Neuroprotection from glutamate toxicity with ultra-low dose glutamate

Exploring the scope of homoeopathy in combating the unfortunate consequences of post-COVID-19 survivors based on non-COVID conditions: a narrative review

OBJECTIVES

The long-term consequences of COVID-19 survivors care and post-coronavirus infection are not yet well understood. The review aims to see whether homoeopathy can help COVID-19 survivors recover from its consequences and improve their quality of life.

CONTENT

A systematic search of published articles for post-COVID sequelae and the impact of Homoeopathy were conducted. For the literature search, the major electronic bio-medical database PubMed/MEDLINE was used. In addition, supplementary searches were conducted through the references of those published articles.

SUMMARY

A total of 113 records were identified of which 61 studies included for this review. Homoeopathy is effective in the treatment of mental disorders including anxiety and depressive disorder (ADD), some research studies have found, although systematic reviews disagree. Likewise, some medical societies denounce homoeopathy for pain management; other literature shows that it can be used to treat pain effectively. Homoeopathy can aid in the treatment of cardiovascular diseases, as Crataegus, a homoeopathic medication, was found to be just as effective as a standard angiotensin-converting enzyme (ACE) inhibitor and diuretic treatment for minor cardiac insufficiency. The outcomes for Chronic Fatigue Syndrome (CFS), Influenza, and Acute Respiratory Tract Infections (ARTIs) are also promising.

OUTLOOK

Based on the results of homoeopathy in non-COVID conditions, it can be thought of in the management of post-COVID-19 outcomes. Consequently, we propose that while investigating post-COVID-19 patient rehabilitation, homoeopathic management may be included as part of the follow-up route and as much data as possible in the context of homoeopathy should be collected, so that in future, the role of homoeopathy in dealing with it can be better demonstrated.

An expression system of channelrhodopsin-2 driven by a minimal Arc/Arg3.1 promoter and Tet system was developed in human neuroblastoma cells

Advances in neuroscience have relied on the development of techniques that examine neuronal cell activities. One major challenge involves the limitations in labeling and controlling neuronal activities relating to the cell's activation state. In this study, the modified human codon-optimized channelrhodopsin-2 photoreceptor hChR2(C128S) was integrated into function with inducible gene expression methods and materials: the Tet system and the highly efficient minimum promoter of Arc/Arg3.1. The system successfully expressed the target fusion gene exclusively in activated SH-SY5Y human neuroblastoma cells while maintaining the essential characteristics of ChR2. The expression of the channelrhodopsin construct was observed, while the expression duration was refined by treatment with doxycycline. The optogenetic construct here tested the application of the minimum Arc/Arg3.1 promoter, an advanced immediate-early gene promoter, for the expression of the channelrhodopsin gene. Along with its noninvasive nature, this expression system promises to serve dual functions as a cell activity indicator and cell actuator, creating the possibility for researchers to precisely label cells according to their activation state and control the activities of specific neuronal cell populations.

Effects of Homeopathic Preparations on Human Prostate Cancer Growth in Cellular and Animal Models

The use of dietary supplements for various ailments enjoys unprecedented popularity. As part of this trend, Sabal serrulata (saw palmetto) constitutes the complementary treatment of choice with regard to prostate health. In homeopathy, Sabal serrulata is commonly prescribed for prostate problems ranging from benign prostatic hyperplasia to prostate cancer. The authors' work assessed the antiproliferative effects of homeopathic preparations of Sabal serrulata, Thuja occidentalis, and Conium maculatum, in vivo, on nude mouse xenografts, and in vitro, on PC-3 and DU-145 human prostate cancer as well as MDA-MB-231 human breast cancer cell lines. Treatment with Sabal serrulata in vitro resulted in a 33% decrease of PC-3 cell proliferation at 72 hours and a 23% reduction of DU-145 cell proliferation at 24 hours (P<.01). The difference in reduction is likely due to the specific doubling time of each cell line. No effect was observed on MDA-MB-231 human breast cancer cells. Thuja occidentalis and Conium maculatum did not have any effect on human prostate cancer cell proliferation. In vivo, prostate tumor xenograft size was significantly reduced in Sabal serrulata–treated mice compared to untreated controls (P=.012). No effect was observed on breast tumor growth. Our study clearly demonstrates a biologic response to homeopathic treatment as manifested by cell proliferation and tumor growth. This biologic effect was (i)significantly stronger to Sabal serrulata than to controls and (ii)specific to human prostate cancer. Sabal serrulata should thus be further investigated as a specific homeopathic remedy for prostate pathology.

A model for homeopathic remedy effects: low dose nanoparticles, allostatic cross-adaptation, and time-dependent sensitization in a complex adaptive system

Background

This paper proposes a novel model for homeopathic remedy action on living systems. Research indicates that homeopathic remedies (a) contain measurable source and silica nanoparticles heterogeneously dispersed in colloidal solution; (b) act by modulating biological function of the allostatic stress response network (c) evoke biphasic actions on living systems via organism-dependent adaptive and endogenously amplified effects; (d) improve systemic resilience.

