Re: Keloids - AA overload diseaseTaka wrote:
> On May 18, 2:06 pm, Marshall Price <d0213...@yahoo . com > wrote:
>> Taka wrote:
>>> Prostaglandins Leukot Essent Fatty Acids. 2000 Nov;63(5):237-45.
>>> Keloids in rural black South Africans. Part 1: general overview and
>>> essential fatty acid hypotheses for keloid formation and prevention.
>>> Louw L.
>>> Department of Anatomy and Cell Morphology, University of the Orange
>>> Free State, Bloemfontein, South Africa.
>>> In the first part of this study a general overview on the hypertrophic
>>> scar and keloid phenomena regarding history, epidemiology,
>>> histopathology and aetiology, in general, together with an essential
>>> fatty acid approach as basis for hypotheses of keloid formation and
>>> prevention are given. Upon reviewing the literature in planning a
>>> strategy for prevention and treatment of keloids, one encounters an
>>> overwhelming amount of hypotheses on this topic. Based on a
>>> preliminary study on total fatty acid compositions in keloids,
>>> compared with normal skin of keloid prone and non-keloid prone
>>> patients, there can be argued as follows: an essential fatty acid
>>> deficiency of precursors and inflammatory competitors for arachidonic
>>> acid may be a factor in the multifactorial aetiology of keloid
>>> formations, and apart from a local essential fatty acid deficiency in
>>> the wound area, nutrition may also be a contributing factor in rural
>>> black South Africans. To confirm or refute the stated hypotheses of
>>> the role of essential fatty acids in keloid formation and prevention
>>> (outlined in this part of the study), dietary questionnaires and blood
>>> (plasma and red blood cell) phospholipid analyses for general
>>> information and true fatty acid intake and metabolism, respectively,
>>> in the diets of these patients (outlined in part II of this study), as
>>> well as a lipid model for keloid formations regarding phospholipids,
>>> triglycerides, cholesterol esters and free fatty acids (outlined in
>>> part III of this study), are given. The purpose of this comprehensive
>>> fatty acid study was an attempt to assess the enigma surrounding
>>> keloids and to end the nightmare of the plastic and reconstructive
>>> surgeon, since these dermal tumours are notoriously recurrent.
>>> PMID: 11090249
>>> Prostaglandins Leukot Essent Fatty Acids. 2000 Nov;63(5):247-53.
>>> Keloids in rural black South Africans. Part 2: dietary fatty acid
>>> intake and total phospholipid fatty acid profile in the blood of
>>> keloid patients.
>>> Louw L, Dannhauser A.
>>> Department of Anatomy and Cell Morphology, University of the Orange
>>> Free State, Bloemfontein, South Africa.
>>> In the second part of this study, emphasis is placed on nutritional
>>> intakes (fatty acids and micronutrients) and fatty acid intake and
>>> metabolism in the blood, respectively, according to a combined 24 h
>>> recall and standardized food frequency questionnaire analyses of
>>> keloid prone patients (n=10), compared with normal black South
>>> Africans (n=80), and total phospholipid blood (plasma and red blood
>>> cell ) analyses of keloid patients (n ), compared with normal
>>> individuals (n ). Lipid extraction and fractionation by standard
>>> procedures, total phospholipid (TPL) separation with thin layer
>>> chromatography, and fatty acid methyl ester analyses with gas liquid
>>> chromatography techniques were used. Since nutrition may play a role
>>> in several disease disorders, the purpose of this study was to confirm
>>> or refute a role for essential fatty acids (EFAs) in the hypothesis of
>>> keloid formations stated in part 1 of this study. (1)According to the
>>> Canadian recommendation (1991), we observed that in keloid patients
>>> linoleic acid (LA) and arachidonic acid (AA) dietary intakes, as EFAs
>>> of the omega-6-series, are higher than the recommended 7-11 g/d.
