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The Modern Patient and Chronic Disease
Apologia
- "The advantages which have been derived from the caution with which hypothetical statements are admitted, are in no instance more obvious than in those sciences which more particularly belong to the healing art. It therefore is necessary, that some conciliatory explanation should be offered for the present publication: in which, it is acknowledged, that mere conjecture takes the place of experiment; and, that analogy is the substitute for anatomical examination, the only sure foundation for pathological knowledge.
- When, however, the nature of the subject, and the circumstances under which it has been here taken up, are considered, it is hoped that the offering of the following pages to the attention of the medical public, will not be severely censured."
- James Parkinson - 1817
Introduction
:First a word of warning. Nothing on this site should be taken as medical advice. This site is the labor of a patient and, regardless of the language used, must be looked at as a beginning point for one's own education, not as an endpoint for one's treatment. Parkinson's Disease is an incredibly complex condition and no one has the answers. Yet.
- While this section of the website resembles the popular site Wikipedia, it needs emphasizing that the resemblance is due entirely to the use of a common software platform, MediaWiki.
- Wikipedia seeks to present a collection of facts. We seek to present not only facts but also a more amorphus entity - conjecture and hypothesis. The structure which lies below the surface consists of the peer reviewed, published works of others with a minimum of commentary. This section is intended to be a reference and relies almost entirely on the PubMed database of abstracts.
- Its purpose is to serve as a "starter" for discussion by providing arguments and citations that will challenge many of you to look at PD in a different manner that is more in keeping with the data. By doing so, we hope to move forward along the road to a cure.
- The material has been arranged to support and illustrate the view of Parkinson's Disease (PD) as a complex, multi-system process. The intent is to support each area only to the extent needed to justify its inclusion here. As such, the individual studies are illustrative, but are not intended to be definitive. We leave it to those more knowledgeable than ourselves to strengthen or weaken the links in the chain.
- Nor is seniority of discovery taken into account. We apologize for this last point in particular, and urge you to correct and enhance as appropriate.
- While we seek to present a more comprehensive view of PD than hitherto assembled in one place, it should be understood that the various factors outlined here are not necessarily expected to be present in all cases. There is, however, enough evidence to posit a link to PD in each instance.
- Your participation is welcomed and may take several forms. First, you may visit the discussion forum by means of the Navigation Bar at left. Second, once you create an account and log in, you may join topic-specific discussion pages where ever they are found or start one where needed. Third, if you have original work that you would like to see published, we would be happy to review it and propose an appropriate location. And fourth, if you want to make a stronger contribution and even help run the project, let us know and we can upgrade your access.
Nature and Nurture - The Laying of the Fire
Genetics and Epigenetics
Preconception - The Past as the Future
The Prenatal / Neonatal Environment
- Both maternal stress hormones and maternal infections, encountered at the proper time, will alter the fetus and the future adult. Those changes result in PD-like symptoms.
Causal Factors - Striking the Match
Bacterial Endotoxins and the Immune System
- Maternal infections can result in hypersensitivity in the adult who encounters similar infection. This leads to an ongoing destruction of neurons by activated microglia, the brain's innate defenders. Their population density is particularly high in the substantia nigra.
Acute Trauma, Chronic Stress, and the Endocrine System
Constipation, Inflammation, and the GI System
Degenerative Processes - The Slow Fire Burns
Neuroinflammation and Microglia
Stress and the Hypothalamus-Pituitary-Adrenal Axis
- The single largest failing of the current view of Parkinson's Disease is its lack of consideration of the role of stress in particular and the endocrine system in general. This is preposterous! It is also an example of the importance of a multi-disciplinary approach to PD beyond the artificial boundaries of neurology and the natural boundaries of the substantia nigra.
Endothelial Compromise
Mitochondrial Failure
Oxidation
Autoimmunity
Excitotoxicity
Misfolded Proteins
Environment - Adding Fuel to the Flame
Pesticides, Toxins, and Metals
Vaccines
Ultra Fine Pollutants
- Ultra Fine Particulates from sources such as coal and diesel combustion may play a roll in Braak's staging. They impact the body at the sinus and gastric boundaries; they are capable of penetrating the defenses there; they can ferry other molecules such as LPS with them; and they are small enough to be transported along the neurons.
Beyond Dopamine and Substantia Nigra - Peering Through the Smoke
System Interaction and Overlap
Cytokines, Hormones, and Neurotransmitters - Mixed Messengers
Living With Parkinson's Disease - A Life in the Ashes
The Pace of Science - A Fool with his Hair on Fire?
