The Immune System: Your Best Friend, Your Worst Enemy

in #steemstem5 years ago (edited)

       

Queen Anne of Great Britain (1665-1714)

Queen_Anne_of_Great_BritainRoyal Collection RCIN 405676 public.jpg

Image: Royal Collection, 1736, public domain

It's not possible to know if Queen Anne's face was really as red as it appears in the picture, or if the portrait artists (Godfrey Kneller, followed by Charles Jervas) took liberties and gave her very high color. However, it is an interesting coincidence that historians entertain the possibility that Queen Anne may have been dealing with systemic lupus erythematosus.

Characteristic Malar Rash in Systemic Lupus

malar rash lupus diagram head.jpg

Compare the rash in the drawing above (by CNX OpenStax, and used under a CC 4.0 license) to the ruddy cheeks evident in Queen Anne's portrait. Often called a 'butterfly rash', this distinctive flush is often symptomatic of a lupus flare (acute activation of disease). An acute activation of lupus can involve any system in the body. Though there are "typical" patterns the disease follows, in fact there is no way to know where the disease may appear. In each case, though, the symptoms are a result of the immune system becoming an enemy, rather than a friend. This is the essence of autoimmune disorders. SLE (systemic lupus) is an autoimmune disease.


A 1947 Picture of Flannery O'Connor (1925-1964)
Robie with Flannery 2 1947 Cmacauley at English Wikipedia 1.0, 2.0. 2.5, 3.0.jpg
Image, Cmacauley at English Wikipedia: CC license 1.0, 2.0. 2.5, 3.0

O'Connor experienced her first symptoms of Lupus in the early 1950s. Her father died from the disease in 1941. Treatment with high doses of corticosteroids allowed O'Connor to live, and to write award-winning stories, for another fourteen years. Corticosteroids were used to treat systemic lupus for first time in 1950.




Our immune system is designed to protect us. It is equipped with an army prepared to battle pathogens that manage to breach external barriers, such as the skin, and the mucous membranes (which are also part of the immune system.) Among the dedicated soldiers in our immune army are phagocytes.



Phagocytosis: Attacking and Destroying the Enemy

Phagocytosis2 Process.svg Alexa cottrell 4.0.jpg

The author (Alexa Cottrell] of this illustration offers a summary of the action: An invading microorganism is detected; a phagocyte surrounds and engulfs it; digestive enzymes are released; the pathogen is destroyed.




Complement Complex : Stalwart Sentinels in the Immune System


Another brigade in our immune army is comprised of the complement complex. Circulating throughout our bodies all the time are proteins that stand ready to defend when we are threatened by something perceived as foreign. (Self vs. nonself)

The complement complex is designed to be activated only when needed. The proteins perform in cascading coordination. One of their jobs is to launch a direct assault on an enemy. The proteins can become a kind of A Team in a membrane attack complex--MAC: A pathogen is targeted; the pathogen's surface membrane is compromised by cooperation between four complement components (C5,C6,C7, and C8); and a fifth complement (C9) moves in to deliver a lethal blow. Watch this YouTube video by JohnArt to see a dramatization of a MAC assault.


Diagram of Membrane Attack Complex in Action

Membrane_Attack_Complex_(Terminal_Complement_Complex_C5b-9)SLiva2016 1.2 license.jpg

This diagram, by SLiva2016 (CC 1.2 license), shows complement complex proteins C5, C6, C7, C8, and C9 as they attack the surface membrane of a microorganism. The first four create the environment for C9 to open a pore and introduce bactericide.


Inflammation and Trash Clearance

Two more activities of the immune system are, promote inflammation and clear away debris. Inflammation serves an important function because it alerts different elements in the system that there's danger and they have to come to the aid of imperiled tissue. Also, debris--bits and pieces left around, including killed pathogens--has to be removed or it will endanger healthy tissue.




The Immune System: A Double-Edged Sword


The immune system can hurt us.

