I had a big genuine smile as I entered my immunologist's clinic for my first immunotherapy. My cowardice hid underneath my big smile. I was afraid of catching another autoimmune disease. I was afraid of triggering another round of inflammation: uveitis or spondylitis. My optimism and hope had overshadowed my fear. I was excited to have give immunotheraphy a try.
Is there room for trying? Whatever... I trust, believe and surrender. But, up to now, I have endless questions about immunology. Maybe it is not a 100% trust. But I choose to surrender. I choose to play the Simon Says Game.
Honestly, I am not so eager to know my crossmatch result. Of course, I wish to attain a 100% PRA and high reaction code of 8 - 8. Why am I not so eager to see my LAT-M result? Maybe up to now, I am not so enrolled with the PRA and LIT thing.
Grrrr.... Why did I choose to surrender to my immunologist? I will have donor screening again on Monday. I am praying my donors will not back out. There is still enthusiasm in playing the Simon Says Game. Hoping my third LIT will push through on Wednesday.
I hope next month is my last LIT. Let us see, if immunology is really a fiction? Or perhaps a placebo. How to explain placebo effect? LIT just give me the feeling that my 'immunologic side' is taken care of, but in fact it is useless. I just addicted to take "empty or sugar pills" and LIT believing it can alleviate my condition.
I hope immunology is not a fiction!
Saturday, August 16, 2014
Wednesday, August 13, 2014
T reg and LIT
LIT and T reg
http://www.ncbi.nlm.nih.gov/pubmed/18675967
T reg and B cell suppression
http://www.jimmunol.org/content/175/7/4180.long
T reg and immune tolerance
http://humupd.oxfordjournals.org/content/15/5/517.full
T cells - th1 , th2 and Treg paradigm study in pregnancy
http://onlinelibrary.wiley.com/store/10.1111/j.1600-0897.2010.00852.x/asset/j.1600-0897.2010.00852.x.pdf?v=1&t=hytce7ik&s=36c4dc55ffb1cf629765f97b33e30af8301017bd
LIT seems to be a one size fits all treatment.
- downregulate b cell
- downregulate th1/th2 ratio
- increase the PRA.
Silver bullet? Wait... What is the correlation between panel reactive antibody and immune tolerance? It seems they are unrelated. I wish to share my undying sentiment again... I don't believe I need high PRA to get pregnant. Some patients get pregnant even with zero PRA.
In my lousy immunology perspective, T reg downregulates B cells. B cells are responsible for producing the antibody against husband's HLA. No blocking antibody, no anti-blocking antibody. T reg also downregulates th1. Therefore, no antibody and t cells will attack the fetus.As long as I have normal count of T reg, I will not have autoimmune disorder and there will be no fetal rejection.
Why am I experiencing little pain my achilles tendon. Is it autoimmune attack again? Grrr... My t reg should take care of my autoimmune arthropathy. Ai... I will go to test my LAT-M IgG later. Anti-anti- HLA ^.^ What is the correlation of PRA to inflammation (caused by autoimmune disorder)? They are completely unrealated. I cannot explain why do I need LIT. I just choose to believe. I don't want to regret my stubborness to believe in the future.
I never heard LIT to be used as a cure for arthritis. Can LIT control inflammation caused by autoimmune disorder?Because LIT downregulates of Th1/Th2. Does LIT produce Treg? Wait... Treg sounds interesting if it can prevent autoimmune inflammation.
http://www.ncbi.nlm.nih.gov/pubmed/18675967
T reg and B cell suppression
http://www.jimmunol.org/content/175/7/4180.long
T reg and immune tolerance
http://humupd.oxfordjournals.org/content/15/5/517.full
T cells - th1 , th2 and Treg paradigm study in pregnancy
http://onlinelibrary.wiley.com/store/10.1111/j.1600-0897.2010.00852.x/asset/j.1600-0897.2010.00852.x.pdf?v=1&t=hytce7ik&s=36c4dc55ffb1cf629765f97b33e30af8301017bd
LIT seems to be a one size fits all treatment.