Alternatives - Heading for the Exits
The Psychology of Medicine, Science, and Suffering
Potential Tools for Brain Repair
- They say that drowning men grasp at straws, as though that were a weakness. They have never been drowning.
- Medicine has limited offerings for the PWP. As a result, we are going to seek alternatives and anyone who condemns that action does not understand the drowning man. It should be kept in mind, too, that more than one doctor or scientist has responded to his own personal encounter with mortality by assuming the role of lab rat. He did so for one reason - hope. It is absurd to lecture upon the futility of the straw and to do so reflects the ignorance of the man standing upon the shore.
- What is needed, however, is information about where the largest straws may be found. To that end, we collect such information here. There are many things that show promise and need to be followed up. All members of the PD community may find something of benefit here.
- This is where there be dragons - the great unknown. Herbs and spices, strange rituals, what some would label the antithesis of modern science. This is where we keep the good stuff, the possibilities. Each entry is a possible cure, a potential Nobel Prize.
Hypotheses
Braak Staging
- PD seems to have a "fingerprint" in the form of the Lewy body. These small clumps of protein are considered confirmation of diagnosis in the post-mortem brain. But it has been found that they appear early in the course of the disease and trace a sequential route deep into the brain. They begin in the olfactory bulb and the myenteric plexus of the gastric wall. Both of these areas are in direct contact with the outer environment.
Gastrointestinal Factors
Sleep and Circadian Rhythms
System Timing and Neural Rhythms
Metabolic and Nutritional Factors
Neuropeptide Dysfunctions
Hypoxia
Cellular Disorders
Pathogens
Related Disorders
Electrolytic Dysfunction
Vagal Nerve
Neuromelanin, Alpha Synuclein, Lewy Bodies
PD's Place in History
It is reported again and again that Parkinson's Disease has existed for millenia. Purportedly, ancient texts ranging from the Vedas of the Indus Valley to the Old Testament describe PD. Later cultures of Greece and fifth century BC China are said to have mentioned it.
But a closer examination reveals a murkier picture. It is true that the Vedas may describe the condition and this is buttressed by a long tradition of treating PD in Ayurvedic medicine. And the Chinese of the era mentioned may well have been aware of it. But the Old Testament writings are so vague as to be useless.
With the ascension of Rome, a great silence fell upon the subject and was not broken until James Parkinson published his pamphlet in 1817. Even then there was little mention in the literature of the next sixty years until Charcot bestowed Parkinson's name to the condition. Another thirty years and the post-influenza epidemic of parkinsonism assured the condition a permanent place in the annals of medicine.
What are we to make of such a history? PD is very distinctive in presentation. And while the numbers vary from culture to culture, prevalence is higher than some more well known diseases. Why is there such a dearth of kings and popes struck down by this particular scourge. So few great artists and poets? Surely, somewhere a scribe recorded the struggles of some Great One?
Barely a peep is heard from history. PD may well have existed prior to 1817 but it was exceedingly rare. Enough so that an Englih physician thought it worth writing about. And enough so that the good doctor could offer only six cases, of which at least one was seen passing on the other side of the street and never again.
Parkinson's has been a mystery from the beginning. Rare to the point of almost non-existence but now all too common. Once a disease of the old, it claims younger and younger victims. Is there a clue in this odd history? If it was indeed known in the Indus Valley and pre-Christian China and London of 1817, is there a link?
We believe there is. It does not provide a definitive explanation but does offer a tantalizing clue. The ancient Indus Civilization had mastered the smelting of copper. The Chinese of 500 BC produced massive bronze work that still cause us to marvel. And James Parkinson was born at the beginning of the Industrial Revolution. All three required a technology that produced ultra-fine particles of air pollution. These tiny pieces of ash are not only capable of penetrating deep into the body, they are also capable of passing the defenses and entering the tissues themselves. Dwarfed by even the neuron, they penetrate deep into our mucosa - not just our lungs, but our sinus tissues into the olfactory bulb, our gastric wall into the myenteric plexus, and our intestines into the bloodstream. They are capable of moving other substances with them. Like tiny sponges, they can soak up toxins from the GI tract to carry along. Toxins such as not only those of our modern culture but also the more mundane, the ever-present bacterial endotoxins.
The slowed transit of constipation increases toxin load and inflammation increases permeability of the intestinal wall. The same permeability opens the blood brain barrier allowing entry. This triggers the innate immune system and damages the neurons it was meant to protect. The signals that would calm these warriors are lost from an endocrine system that approaches exhaustion.
Are the tiny, soot-like particles the thread linking these three cultures and PD? Again, the hypothesis may be right or it may be wrong. It is certainly a place to begin discussion.