Anyone who has ever had an allergic reaction, has experienced the immune system overreacting to a substance. And most of us know someone who is dealing with an autoimmune disorder--diabetes, rheumatoid arthritis, multiple sclerosis, (schizophrenia?), COPD--the list is endless. When people are stricken by one of these diseases, the immune system becomes their enemy, not their friend.

The complement complex plays a significant role in aberrant immune system behavior.


The Membrane Attack Complex (MAC) in Multiple Sclerosis


Immune Cells Attack Healthy Nerve Tissue in MS
demyelination MS adapted.jpg
Image Credit: Adapted from a diagram by BruceBlaus on Wikimedia Commons. Used under CC 4.0 license


Autoimmune disorders present a dilemma to treating physicians and patients: how to stop the immune system's damaging activity without compromising its essential defensive function. Meeting this challenge may explain why one of the most expensive medicines in the world, Eculizumab, is designed to combat an autoimmune disease: multiple sclerosis (Eculizumab also is used to treat other autoimmune diseases). The list price for this medicine is about $500,000 a year--though that price varies by country.

Eculizumab Attaching to Complement C5

GIFCredit:Campylobacter on Wikimedia Commons CC 4.0 international license

By attaching to C5 Eculizumab prevents the complement cascade from going forward--it stops the Membrane Attack Complex from being inflicted on healthy tissue. However, use of the drug does carry with it an increased risk of serious, possibly life-threatening infection.



Bitten by a Coral Snake? The Complement Complex May Kill You

The Membrane Attack Complex is a thing of beauty, but complement complex is a fickle friend. Note the case of snake bite, described below.



Micrurus fulvius, Eastern Coral Snake, Jacksonville, FL
micrurus Coral snake 009 Norman.benton 3.0.jpg
Image: Norman.benton 3.0 Unported license

According to BMC Immunology, if you are bitten by a coral snake, the venom from the snake may activate the complement complex. Instead of coming to your rescue, as would be the case in MAC, the complement cascade will generate a "significant amount of anaphylatoxins". These toxins will aid in the spread of venom throughout your system, and the effects may be fatal.



Cancer: Another Example of the Double-Edged Sword

The immune system may identify, target and destroy cancer cells. Paradoxically, a number of studies have demonstrated that activation of the complement complex in the presence of cancer, may actually promote tumor growth. A 2012 article in Journal of Clinical Investigation describes studies that show the complement complex induces inflammation, which in turn promotes tumor growth.



Systemic Lupus and Its Relationship to the Complement Complex, Especially C4


Ferdinand Marcos (1917-1989), Ronald Reagan and Imelda Marcos, 1982
Marcos visit_Reagan_1982 U.S. government photographer public.jpg
Image by U. S. government employee. Public domain

Ferdinand Marcos fought systemic lupus for many years and died of the disorder in a Hawaii hospital.



I began this blog by talking about Queen Anne and the suggestion that she might have had systemic lupus. Historians and physicians guess this might have been the case because of the constellation of symptoms she evinced. These included not only trouble with blushing, but also many failed pregnancies, dropsy, gout, hemorrhage and stroke It is a patently frustrating exercise to try and diagnose an illness three hundred years after someone has died. With regard to lupus, however, the exercise is almost as frustrating when it is conducted in the present.

There exists no single lupus test. Usually, a diagnosis is made by observing symptoms and by performing a series of agreed upon laboratory tests. One of these tests is to assess complement levels, It turns out that a particular complement, C4, is associated with lupus--and a number of autoimmune diseases.


Chart of Some Autoimmune Diseases and C4 Association

table autoimmune1.jpg
My chart, assembled from sources listed at the end of this blog. Anybody can use the chart for any reason.

One of the reasons I included chromosome association is because autoimmunity often has a genetic link, though perhaps not a genetic cause. It's interesting that C4 itself is located on Chromosme 6, which seems to pop up in a lot of the associations on the chart.