- downregulate b cell
- downregulate th1/th2 ratio
- increase the PRA.
Silver bullet? Wait... What is the correlation between panel reactive antibody and immune tolerance? It seems they are unrelated. I wish to share my undying sentiment again... I don't believe I need high PRA to get pregnant. Some patients get pregnant even with zero PRA.
In my lousy immunology perspective, T reg downregulates B cells. B cells are responsible for producing the antibody against husband's HLA. No blocking antibody, no anti-blocking antibody. T reg also downregulates th1. Therefore, no antibody and t cells will attack the fetus.As long as I have normal count of T reg, I will not have autoimmune disorder and there will be no fetal rejection.
Why am I experiencing little pain my achilles tendon. Is it autoimmune attack again? Grrr... My t reg should take care of my autoimmune arthropathy. Ai... I will go to test my LAT-M IgG later. Anti-anti- HLA ^.^ What is the correlation of PRA to inflammation (caused by autoimmune disorder)? They are completely unrealated. I cannot explain why do I need LIT. I just choose to believe. I don't want to regret my stubborness to believe in the future.
Immune tolerance- puzzled
Doctor said i have developed tolerance against my husband's lymphocyte. His conclusion was based on my induration size comparison.
How did my doctor program the immunologic tolerance? Is it by coincidence? Did my immune system become unresponsive to my husband's lymphocyte? Is this immune dysfunction, immune suppression or immune tolerance? If I had developed immune tolerance, then on my second LIT I should react to my husband's lymphocyte? Should I or should I not develop pustules from 'new' donor lymphocyte? What is the mechanism behind immune tolerance?
What is the definition of immune tolerance? Does immune tolerance mean immune suppresion? If I was exposed to tuberculosis bacteria for 6 months, my immune system will be programmed to tag tuberculosis bacteria as 'self' and will allow it to proliferate? Immune tolerance is scary in my crazy perspective. Btw, how does my immune system differentiate bacteria from foreign lymphocyte? What cells will attack bacteria? What cell will attack foreign lymphocytes? And most importantly, what cells will attack the fetus? Is mechanism behind foreign lymphocyte tolerance the same as the mechanism behind bacteria tolerance?
What is autoimmune disorder? My understanding about my autoimmune disorder is my T cells mistakenly tagged my eyes as 'foreign', then it attacked my eyes causing my eyes to get inflammed. I need immune tolerance so that my immune system will not attack my eyes.
Is autoimmune disease the cause of my infertility? Will I be at higher pregnancy risk compared to his other patients? I remember on my initial consultation with my immunologist he has mentioned Th1, Th2 and T reg. T regulatory cell is the police or immune supressor... Will check immunotherapy and T reg on my free time. How does lymphocyte immunization therapy work? Does LIT increases the T reg cells? I guess T reg cell and anti-idiotypic antibody are two difference entities.
Regulatory T cell and immune tolerance
How did my doctor program the immunologic tolerance? Is it by coincidence? Did my immune system become unresponsive to my husband's lymphocyte? Is this immune dysfunction, immune suppression or immune tolerance? If I had developed immune tolerance, then on my second LIT I should react to my husband's lymphocyte? Should I or should I not develop pustules from 'new' donor lymphocyte? What is the mechanism behind immune tolerance?
What is the definition of immune tolerance? Does immune tolerance mean immune suppresion? If I was exposed to tuberculosis bacteria for 6 months, my immune system will be programmed to tag tuberculosis bacteria as 'self' and will allow it to proliferate? Immune tolerance is scary in my crazy perspective. Btw, how does my immune system differentiate bacteria from foreign lymphocyte? What cells will attack bacteria? What cell will attack foreign lymphocytes? And most importantly, what cells will attack the fetus? Is mechanism behind foreign lymphocyte tolerance the same as the mechanism behind bacteria tolerance?
