Report of tainted curcumin…

February 8, 2008 / / 19 Comments

Yesterday I read a Google Alert concerning a recent report by Consumer Lab (“a leading provider of consumer information and independent evaluations of products that affect health and nutrition”) on some tainted curcumin brands. You can read the CNN story here: http://www.healthnewsdigest.com/news/Research_270/Consumers_Warned_of_Lead_in_Some_Turmeric_Supplements.shtml

Needless to say, I was alarmed by the mention of an incredibly high amount of lead found in a “popular” curcumin brand and by the news that some brands did not provide the amount of curcuminoids stated on the label. Yikes! In order to view the report, I subscribed to Consumer Lab for an entire year. Interesting website. I am now glad I subscribed. I will be checking out other supplements as well.

I cannot publish the curcumin report here, for obvious reasons, but I can tell you (without getting into trouble, I hope!) the following: the “popular” brand reported by Consumer Lab is no longer available. It was the NSI, or Nutraceutical Sciences Institute, Superior Turmeric Curcuma Longa Non-Irradiated (400 mg per capsule). In the beginning, I confused it with the NSI curcumin that I have taken on occasion. Luckily for me, these are two different products. Phew! (I still have quite a bit of this particular brand in my cupboard!)

Another brand that was found to contain an excess amount of lead was Solgar. Surprise.

But my biggest surprise was to see that Ageless Cures Curcumin C3 Complex contained only 49,3% of “claimed curcuminoids.” I have never bought or used this brand, but I know that other curcumin-takers take it. Another brand that did not pass the Consumer Lab test was Physician Formulas, which had a very low content of curcuminoids. And Vibrant Health did not specify the “plant part” used in its product, so it failed the test as well. Never heard of either of these.

I would like to point out that most curcumin brands, of the ones that were tested, passed the Consumer Lab test. About two-thirds. I was very disappointed, though, to see that the brand that I usually take had not been tested. Drat. Oh well…

IL-17 and medical day: stability!

February 6, 2008 / / 2 Comments

Well, the answer to yesterday’s question is as follows: yes, we can. Curcumin inhibits IL-17. Figures, huh? There are three (possibly more) studies that mention the IL-17-inhibiting role of curcumin. The abstracts can be viewed here: http://tinyurl.com/2rn3jy (a 2003 study), http://tinyurl.com/ynvkdj (a 2005 study). Thanks to Sherlock, I read the full study of the third abstract, a 2004 study published in “Cellular Signaling” and titled, get this: “Interleukin-17 signal transduction pathways implicated in inducing matrix metalloproteinase-3, -13 and aggrecanase-1 genes in articular chondrocytes” (see abstract: http://tinyurl.com/2lfy7t).

All these studies tell us that curcumin inhibits IL-17. Simple as that.

Haematologist appointment. Stefano and I went to see my haematologist at noon today. I asked her outright to classify me. She said that I am definitely not MGUS, no way. My IgGs are too high, and let’s not forget the 40% bone marrow biopsy result (from last year). So it’s official: I’m "smouldering," which means, among other things: "to exist in a state of suppressed activity." Heh. She examined my tests more in detail and pronounced me stable. Stable as a rock. So, all good news.

I asked her what the half-life of a myeloma cell is. She replied that it depends on a variety of factors, such as the type of myeloma and its proliferation rate. It can be calculated using cells from a BMB. She told me that a myeloma cell can live up to several months. MONTHS? Drat, now I am almost sorry I asked!

She confirmed that I am taking the correct amount of vitamin D. She also told me NOT to stop taking curcumin when I get a cold or an infection of any sort. Even though it inhibits NF-kB, she said that stopping cold turkey (odd expression, that one, when you think of it) is not a good thing. Good to know.

Let’s see. I am going down my list of questions and scribbles right now, not necessarily in order of importance. Oh, speaking of importance, this is exciting: I gave her the myeloma stem cell study (she had read the abstract, not the full study) and the DMAPT study, and she is going to find out about the DMAPT trial that should be starting soon in the UK to see if I qualify for it. She is going to contact the researchers that she knows personally. I am at a loss for words. Can’t wait to hear back from her. Gulp!

She is going to push the lab technicians to get more details on my “old” bone marrow samples, which would be fantastic. And, last but not least, she is going to try to attend the upcoming presentation in Calenzano, where I will be giving a brief speech. She is leaving for a conference in Turkey that evening, so it’s iffy. Even if she isn’t able to make it, however, she is sending five people from her lab to the presentation. Five? Fabulous.