Discussion

The proposed active components of homeopathic remedies are nanoparticles of source substance in water-based colloidal solution, not bulk-form drugs. Nanoparticles have unique biological and physico-chemical properties, including increased catalytic reactivity, protein and DNA adsorption, bioavailability, dose-sparing, electromagnetic, and quantum effects different from bulk-form materials. Trituration and/or liquid succussions during classical remedy preparation create “top-down” nanostructures. Plants can biosynthesize remedy-templated silica nanostructures. Nanoparticles stimulate hormesis, a beneficial low-dose adaptive response. Homeopathic remedies prescribed in low doses spaced intermittently over time act as biological signals that stimulate the organism’s allostatic biological stress response network, evoking nonlinear modulatory, self-organizing change. Potential mechanisms include time-dependent sensitization (TDS), a type of adaptive plasticity/metaplasticity involving progressive amplification of host responses, which reverse direction and oscillate at physiological limits. To mobilize hormesis and TDS, the remedy must be appraised as a salient, but low level, novel threat, stressor, or homeostatic disruption for the whole organism. Silica nanoparticles adsorb remedy source and amplify effects. Properly-timed remedy dosing elicits disease-primed compensatory reversal in direction of maladaptive dynamics of the allostatic network, thus promoting resilience and recovery from disease.

Summary

Homeopathic remedies are proposed as source nanoparticles that mobilize hormesis and time-dependent sensitization via non-pharmacological effects on specific biological adaptive and amplification mechanisms. The nanoparticle nature of remedies would distinguish them from conventional bulk drugs in structure, morphology, and functional properties. Outcomes would depend upon the ability of the organism to respond to the remedy as a novel stressor or heterotypic biological threat, initiating reversals of cumulative, cross-adapted biological maladaptations underlying disease in the allostatic stress response network. Systemic resilience would improve. This model provides a foundation for theory-driven research on the role of nanomaterials in living systems, mechanisms of homeopathic remedy actions and translational uses in nanomedicine.

A Review of Use of Enantiomers in Homeopathy

This paper reviews publications of laboratory experiments using pairs of enantiomers in homeopathy. Many molecules in nature have geometry which enables them to exist as nonsuperimposable mirror images or enantiomers. Modulation of toxicity of such molecules provides possibility for therapeutics, since they target multiple points in biochemical pathways. It was hypothesized that toxicity of a chemical agent could be counteracted by a homeopathic preparation of the enantiomer of the chemical agent (patents applied for: PCT/AU2003/000219-PCT/AU2008/001611). A diverse body of data, including controlled laboratory studies, supports the conclusion that toxicity of optical isomers may be inhibited by homeopathic enantiomer preparations. These data were obtained with minimal or no pretesting to determine optimal test solutions. Inhibition of the excitotoxic neurotransmitter L-glutamic acid with homeopathic preparations of D-glutamic acid indicates the latter may be of use for amelioration of symptoms of disturbances of mood. Similarly, homeopathic preparation of (+)-nicotine may be of use for inhibition of effects of nicotine in tobacco.

Hormesis, cell death, and regenerative medicine for neurode-generative diseases

Although the adult human brain has a small number of neural stem cells, they are insufficient to repair the damaged brain to achieve significant functional recovery for neurodegenerative diseases and stroke. Stem cell therapy, by either enhancing endogenous neurogenesis, or transplanting stem cells, has been regarded as a promising solution. However, the harsh environment of the diseased brain posts a severe threat to the survival and correct differentiation of those new stem cells. Hormesis (or preconditioning, stress adaptation) is an adaptation mechanism by which cells or organisms are potentiated to survive an otherwise lethal condition, such as the harsh oxidative stress in the stroke brain. Stem cells treated by low levels of chemical, physical, or pharmacological stimuli have been shown to survive better in the neurodegenerative brain. Thus combining hormesis and stem cell therapy might improve the outcome for treatment of these diseases. In addition, since the cell death patterns and their underlying molecular mechanism may vary in different neurodegenerative diseases, even in different progression stages of the same disease, it is essential to design a suitable and optimum hormetic strategy that is tailored to the individual patient.

Postconditioning hormesis put in perspective: an overview of experimental and clinical studies

A beneficial effect of applying mild stress to cells or organisms, that were initially exposed to a high dose of stress, has been referred to as 'postconditioning hormesis'. The initial high dose of stress activates intrinsic self-recovery mechanisms. Modulation of these endogenous adaptation strategies by administration of a subsequent low dose of stress can confer effects that are beneficial to the biological system. Owing to its potentially therapeutic applications, postconditioning hormesis is subject to research in various scientific disciplines. This paper presents an overview of the dynamics of postconditioning hormesis and illustrates this phenomenon with a number of examples in experimental and clinical research.

