The Autoimmune Epidemic: Bodies Gone Haywire in a World Out of Balance--and the Cutting-Edge Science that Promises Hope (No Series) (40 page)

In the years between 1985 and 1995:
Kilburn KH, Warshaw RH. Prevalence of symptoms of systemic lupus erythematosus (SLE) and of fluorescent antinuclear antibodies associated with chronic exposure to trichloroethylene and other chemicals in well water. Environ Res 1992 Feb;57(1):1–9. Adyel FZ et al. Characterization of autoantibody activities in sera anti-DNA antibody and circulating immune complexes from 12 systemic lupus erythematosus patients. J Clin Lab Anal 1996;10(6):451–7. Silman AJ, Jones S. What is the contribution of occupational environmental factors to the occurrence of scleroderma in men? Ann Rheum Dis 1992 Dec;51(12):1322–4. Bovenzi M et al. Scleroderma and occupational exposure. Scand J Work Environ Health 1995 Aug;21(4):289–92.

as we have seen in the previous chapter, the science demonstrating:
Yurino H et al. Endocrine disruptors (environmental estrogens) enhance autoantibody production by B1 cells. Toxicol Science 2004 Sep;81(1):139–47. Epub 2004 May 27. Schoenroth L et al. Autoantibodies and levels of polychlorinated biphenyls in persons living near a hazardous waste treatment facility. J Investig Med 2004 Apr;52(3):170–6.

the area cannot be artificially constructed:
Mayes MD. Scleroderma epidemiology. Rheum Dis Clin North Am 2003 May;29(2):239–54.

This information is available to all:
See http://seer.cancer.gov—or, specifically, a document called the “Cancer Statistics Review” at http://seer.cancer.gov/csr/1975_2004 (accessed July 18, 2007). For local and regional state cancer profiles, see http://statecancerprofiles.cancer.gov (accessed July 18, 2007)

The Toxic Waste/Lupus Coalition approached Joseph Gardella:
More information is available about Gardella’s work in Gardella J et al. Linking community service, learning and environmental analytical chemistry. Anal Chem 2007;Feb79(3):811–18.

According to the Lupus Foundation of America:
http://www.lupus.org/education/stats.html (accessed May 18, 2007).

one 2004 study conducted in the city of Buffalo:
Rey J. Watchdog group accuses state of environmental racism. Buffalo News, 2004 Mar 12;B22. The study “Environmental Racism in New York State” was conducted by the Citizens Environmental Coalition, a statewide environmental watchdog organization.

Elsewhere in the United States and around the world:
Kilburn KH, Warshow RH. Prevalence of symptoms of systemic lupus erythematosus (SLE) and of fluorescent antinuclear antibodies associated with chronic exposure to trichloroethylene and other chemicals in well water. Environ Res 1992 Feb;57(1):1–9.

Further investigation found that these MS patients’:
Agency for Toxic Substances and Disease Registry. Public comment draft final report, El Paso multiple sclerosis cluster investigation. Available from http:// www.atsdr.cdc.gov/elpaso/pubcom.html (accessed May 18, 2007).

Seven other heavy-metal-based clusters of MS:
Ibid. See section titled “Environmental Exposures and Multiple Sclerosis.”

A combination of chemical exposures:
Ibid. Also see http://www.rideforlife.com/news/als_research/feds_to_study_possible_als_and_ms_cluster_in_illinois.html (accessed May 18, 2007). Also see http://www.mult-sclerosis.org/news/Nov2002/MSClusterinFultonCounty.html (accessed May 18, 2007).

Likewise, a heightened incidence of lupus:
Kardestuncer T, Frumkin H. Systemic lupus erythematosus in relation to environmental pollution: an investigation in an African-American community in North Georgia. Arch Environ Health 1997 Mar–Apr;52(2):85–90.

Although genetics in the closely related Choctaw population:
Arnett FC et al. Increased prevalence of systemic sclerosis in a Native American tribe in Oklahoma. Association with an Amerindian HLA haplotype. Arthritis Rheum 1996 Aug;39(8):1362–70. Mayes MD. Scleroderma epidemiology. Rheum Dis Clin North Am 2003 May;29(2):239–54.

Other high rates of scleroderma:
Thompson AE, Pope JE. Increased prevalence of scleroderma in southwestern Ontario: A cluster analysis. J Rheumatol 2002 Sep;29(9):1867–73.

of a small rural area in the province of Rome, Italy:
Valesini G et al. Geographical clustering of scleroderma in a rural area in the province of Rome. Clin Exp Rheumatol 1993 Jan–Feb;11(1):41–7.

