

> > and ligaments. Importantly, neither fibromyalgia or CFS is

> associated

> > with tissue inflammation and the etiology of the pain and fatigue

> is

> > not thought to be immune-mediated. This is key: patients with

> > fibromyalgia and, in particular, those labeled to have chronic

> > fatigue syndrome, may be told or believe that their illness is

> caused

> > by an undiagnosed infection, but there's no direct evidence that

> > these syndromes are related to persistent infection or ongoing

> > immunologic abnormalities. Of course, these conditions may have

> begun

> > as a post-microbial syndrome. But I suspect the direct cause will

> be

> > found related to neurohormonal activity involving pain

perception,

> > fatigue, abnormal sleep, and depression, since many (alas, not

all)

> > respond to some form of therapy using tricyclic antidepressants

and

> > serotonin reuptake inhibitors.

> >

> > This is very, very confusing, heady stuff with an emphasis on

> > research as much or more than on clinical medicine, which

explains

> > why I didn't go into immunology. I don't know that I have

much

> > more to say about any of these.

> >

> > I am intrigued by the whisper of immune-mediated pathology in

> > rosacea. I'm going to educate myself on this more, and will share

> > with the group anything interesting I uncover. I hope others will

> do

> > the same.

> >

> > Marjorie

> >

> > Marjorie Lazoff, MD