N-methyl-D-aspartate preconditioning improves short-term motor deficits outcome after mild traumatic brain injury in mice

Traumatic brain injury (TBI) causes impairment of fine motor functions in humans and nonhuman mammals that often persists for months after the injury occurs. Neuroprotective strategies for prevention of the sequelae of TBI and understanding the molecular mechanisms and cellular pathways are related to the glutamatergic system. It has been suggested that cellular damage subsequent to TBI is mediated by the excitatory neurotransmitters, glutamate and aspartate, through the excessive activation of the N-methyl-D-aspartate (NMDA) receptors. Thus, preconditioning with a low dose of NMDA was used as a strategy for protection against locomotor deficits observed after TBI in mice. Male adult mice CF-1 were preconditioned with NMDA (75 mg/kg) 24 hr before the TBI induction. Under anesthesia with O(2)/N(2)O (33%: 66%) inhalation, the animals were subjected to the experimental model of trauma that occurs by the impact of a 25 g weight on the skull. Sensorimotor gating was evaluated at 1.5, 6, or 24 hr after TBI induction by using footprint and rotarod tests. Cellular damage also was assessed 24 hr after occurrence of cortical trauma. Mice preconditioned with NMDA were protected against all motor deficits revealed by footprint tests, but not those observed in rotarod tasks. Although mice showed motor deficits after TBI, no cellular damage was observed. These data corroborate the hypothesis that glutamatergic excitotoxicity, especially via NMDA receptors, contributes to severity of trauma. They also point to a putative neuroprotective mechanism induced by a sublethal dose of NMDA to improve motor behavioral deficits after TBI.

Enzyme stabilization by glass-derived silicates in glass-exposed aqueous solutions

OBJECTIVES

To analyze the solutes leaching from glass containers into aqueous solutions, and to show that these solutes have enzyme activity stabilizing effects in very dilute solutions.

METHODS

Enzyme assays with acetylcholine esterase were used to analyze serially succussed and diluted (SSD) solutions prepared in glass and plastic containers. Aqueous SSD preparations starting with various solutes, or water alone, were prepared under several conditions, and tested for their solute content and their ability to affect enzyme stability in dilute solution.

RESULTS

We confirm that water acts to dissolve constituents from glass vials, and show that the solutes derived from the glass have effects on enzymes in the resultant solutions. Enzyme assays demonstrated that enzyme stability in purified and deionized water was enhanced in SSD solutions that were prepared in glass containers, but not those prepared in plastic. The increased enzyme stability could be mimicked in a dose-dependent manner by the addition of silicates to the purified, deionized water that enzymes were dissolved in. Elemental analyses of SSD water preparations made in glass vials showed that boron, silicon, and sodium were present at micromolar concentrations.

CONCLUSIONS

These results show that silicates and other solutes are present at micromolar levels in all glass-exposed solutions, whether pharmaceutical or homeopathic in nature. Even though silicates are known to have biological activity at higher concentrations, the silicate concentrations we measured in homeopathic preparations were too low to account for any purported in vivo efficacy, but could potentially influence in vitro biological assays reporting homeopathic effects.

What dose metaphor?

The concept of hormesis, or low-dose U-shaped responses, is now well established in toxicology and pharmacology but requires development in medicine and therapeutics. In doing so, care must be taken to not confuse metaphorical and chemical uses of the term hormesis. Low dose, continuous adaptive responses are fundamentally different than conventional pharmacology, and they may improve the scientific underpinning for complementary medicine, nutrition and lifestyle therapies.

Antibodies to calcium-binding S100B protein block the conditioning of long-term sensitization in the terrestrial snail

The effects of antibodies to calcium-binding S100B protein diluted to 10(-12) (LAS100B) on the long-term sensitization in the Helix lucorum snail (neurobiological model of the anxious-depressive state) were evaluated. The administration of LAS100B prior to conditioning of long-term sensitization in the terrestrial snail 10 min prior to the first electric stimulus) prevents strengthening of the defensive reaction of withdrawing the ommatophores (eye tentacles) and the defensive reaction of closing the pneumostome. This effect is termed "protective", as it prevents the conditioning of long-term sensitization. At the same time, snails given an injection of saline developed long-term sensitization with a significant strengthening of the defensive reactions of withdrawing the ommatophores and closing the pneumostome. When LAS100B was administered before long-term sensitization in advance, the membrane and threshold potentials of premotor interneurons, which regulate defensive behaviour, decreased to a significantly lesser extent compared to the long-term sensitization arm. It is possible that the "protective" effect is linked to the mechanisms of maintaining the membrane potential and changes in extra- and intracellular balance of calcium-binding S100B protein.

Isopathic versus enantiomeric inhibition of U-50488 HCl toxicity--experimental studies

BACKGROUND

Previous studies have investigated toxicity inhibition of optically active compounds by potentized preparations of their enantiomers. It was hypothesised that inhibition of toxicity may be stereospecific. This paper presents 2 studies investigating stereoisomer potencies in terms of their ability to counteract toxicity of the (-) stereoisomer. The stereoisomers used were (-)-trans-(1S,2S)-U-50488 HCl and (+)-trans-(1R,2R)-U-50488 HCl.