What is autoimmune disorder? My understanding about my autoimmune disorder is my T cells mistakenly tagged my eyes as 'foreign', then it attacked my eyes causing my eyes to get inflammed. I need immune tolerance so that my immune system will not attack my eyes.
Is autoimmune disease the cause of my infertility? Will I be at higher pregnancy risk compared to his other patients? I remember on my initial consultation with my immunologist he has mentioned Th1, Th2 and T reg. T regulatory cell is the police or immune supressor... Will check immunotherapy and T reg on my free time. How does lymphocyte immunization therapy work? Does LIT increases the T reg cells? I guess T reg cell and anti-idiotypic antibody are two difference entities.
Regulatory T cell and immune tolerance
Sunday, August 10, 2014
Methylcobalamin vs cyanocobalamin
My homocysteine is on the high side. I am at risk of heart attack. For this, my doctor prescribed methylcobalamin and folic acid.
I got curious this evening when I saw the cheap vitamin B - complex sold in supermarkets. Cyanocobalamin - vitamin B12. So what is the difference between cyanocobalamin and methycobalamin? Aren't they both vitamin B12? Hey, what is the prefix cyano mean? Scarry...
I found out that not all vitamins are created equal. cyanocobalamin-versus-methylcobalamin?blog=27 Cyanocobalamin vs methylcobalamin.
What about calcitriol vs vitamin d?
Who cares about PRA (panel reactive antibody)?
In my IVF inquiry, the doctor said there is no need for me to do LIT because I never had miscarriage. Many obgynes don't believe in immunology either. The question is: should I believe or not to believe in immunology as my primary cause of infertility?
Who cares about PRA? I thought I have conceded to immunology. But... Ai... Anyway, I just post my side comments and questions here.
There are studies to support that women with recurrent pregnancy loss and / or recurrent spontaneous abortion often has 0 to <50% PRA. This is one side of the coin. Most of the studies are focused on this side. But, what about the other side of the coin? I guess nobody will care to finance testing the PRA of normal population say 10000 people. Who knows... half of the normal population has 0 to <50% PRA. To me, this MAYBE a biased fact.
Immunotherapy maybe just a placebo. But, It doesn't matter. I am not yet bored playing the Simon Says Game. Simon Says give me a high PRA score next week.
Who cares about PRA? I thought I have conceded to immunology. But... Ai... Anyway, I just post my side comments and questions here.
There are studies to support that women with recurrent pregnancy loss and / or recurrent spontaneous abortion often has 0 to <50% PRA. This is one side of the coin. Most of the studies are focused on this side. But, what about the other side of the coin? I guess nobody will care to finance testing the PRA of normal population say 10000 people. Who knows... half of the normal population has 0 to <50% PRA. To me, this MAYBE a biased fact.
Immunotherapy maybe just a placebo. But, It doesn't matter. I am not yet bored playing the Simon Says Game. Simon Says give me a high PRA score next week.
Thursday, August 7, 2014
Fate and choice
I don't play a blaming game here. I put all my trust, I believe and I surrender to Obgyne1. But, there was no positive result the first 10 months of my trying to conceive. Maybe timing was also a factor.
I will ran away from her clinic if on day1, she tells me that my autoimmune disorder is the culprit for my infertility. Because, I have not tried anything yet then. It was funny and sarcastic that I have eventually seek second opinion from my obgyne1. It is like a homecoming. Is it fate that lead us to cross each others path again?
And after shopping around for 4 doctors (1 obgyne, 3 immunologist). I feel it is not comfortable to fully trust, believe and surrender. Same medical books, same medical but different school of thoughts. I am trapped in between. Why did I go back to Obgyne1? Is it a coincidence? For sure, it is my choice! Is Fairy Godmother my fate or my fairy godmother for my fairytale pregnancy?