Last but not least. For the first time, she wrote that I am stable "perhaps" due to curcumin. And that I should continue with the same treatment. (When my GP read those two sentences this afternoon, he got very excited.)

As we stood up to leave at the end of the visit, she asked me to explain why there are cases of myeloma in India, if curcumin is so effective. I answered that there are only a handful of cases compared to the Western world, and besides, I managed to add with a straight face, those folks undoubtedly didn’t use turmeric in their diet. My husband let out a snort, and she gave me a big smile and shooed us out of her office. Hehe. I love my haematologist. Good sense of humour.

Yes, today was a good day.

Another pro-inflammatory cytokine: IL-17

February 5, 2008 / / Leave a comment

About a month ago I read a Science Daily article with an intriguing title: “Protein’s New Role Discovered In Autoimmune Disease.” (see: http://tinyurl.com/yrzaud). In a nutshell, University of Alabama researchers identified a previously unknown effect of a T cell-derived cytokine named interleukin-17, or IL-17 for short. This is an “immunity protein,” that helps induce and mediate pro-inflammatory responses, such as allergies, autoimmune diseases and whatnot. IL-17 also induces the production of many other cytokines, such as the infamous IL-6! Uh-oh!

Now, the news reported in Science Daily is that when the “messenger” signals from IL-17 were blocked, the disease-causing B cells dropped from 17 to 2 percent. Coincidence? Ah, no. As the articles states, “The drop was a clear sign that IL-17 plays a major role on shaping B cells’ ability to create more and more disease-causing antibodies.” So if IL-17 can be inhibited, B cells are slowed down in their efforts to create wacky antibodies. And here I thought B cells were the good guys, the cells that defend us against infections etc. Well, in autoimmune diseases they can go bonkers, as we can read in the Science Daily article.

After reading this article, I immediately checked out if IL-17 is involved in myeloma. Of course it is. Hah, figures! For instance, see the abstract of this 2006 study (http://tinyurl.com/2786gs), which shows that IL-17 “is a CD4 T-cell-derived mediator of angiogenesis that stimulates vascular endothelial cell migration and regulates the production of a variety of proangiogenic factors, such as tumor necrosis factor-alpha (TNF-alpha) and vascular endothelial cell growth factor (VEGF).” Need I add more? Oh, ok, just this bit: the researchers conclude that “IL-17 plays a role in the promotion of angiogenesis and associated disease progression in MM.” Bad, bad IL-17!

I found an interesting bit of information on IL-17 in the MD Anderson October 31^st 2005 “Weekly News and Notes for Patients, Families and Visitors.” The article is titled “New immune cell found to be a key to inflammatory diseases” (see: http://tinyurl.com/2moorw). MD Anderson and other researchers discovered a new type of T-cell, called THi, produced IL-17, which they “linked to an immune system gone awry." An awry immune system? Well, if that doesn’t sound familiar…! Before this discovery, IL-17 was known to play a role in autoimmune and inflammatory diseases, but its origin was a mystery. The study’s lead investigator stated that “These findings suggest that shutting down the activity of these THi cells might stop chronic inflammatory diseases from developing in the first place.” How about that?

Okay, IL-17 is now officially on my list of evil pro-inflammatory cytokines. It is also connected, by the way, to NF-kB (I need to do more research on this topic; I may get to it, someday…). IL-17 also stimulates IL-8, which is an angiogenesis cytokine in myeloma. This reminds me that one of my future projects is to create a permanent page listing all of these pro-inflammatory cytokines and their role in myeloma progression. Eh.

I would like to end today with a question: is there anything that we can do to inhibit IL-17? Or could we already be doing something? The answer to this question will be in tomorrow’s post. Oh, and tomorrow is "medical day." I am seeing my haematologist at noon (with a list of questions as long as the highway between Florence and Bologna), then my family doctor in the afternoon (shorter list of questions). I imagine I will have quite a long post tomorrow!

Less IgA than a newborn…

February 3, 2008 / / 3 Comments

It’s a rainy day in Florence, and I am alone in the house (as “alone” as one can be with four cats, hah!…they are napping now, gathering up enough strength to totter downstairs for some lunch…), so it’s a perfect morning to do some research. I am working on at least four different topics that I find enthralling. But right now I would like to post about something different.