MATERIALS & METHODS

Designs were prospective, blind, randomised, intention-to-treat and compared the efficacy of 2 indistinguishable treatments. The outcome was the difference in survival. Potency 'chords' consisting of 4th, 12th and 30th approximately centesimal dilutions were prepared, representing concentrations of 1.08 x 10(-10) M. One study compared inhibition of (-)-U-50488 toxicity injected ip at the estimated LD50 into male ICR mice, treated with a potency chord of the same stereoisomer, with control ('isopathic' study). The other study compared inhibition of toxicity by potency chords made from the stereoisomers (+)-U-50488 and (-)-U-50488 ('enantiomer' study), Treatments were administered orally on 11 occasions: twice before and nine times after ip injections.

RESULTS

The isopathic study did not yield a significant result. In the enantiomer study, comparison of isopathy with enantiomer potency treatment showed a highly significant difference odds ratio 1.97 (95% CI: 1.23-3.14).

CONCLUSION

We conclude that enantiomeric potencies are superior to identically produced isopathic potencies, in inhibiting toxicity of (-)-U-50488 HCl. Homeopathic inhibition of toxicity may be stereospecific.

Post traumatic epilepsy. An analysis of 12 cases

An analysis of the mechanism of epilepsy and epileptogenesis after traumatic brain injury will give us an insight into neural circuitry. In a retrospective analysis of 48 cases of moderate and severe traumatic brain injury, who reported for follow up to our centre over a period of two years. Of these, 12 patients with post traumatic epilepsy were identified. The risk factors, EEG patterns and the quality of control were analyzed. The pathophysiology and paradigms of management have been discussed.

Protective effect of low-doses of antibodies to S-100 protein on the formation of long-term sensitization in helix lucorum

Injection of antibodies to Ca-binding protein S-100 in a dilution of 10(-12) before the formation of long-term sensitization in Helix lucorum (10 min before the first electric shock) prevented the increase in defense reactions of pneumostome closure and ommatophore withdrawal. Thus, we demonstrated a protective effect of low-dose antibodies to S-100 on the formation of long-term sensitization as a neurobiological model of anxiety and depression.

Should we explore the clinical utility of hormesis?

The idea that low-dose adaptive effects as described in hormesis can be used clinically has been discussed for hundreds if not thousands of years. Paracelsus famous adage that `the dose makes the poison' and the common folk saying that one can be cured by `the hair of the dog that bit you' speak to this idea. So why has so little research been done on the possible clinical utility of hormesis? What areas of clinical hormesis seem to be the most promising to explore? This article examines these concepts and proposes some initial areas or research where the possible utility of hormeiss might be investigated.

Hormesis: a promising strategy to sustain endogenous neuronal survival pathways against neurodegenerative disorders

The brain developed adaptive mechanisms in the face of changing environments and stresses imposed on the nervous system. The addition of glutamate as the major excitatory amino acid neurotransmitter to the brain's complement of amino acids and peptides dictated a coordinated transcriptional and translational program to meet the demands of excitatory neurotransmission. One such program is the ability of neurons to sustain and maintain their survival given the nature of glutamate-mediated receptor activation. The unique development of endogenous neuronal pathways activated by glutamate receptors transformed neurons and allowed them to survive under conditions of high energy demands. These same endogenous survival pathways also mediate plastic responses to meet another demand of the brain, adaptation. An endogenous protein that plays a central role in glutamate receptor-mediated survival pathways is brain-derived neurotrophic factor (BDNF). Intermittent but frequent synaptic ionotropic glutamate receptor activation ensures neuronal survival through a BDNF autocrine loop. In sharp contrast, overactivation of ionotropic glutamate receptors leads to neuronal cell death. Thus, innovative strategies that induce endogenous neuronal survival pathways through low-level activation of ionotropic glutamate receptors or those that bypass receptor activation but upregulate endogenous survival pathways may not only prevent neurodegenerative disorders that involve glutamate as a final common pathway that kills neurons, but may also provide treatment alternatives critical for neurons to survive stressful conditions such as stroke, status epilepticus and hypoglycemic-induced neuronal cell death.

Adjunctive care with nutritional, herbal, and homeopathic complementary and alternative medicine modalities in stroke treatment and rehabilitation

This article presents an overview of nutritional, herbal, and homeopathic treatment options from complementary and alternative medicine (CAM) as adjuncts in stroke prevention, treatment, and rehabilitation. Despite many promising leads, the evidence does not favor recommendation of most of these treatments from a public health policy perspective. However, simple preventive interventions such as use of a high-quality multivitamin/multimineral supplement in patients with undernutrition may improve outcomes with minimal long-term risk. Natural agents such as the antioxidant alphalipoic acid, certain traditional Asian herbal mixtures, and some homeopathically prepared remedies show promise for reducing infarct size and associated impairments. A number of nutrients and herbs may assist in treatment of stroke-related complications such as pressure sores, urinary tract infections, and pneumonia. Individualized homeopathy may even play a helpful adjunctive role in treatment of sepsis. However, a great deal of systematic research effort lies ahead before most of the options discussed would meet mainstream medical standards for introduction into routine treatment regimens.

The in vitro evidence for an effect of high homeopathic potencies—A systematic review of the literature

OBJECTIVE

Systematic assessment of the in vitro research on high potency effects.