In the south of Boston:
http://www.sclero.org/medical/research/causes/clusters/south-boston.html and http://www.thebostonchannel.com/print/3999742/detail.html (both accessed May 18, 2007).

Blood serum levels of PCBs:
For more on this see http://www.atsdr.cdc.gov/HS/anniston-final-report.html (accessed July 18, 2007).

The CDC considers a blood PCB level:
http://www.atsdr.cdc.gov/hac/pha/solvtia/sol_p2.html (accessed August 2, 2007).

And in Libby, Montana:
American Autoimmune Related Diseases Association. New study linking asbestos to autoimmunity is preliminary, but promising, says American Autoimmune Related Diseases Association.” Press release, 2005 January 10. Available from http://www.aarda.org/press_release_display.php?ID=26 (accessed May 21, 2007).

the Environmental Protection Agency’s EnviroMapper:
http://www.epa.gov/enviro/emef (accessed May 18, 2007).

Just take a peek at one small community:
http://oaspub.epa.gov/enviro/ef_home3.top_display_zip?p_zipcode=37055 (accessed January 31, 2006, using zip code 37055). Also see Herbert B. Poisoned on Eno Road. New York Times, 2006 Oct 2. Available from http://peaceandjustice.org/article.php?story=20061002104142504&mode=print (accessed May 22, 2007).

In another 2002 assessment, ATSDR:
http://www.atsdr.cdc.gov/annual-reports/2002/2002annualreport.html (accessed May 22, 2007).

The Environmental Protection Agency does not release projections:
Shogren, E. Lawmakers band together to challenge EPA. Morning Edition, National Public Radio, broadcast 2006 Sep 18. Available from http://www.npr.org/templates/story/story.php?storyId=6095913 (accessed September 19, 2006).

CHAPTER FOUR: A POTENT PACKAGE

Since 1997, Harley and James have published:
Harley JB et al. An altered immune response to Epstein-Barr nuclear antigen 1 in pediatric systemic lupus erythematosus. Arthritis Rheum 2006 Jan;54(1): 360–8. Harley JB et al. Epstein-Barr virus and molecular mimicry in systemic lupus erythematosus. Autoimmunity 2006 Feb;39(1)63–70.

One recent study supporting the link between Epstein-Barr:
Parks CG et al. Association of Epstein-Barr virus with systemic lupus erythematosus: Effect modification by race, age, and cytotoxic T lymphocyte-associated antigen 4 genotype. Arthritis Rheum 2005 Apr;52(4):1148–59.

Researchers concluded that mounting evidence:
DeLorenze GN et al. Epstein-Barr virus and multiple sclerosis: Evidence of association from a prospective study with long-term follow-up. Arch Neurol 2006 Jun;63(6):839–44. Epub 2006 Apr 10.

Likewise, National Institutes of Health researchers:
Lunemann JD et al. Increased frequency and broadened specificity of latent EBV nuclear antigen-1-specific T cells in multiple sclerosis. Brain 2006 Jun;129(Pt 6):1493–506. Epub 2006 Mar 28.

One particularly provocative study out of the Hospital for Sick Children:
Alotaibi S et al. Epstein-Barr virus in pediatric multiple sclerosis. JAMA 2004 Apr 21;291(15):1875–9.

Scientists can now show the precise process:
Ellis NM et al. T cell mimicry and epitope specificity of cross-reactive T cell clones from rheumatic heart disease. Immunol 2005 Oct 15;175(8):5448–56. Fae KC et al. How an autoimmune reaction triggered by molecular mimicry between streptococcal M protein and cardiac tissue proteins leads to heart lesions in rheumatic heart disease. Autoimmun 2005 Mar;24(2):101–9.

the relationship between the measles virus and multiple sclerosis:
Anlar B. Infection and multiple sclerosis. J Neurol Neurosurg Psychiatry 2003 May;74(5):692–3.

viral outbreaks of measles:
Sumelahti ML et al. Multiple sclerosis in Finland: Incidence trends and differences in relapsing remitting and primary progressive disease courses. J Neurol Neurosurg Psychiatry 2003 Jan;74(1):25–8.

enteroviral infection during pregnancy:
Hyoty H et al. A prospective study of the role of coxsackie B and other enterovirus infections in the pathogenesis of IDDM. Diabetes 1995 Jun;44(6):652–7. Dahlquist G et al. Maternal enteroviral infection during pregnancy as a risk factor for childhood IDDM: A population-based case-control study. Diabetes 1995 Apr;44(4):408–13. Dahlquist G et al. Indications that maternal coxsackie B virus infection during pregnancy is a risk factor for childhood-onset IDDM. Diabetologia 1995 Nov;38(11):1371–3.