Take Out the Trash!

Somewhere in the middle of this blog I mentioned that the immune system is charged with housekeeping, with removing debris. A lot of this debris is dead cells, some of these killed through trauma, some that die naturally.

Scheduled cell death is called apoptosis. According to an article in Frontiers in Autoimmunity, Clearance Deficiency and Cell Death Pathways: A Model for the Pathogenesis of SLE: "Defects in the clearance of apoptotic cells may be responsible for the initiation of systemic autoimmunity in several chronic inflammatory diseases, including systemic lupus erythematosus (SLE)". The article explains that C4 plays an important role in clearing apoptotic cells. Therefore, low levels of C4 may contribute to the accumulation of the debris and may consequently promote the inflammatory disease process.


Apoptosis Diagram

Apoptotic cell 2disassembly Aaron Smith, Michael AF Parkes, Georgia K Atkin-Smith, Rochelle Tixeira, Ivan KH Poon 4.0.jpg



Conclusion

Dear readers, I've taken you down a long and somewhat circuitous path through the ups and downs of the immune system. This might seem dull, but the information is really important, because we all may be touched by an aberration in the immune system. In my own family we have rheumatoid arthritis, systemic lupus, pemphigus, diabetes, autoimmune encephalitis, COPD, psoriatic arthritis and more allergies than I can count. So I'm interested in how autoimmune diseases come about.

Information is power. When someone in my family goes to a doctor, I'd like to understand why a course of treatment is recommended--and to perhaps take part in a treatment plan. I hope this information might be helpful to you if you find yourself in a similar situation.
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Some Sources Used in Writing This Blog


1.Mayo Clinic https://www.mayoclinic.org/diseases-conditions/lupus/symptoms-causes/syc-20365789
2;Biblio.com Flannery O'Connor https://www.biblio.com/flannery-oconnor/author/1780
3.NIH.gov https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5565217/
4.ScienceLearn.org.nz https://www.sciencelearn.org.nz/resources/177-the-body-s-first-line-of-defence
5.Britannica.com: Mucous Membrane https://www.britannica.com/science/mucous-membrane
6.Alex Cotrell: Phagocytosis
7.Apellis.com https://www.apellis.com/focus-science.html
8.Merck Manual https://www.merckmanuals.com/home/immune-disorders/biology-of-the-immune-system/overview-of-the-immune-system
9.Science Direct https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/complement-membrane-attack-complex
10.MAC

11.Embopress https://www.embopress.org/doi/full/10.15252/embj.201899852
12.Live Science https://www.livescience.com/52344-inflammation.html
13.Cell.com https://www.cell.com/fulltext/S0092-8674(10)00129-7
14.Frontiers in Psychiatry https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435494/
15.Eculizumab https://www.drugbank.ca/drugs/DB01257
16.Centers for Biosimilars.com https://www.centerforbiosimilars.com/news/alexions-second-c5-complement-inhibitor-requires-less-frequent-dosing-carries-new-p
17.Current Opinions in Infectious Disease https://www.ncbi.nlm.nih.gov/pubmed/27257797
18.BMC Immunology https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3398285/
19.Cancer Research UK.org https://www.cancerresearchuk.org/about-cancer/what-is-cancer/body-systems-and-cancer/the-immune-system-and-cancer
20.https://cancerres.aacrjournals.org/content/79/13_Supplement/2334
21.The Journal of Clinical Investigation https://dm5migu4zj3pb.cloudfront.net/manuscripts/90000/90962/JCI90962.v1.pdf
22.Washington Post: Ferdinand Marcos https://www.washingtonpost.com/archive/politics/1989/09/29/ferdinand-marcos-dies-in-hawaii-at-72/d1c26275-d9bd-4bfd-8934-c2a02ff4ab51/
23.BMJ: Medicine and History https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC1882031&blobtype=pdf
24.FASEB Journal:Queen Anne's Lupus: Phospholipids and the Course of the Empire
https://www.fasebj.org/doi/abs/10.1096/fj.14-0401ufm?journalCode=fasebj
25.Bentham Open: The Open Rheumatology Journal https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5101629/
26.Arthritis Research: Complement and Systemic Lupus Erythematosus https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3240161/
27.Frontiers in Autoimmunity https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4745266/
28.Journal of Venomous Animals and Toxins including Tropical Diseases http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1678-91992015000100336
29.Journal of Venomous Animals and Toxins including Tropical Diseaseshttp://www.scielo.br/scielo.php?script=sci_arttext&pid=S1678-91992011000200003
30.Journal of Venomous Animals and Toxins including Tropical Diseases http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1678-91992009000100002
31.Journal of Venomous Animals and Toxins including Tropical Diseases https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5831611/
32.Juvenile diabetes C4 deficiency https://www.pacificejournals.com/journal/index.php/aabs/article/view/aabs661
33.Juvenile diabetes genetics https://www.ncbi.nlm.nih.gov/books/NBK22256/
34.NCBI Resources: https://www.ncbi.nlm.nih.gov/gene/720
34.Frontiers in Immunology https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6737392/
35.Table of Autoimmune Diseases, with Resources (by me)