METHOD

Publications of experiments were collected through databases, experts, previous reviews, citation tracking.

INCLUSION CRITERIA

stepwise agitated dilutions <10(-23); cells or molecules from human or animal. Experiments were assessed with the modified SAPEH score.

RESULTS

From 75 publications, 67 experiments (1/3 of them replications) were evaluated. Nearly 3/4 of them found a high potency effect, and 2/3 of those 18 that scored 6 points or more and controlled contamination. Nearly 3/4 of all replications were positive. Design and experimental models of the reviewed experiments were inhomogenous, most were performed on basophiles.

CONCLUSIONS

Even experiments with a high methodological standard could demonstrate an effect of high potencies. No positive result was stable enough to be reproduced by all investigators. A general adoption of succussed controls, randomization and blinding would strengthen the evidence of future experiments.

Modulatory action of combined treatment with antibodies against S100 protein and low doses of this protein on membrane effects of quinine

Antibodies against calcium-binding protein S100 (AB-S100) 1.5-fold increased, while quinine 2-fold decreased the frequency of action potential generation in B4 and B6 neurons. Application of quinine against the background of AB-S100 treatment returned this parameter to the initial level. Pretreatment with AB-S100 in low doses prevents changes the frequency of action potential generation induced by application of AB-S100 in the initial dilution. The duration of action potential increased by 1.6 times after application of AB-S100 and quinine, while after application of quinine increased this parameter by more than 6 times. AB-S100 decreased maximum inward current by 20%. Our experiments demonstrated a modulating effect of combined administration of AB-S100 and its low doses on the membrane effects of quinine.

Effect of Low Doses and High Homeopathic Potencies in Normal and Cancerous Human Lymphocytes: An In Vitro Isopathic Study

OBJECTIVES

Biologic effects of high homeopathic potencies can be studied in cell cultures using cell lines or primary cells. We hypothesized that primary cells would be more apt to respond to high potencies than cell lines, especially cancer cell lines. We set out to investigate the effects of low doses and high homeopathic potencies of cadmium chloride, respectively, in an intoxication model with human primary lymphocytes compared to a human leukemia cell line (Jurkat).

DESIGN

Cells were pretreated with either low concentrations (nM-microM) or high potencies (pool 15-20c) of cadmium for 120 hours, following which they were exposed to a toxic treatment with a range of cadmium concentrations (8-80 microM) during 24 hours. Cell viability was eventually assessed by use of the MTS/PES assay. Controls included a vehicle (NaCl 0.9%) for the low concentrations of cadmium or water 15-20c for cadmium 15-20c. A total of 34 experiments were conducted, 23 with low concentrations and 11 with high potencies of cadmium. Data were analyzed by analysis of variance.

RESULTS

Pretreatment with low concentrations or high potencies of cadmium significantly increased cell viability in primary lymphocytes after toxic challenge, compared to control cells (mean effect +/- standard error = 19% +/- 0.9% for low concentrations respectively 8% +/- 0.6% for high potencies of cadmium; p < 0.001 in both cases). The pretreatment effect of low doses was significant also in cancerous lymphocytes (4% +/- 0.5%; p < 0.001), albeit weaker than in normal lymphocytes. However, high homeopathic potencies had no effect on cancerous lymphocytes (1% +/- 1.9%; p = 0.45).

CONCLUSIONS

High homeopathic potencies exhibit a biologic effect on cell cultures of normal primary lymphocytes. Cancerous lymphocytes (Jurkat), having lost the ability to respond to regulatory signals, seem to be fairly unresponsive to high homeopathic potencies.

Discrepancy between effects of milligram and nanogram doses of a COX-2 inhibitor (celecoxib) on morphine state-dependent memory of passive avoidance in mice

This experiment examined and compared the effects of pre-test administration of a selective COX-2 inhibitor (celecoxib), at the doses in the range of mg/kg and ng/kg on morphine state-dependent learning in step-down passive avoidance task in mice. Pre-training administration of 5mg/kg of morphine-impaired memory retrieval tested 24h later, which was restored by pre-test administration of the same dose of the drug. Pre-test administration of celecoxib (12.5, 25 and 50mg/kg), alone or in combination with morphine (1mg/kg) prevents morphine-induced memory impairment. Ultra-low doses (ULDs) of celecoxib (2, 10 and 50 ng/kg) produced no change in morphine-induced memory impairment. However, co-administration of nanogram doses of celecoxib with 5mg/kg of morphine in the test day prevented morphine-induced memory improvement, an action different from mg/kg doses. These findings implicate the involvement of COX-2 in memory retrieval and demonstrate that the effect of celecoxib ULD is different from that of mg/kg doses.