Yesterday I wrote a post to the MMA patient mailing list (by the way, you may sign up for it by clicking on the link in my Blogroll, just scroll down until you reach: "Join the MMA myeloma patients’ listserv") asking a question about my recent test results. I got many useful replies, some in private, some in public.

A very interesting reply was posted by one of my blog readers. This morning I wrote to him asking for permission to post his reply on my blog as well, and he kindly consented. So here goes:

“Immunoglobulins are produced by B-lymphocytes. The faulty ones produce monoclonal immunoglobulins or parts thereof. Immunoglobulin-G is the most prominent type. A molecule decays, after 21 days typically half will have been reabsorbed by the body. The IgG count is the total concentration of immunoglobulin-G in mg/dl, normal and monoclonal. The m-spike is a measure of only the monoclonal Ig. In normal individuals IgG counts are as given below.

Reference values for normal immunoglobulins

	in mg/dL
Age	IgA	IgG	IgM
newborn	1 – 50	200 – 1070	0 – 80
1 – 6 months	2 – 80	200 – 1070	25 – 150
7 – 12 months	8 – 90	200 – 1070	25 – 150
1 – 6 years	15 – 160	340 – 1240	45 – 250
7 – 12 years	35 – 250	650 – 1600	45 – 250
12 years and up	40 – 350	650 – 1600	50 – 300

A rise of the IgG may be caused by acute or chronic infections and does not necessarily mean increased MM. A change in m-spike may reflect a change in MM plasma cell concentration. Remember that the IgG number or m-spike is always somewhat inaccurate, so a small change may simply be due to a uncontrolled variation in the measurement procedure.”

Interesting. As for the issue of "molecule decay," I will be looking more deeply into it and will ask my haematologist about it on Wednesday. For now, I will leave it pending. Well, this has certainly been an interesting exchange. I now have plenty of fodder for thought. But it’s time for lunch so I am getting off the computer.

One last comment: thanks to this chart, I found out that I have less IgA than a newborn, and as much IgM as a newborn (barely)! Ahhhh, I feel so young, today…hmmm, almost…newly born!

The dual nature of NF-kB

February 2, 2008 / / 2 Comments

This is the continuation of my January 22 post. From the Aggarwal (et al) NF-kB study, we know that when NF-kB “is found to persist in the nucleus, it is referred to as constitutive activation. […] The precise role of constitutive activation in tumors is not known but has been linked to resistance to apoptosis in human cutaneous T-cell lymphoma cells. It is tempting to believe that a similar mechanism accounts for the progression of all tumors that constitutively express NF-kB, but such a link has yet to be clearly identified.”

This entire section is interesting, actually, since it reports that another thing that has not been identified is the actual stimulus that renders NF-kB active all the time. What is clear, though, is that “Cells that express constitutively activated NF-kB are resistant to various chemotherapeutic agents and radiation treatment.”

And read this. In renal cell carcinoma (RCC) patients, “Serum C-reactive protein (CRP) elevation correlated with the increase in NF-kB activation; therefore, NF-kB may be a cause of the inflammatory paraneoplastic syndrome.” As we Myeloma Club members know, CRP reflects IL-6 activity and is thus an important marker for us. (My CRP, by the way, is within the normal range.) At any rate, I thought it interesting that this study reports a connection between high CRP and NF-kB. Well, well.

Another interesting quote: “Another virus that contributes to human cancer via NF-kB is the Epstein-Barr virus (EBV) implicated in Burkitt’s and Hodgkin’s lymphomas. The EBV nuclear antigen (EBNA)-2 and latent membrane protein (LMP)-1 enhance NF-kB activity thereby preventing apoptosis in EBV-transformed B cells.” While I was in grad school in Toronto, I tested positive for EBV. I was quite ill for about a month, tired all the time, etc., as I recall. Anyway, coincidentally (or…not?), a few years later I was diagnosed with MGUS. Well, I suppose it’s pointless to speculate, but this is not the first time I have read about the EBV-cancer link. Let’s proceed.

I found a fascinating study online (full study: http://tinyurl.com/2ntng6) titled “Good cop, bad cop: the different faces of NF-kB” that appeared in the January 2006 issue of “Cell Death and Differentiation.” It examines the different functions of this transcription factor, including that (drum roll!) of TUMOUR SUPPRESSOR. No kidding. NF-kB can promote both tumour growth and tumour suppression. Bad cop, good cop. How about that?