Other studies tie mumps infection:
Sultz HA et al. Is mumps virus an etiologic factor in juvenile diabetes mellitus? J Pediatr 1975 Apr;86(4):654–6. Prince GA et al. Infection of human pancreatic beta cell cultures with mumps virus. Nature 1978 Jan 12;271(5641):158–61. Sinaniotis CA et al. Letter: Diabetes mellitus after mumps vaccination. Arch Dis Child 1975 Sep;50(9):749–50.

Even some psychiatric conditions:
O’Connor S et al. Infectious etiologies of chronic diseases: Focus on women. Emerg Infect Dis 2004 Nov;10(11):2028–9.

And scientists are now finding tentative links between viral infections and obesity:
Henig RM. Microbesity? Biology researchers are looking beyond diet and genes—to intestinal microbes, viruses and other bugs—in a quest to understand more clearly what makes so many of us so fat. New York Times Magazine, 2006 Aug 13;28.

These new potential plagues:
Cunningham AA. A walk on the wild side—emerging wildlife diseases. BMJ 2005 Nov 26;331(7527): 1214–15.

That’s how researchers came to understand that “cold” viruses:
Interview with DeLisa Fairweather, PhD, assistant professor at the Bloomberg School of Public Health’s Department of Environmental Health Sciences Division of Toxicology, via e-mail correspondence, October 16, 2006.

Whether those with a predisposition to autoimmunity:
Brown D. Scientists race to head off lethal potential of avian flu. Washington Post, 2005 Aug 23;A1. Chase M. Avian-flu death rate may be tied to overkill by immune systems. Wall Street Journal, 2005 Dec 16;B1.

Initially, nearly 1 million Americans were vaccinated:
Laitin EA, Pelletier EM. The influenza A/New Jersey (swine flu) vaccine and Guillain-Barré syndrome: The arguments for a causal association. Harvard School of Public Health, Drugs and Devices Information Line. Available from http://www.hsph.harvard.edu/Organizations/DDIL/swineflu.html (accessed May 22, 2007).

Later calculations showed:
Ibid.

Epidemiologists wondered if the cause:
Not all scientists today agree that autoimmunity is triggered by molecular mimicry. DeLisa Fairweather, PhD, assistant professor at the Bloomberg School of Public Health’s Department of Environmental Health Sciences Division of Toxicology, for example, believes that what may have happened in the swine flu and GBS epidemic is slightly different and the result of “the adjuvant effect” rather than molecular mimicry. According to Fairweather, all animal models of autoimmune disease that are not induced by genetic mutations are induced by inoculation of mice with self-peptides (like myelin from the myelin sheaths) along with adjuvant, or peptides from a bacteria or virus. This same sort of adjuvant may have been in the swine-flu vaccine. Thus, the innate immune response takes the self-information (a string of amino acids, or peptides, from the myelin) and foreign information (a string of amino acids, or peptides, from the virus) and interprets it as if there were an actual infection in the myelin sheaths of the nervous system. So it launches an antibody and immune-cell response to clear the infection and sends out autoantibodies against the myelin. Because there is no actual infection or damage caused by infection to the nerves, this response actually causes damage in genetically susceptible individuals, causing the damage to myelin and Guillain-Barré syndrome. Fairweather believes that this is how autoimmunity is initiated—a slightly different theory from molecular mimicry. She believes that autoimmune disease develops because both the self and foreign peptides are presented to the immune system at the same time. But exactly how this occurs in patients remains a mystery.

People developed Guillain-Barré:
Lasky T et al. The Guillain-Barré syndrome and the 1992–1993 and 1993–1994 influenza vaccines. N Engl J Med 1998 Dec 17;339(25):1797–802.

In 1994, the
Journal of the American Medical Association: Stratton KR et al. Adverse events associated with childhood vaccines other than pertussis and rubella. Summary of a report from the Institute of Medicine. JAMA 1994 May 25;271(20):1602–5.

Similarly, a correlation has been reported:
Herroelen L et al. Central-nervous-system demyelination after immunisation with recombinant hepatitis B vaccine. Lancet 1991 Nov 9;338(8776):1174–5. Nadler JP. Multiple sclerosis and hepatitis B vaccination. Clin Infect Dis 1993 Nov;17(5):928–9.