Effects of ultra-low doses of morphine, naloxone and ethanol on morphine state-dependent memory of passive avoidance in mice

This experiment examined and compared the effects of pre-test administration of morphine, naloxone and ethanol, at doses in the range of milligram/kg to those of nanogram/kg, on morphine state-dependent learning in a step-down passive avoidance task in mice. Morphine (5 mg/kg) administered before training impaired retention tested 24 hours later, but when the same dose of morphine was also administered before the test, the retention was significantly restored. Pre-training administration of 10 or 20 ng/kg (i.p.) of morphine had no effect, but when co-administered with the same drug at 5 mg/kg (s.c.), it prevented significantly the memory recall improvement after the administration of morphine (5 mg/kg, s.c.) alone. In a parallel experiment, naloxone (5 mg/kg) prevented the memory recall improvement by morphine. However, the effects of naloxone at doses in the range of ng/kg were opposite to those of milligram doses of the same drug. Pre-test administration of ethanol (1 mg/kg) improved memory recall and mimicked the effects of pre-test morphine administration. At doses in the nanogram range, the effects of ethanol were opposite those of mg/kg of the drug. A review of the literature indicates that, for several drugs and chemicals, the effects of nanogram doses are the opposite of the effects of milligrams, because different doses have different sites as well as mechanisms of actions. In conclusion, from the above results one may suggest that, in determination of the dose-response of at least some drugs, the study of the effects of doses much lower than two orders of magnitude of the minimum effective dose are warranted.

Priorities and methods for developing the evidence profile of homeopathy Recommendations of the ECH General Assembly and XVIII Symposium of GIRI

To achieve scientific acceptance, homeopathy must investigate several questions: 1. The activity of very highly diluted preparations. The consensus of the meeting was that there is clear evidence of this. 2. The content of very highly diluted homeopathic preparations. More research is needed but evidence exists that a specific signal is present in homeopathic preparations. 3. A theoretical framework in which the effects of homeopathic diluted preparations can be explained. The 'Body Information Theory' is such a theory. 4. The clinical effectiveness of homeopathy. Because they avoid the placebo effect, animal studies are a priority. For human trials using Quality of Life questionnaires, studies on the activity, content and theoretical basis of homeopathic preparations were reviewed approximately 70% of cases; more in children showed improvement. Homeopathy reduced costs and allowed a better improvement in work-days lost compared with conventional practice. Randomised controlled trials (RCTs) implicitly test the placebo hypothesis; RCTs have been performed and meta-analyses conclude that there is clear evidence of efficacy which cannot be attributed to placebo effect. Priorities depend on the audience. More research is needed especially regarding the content of homeopathic preparations and the transmission of information. Theoretical issues are also important to avoid incorrect design of research protocols. More effort should be dedicated to veterinary research. Clinical effects analysis in humans remains important. Many other questions should be prioritised, such as the potential of homeopathy to avoid invasive procedures in children and the long-term effects of homeopathy in preventing chronic complications.

Rapid induction of protective tolerance to potential terrorist agents: a systematic review of low- and ultra-low dose research

OBJECTIVE

To systematically review the literature on the ability of low-dose (LD) and ultra-low-dose (ULD) toxin exposure to prevent and treat biological and chemical threats.

METHODS

Laboratory research articles on protection or treatment from LD or ULD exposure for the 13 high-risk chemical and biological warfare threats were collected and systematically evaluated for quantity and scientific quality using pre-defined methodological criteria.

RESULTS

Over 2600 articles were screened. Only five studies met the inclusion criteria examining stimulation and protective effects of LD- or ULD-exposures to the 13 pre-identified biological and chemical agents. The quality evaluation (QE) of these studies was above average with a mean QE score of 70.6% of maximum. Two articles of fair to good quality reported both protective and treatment efficacy from exposure of animals or humans to LD- and ULD-exposures to toxins of risk in biochemical warfare.

CONCLUSION

There is little research on agents of biological and chemical warfare investigating the possible use of LD- and ULD-toxins for protection and treatment. The existing literature is generally of good quality and indicates that rapid induction of protective tolerance is a feasible but under-investigated approach to bioterrorist or biowarfare defense. In our opinion, further research into the role of induced protection with LD- and ULD-toxic agents is needed.

Simultaneous neuroprotection and blockade of inflammation reverses autoimmune encephalomyelitis

In multiple sclerosis, the immune system attacks the white matter of the brain and spinal cord, leading to disability and/or paralysis. Myelin, oligodendrocytes and neurons are lost due to the release by immune cells of cytotoxic cytokines, autoantibodies and toxic amounts of the excitatory neurotransmitter glutamate. Experimental autoimmune encephalomyelitis (EAE) is an animal model that exhibits the clinical and pathological features of multiple sclerosis. Current therapies that suppress either the inflammation or glutamate excitotoxicity are partially effective when administered at an early stage of EAE, but cannot block advanced disease. In a multi-faceted approach to combat EAE, we blocked inflammation with an anti-MAdCAM-1 (mucosal addressin cell adhesion molecule-1) monoclonal antibody and simultaneously protected oligodendrocytes and neurons against glutamate-mediated damage with the alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionate (AMPA)/kainate antagonist 2,3-dihydroxy-6-nitro-7- sulfamoylbenzo(f)quinoxaline (NBQX) and the neuroprotector glycine-proline-glutamic acid (GPE; N-terminal tripeptide of insulin-like growth factor). Remarkably, administration at an advanced stage of unremitting EAE of either a combination of NBQX and GPE, or preferably all three latter reagents, resulted in amelioration of disease and repair of the CNS, as assessed by increased oligodendrocyte survival and remyelination, and corresponding decreased paralysis, inflammation, CNS apoptosis and axonal damage. Each treatment reduced the expression of nitric oxide and a large panel of proinflammatory and immunoregulatory cytokines, in particular IL-6 which plays a critical role in mediating EAE. Mice displayed discernible improvements in all physical features examined. Disease was suppressed for 5 weeks, but relapsed when treatment was suspended, suggesting treatment must be maintained to be effective. The above approaches, which allow CNS repair by inhibiting inflammation and/or simultaneously protect neurons and oligodendrocytes from damage, could thus be effective therapies for multiple sclerosis.

