Thank you jam for thinking of us and posting this information. That is very kind of you. Will have a look at the other site you mentioned. Sounds very interesting.

Patricia x

I would like to see more info on this topic. If anyone has anything to add I am interested. Where are the studies, if this has been used in europe for so long? Can’t find a lot on this!

@jaminhealth wrote:

I think we are permitted to mention docs, here, right?

Yes, other docs names can be used here, Jamin, but just not AP Physician or LLMD names.

I’ve been doing a little research on Peptide therapy for a while. I started researching peptides as it intrigued me that RAers can be anti-CCP positive. Anti-CCP is short for auto-antibodies created against “cyclic citrullinated protein (peptide).”

As Wikipedia explains,

http://en.wikipedia.org/wiki/Anti-citrullinated_protein_antibody

“During inflammation, arginine residues in proteins such as vimentin can be enzymatically converted into citrulline ones (a process called citrullination), and, if their shapes are significantly altered, the proteins may be seen as antigens by the immune system, thereby generating an immune response.[3]”

P.Gingivalis, causing oral infections and periodontal disease, leads to inflammation through a process of citrullination that breaks down bone structure surrounding teeth. Recent research seems to be indicating that bugs like P. Gingivalis that lead to citrullination are being found in joint tissues of RAers…hence, the local breakdown of collagenous and bone tissue in joints and the chemical changes caused by antigenic emissions from these bugs.

http://www.ncbi.nlm.nih.gov/pubmed/22347541

“Genetic factors are driving the host responses in both RA and periodontitis. Tumor necrosis factor-?, a proinflammatory cytokine, regulates a cascade of inflammatory events in both RA and periodontitis. Porphyromonas gingivalis is a common pathogen in periodontal infection. P. gingivalis has also been identified in synovial fluid. The specific abilities of P. gingivalis to citrullinate host peptides by proteolytic cleavage at Arg-X peptide bonds by arginine gingipains can induce autoimmune responses in RA through development of anticyclic citrullinated peptide antibodies.“

So, this led me on a hunt further into arginine, which is an amino acid. I had read that anyone with an AI disease should not supplement with arginine as this “feeds the bugs.” So, I found this correlation interesting…I know…my mind is kinda weird like that, heading off on bizarre tangents to try to connect dots. Nevertheless, following the dot on how this amino acid converts to citrulline and appears to the immune system as a foreign antigen, I wanted to know more about peptides, in general. I had heard about atineoplastin therapy (Burzynski) in the treatment of cancer, which are also peptides, and so the mystery was beginning to unfold further and I wanted to know if Burzynski’s peptide therapy may also work for AI diseases. I didn’t get much further on that tangent, but sure would enjoy a chat with this doctor.

http://www.burzynskiclinic.com/what-are-antineoplastons.html

“Dr. Burzynski first identified naturally occurring peptides in the human body that control cancer growth. He observed that cancer patients typically had deficiency of certain peptides in their blood as compared to healthy individuals. According to Dr. Burzynski, Antineoplastons are components of a biochemical defense system that controls cancer without destroying normal cells.

Chemically, the Antineoplastons include peptides, amino acid derivatives and organic acids. They occur naturally in blood and urine and they are reproduced synthetically for medicinal use. The name of Antineoplastons comes from their functions in controlling neoplastic, or cancerous, cells (anti-neoplastic cells agents).”

Hmmm….so this little research trip I was on was getting curiouser and curiouser. On closer examination, seems peptide therapy has been fairly successful in mouse models and in various human trials for AI patients (for the past decade or so):

http://www.ohsu.edu/nod/documents/2007/04-04/Vandenbark%20et%20al%20%282001%29.pdf

http://www.ncbi.nlm.nih.gov/pubmed/10955324

This research was included in a past RBF eBulletin:

http://www.rctherapy.net/treatments-for-rheumatoid-arthritis/

So, why isn’t this therapy being investigated like crazy by pharmaceuticals??? Well, my guess is that they can’t profit due to patent ownership (unless they buy out the researcher) and, even if they do buy patents for these, it’s possible the research would be halted as it is not as profitable as some of the current blockbuster meds, like the biologics, which cost in the range of $10000 to 12000 per annum per patient. Additionally, if peptide therapy replaced the need for other arthritis drugs, like DMARDs and pain relievers, this could crash the industry. Arthritis and cancer drugs are multi-billion dollar profit industries. So, as of now, doctors, like Dr. Dakos, are using peptide therapy in-office, experimentally, and this is likely to remain an out-of-pocket expense for the time being. To date, this therapy hasn’t been approved for general use and isn’t covered by insurance. From what I can gather, monthly shots are approximately $300 and these need to be continued indefinitely. They seem to be palliative, but it’s not clear if they are a “cure” in the longer term nor if they would be needed for life. In the case of Burzynski’s atineoplastins, cancers have returned upon discontinuation of therapy, but are quickly reversed again when therapy is reinstated. Heck – who cares, if it works to relieve pain and suffering safely…whatever it takes, eh?

