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TNF inhibition as a likely candidate for the treatment of Dupuytren's Disease

by Jim Carver

Conventional western medicine provides very little aside from surgery, radiation (in Europe) and an enzyme (collagenase) for the treatment of Dupuytren's Contracture or Disease (DC) . All these procedures are destructive, (I've had the physical surgery myself.), and lead to complications of their own. These therapies also have a very high rate of re-occurrence with subsequent treatments leading to further complications. What is needed then, is a chemical solution that greatly slows or arrests the disease completely. I have some positive results and while I have not done a long term study, I do believe I have enough positive results on myself that I can recommend some things to try.

Dupuytren's contracture is a genetic disease in which the palmar fascia becomes abnormally thick due to the fact that there is a change of collagen type. Normally, the palmar fascia consists of collagen type I, but if a patient has Dupuytren’s disease, the collagen type I changes to collagen type III, which is significantly thicker than collagen type I. Onset of the disease is usually the formation of a nodule of hardened tissue and later a visible cord develops and thickens. This leads to loss of function, a drawing in of the tendon and weakness.

The cell responsible for development of the disease is the myofibroblast. Researchers (Liaquat S. Verjee et al, 2013) excised myofibroblasts from patients with the disease to try and define the signaling pathways for their formation. They found significant numbers of immune cells, including classically activated macrophages and high levels of proinflammatory cytokines. They compared the effects of these cytokines on contraction and profibrotic signaling pathways in fibroblasts from the palmar and nonpalmar dermis of Dupuytren’s patients and palmar fibroblasts from non-Dupuytren’s patients. Addition of TNF (Tumor necrosis factors), but not other cytokines, promoted differentiation of fibroblasts into myofibroblasts in Dupuytren's patients. Neutralizing antibodies to TNF inhibited the contractile activity of myofibroblasts derived from Dupuytren’s patients, reduced their expression of α-smooth muscle actin, and mediated disassembly of the contractile apparatus.

In plain English: There are compounds known as TNFs and for a short explanation of these I refer you to the wiki: TNF . Some TNF is absolutely necessary for proper immune function. Excessive amounts are being implicated in a host of autoimmune disorders and some types of cancer. There are some new drugs on the market that are TNF inhibitors but none currently in testing for DC. I also note that these drugs (one of which is self-injectable) carry a high price tag and some potentially fatal side-effects. This is of course depending if you could get your doctor to prescribe an off label use and that is by no means certain. So the rest of this article focuses on natural ways to lower TNF by the use of naturally derived substances. (We don't have time to wait on them.)

The first things to do are the simplest and the hardest:
1. Eat a healthy balanced diet.
2. Exercise, especially stretching, of the whole body, not just the hand(s).
3. If you smoke, try to quit. If you drink, quit or cut down.
4. Eat foods and drink teas that have a high degree of antioxidants, green tea, black tea, sour cherry juice, cranberry, etc.
5. Take supplements that have a high TNF inhibitory response, you can google around for yourself, but here's some I have come up with:

Fish oil (9 g per day in three divided doses)
CoEnzyme Q10
Vitamin E (mixed tocopherols)
Flax seed oil
Turmeric (courcumin)
N-Acetyl-L-Cysteine
Acetyl-L-Carnitine
Garlic capsules and use Allium species in the diet such as onions, garlic and leeks
Magnesium (preferably a time release form like Jig Saw brand)
Herbs and spices that have a good degree of polyphenolic compounds such as cloves, cinnamon and basil.

Free form amino acids to help the stuff work better

Now I did save the best for last and the ones that have had the largest effect lately:
*A proprietary product called Nexrutine, it is the extract of Phellodendron amurense (cork tree) 500 mg/4 times per day
*Seasons of Discontent herbal tea blend from Mountain Rose, formulated for people with allergies (see the connection?).
Contains: organic Nettle leaf, organic Fennel seed, organic Lemongrass, organic Spearmint leaf, organic Eyebright, organic Calendula flowers, organic Peppermint leaf, organic Red Clover herb and blossoms, organic Lavender flowers, organic Blue Vervain, and organic Stevia leaf.
Drink it three times a day. If you can't get this blend, then use stinging nettle leaf.

Okay that's it for now. I'm working on a topical creme to go with the supplements and will feature Red Sage root for its novel magnesium compound. There's also some other Japanese herbs I can't find in the US I'm working on getting also.
If you want to see the papers I've been reviewing go to:
http://gloresis.com/node/575 through 587 or just follow along in the book or choose from the list below.

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