It is in this study that I read that NF-kB can be triggered by hundreds of “activators.” Hundreds? Parts of this study are barely intelligible, but I did manage to grasp a few basic concepts. The “classical” or “canonical” NF-kB pathway occurs when this transcription factor translocates, or moves, from the cytoplasm to the nucleus. This is when NF-kB gets activated by inflammatory cytokines such as tumour necrosis factor (TNF)-alpha and IL-1, in response, say, to a bacterial infection. The rest of that particular paragraph is not meant for non-scientific brains, for sure. So, skip, skip, skip! What matters is that at the end of this complicated process of activation, NF-kB ends up in the cell’s nucleus. This can occur in a matter of minutes. Amazing, eh? Then, once it has performed its good cop duties, under normal circumstances, NF-kB is escorted back (by a gene called IKB-alpha) to the cytoplasm, a process I mentioned briefly in my earlier post.

Then we have the “noncanonical” or “alternative” NF-kB pathway, which is activated by other kinases and, for instance, chemotherapy drugs. Some stimuli, such as UV-C (Short-wave ultraviolet radiation), activate NF-kB both by IKK-dependent and IKK-independent pathways. Ok, ok, my eyes are glazing over, too, and besides, I don’t want to get into too many details. Let’s stay focused on the main points.

Under certain conditions and in response to certain types of stimuli, it would appear that NF-kB can have proapoptotic effects. This “is consistent with the hypothesis that it is the mechanism of induction of NF-kB that determines its physiological function.” It’s all a matter of context, in other words. The important thing is that “If differences in the NF-kB response to a chemotherapeutic drug also occur in different tumors in patients or between patients with apparently the same type of cancer, the ability to more accurately diagnose NF-kB status could profoundly affect treatment choice and outcome.” (Apart from that unfortunate split infinitive, this is quite an interesting statement.)

We already know that NF-kB has pro-inflammatory effects. But the study shows that “NF-kB activity can also be required for the resolution of an inflammatory response. NF-kB activity in the later stages of inflammation has been associated with induction of anti-inflammatory genes and the induction of cell death. Moreover, inhibition of this late-stage NF-kB activity extended the length of the inflammatory response, inhibited the expression of p53 and Bax, and prevented apoptosis.” So sometimes NF-kB can reduce inflammation. I am not sure what late-stage NF-kB activity means, but the inhibition of the tumour-suppressing p53 gene is certainly not a good thing. More research needed.

Now read this shocker: “Because NF-B can perform a tumor suppressor function in some tissues, will its inhibition actually promote cancer in some situations?” Ouch!

The answer is: probably not, since treatment is “relatively short term,” and thus its inhibition of NF-kB would not have enough time to give rise to cancer. So the inhibition of NF-kB, the study states, seems to be the best approach to treating cancer. If the treatment were long-term, though, such as in the treatment of chronic inflammatory diseases, the “continuous suppression of NF-kB activity over a number of years could manifest itself in, for example, squamous cell carcinoma.”

This is a real head-scratcher. A "damned if you do, damned if you don’t" situation. I’d better stop here before my brain melts. But I have not finished with this topic. Not at all.

A quick update before I sign off to go feed the cats: since my so-so test results, I have introduced flaxseed oil capsules into my protocol, also because Sherlock is taking them, too. A slight change. I will update my protocol soon. Have a great weekend, everyone!

Be happy, but not TOO happy…(oh, and my test results…)

January 31, 2008 / / 8 Comments

The first part of my post title refers to a Science Daily article I read this morning while waiting, or fidgeting is more like it!, to drive to the hospital to pick up my blood test results: these refer to the tests that Sherlock and I took before beginning our biocurcumax experiment. More precisely, to the November-January period of my CMC (cocoa mass curcumin) experiment, when I was also taking a low dose, no more than the daily recommended dose, of Scutellaria baicalensis and Zyflamend.

A quick aside: you can read this rather interesting Science Daily "happiness" article here: http://tinyurl.com/2l38re In a few words, a new study suggests that "moderate happiness may be preferable to full-fledged elation." The “don’t be too elated” study seems quite appropriate in view of my current test results: yep, more seesaw results. I am getting used to going a bit up then down, so it’s no big deal, now that I have had time, a few hours, to process and digest the numbers. Ready? Ok, here goes.