At first, I don't like my current immunologist. His NK cell scare and his deduction style. As time goes by, I feel my immunologist is not bad. But, his first impression lasts. Ai... on our last consultation he said because my NK cells are active. Grr... I easily catch colds and cough. I always forget to mention this to him. I don't know why I am so sensitive to NK cells. I hate to hear my NK cell is very active. My NK cell has no killing power.
I always forget to ask the C3 and C4. Does C3 and C4 has something to do with NK cell? I am not complaining about my immunologist. Btw, what is my immunologist a fate or a choice? A choice perhaps. Yes, I surrender to Simon.
I will ran away from her clinic if on day1, she tells me that my autoimmune disorder is the culprit for my infertility. Because, I have not tried anything yet then. It was funny and sarcastic that I have eventually seek second opinion from my obgyne1. It is like a homecoming. Is it fate that lead us to cross each others path again?
And after shopping around for 4 doctors (1 obgyne, 3 immunologist). I feel it is not comfortable to fully trust, believe and surrender. Same medical books, same medical but different school of thoughts. I am trapped in between. Why did I go back to Obgyne1? Is it a coincidence? For sure, it is my choice! Is Fairy Godmother my fate or my fairy godmother for my fairytale pregnancy?
At first, I don't like my current immunologist. His NK cell scare and his deduction style. As time goes by, I feel my immunologist is not bad. But, his first impression lasts. Ai... on our last consultation he said because my NK cells are active. Grr... I easily catch colds and cough. I always forget to mention this to him. I don't know why I am so sensitive to NK cells. I hate to hear my NK cell is very active. My NK cell has no killing power.
I always forget to ask the C3 and C4. Does C3 and C4 has something to do with NK cell? I am not complaining about my immunologist. Btw, what is my immunologist a fate or a choice? A choice perhaps. Yes, I surrender to Simon.
Tuesday, August 5, 2014
I wish Simon is a good guy
Hopefully, I can decode the HLA, anti-HLA and anti-anti-HLA in few more months. I need to create as many anti-anti-HLA (the precise medical term is anti-idiotypic antibody) as I can. Btw, what is the root word of idiotypic antibody? Is it "idiot"? Maybe! My T cells and B cells are acting like idiot. Asking too many questions, don't make me feel like an idiot. Haha, I never dared to ask about my wicked Th1/Th2 theory yet. Where is my immunologist?
Let me try again to decipher the anti-anti-HLA antibody.
Anti- HLA antibody = antibody against HLA. and Anti-Anti-HLA antibody= antibody against anti-HLA antibody. Therefore, anti-anti-HLA antibody mimics that of HLA.This reminds me of my unsolved puzzle during my high school days. Why is -1x-1=+1?
This is a principle of double negation.
NOT boy= girl. NOT girl= boy. Not (Not Boy)= NOT girl= boy
Anti-anti-hla-antibody= antibody against (anti-HLA antibody)= antibody against (antibody against HLA)= HLA.
Simon says raise you hands... Simon says bring me a cup of water. Simon says have LIT and you will be rewarded with children. ^.^ I wish Simon is an intelligent and good guy!
Let me try again to decipher the anti-anti-HLA antibody.
Anti- HLA antibody = antibody against HLA. and Anti-Anti-HLA antibody= antibody against anti-HLA antibody. Therefore, anti-anti-HLA antibody mimics that of HLA.This reminds me of my unsolved puzzle during my high school days. Why is -1x-1=+1?
This is a principle of double negation.
NOT boy= girl. NOT girl= boy. Not (Not Boy)= NOT girl= boy
Anti-anti-hla-antibody= antibody against (anti-HLA antibody)= antibody against (antibody against HLA)= HLA.
Simon says raise you hands... Simon says bring me a cup of water. Simon says have LIT and you will be rewarded with children. ^.^ I wish Simon is an intelligent and good guy!
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