Euthyroid sick syndrome
Euthyroid sick syndrome is defined as a condition of low T3 low T4 syndrome. According ot the study by the Mayo Clinic, in other word this is the abnormalities of thyroid hormone
concentrations seen commonly in a wide variety of nonthyroidal
illnesses, resulting in low triiodothyronine, total thyroxine, and thyroid stimulating hormone concentrations(a). Decreased triiodothyronine (T3) levels are most common. Patients with more severe or prolonged illness also have decreased thyroxine (T4) levels. Serum reverse T3 (rT3)
is increased. Patients are clinically euthyroid and do not have
elevated thyroid-stimulating hormone (TSH) levels(b). Causes of
euthyroid sick syndrome include a number of acute and chronic
conditions, including pneumonia, fasting, starvation, sepsis, trauma,
cardiopulmonary bypass, malignancy, stress, heart failure, hypothermia,
myocardial infarction, chronic renal failure, cirrhosis, and diabetic
ketoacidosis and inflammatory bowel disease(c). Others, in the study of
classified SES into 3 subgroups according
to the different alterations seen in the values of T3, T4, FT3, FT4,
TSH, rT3 and TBG suggested that in SES type I
the diseases seen, in order of frequency, were: obstructive chronic
bronchopneumopathy with acute respiratory failure, diabetic
ketoacidosis, neoplasms,
ischemic heart disease, cardiac failure, chronic renal failure, liver
diseases, acute cerebral vasculopathies, sepsis and collagenopathies.
The disease seen in the 2 cases of SES type II was obstructive chronic bronchopneumopathy with acute respiratory failure. In SES
type III the diseases seen were, in order of frequency: diabetic
ketoacidosis, lung diseases, ischemic heart disease, cardiac failure,
peripheral arteriopathies, acute cerebral vasculopathies, neoplasms, liver diseases, acute renal failure(d).
Euthyroid sick syndrome as a result of Sepsis
Sepsis is defined as a condition caused by chemicals released
into the bloodstream to fight the infection trigger inflammation
throughout the body as a result of severe infection(a)(b). according to
the study by the University of Utah, sepsis is the commonest cause of admission to medical ICUs across the world. Mortality from sepsis continues to be high. Besides shock and multi-organ dysfunction occurring following the intense inflammatory reaction to sepsis, complications arising from sepsis-related immunoparalysis contribute to the morbidity and mortality from sepsis(c).
Preventions
Phytochemicals and antioxidants to prevent sepsis
1. Vitamin A and Immunity as antioxidants
Vitamin A occurs in the form retinol and is best known for its function
in maintaining the health of cell membrane, hair, skin, bone, teeth
and eyes. It also plays an important role as an antioxidant as it
scavenges free radicals in the lining of the mouth and lungs; prevents
its depletion in fighting the increased free radicals activity by
radiation; boosts immune system in controlling of free radicals;
prevents oxidation of LDL and enhances the productions of insulin
pancreas(51).
2. High dose of vitamin C and Immune system
In the first comparative analysis of the ex vivo and in vitro molecular and
cellular mechanisms of action of IFN-α and high-dose AA in HAM/TSP, found that in comparison to IFN-α, high-dose AA treatment has superior ex vivo and
in vitro cell death-inducing, antiproliferative and immunomodulatory
anti-HTLV-1 effects. Differential pathway activation by both drugs opens
up avenues for targeted treatment in specific patient subsets(52).
3. Vitamin E and Immunity
Vitamin E is the most important chain-breaking, lipid-soluble
antioxidant present in body tissues of all cells and is considered the
first line of defense against lipid peroxidation and it is important for
normal function of the immune cells. However, vitamin E deficiency
is rare in well-nourished healthy subjects and is not a problem, even
among people living on relatively poor diets, both T- and B-cell
functions are impaired by vitamin E deficiency. While immune
cells are particularly enriched in vitamin E because of their high
polyunsaturated fatty acid content, this point puts them at especially
high risk for oxidative damage, according to the study by Dr. Pekmezci D. at the University of Ondokuz Mayıs(53).
4. Allyl sulfides and Immune system
According
to the article of "GARLICTHE BOUNTIFUL BULB" by Carmia Borek, Ph.D.
posted in Life extension magazine, the author indicated that human
studies confirm immune stimulation by garlic. Subjects receiving aged
garlic extract at 1800 mg a day for three weeks showed a 155.5%
increase in natural killer immune cell activity that kills invaders and
cancer cells. Other subjects receiving large amounts of fresh garlic
of 35g a day, equivalent to 10 cloves, showed an increase of 139.9%.