Individual Differences in Response to Randomly Assigned Active Individualized Homeopathic and Placebo Treatment in Fibromyalgia: Implications of a Double-Blinded Optional Crossover Design

OBJECTIVE

To assess individual difference characteristics of subgroups of patients with fibromyalgia (FM) patients with respect to the decision to stay in or switch from randomly-assigned verum or placebo treatment during an optional crossover phase of a double-blinded homeopathy study.

DESIGN

Double-blinded, randomized, placebo-controlled, optional crossover clinical trial.

PARTICIPANTS

Fifty-three (53) community-recruited patients with FM entered the optional crossover phase.

INTERVENTION

Two homeopaths jointly selected an individualized homeopathic remedy for all patients. The pharmacy dispensed either verum LM remedy or indistinguishable placebo in accord with randomized assignment for 4 months and the patient's optional crossover decision for an additional 2 months.

OUTCOME MEASURES

Patients completed a battery of baseline state/trait questionnaires, including mood, childhood neglect and abuse, and trait absorption. They rated global health (whole person-centered) and tender point pain on physical examination (disease-specific) at baseline, 3 months, and 6 months.

RESULTS

Rates of optional crossover from verum to placebo or placebo to verum were comparable (p = 0.6; 31%, and 41%, respectively). The switch subgroups had greater baseline psychologic issues (emotional neglect in placebo-switch; depression and anger in verum-switch). The verum-stay subgroup scored highest on treatment helpfulness and included all six exceptional responders who fell, prior to crossover, into the top terciles for improvement in both global health and pain. Patients staying in their randomly assigned groups, active or placebo (n = 34), scored significantly higher in trait absorption than did those who switched groups (n = 19).

CONCLUSION

Individual difference factors may predict better and poorer responders with FM to specific and nonspecific effects of homeopathic and placebo treatment.

Dose-dependent effects of glutamate in pyridoxine-induced neuropathy

In order to explore the effects of glutamate in a pyridoxine megadose-induced neuropathy, rats were received glutamate either 0.5 or 1 g/kg/day orally with or without pyridoxine 0.8 g/kg/day intraperitoneally for 14 days. The animal's motor coordination, the muscle power and the thermal threshold were observed daily. The nerve conduction velocity was measured at day 0 and day 15 of the treatment. Glutamate either 0.5 or 1 g/kg/day appeared to have no effect on motor coordination, the nerve conduction velocity and the muscle power score compared with control. However, the thermal response latency was significantly decreased (from day 9) in animals treated with 1 g/kg/day glutamate. In pyridoxine-induced neuropathy rats, glutamate 0.5 g/kg/day significantly decreased the effects of pyridoxine on the sciatic nerve conduction velocity, the muscle power score and the motor coordination. Interestingly, glutamate at a dose of 1 g/kg/day worsened the neurotoxic effects cause by pyridoxine.

Effects of ultrahigh dilutions of 3,5-dichlorophenol on the luminescence of the bacterium Vibrio fischeri

There is a great need for research in the field of homeopathy for laboratory test systems to investigate the actions of ultrahighly diluted biological effectors. With this in mind, we used the luminescent bacterium Vibrio fischeri, which is used throughout the world in testing water quality. Luminescence inhibition is utilized as a test parameter for the toxicity of a sample. We used ultrahigh dilutions (UHD) of 3,5-dichlorophenol as effector and adapted the standard test procedure for water toxicity in a way that let us evaluate very minute effects. Three groups of samples were prepared and then blinded: 45 dilutions of 3,5-dichlorophenol in steps of 10, starting with 4.2 x 10(-2) M, with vigorous shaking between dilution steps; 45 identical dilutions of 3,5-dichlorophenol without vigorous shaking; and 49 control samples of the diluent. The results of, and the discussion based on, a thorough statistical analysis led to the conclusion that an effect based on UHD, which results in an inhibition of luminescence of less than 1.5%, can be confirmed for some of the potency samples. There were both effective and ineffective samples in the three sample groups. The size of the effect was very small (ca. 1.5%), though statistically significant. The number of effective samples was significantly higher among the vigorously shaken samples than among the controls and the unshaken samples (14, 6 and 7 effective samples, respectively).

