Tuesday, 11 December 2012

GcMAF, nagalase and autism

I think it might be worth starting this blog post with (a) reference to my very well-trodden caveat of not making any medical recommendations on this blog and (b) a little bit of a description of some of the key terms connected with the paper by Jeff Bradstreet and colleagues* (open-access) on nagalase, GcMAF and autism bearing in mind my amateur status in this area. I might also add, don't shoot the messenger.
I'm the big eater @ Wikipedia  

Macrophages. It all begins with monocytes, white blood cells produced in bone marrow from hematopoietic stem cells. Monocytes grow into different types of macrophages.

Macrophages, known as the big eaters of the immune system, are present in every cell of the body and include microglia (in the brain).

As part of their big eating duties, macrophages enjoy dining out on the odd invading pathogen or cell programmed for destruction as well as telling other immune cells what to do. A sort of Mr Creosote if you will (without the bucket). If you want the Star Wars version of macrophages (I'm not kidding) ... here you go (open-access).

Macrophages are activated by Gc-MAF (Gc Macrophage Activating Factor). The production of Gc-MAF is affected by nagalase (alpha-N-acetylgalactosaminidase) encoded by the gene NAGA. Nagalase affects the Gc protein (vitamin D3 binding protein) which has a knock-on effect blocking the production of Gc-MAF. The more nagalase activity, the less Gc-MAF is a rough-and-ready way to look at it. Less Gc-MAF equates as less macrophage activation according to this logic and some potential onward effects for immune function.

Why is it important? Well in cancer research, there is some preliminary chatter that tumors might be able to affect Gc-MAF function by way of altering nagalase activity (open-access)**. Such is the effect of increased nagalase and depressed Gc-MAF function that this has been put forward as a potential explanation of why cancers are able to 'avoid' the immune system and so develop unchecked. There is also some very preliminary evidence that giving supplemental Gc-MAF as an injection might affect cancer growth in animal models*** and human participants**** although this is still an area of some controversy given that one lab seems to be producing all the research.

So what's the logic of this area with autism in mind? I can't claim to be able to provide a definitive answer but one suggestion from press releases such as this one, are the reports of high levels of nagalase activity to be present in quite a few of the cohorts with autism looked at. Remember, nagalase negatively affects levels of Gc-MAF so potentially disrupting the activation of macrophages. Outside of malignant cells, there is a suggestion that elevated nagalase activity might be part and parcel of issues with immune function in cases of autism onwards to things like the presence of some kind of viral activity. Indeed this last point on viruses and nagalase I assume comes from other results on the use of Gc-MAF in the clearance of HIV infection***** bearing in mind replication is still required for this area of work.

So eventually we get back to the paper from Bradstreet and colleagues and in more detail:

  • Described as a chart review, 40 participants with autism who sought testing for nagalase activity, pre- and post assessment of nagalase following Gc-MAF injections were followed.
  • Diagnosis of participants was determined by having already received a DSM-IV diagnosis of autism independent of the study together with some in-house assessments on the severity of presentation.
  • Blood draws signalled the start of the nagalase activity assessment which was shipped to a lab already versed in looking for the enzymatic activity. 
  • Gc-MAF was injected on a weekly basis covering an average of 14 injections to get those macrophages stimulated, and nagalase activity assessed again.
  • Results: nagalase activity was generally higher in the autism group than the various reference ranges cited by the assaying laboratory.
  • Nagalase activity levels dropped in quite a few participants following Gc-MAF administration (24 of 40 decreased to within laboratory reference ranges) and "uncontrolled observations of GcMAF therapy indicated substantial improvements in language, socialization and cognition". Before we get too carried away though, lets remember those words "uncontrolled observations". 
  • Importantly (very importantly) no significant side-effects were reported, bearing in mind reports of elevated body temperature occurred post infusion and words like "By the second month, no patients experienced significant febrile events" were used.
  • The authors conclude that more research is required in this area.