>>> However, the a-linolenic acid (ALA), eicosapentaenoic acid (EPA) and
>>> docosahexaenoic acid (DHA) dietary intakes, as EFAs of the omega-3
>>> series, are lower than the recommendation of 1.1-1.5 g/d. This was
>>> also the case in the control group, where a higher dietary intake of
>>> the omega-6 fatty acids and a slightly lower dietary intake of the
>>> omega-3 fatty acids occurred. Thus, we confirm a high dietary intake
>>> of LA (as a product of organ meats, diary products and many vegetable
>>> oils) and AA (as a product of meats and egg yolks), as well as lower
>>> dietary intakes of ALA (as a product of grains, green leafy
>>> vegetables, soy oil, rapeseed oil and linseed), and EPA and DHA (as
>>> products of marine oils). Lower micronutrient intakes than the
>>> recommended dietary allowances were observed in the keloid group that
>>> may influence EFA metabolism and/or collagen synthesis. Of cardinal
>>> importance may be the lower intake of calcium in the keloid patients
>>> that may contribute to abnormal cell signal transduction in
>>> fibroblasts and consequent collagen overproduction, and the lower
>>> copper intake that may influence the immune system, or perhaps even
>>> the high magnesium intake that stimulates metabolic activity.
>>> Micronutrient deficiencies also occurred in the diets of the normal
>>> black South Africans that served as a control group. In the case of
>>> plasma TPLs, deficiency of the omega-3 EFA series (ALA, EPA and DHA)
>>> occurred, and this is in accordance with the apparent lower omega-3
>>> EFA intake in the diets of these patients. In the case of the red
>>> blood cell TPLs, as a true and reliable source of dietary fatty acid
>>> intake and metabolism, sufficient EFAs of the omega-6 series (LA and
>>> AA) and the omega-3 series (ALA, EPA and DHA) occurred. For this study
>>> group a relative deficiency of nutritional omega-3 EFA intake
>>> apparently did occur, but was probably compensated for by blood fatty
>>> acid metabolism.
>>> PMID: 11090250
>>> Prostaglandins Leukot Essent Fatty Acids. 2000 Nov;63(5):255-62.
>>> Keloids in rural black South Africans. Part 3: a lipid model for the
>>> prevention and treatment of keloid formations.
>>> Louw L.
>>> Department of Anatomy and Cell Morphology, University of the Orange
>>> Free State, Bloemfontein, South Africa.
>>> In the third part of this study a basic lipid model (regarding
>>> phospholipids, triglycerides, cholesterol esters and free fatty acids)
>>> for keloids (n ), compared with normal skin of keloid prone and non-
>>> keloid prone patients (n of each), was constructed according to
>>> standard methods, to serve as a sound foundation for essential fatty
>>> acid supplementation strategies in the prevention and treatment of
>>> keloid formations. Essential fatty acid deficiency (EFAD) of the
>>> omega-6 series (linoleic acid (LA), g-linolenic acid (GLA), and dihomo-
>>> g-linolenic acid (DGLA)) and the omega-3 series (a-linolenic acid
>>> (ALA) and eicosapentaenoic acid (EPA)), but enhanced arachidonic acid
>>> (AA) levels, were prevalent in keloid formations. Enhanced AA, but a
>>> deficiency of AA precursors (LA, GLA and DGLA) and inflammatory
>>> competitors (DGLA and EPA), are inevitably responsible for the
>>> overproduction of pro-inflammatory metabolites (prostaglandin E(2)
>>> (PGE(2))) participating in the pathogenesis of inflammation. Of
>>> particular interest was the extremely high free oleic acid (OA) levels
>>> present, apart from the high free AA levels, in the keloid formations.
>>> OA stimulates PKC activity which, in turn, activates PLA(2)activity
>>> for the release or further release of AA from membrane pools.