In six weeks, patients with AIDS receiving aged garlic extract showed
an enhancement of natural killer cells from a seriously low level to a
normal level(54).
5. Allicin is phytochemical containing sulfur in the class of organosulfur compound, found abundantly in onion and garlic.
Antibacterial activities
In the comparison of those of allicin
and several clinically useful antibiotics using two representative
bacteria commonly found in the human environment, Gram-positive S.
aureus and Gram-negative Escherichia coli, indicated that The garlic
extract had more potent anti-staphylococcal activity than an equal
amount of allicin. In terms of antibiotic potency against Gram-positive and Gram-negative bacteria, authentic allicin
had roughly 1-2% of the potency of streptomycin (vs. S. aureus), 8%
of that of vancomycin (vs. S. aureus), and only 0.2% of that of
colistin (vs. E. coli), according to "Antibacterial potential of garlic-derived allicin and its cancellation by sulfhydryl compounds" by Fujisawa H, Watanabe K, Suma K, Origuchi K, Matsufuji H, Seki T, Ariga T.(54).
6. Cinnamon
a. Immunomodulatory effect
In
administration of popular herb used in traditional medicine to treat
various disorders such as chronic gastric symptoms, arthritis, and the
common cold and its immunomodulatory effect found that observations
provided evidence that CWE was able to down-regulate IFN-γ expression
in activated T cells without altering IL-2 production, involving
inhibition of p38, JNK, ERK1/2, and STAT4, according to the study of "Immunomodulatory effect of water extract of cinnamon on anti-CD3-induced cytokine responses and p38, JNK, ERK1/2, and STAT4 activation" by Lee BJ, Kim YJ, Cho DH, Sohn NW, Kang H.(55)
b. Antimicrobial Activities
In the observation of three natural essential oils (i.e., clove bud oil, cinnamon oil, and star anise oil) and their antimicrobal effects found that the cinnamon
oil-chitosan film had also better antimicrobial activity than the
clove bud oil-chitosan film. The results also showed that the
compatibility of cinnamon oil with chitosan in film formation was better than that of the clove bud oil with chitosan, according to the study of "Synergistic Antimicrobial Activities of Natural Essential Oils with Chitosan Films" by Wang L, Liu F, Jiang Y, Chai Z, Li P, Cheng Y, Jing H, Leng X.(56)
c. Anti-inflammatory activity
In
the investigation of Myristicin
(1-allyl-5-methoxy-3,4-methylenedioxybenzene) is an active aromatic
compound found in nutmeg (the seed of Myristica fragrans), carrot,
basil,cinnamon,
and parsley and it anti-inflammatory effects found that Myristicin
significantly inhibited the production of calcium, nitric oxide
(NO),interleukin (IL)-6, IL-10, interferon inducible protein-10,
monocyte chemotactic protein(MCP)-1, MCP-3, granulocyte-macrophage
colony-stimulating factor, macrophage inflammatory protein (MIP)-1α,
MIP-1β, and leukemia inhibitory factor in
dsRNA[polyinosinic-polycytidylic acid]-induced RAW 264.7 cells (P <
0.05), according to the study of "Anti-inflammatory effect of myristicin on RAW 264.7 macrophages stimulated with polyinosinic-polycytidylic acid" by Lee JY, Park W.(57)
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Sources
(a) http://en.wikipedia.org/wiki/Sepsis
(b) http://www.mayoclinic.com/health/sepsis/DS01004
(c) http://www.ncbi.nlm.nih.gov/pubmed/24082613
(51) http://medicaladvisorjournals.blogspot.ca/2012/01/antioxidants-and-common-free-radical.html
(52) http://www.ncbi.nlm.nih.gov/pubmed/22848768
(53) http://www.ncbi.nlm.nih.gov/pubmed/21419272
(54) http://www.ncbi.nlm.nih.gov/pubmed/19734685
(55) http://www.ncbi.nlm.nih.gov/pubmed/22053946
(56) http://www.ncbi.nlm.nih.gov/pubmed/22034912
(57) http://www.ncbi.nlm.nih.gov/pubmed/21991618
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