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This has been an interesting read for me in many ways my dear friend. Above all, because of my very personal reasons to understand the workings of our immune system. See, I am allergic to every other thing on this planet. From household products to foods. I was very ill in my mid-20's, but not anymore ;) I have been strong and healthy for most of the past 13 years thanks to what you said: 'information is power' 😎

You have covered numerous topics here. And I always ask myself how you manage to do this without ever overwhelming your readers (?)! But I was mostly drawn to the 'Take out the trash' part, particularly when you highlighted chronic inflammation as a possible cause for autoimmune deficiencies, and linked this to specific conditions (e.g. SLE). As you might guess I have huge interest in, and have dedicated some time (for the past 3 years) to look into the links between inflammation and brain/mind disorders. It's incredibly revealing!

This is why I didn't think twice before downloading the recent study you pointed us to here on 'Autoimmune diseases & Psychotic disorders', in which the authors say (p.5):

Signs of a dysregulated immune system has also been found in mental illnesses and might play a role in the association found between the two.

This supports many, many other studies I have come across in the past. And, although such studies tend to place huge emphasis on the hereditary, biological side of these scenarios. Oftentimes painting a picture of little choice for patients, I see it as a glimpse of hope in how symptoms and suffering could be alleviated by life changes such as eating habits. Even more so when the role of the microbiome comes up over and over again. For example (p.7):

Psychological stress have been thought to influence composition of the microbiome and vice versa, as well as the microbiome's effect on peripheral inflammation.

As always, you have enlightened us with your thorough, well-researched work <3 Simply incredible and impressive!! :D

Much love to you always & forever my dear @agmoore2,
Your friend from across the ocean :*

Dear Abigail, I began this response earlier...had to leave on family business.

First of all, thank you for those kind words. I try when writing about medical topics to give people the sense that they should be partners in their medical care--not passive consumers.

This is something you apparently came to understand through experience. That is a terrible lesson to learn as a young woman. Overcoming serious illness gives you strength and insight I think. This may be one source of your great empathy. May your good health continue--for at another 50 years :)

As for allergies... I think you and I may have more in common than I suspected. Super-charged immune systems. But that's OK, because we have the resources to get what we need. And the good sense to avoid what can hurt us.

And I'm not likely to be overwhelming my readers with information..because I usually start from ignorance. I have to study the stuff inside out until it makes sense to me, before I can explain it to anyone else. No jargon in my pieces because I don't know any :))

I think epigenetics gives lie to all those who would blame heredity--for anything. The environment has such a profound effect on gene expression. Knowing this makes social policy--social equity-- all the more compelling. Heredity is a cop out, I think. Even something like Huntington's Disease, which is generally described as a genetically transmitted disorder, can be affected by lifestyle and environment.