>>> Interactions between EFAs, eicosanoids, cytokines, growth factors and
>>> free radicals can modulate the immune response and the immune system
>>> in undoubtedly involved in keloid formation. The histopathology of
>>> keloids can be adequately explained by: persistence of inflammatory-
>>> and cytokine-mediated reactions in the keloid/dermal interface and
>>> peripheral areas, where fibroblast proliferation and continuous
>>> depletion of membrane linoleic acid occur; microvascular regeneration
>>> and circulation of sufficient EFAs in the interface and peripheral
>>> areas, where maintenance of metabolic active fibroblasts for collagen
>>> production occur; microvessel occlusion and hypoxia in the central
>>> areas, where deprivation of EFAs and oxygen with consequent fibroblast
>>> apoptosis occur, while excessive collagen remain. All these factors
>>> contribute to different fibroblast populations present in: the
>>> keloid / dermal interface and peripheral areas where increases in
>>> fibroblast proliferation and endogenous TGF-b occur, and these
>>> metabolic active fibroblast populations are responsible for enhanced
>>> collagen production: the central areas where fibroblast populations
>>> under hypoxic conditions occur, and these fibroblasts are responsible
>>> for excessive collagen production. It was concluded that: fibroblast
>>> membrane EFAD of AA precursors and inflammatory competitors, but
>>> prevailing enhanced AA levels, can contribute to a chain of reactions
>>> eventually responsible for keloid formations.
>>> PMID: 11090251
>> Incidentally, I saw a show on TV recently about Captain Cook's first
>> exploratory voyage (in 1768, searching for the hypothetical great
>> southern continent) in which it was stated that one of the signs of
>> scurvy is that "old wounds re-open." I can't help wondering whether
>> ascorbic acid might play an important role in the formation and
>> maintenance of scar tissue.
>>
>> Assuming that the fatty acid connection (the "basic lipid model")
>> discussed in these articles is valid, I wonder whether ascorbyl
>> palmitate (which mixes with lipids) might help heal wounds with healthy
>> scars, and prevent keloid formation.
>>
>> Another thought. There was a report on TV recently about a man who'd
>> lost a significant amount of the distal portion of one of his fingers in
>> an accident. By grafting on some sort of artificially-formed connective
>> tissue, his medical team encouraged the finger to regrow perfectly.
>> Considering the complexity of fingertips, I found this very impressive.
>>
>> It suggests that wound healing might be improved not only by fixing a
>> "raw" matrix of connective tissue in place, but also, perhaps, by
>> encouraging the formation of new connective tissue by nutritional
>> interventions.
>>
>> --
>> Marshall Price of Miami
>> Known to Yahoo as d021317c
>
> What you need to regenerate tissue rather than scar it is
> dedifferentiated fibroblasts with the local clues in which part of the
> body they are. Scar formation is encouraged by oxygen and the
> mediator here is likely AA. Also one organ which can completely
> regenerate is the liver but when it is overloaded with AA it rather
> forms scar tissue resulting in a disease. Immunity plays a major role
> in regeneration versus scarring as demonstrated on the unusual
> "autoimmune" MRL mouse strain ( * news.bbc.co.uk/2/hi/science/nature/4888080.stm
> ). I would love to see which lipids and eicosanoids this mouse versus
> normal mouse use. I bet Mead acid is the major PUFA in the blastemas
> such as in the growing deer antlers. Also look at what Monty has to
> say about his wounds - perfect healing. Ray Peat also wrote an
> interesting essay about regeneration:
> * raypeat . com /articles/articles/adaptive-substance.shtml
That's "an interesting essay about regeneration"? Whatever it is,
it's too long and kooky for me. I read about a quarter of it before I
realized I had no idea what he was going on about.
I liked the mouse article, though.
About livers, it isn't true that they can completely regenerate
themselves. Once a lobe is gone, the other two can grow bigger, but
that lobe will never grow back, and if all three are sick enough, the
whole organ is lost.
I remember reading a disappointing passage in my pathology textbook,
where I discovered that contrary to my intuition, there is no "ideal
pattern" that an organism constantly strives to complete. Instead,
healing consists of many mechanisms for dealing with specific problems
which have evolved over time to promote survival. If a broken bone is
improperly aligned, the organism will adapt in multifarious ways to cope
with the new shape, but the fracture itself won't gradually straighten
out. The forces on it will always be different from those on a newly
developing bone.
--
Marshall Price of Miami
Known to Yahoo as d021317c