The larger question for me is that while peptide therapy may be palliative and regulate immune function (so it’s better able to target bugs without over-reacting to antigen), the bugs are still present until the immune system is able to mop them up on its own. So, if I were personally to try peptide therapy, I would not be dropping my abx therapy in order to do so (bugs still there and doing their dirty work), but would greatly enjoy killing one bird with two stones, so to speak. Just my rambling two cents, though. 😉

Wow Maz ! You really covered all the bases with your research…Kind of “broad spectrum” yourself huh? I am intrigued with this peptide therapy and you have definately provided a great insight into it. Many many thanks to you and to Jamin for the post. I want to seriously consider this … Looking for the name of the central fl doc who offers this… I will probably email the doc in Ft. Myers and ask around. I plan to keep this on my immediate watch list for now.

Thank you both …..Suzy

@Suzy wrote:

Wow Maz ! You really covered all the bases with your research…Kind of “broad spectrum” yourself huh? I am intrigued with this peptide therapy and you have definately provided a great insight into it. Many many thanks to you and to Jamin for the post. I want to seriously consider this … Looking for the name of the central fl doc who offers this… I will probably email the doc in Ft. Myers and ask around. I plan to keep this on my immediate watch list for now.

Thank you both …..Suzy

Hi Suzy,

Another word for “broad spectrum” might be “quite mad!” I sometimes get these OCD impulses to research something that piques my interest and usually that I don’t yet understand (I think you’d understand this as you love research, too, and come up with some amazing hits). Sometimes it leads somewhere and sometimes not. I just don’t have the chemistry background to ‘get’ all the terminology. I just couldn’t believe it, though, when it seemed so clear that P. Gingivalis has now been documented to cause citrullination, repeatedly in numerous studies, had even been found in RA joints, and yet “they” are still calling RA idiopathic. Not forgetting that if one infection can cause citrullination, then why not others? We know spirochetal infections break down cartilage(oral, HP, Lyme and syhilis), as well as other infections, like strep that can torment rheumatic fever patients and protozoans that love collagen-rich tissue. Anyone can follow the dots backwards and go back to square 1 to see how P. Gingivalis breaks down teeth, invades gums and roots and can destroy surrounding bone with inflammation to see, on a larger scale, how this infection may travel to other parts of the body via the blood stream (not forgetting the heart) to wreak its dirty work elsewhere. I think I’m just so perplexed as to why this is so difficult for conventional medicine to grasp.

And, why don’t some RAers have the anti-CCP marker? Do they have some other joint destructive process going on that just hasn’t been identified yet? Is this test just not sensitive enough to capture this in the blood of some rheumatics? Is some “walling off” process occurring, as Brown described? Or, is it some other type of infection that uses different pathways? So many questions.

No doubt peptide therapy is interfering with this process of citrullination and will be a wonderful substitute for damaging DMARDs and pain meds, if it works for all arthritics, but is it a “cure?” My guess is that RAers are lacking some “blocking” component/enzyme/peptide as the article above states and that while the offending infection is still present, the problem will recur when the injected peptide is metabolized over time. That’s okay if insurance approved this therapy, but if shots were needed over a lifetime, this could be an expensive business, out of pocket. Brown was a pretty smart cookie. His goal was to lower the pathogen load to gradually re-train immunity to function normally on its own again. So, I think treating the bugs while also blocking citrullination from occurring could be powerful medicine if used together. Playing devil’s advocate here, but the bottom line may well be that peptide therapy is palliative, but while the offending infection(s) persist, the RA will never really just go away.

Peptide therapy is a relatively new therapy and no long-term studies have been run. No one yet knows the long-term outcomes …there are no immediately obvious side-effects, but there is also no info on what may occur down the road. Amino acids are vital to human body functioning in countless ways, but this doesn’t necessarily mean other bodily functions may not be off-set by the treatment in a sort of domino effect. This is not to be a Debbie-downer, as I think this research is pretty exciting, too. Just mentioning this, because the therapy is still in the realm of the “experimental” and, as all self-advocating rheumatics have learned to accept and to become critical thinkers, short-term benefits may well come with long-term risks. 😉 What that risk/benefit may be is still in the realm of the unknown.

If you try it, Suzy, be sure to let us know how you go!