Thank you for reading, and commenting on my long blog. I know you're busy, especially this time of year. So your feedback is much appreciated.

We are getting ready for Thanksgiving here, in the USA. I'm barely used to fall, and it seems winter is pressing upon us. Fall is my favorite season..best time for walking.

Hope you are well, peaceful, and not too pressed for time.

Love, from your good friend, in chilly New York,

AG

Dear Abigail,
A postscript to my comment--my son just sent me a University of Birmingham article, which I thought you might find interesting (in light of your remarks about the relationship between inflammation and mental illness):

Link between inflammation and mental sluggishness shown in new study.

If you have ever visited an online lupus support groups, one of the most common complaints is 'brain fog'.

Hope you are having a great day, dear Abigail 😇

Oh, thank you so much my friend! 😃 I had a quick look at the article and already saw they discuss something that I have interest in - the brain processes involved in visual attention! And no, I never knew that people who have lupus complain of ‘brain fog’.

The article has been saved and it will be with me during my post lunch coffee today! I will also think of you 😘

Much love <3

Hello friend @agmoore2, very interesting and detailed your publication, in fact our defense we have with the immune system, in case you did not know the company 4Life is the Company of the Immune System which offers the transfer factor that helps modulate the immune system, Here you can get information about the company and any details do not hesitate to ask me. Receive my affections.

Thank you for those kind words! And I appreciate the reference, but I don't take supplements of any kind (sometimes a Flintstones multivitamin). My doctors can barely get me to take prescribed medicine. I just hope for the best and try to live 'right'. So far, I've survived.😄

I wish you peace and good health,

With warm regards,
AG

@agmoore2 I am glad that you are the best and recovered, you can also investigate regarding the supplements that I am recommending you, there are multiple testimonials of its benefits. They are included in the Physicians´ Desk Reference Guide. Cheers

So interesting! My husband's family had Crohn's everywhere, so now all three of my children do as well. One gets lupus from the medications (biologics, a whole slew of them but not the one you mention here)
Great work thanks for putting all this together.

I'm so sorry about the Crohn's in your family. That's one my family seems to have escaped. It is true that lupus can be caused by some medicines--I'm not aware that biologics cause it, but extensive research has shown other substances and medicines can cause it. These include medicines to treat high blood pressure, and silicates. Twin studies show that genetics play a compelling role in lupus but that the environment also plays a very large role.

I hope your children are receiving good, effective treatment.
Regards, AG

"effective treatment" regarding anything gastrointestinal is an oxymoron. GI's push nothing but super expensive biologics for crohn's now. I recently heard from someone in the lyme community (those who are shunned by the standard medical community as lunatics and criminals) that lyme in combo with biologics causes lupus, and my daughter is now experiencing medically induced lupus for the third time. Good luck getting a GI to prescribe any thing else though. They've all gone brain dead from the kickbacks they get for prescribing biologics. It's likely my kids have lyme because it is rampant here. I just started treatment for lyme myself to see if it helps my knees.



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Dear AG,

I have to let you know how interested I read your scientific essay about the immune system, even if I didn't understand everything. I'm very impressed by your expertise!

The immune system - your worst enemy. From my own experience I can only agree with that. Besides some allergies and allergic asthma I have a thyroid disease. I don't want to go into more detail here, but I know the effects of a misdirected immune system that attacks the body's own structures (cells and organs).

When this autoimmune disease was diagnosed many years ago, I read a lot about it, but I never dealt with it on a scientific level. Your article gives me the impetus to catch this up now. Because as you say correctly: "Information is power".

Thank you for this important, extremely interesting post!

