An infection can be described as an invasion of microorganisms in a bodily part or tissue that will subsequently worsen over time and eventually be recognized as a disease process such as an ear or sinus infection, or pneumonia, just to name a few. Remember, any part of the human being can be infected with some type of organism. These microorganisms can be:
There are other infective agents, but they are well beyond the scope of this discussion. Generally, it is up to our immune system, when normally functioning, to recognize these invading organisms and destroy them. Even under the best circumstances, our immune system may need a little help with a medication to kill some type of organism that just seems not to be “containable.”
In my clinic, many of the children that I see have an immune system that has been impaired one way or another. The results can be devastating for the overall health and well-being of the child. It is not unusual for me to see a patient that has been on 20 or more courses of antibiotics and no one has even thought to evaluate the child’s immune system to see what might be impaired. The immune system has two responses it has to make:
• recognize that a pathogen (potentially infectious agent) is present
• ensure its destruction.
Let’s see how blood work can help us understand how the child’s immune system is working (or not!).
LABORATORY WORK: Let’s start with what we can learn in the blood test:
Complete Blood Count: also known as a CBC with differential will allow the physician to see how many WHITE BLOOD CELLS the patient has. These very specific cells are tasked with defending the body from infectious agents. And like the military, they have different branches that perform very separate activities. Under the heading of White Blood cells, we find these main types:
• Neutrophils: primarily attack bacteria
• Lymphocytes: primarily attack viruses
• Monocytes: can rapidly move into infected tissue and start to engulf the infectious agent (as macrophages…it complicated!)
There are more, but you get the point.
Lymphocyte Subsets and Natural killer cell activity: This test helps the clinician to further discern where there may be problem with respect to the patient having recurrent infections.
Immunoglobulin profile: Immunoglobulins is abbreviated as “Ig.” There are 4 classes generally evaluated: IgG, IgA, IgM, and IgE (there is also IgD, but no one really knows what this class does just yet). Now we can count how many of each class is present in the blood stream, and have published ranges of what normal is and is not. So, specifically, we order: IgG total and subclass 1-4, IgA (rarely subclass 1,2) IgM, and IgE levels
Immunoglobulins, also known as antibodies, are proteins made by the immune system that will seek out and destroy bacteria, viruses, yeast and other infectious material ls. There are different classifications of these antibodies (IgG, IgA, IgM, and IgE) and each class has a specific function in the body. When one or more of these classes is not being produced in sufficient quantities, the likelihood of disease increases. Being “low” in any of these is called hypogammaglobulinemia.
Inflammatory markers: We can look for specific markers that indicate that an infection is present and ongoing. They do not tell us what kind of infection or even where the infection is, but merely point us in the right direction. They are not always elevated in an infection, but if they ARE elevated, we know something is really a problem in the body. The common markers are:
• Erythrocyte Sedimentation Rate: also know as ESR
• C-reactive Protein: known as CRP
• Platelet count: when elevated, also suggestive of on-going inflammation/infection
Specific Viral Markers: most viruses have a short life span in our body, such as colds. There are a few, however, that can actually stay for a long time…some will even stay forever! If these viruses continue to grow and operate in our body, they can cause a whole host of problems that include a cascade of chronic inflammation, dull thinking, loss of energy, body aches and pains, just to name a few symptoms. There are some physicians who feel the entire autism syndrome is entirely due to chronic infection by a virus! There is strong evidence this may be the case in many individuals. Common blood markers used to evaluate for chronic viral infection:
Antibody production (called titers) to:
• Cytomegalovirus (CMV)
• Epstein Barr Virus (EBV)
• Human Herpes virus 1,2, and 6
There is a concern that some individuals were susceptible to actual viral infection from a vaccine:
• Rubella (we can obtain blood titers)
• Measles (we can obtain blood titers, and actual tissue determination if this is an ongoing infection)
Specific Bacterial Markers: Chronic bacterial infections may also contribute to autistic behaviors. Common blood markers for bacteria include:
• H Pylori
• Antistreptolysin O
• Anti DNAse B
Gastrointestinal infections: These types of infections include those caused by bacteria, yeast and fungi. They are more easily identified in stool and urine testing (as opposed to blood testing).
Stool Studies: These lab tests should include a report on healthy bacteria, such as lactobacillus, as well as growth of harmful bacteria and presence of parasites and yeast. Many reports also include information on how well the bowel is digesting food and how well this digested food is absorbed into the body.
Urine Organic Acid Studies: These studies are very helpful in many different ways. They can alert the physician to abnormal growth of bacteria and yeast, as well as multiple metabolic pathway “corruptions.”
The immune system has a tremendous job. It protects the body from infections and disease (prevention). When it is not able to operate properly, an infection is likely going to occur. Once there is an infection, the immune system switches into a more aggressive role mainly to tag and destroy. When it can’t contain and eliminate the infection, disease occurs. In many of our children, they have an on-going disease process that is treatable with different modalities:
• Improve the immune systems’ response to infection
• Destroy the offending agent with medications such as antibiotics, antifungals, antivirals, etc.
• Remove agents that can compromise the immune system such as heavy metals, allergic exposures, and toxic exposures.
Our next specific topic: HOW TO IMPROVE IMMUNE SYSTEM FUNCTION.