My IgG went up from 27,80 to 31,90 g/L. Now, that’s not a huge jump in the wrong direction, but it’s still a jump, 12% or so. However (!), my m-spike went down slightly, from 2,20 to 2,17, and my monoclonal component decreased from 25,7 to 25 %. These aren’t huge changes compared to my previous tests, but I think the two itsy bitsy decreases are interesting. From what I understand, in fact, the m-spike and IgG count go down together, hand in hand, and vice versa. Perhaps I was fighting a cold or some sort of infection during those two months, so my good immunoglobulins increased. It’s very possible. Well, I won’t say any more on the matter until I speak with my hematologist next Wednesday.

Ok, first let’s get the negative stuff out of the way:

Ferritin ( = iron stores) is back to 7, down from last test’s 10 ng/mL. No worries, it has been that low. It will go back up.

My albumin is down from 49,5 to 48,2 %. Oh well. It’s been lower.

Beta-2 microglobulin went up to 1,9 from 1,6 mg/L. Still way within normal range, though.

Hematocrit went down a bit, from 39,5 to 37,4 g/dL. Hmmm. Well, it, too, has been lower.

Now for the good stuff:

My serum iron jumped from 62 (barely within the normal range) to 81 microg/dL. Guess all those steaks and spinach with lemon juice made a difference, after all!

Bence Jones is negative. For the blog readers who are not members of the very exclusive Myeloma Club: that’s good.

Total protein went down a teeny bit, from 8,8 to 8,7, creeping back toward the normal range (high end of the normal range is 8,6 g/dL). Good.

LDH, or lactate dehydrogenase, decreased from 158 to 146 U/L. Also good, since high levels of the LDH enzyme are associated with aggressive disease, which we do not want!

Creatinine is stable at 0,7, no change.

Calcium went down from 9,6 to 9,2 mg/dL. Still way within the normal range. Nice to see it go down a fraction.

CRP is still within the normal range. I hate it that I don’t get a number but only a “less than” value.

Oh, I almost forgot. All of my celiac disease tests were negative, and you know what that means: pasta for lunch!

Well, even though I know that the myeloma is still stable (Sherlock, whose mind is much more analytical than mine, confirmed my feeling), I admit that I am not the happiest camper in the world right now. I would have liked to have seen a drop in my IgG count, a substantial drop. But it’s true that my m-spike dropped a wee bit, and besides, the above-mentioned happiness study shows that, compared to blissfully happy folks, people who are only mildly happy have room for improvement. I like that. Furthermore, if you are completely happy and satisfied, you have nothing to wish for, as Sherlock wisely pointed out to me earlier today. And that is no fun. So, hey, every so-so test result has a silver lining, isn’t that the saying?

My questions, for now:

1. Did the Scutellaria baicalensis clash with the curcumin cocoa mix, even though I took them at different times of the day?

2. Did I take enough Scutellaria to make a difference? (Off the top of my head: probably not.)

3. Do tests taken in certain periods of the year yield similar results? (Work in progress.)

4. When I am testing one supplement, should I quit taking curcumin for a month or so, to see if said supplement really works by itself? Now there is a scary thought. It’s like asking the Peanuts character Linus to give up his security blanket for a month or so. Tremble tremble ! But, in the interest of science…who knows…I might consider it.

Sherlock and I agreed earlier that I should change over to the…atomic bomb, i.e. take biocurcumax the way she is: once a day, all in one gulp. Forget about tickling my myeloma cells with a half dose twice a day. My gut feeling right now is that I want to blast the blasted myeloma cells with the entire arsenal, i.e. the full dose. At this point, I should mention that I am a pacifist in real life, but when it comes to myeloma cells, well, I feel like crawling down my bone marrow with a bow and curcumin-containing arrow and hunt the malignant cells down one by one.

I am going to look over my tests this weekend, and Sherlock and I will come up with a plan for March. Tomorrow Stefano is driving to southern Italy with his parents and brother to make sausages and whatnot out of a poor dead pig (I tried to save the pig’s life, but was outnumbered…this is a long-standing family tradition), so I will be “alone” in Florence with the four kitties. Plenty of time to study this issue. And go play cards with my girlfriends. Life is good.