OK. With the science hat on, one reiterates that this was a very, very preliminary case review and although Gc-MAF was "checked for sterility in-house and externally by the UK Health Protection Agency" apparently, this is still a compound under investigation and is still very experimental. I've not specifically made mention of Gc-MAF on this blog before this post. That being said, I have talked about nagalase in relation to some speculations on the now de-discovered work on XMRV and chronic fatigue syndrome (CFS).

There are some obvious questions raised from the findings reported by Bradstreet. So, assuming all that Gc-MAF does and how it apparently does it, the whole 'underactive immunity' side of autism comes into play. Indeed I'm immediately drawn back to the work by Harumi Jyonouchi and colleagues on SPAD and immunodeficiency detected in their cohort and the possible link with gastrointestinal (GI) dysfunction. That and the low IgA findings also observed on more than one occasion in cases of autism. Of course balancing all that with other findings indicative of other issues with immune function in cases of autism such as an overactive immune system and the whole autoimmunity side of things. I should perhaps also stress that I am not equating autism with HIV or cancer or anything else based on the description of these findings.

Perhaps just as important is the whole viral infection link being implied in some cases of autism by this work. I know this starts to take us into some quite uncomfortable territory with autism in mind as per the study by Mady Hornig and colleagues****** (including virus hunter Ian Lipkin) on a (mostly) lack of measles virus in reply to studies like the one from Kawashima and colleagues*******. I'm not really in a position to offer an expert opinion as to whether this is proof positive that specific viruses are or aren't involved in autism, over an above the multitude of viruses everyone comes across in a lifetime, albeit with an immune response in full working order and the focus being on autisms not autism. Think also back to that most classical autism-viral connection which looked at rubella******** quite a few years back. And then all those ancient remnants of viruses which we all carry in our genome and have been recently looked at with autism in mind and whether there are any connections to be made or not.

Irrespective of any controversy this might unearth - which I assume it probably will - the Bradstreet results are peer-reviewed results and hence worthy of further independent analysis. Perhaps Prof. Lipkin might once again step up to this task?

[Update: you may also want to have a look at the second time Gc-MAF has cropped up on the autism  research circuit too.]

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* Bradstreet JJ. et al. Initial observations of elevated alpha-N-acetylgalactosaminidase activity associated with autism and observed reductions from GC protein—macrophage activating factor injections. Autism Insights. 2012. 4: 31-38.

** Korbelik M. et al. The value of serum alpha-N-acetylgalactosaminidase measurement for the assessment of tumour response to radio- and photodynamic therapy. Br J Cancer. 1998; 77: 1009-1014.

*** Yamamoto N. & Nataparaju VR. Immunotherapy of BALB/c mice bearing Ehrlich ascites tumor with vitamin D-binding protein-derived macrophage activating factor. Cancer Res. 1997 Jun 1;57(11):2187-92.

**** Yamamoto N. et al. Immunotherapy of metastatic breast cancer patients with vitamin D-binding protein-derived macrophage activating factor (GcMAF). Int J Cancer. 2008; 122: 461-467.

***** Yamamoto N. et al. Immunotherapy of HIV-infected patients with Gc protein-derived macrophage activating factor (GcMAF). J Med Virol. 2009; 81: 16-26.

****** Hornig M. et al. Lack of association between measles virus vaccine and autism with enteropathy: a case-control study. PLoS ONE. 2008; 3: e3140.

******* Kawshima H. et al. Detection and sequencing of measles virus from peripheral mononuclear cells from patients with inflammatory bowel disease and autism. Dig Dis Sci. 2000; 45: 723-729.

******** Chess S. Follow-up report on autism in congenital rubella. J Autism Child Schizophr. 1977; 7: 69-81.

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ResearchBlogging.org James Jeffrey Bradstreet, Emar Vogelaar, & Lynda Thyer (2012). Initial observations of elevated alpha-N-acetylgalactosaminidase activity associated with autism and observed reductions from GC protein—macrophage activating factor injections Autism Insights

6 comments:

  1. Hi Paul Whiteley -

    Interesting stuff. I can tell you that my son with autism gets sick all the time, and stays sick a long time, for whatever that is worth. Speaking specifically towards viral clearance, it is interesting to note that when Enstrom (Differential monocyte responses to TLR ligands in children with autism spectrum disorders) toggled monocytes with different ligands, she reported that TLRs which recognize bacterial molecular patterns responded with more vigor, some TLRs that recognize viral infections responded less robustly compared to the control group.