Warm regards from sunny but cold Vienna,
Anna

Dear Anna,
What a pleasure to find your comment here. Thank you for saying my blog had value for you. These technical blogs are so challenging. I spend a great deal of time looking up terms. But, as is true with you, some years ago I was diagnosed with an autoimmune disease. The process of getting diagnosed and receiving treatment was pretty dreadful. When I came out of that (and did receive effective treatment) there was a sense of community with others who were in a similar position. That's when I wrote my first book.

Since then I've been committed to addressing barriers that separate ordinary folks (me) from understanding basic science, and healthcare in particular. I don't like barriers of any kind :))

I read your glorious piece this week. It gave me a strong desire to visit one of the wonderful museums that are available to me. What's amazing about your blogs is that you don't passively observe, but investigate and make what you see an intrinsic part of your experience -- of our experience.

Thanks again for your comment. It's really encouraging (as I try to understand another puzzle for my next blog).

Looking forward to your future blogs as you use an extraordinary sensibility to appreciate, and share, culture.

Affectionately, your friend from an also chilly but sunny New York,

AG

Being proactive yourself is so important, not only when it comes to healthcare, but of course also when you are already suffering from a disease. I admire you and have such great respect for you that you have acquired all this knowledge! You overcome barriers that often seem insurmountable to us laypeople and which we therefore do not even try to manage. I can learn so much from you!

Thank you for your kind words on my last post! I have just started with the 3rd part. The nice thing about it is that I relive everything I saw and experienced in the museum while writing.

I wish you that you were already able to solve the puzzle for your next blog post!

With great affection,
Anna

Dear Anna,

Here we are, on different continents, I admiring you and you admiring me. The amazing thing about this platform--it brings interesting, creative (and nice) people together.

I really appreciate your encouragement. If you knew me, you'd see I'm more determination than talent. But sometimes, that's enough :)) Eager to read part 3--and yes, I made headway on that puzzle last night.

Have the most wonderful, creative week.

Affectionately,

Your friend from across the sea,
AG

Have the most wonderful, creative week.

I wish you the same, my dear friend. Life is so beautiful if you only let it happen. 🌞

Affectionately,
Anna

🌟 🍁 🍂 🎨 🌟


Questo post è stato condiviso e votato dal team di curatori di discovery-it.
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Thank you, very very much!

Hello, I am delighted to see other users write medical articles! It's a really well done post with great content, I myself am working on some immunology projects to bring to the community, I think it's very important!

I gave you 100% with stem.curate and I curated your post, if you like to come and visit us you are welcome!

riccc96

Hello,

Your post has been manually curated by a @stem.curate curator.

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Hello @riccc96,
Thank you so much. It takes a lot of work for me to understand some concepts (like MAC) well enough to explain to others. But the process of learning and sharing is very enjoyable. When my effort meets the standards of a professional--wow, that's gratifying.

I appreciate your kind words.
AG

I had a feeling you were going to say Lupus about Queen Anne's face. My moms best friend's daughter who lives far away has been dealing with Lupus for 30 years now. She had that butterfly rash many times. She has had a kidney transplant and has been in a wheelchair for the past 10 years now. Her mom told her that she got Lupus because of a medication that her mom had to take when she was pregnant with her. I don;t remember the name of that medication. Eoulizumab costs $500,000 per year? Insane! Sometimes the medication you take can cause more severe symptoms or diseases that are worse than you already have. And what really makes me mad is when doctors put a band-aide on the problem with medications instead of getting to the bottom of what caused your symptoms.

What you wrote about low levels of C4 was very interesting. I will have to get those levels checked when I get my next blood test done. I am sorry to hear about all of the diseases that run in your family. Thank goodness they have you for their advocate. Very informative post and well done @agmoore! Great chart that you made too. : )

P.S. Remember your post about Polio and I told you that when I was a child, we were given sugar cubes as a vaccine for polio? Well, the prompt for one of the freewrites was, of all things, "sugar cubes" and I wrote about the polio sugar cubes. While writing I did remember a few other things about it. I thought you might in interested in reading it...read only...do not upvote please!

