Mali Update–March 2008

View: Report from Mali – Part One or Report from Mali – Part Two or Report from Mail – Part Three

After several months of gaining approvals from Mali Health Officials (the need for one of which was unexpected due to a new Health Minister) and clarifying various protocol details, the LDN Research Program is now in full swing. The team of doctors and support people has been working together since September; we have been conducting weekly phone conference calls with the Leadership Team since the first of the year; and everyone’s enthusiasm is growing as we actively recruit participants for the program.

Part of the Leadership Team
Part of the Leadership Team

For Drs. Bihari and Gluck (in New York) who have been pursuing LDN in the treatment of HIV/AIDS for more than twenty years and trying to get the Mali Program going since 2000, this is a exciting moment. For Malians like the Nafo family who have been instrumental in getting the Mali Project going for many years and Seyni Nafo in particular (now getting a graduate degree in economics in Montreal) this is a particularly auspicious time.

As of the end of February, the group of people who will be getting LDN only should be at least half enrolled and the group receiving both the anti-retrovirals and LDN, and the group receiving just the HAART drugs could reach full enrollment by the middle of April. That means we could be getting preliminary results from the study by the end of the summer and almost certainly by the time we return to Mali in November.

The first of the council groups that are the core of the “Gender Education and Communication Project” will start this week. We have decided to begin with separate men’s and women’s groups in order to get the council program off the ground as effectively as possible. The lack of cultural traditions that support open dialog between men and women—including husbands and wives—is so prevalent that it will take some time before mixed council groups are likely to be successful. The mixture of polygamous and monogamous marriage that is the current scene in Bamako adds to the challenges involved in achieving open dialog. We are hopeful, however–and so are the trained Mali facilitators–that mixed groups will eventually be possible, hopefully well before the end of the program.

Another piece of exciting news is that Jaquelyn has been asked to be a speaker at the 4th annual LDN Conference, which will be held this year at the University of Southern California in Los Angeles on Saturday, October 11th.. This conference deals with the growing role of LDN in the treatment of a variety of illnesses including: MS, Crohn’s Disease, Fibromyalgia and, of course HIV/AIDS. LDN is also showing up increasingly in the treatment of cancer, diabetes and many other illnesses where a stronger immune system can play a major role in healing. We continue to feel that LDN will play an increasingly important role in the “New Medicine” that works directly to strengthen the immune system rather than dealing primarily with the suppression of symptoms. Jaquelyn will present whatever preliminary results are available from the Mali Program in October, as well as discussing her ongoing and successful use of LDN in the treatment of autism. We are also hopeful that the Mali Project Principal Physician Investigator, Professor Abdel Kader Traore` will be able to participate in the October meeting.

Various people have been asking us about how LDN works and why it is remarkably (almost miraculously) effective in some situations and less so in others. There is a growing amount of basic LDN research going on at major universities (Stanford, Pennsylvania State University) and some of the mechanisms that make LDN so useful are beginning to be understood. Here’s a brief summary of what we know at this time.

Naltrexone is an opiate antagonist widely used treating opiate drug and alcohol addiction since the 1970s. It has been FDA-approved since 1985 and is now available in generic form as well as in the brand name ReVia in 50mg tablets. At the regular dosage for treating addiction (usually less than 150 mg a day) Naltrexone blocks the euphoric response to opiates such as heroin or morphine as well as alcohol. At its ultra small doses (less than 4.5 mg a day) LDN acts as an immune system booster/modulator.

Opioids are endorphins which are known from extensive recent research to operate as the principal communication signalers of the immune system (called “cytokines”). Opioids create immunomodulatory effects through opioid receptors on immune cells. The immune system works in two basic ways: “Th1” cells promote cell-mediated immunity; “Th2” cells induce immunity in and through the fluid systems of the body. Simplistically, the inability to respond adequately with a Th1 response can result in chronic infection and serious illnesses such as cancer. An overactive Th2 response can contribute to allergies and related syndromes, and plays a role in autoimmune disease (such as autism and HIV/AIDS). The Th1/Th2 balance is a critical measure of the health of an immune system. A large body of research in the last two decades has pointed repeatedly to the opioid secretions that our bodies generate as playing the central role in the beneficial orchestration of the immune system.

An Up Close Glimpse of NaltrexoneWhen LDN is given (only once daily as a capsule or crème) between 9 p.m. and 2 a.m., the pituitary is alerted and the body attempts to overcome the opioid block with an endorphin elevation, staying elevated throughout the next 18 hours. This timing is important as it works with the circadian rhythm to put out the needed endorphins between 2-4 am. The endorphin elevation, in turn, tends to normalize the immune system with virtually no side effects or toxicity. Naltrexone, even at full dosage, is considered very safe, has never been reported as being addicting and is not contraindicated with any medication except, of course, narcotics (e.g. painkillers), as it may lower their effectiveness. It may slightly offset the benefits of steroids when given simultaneously but we hear from many people now who are using both that they are doing so without any problems while they wean themselves off of steroids. Studies in human cancer patients show that LDN acts to increase natural killer cells and other healthy immune defenses, and hundreds of multiple sclerosis patients have totally halted progression of their disease for up to 8-10 years or more since they started using LDN regularly. Photo: An Up Close Glimpse of Naltrexone (Courtesy of Michael W. Davidson, Florida State Univ.)

So, briefly said, the major therapeutic action of LDN is the restoration of the body’s normal production of endorphins in those with autoimmune diseases such as HIV/AIDS. We trust that the Mali Program, now fully underway, will show conclusively that this restoration is significant enough to prevent the vast majority of HIV + individuals from developing full-blown AIDS.

Children Playing at the Mali Center for Disease Control
Children Playing at the Mali Center for Disease Control

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