    I think that it is important to note that Bradstreets cohort likely isn't a random sampling of kids with autism; he's a big DAN doctor, and most of the people who are going to him likely are doing so because:

    1) They have children that are severely affected.

    2) They've tried everything else. They've also probably tried lots of other things that Bradstreet has ideas on, didn't see progress, were the so called 'tough nuts', and eventually tried GC therpay.

    I'm not coming down on those parents, I was one and I understand their mind set, but I don't think we'd see 80% hits on a random sampling of kids with autism. Food for thought.

    - pD

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    1. I work part time as customer follow up for First Immune GcMAF and also monitor the web for mentions of GcMAF, hence I read your very interesting and well researched blog. In response to pD, I can assure you it works across the board and that parents of children with mild ADHD are seeing improvements, in fact this morning I received this reply - "Although C was diagnosed with autism 8 years ago he is now really adhd so the changes may be more subtle. He scored himself on the symptom severity profile. C says he feels energized after the jabs and has looked forward to having the last 2 jabs." So you can see, it isn't just the 'tough nuts' that it is working on. But, it only works on 85% of cases, there are 15% that show no improvement. Interestingly, we have also just seen improvements in type 1 diabetes, and that was a surprise to us. But it appears that also can have its roots in viral infection, and all GcMAF does is to improve the immune system.

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  2. Thanks pD.

    The Enstrom paper: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3014091/ remains of some real importance to autism for lots of different reasons. More reading on my part I think...

    I agree that questions about the representativeness of the Bradstreet cohort will need to be answered and whilst this paper is an initial foray into the world of nagalase and Gc-MAF and autism, we are left tantalised about many different variables potentially affecting the results and generalisability to other cases and other medical histories.

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  3. " given that one lab seems to be producing all the research." There are 48 research papers on GcMAF produced in a dozen research laboratories in countries including Japan, Italy, Belgium the UK and the USA - right around the world. Yes, the gcmaf.eu lab does both research and supplies the public, including the GcMAF for Dr Bradstreets work, but they are not the only research laboratory by a long chalk.

    GcMAF is a very well understood molecule. And its not controversial. Its the body's way of eradicating viruses - including those of autism. In viral, bacterial diseases and cancer, GcMAF is often the missing part of the immune system.

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  4. Thanks for the comment David.

    No offence was intended in that statement aside from noting that Yamamoto features heavily in the research so far conducted on Gc-MAF:
    http://www.ncbi.nlm.nih.gov/pubmed?term=gcmaf

    With autism in mind (the topic of this paper and post), Gc-MAF is currently not well understood insofar as autism is not well understood, and why nagalase levels for example, are elevated in some cases "beyond levels typically observed in metastatic cancer patients and HIV-infected patients".

    By saying this I'm not trying to take away from Dr Bradstreet's results; merely that these results invite much more scientific inquiry on both potential mechanism(s) and also related to clinical outcome (i.e. presentation of autistic and other symptoms).

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    1. Thanks Paul.

      Yamamoto was indeed the first, but the Professors Ruggiero and Pacini team of 10 scientists have done as much or more work on GcMAF.

      The GcMAF papers published on the American Pubmed system show many institutions and about 115 eminent scientists have been involved so far.

      I agree with your point about more research into autism mechanisms, but about 1,500 autistic children have now been through GcMAF treatment, (1000 through Dr Bradstreet, 200 through Dr Antonucci in Italy, smaller numbers through other doctors) and the results are pretty much uniform - 85% respond, and 15% have autism eradicated.

      And for the other 15% it does nothing at all.

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