Stay warm and well AG! Hugs!

Hi @whatisnew! Thanks for those kind words. I'm sorry about your friend...approximately 40% of people who have lupus eventually develop kidney problems. Sounds like that young lady has a terrible case. I am so sorry. It is a miserable, miserable disease.

I can't think of any medication taken in pregnancy that can cause lupus in offspring. I'll have to look into that. If a mother has autoantibodies, (elevated ANA) that may cross the placenta, maybe, in a very small number of cases and lead to lupus in a child. That's what I've read, anyway.

I don't think the mother should feel the burden of thinking she caused her daughter to become ill.

I do remember our polio discussion...you never know when something will come in handy. That's the creative mind for you.

As for my family...probably weird genes. I think we should submit to some kind of study and do science a favor :))

I'm going to go look at that polio story now and definitely will not upvote :))

You stay warm, and creative.

From rainy New York,
Hugs back, AG


I just upvoted myself...nice that I approve of my own opinion. Silly woman.

HaHaHaHa! I will give you my stamp of approval too. LOL!

An interesting read. I've done a fair bit of research on autoimmune disease myself since I developed eczema about 15 years ago. I attended a skin clinic where they prescribed cream but said it wouldn't cure the condition just control it. Not a word was said about diet. After doing a bit of research into the causes of inflamation, I changed my diet completely and started juicing daily, something I still do to this day, and within about 3 months the eczema had completely disappeared and hasn't troubled me since.
It's made me a great believer in the old 'let food be thy medicine.'

Thanks for reading (I know it's a long blog). The steroid creams cover the symptoms but don't solve the problem. You were clever to find the antagonist. Eczema can be very troubling, and resistant to treatment. I'm happy your change in lifestyle did the trick :)

You say "this might seem dull" - not a chance! What a fantastic lead into this magazine-worthy piece. Seriously, there have to be magazines that would pay you for a well-researched and cleverly written article like this. I love the header "Inflammation and Trash Clearance" - the concept of our cells with little brooms whisking away the detritus of living. I love the belated diagnosis of the queen's medical condition. You've put so much time and effort into this and documented all your sources. How many Steemians will see this? How many readers outside of Steemit? You're ready for the big league - a wider audience than any Steemit blogger seems to find. (Correct me if I'm wrong, but it seems to me a lot of good content at Steemit is not seen by many.)
Congratulatios on a well-earned stem-curie (first time I've seen this one). Thank you for your imaginative and informative posts!
(I'm still pondering the inflammation and auto-immune part: Intermittent Fasting seems to help with that, and AIP diet, but we expose ourselves to toxins all the time. Windex. Ammonia. Check out the ingredients label on an bottle of shampoo or lotion. Why, why, why do we smear this stuff on our skin??)

Hi @carolkean,

Thank you for that great critique of my writing. It is something I love to do. The whole process, learning, planning, writing, editing. Just satisfying. And when readers say they get something from it... that's rewarding.

Magazines? That's kind of you. But how? I really don't like rejection. If it happened magically, well, I'd take that :)

I love this community. Some unpleasant aspects, but I don't see them. I just keep my head above the fray and focus on the good stuff. It's a bubble, but it's my bubble. 😇 My days of active employment are long past, and making money from writing at this point seems to be a fantasy--though it is a nice fantasy.

Thank you again, for all your support and kind words. That sure do make a girl smile.
Have a wonderful night.
AG

You sound like me: If it happened magically, well, I'd take that :)
(Getting Published)
I love your attitude - focusing on the good, avoiding the unpleasant, keeping your head above the fray. It may not make us big fish, but I'm not all that competitive, and I don't try hard enough to "rise to the top" or earn fair wages or any wages for my writing. Should I try harder? Eh. Everyone could do more and do better, but is it worth the effort, the time, the cost (in what ever else is neglected, or the lack of sleep, or the added stress).
Write on!

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