N-methyl-D-aspartate and TrkB receptor activation in cerebellar granule cells: an in vitro model of preconditioning to stimulate intrinsic survival pathways in neurons

Delineating the mechanisms of survival pathways that exist in neurons will provide important insight into how neurons utilize intracellular proteins as neuroprotectants against the causes of acute neurodegeneration. We have employed cultured rat cerebellar granule cells as a model for determining the mechanisms of these intraneuronal survival pathways. Glutamate has long been known to kill neurons by an N-methyl-d-aspartate (NMDA) receptor-mediated mechanism. Paradoxically, subtoxic concentrations of NMDA protect neurons against glutamate-mediated excitotoxicity. Because NMDA protects neurons in physiologic concentrations of glucose and oxygen, we refer to this phenomenon as physiologic preconditioning. One of the major mechanisms of NMDA neuroprotection involves the activation of NMDA receptors leading to the rapid release of brain-derived neurotrophic factor (BDNF). BDNF then binds to and activates its cognate receptor, receptor tyrosine kinase B (TrkB). The efficient utilization of these two receptors confers remarkable resistance against millimolar concentrations of glutamate that kill more than eighty percent of the neurons in the absence of preconditioning the neurons with a subtoxic concentration of NMDA. Exactly how the neurons mediate neuroprotection by activation of both receptors is just beginning to be understood. Both NMDA and TrkB receptors activate nuclear factor kappaB (NF-kappaB), a transcription factor known to be involved in protecting neurons against many different kinds of toxic insults. By converging on survival transcription factors, such as NF-kappaB, NMDA and TrkB receptors protect neurons. Thus, crosstalk between these very different receptors provides a rapid means of neuronal communication to upregulate survival proteins through release and transcriptional activation of messenger RNA.

Nonlinear effects of glutamate and KCl on glutamate toxicity in cultured rat cerebellar neurons

Nonlinear responses to toxin exposure have been observed in multiple cell types and organisms across a wide array of phyla. High dose toxin exposures inhibit or kill biological systems, while low dose exposures can stimulate survival mechanisms. We examined the effects of low (10(-3), 10(-5), 10(-7), and 10(-9) M) and ultra-low (10(-25) and 10(-61) M) KCl and glutamate pretreatment (72 h) against glutamate toxicity in rat cerebellar neurons. Ultra-low dilutions (10(-31), 10(-61), and 10(-401)) of an Arnica montana mother tincture were also investigated for their neuroprotective potentials. Viability was significantly enhanced in neurons pretreated with either 10(-3) M glutamate (10.6%) or 10(-9) M KCl (6.3%). None of the toxins evaluated displayed significant toxicity at the concentrations indicated. The protective effect of glutamate is likely mediated through activation of N-methyl-D-aspartate receptors, whereas low dose KCl might confer neuroprotection through enhanced alteration of Na+/K+ receptor dynamics. This is the first time high dose glutamate tolerance has been shown along with low dose KCl, and is consistent with previous reports demonstrating tolerance induced by low dose toxin exposure.

Considerations relating to the epidemiology of human immunodeficiency virus infection: the impact of bacterial antigens and consequences for treatment

OBJECTIVE

A treatment for patients with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) is presented, which is based on an isopathic method that appears to be effective in eliminating bacterial antigens from the body. The concept is based on a new hypothesis concerning the outbreak and spread of AIDS in Africa and worldwide.

SUBJECTS AND DESIGN

Laboratory data are presented from five European and seven African patients with HIV.

RESULTS

Oral administration of ultra-low doses of a lysate of Staphylococcus aureus Cowan I (12c potency) resulted in a significant increase of CD4 T-cell subsets and CD4/CD8 ratios in patients with HIV infection as well as in advanced stages of HIV disease, concomitant with the improvement of clinical HIV-related symptoms.

CONCLUSIONS

Based on epidemiologic data, the beginning of the African AIDS epidemic is related-to time, place, and circumstances-to the initial large-scale introduction of antibiotics in areas of Central Africa that would later comprise the AIDS belt. It is concluded that certain antimicrobial agents can enhance the formation of persistent bacterial superantigens, which may indicate a link between asymptomatic HIV carriers and the development of AIDS. According to this view, superantigens and bacterial cell wall components remaining in the body after antibiotic treatment cause a permanent activation of the immune system and would thus favor T-cell infection and viral replication in HIV-infected individuals.

Gas discharge visualization evaluation of ultramolecular doses of homeopathic medicines under blinded, controlled conditions

OBJECTIVES

To determine the feasibility of using a computerized biophysical method, gas discharge visualization (GDV), to differentiate ultramolecular doses of homeopathic remedies from solvent controls and from each other.

DESIGN

Blinded, randomized assessment of four split samples each of 30c potencies of three homeopathic remedies from different kingdoms, for example, Natrum muriaticum (mineral), Pulsatilla (plant), and Lachesis (animal), dissolved in a 20% alcohol-water solvent versus two different control solutions (that is, solvent with untreated lactose/sucrose pellets and unsuccussed solvent alone).

PROCEDURES

GDV measurements, involving application of a brief electrical impulse at four different voltage levels, were performed over 10 successive images on each of 10 drops from each bottle (total 400 images per test solution per voltage). The dependent variables were the quantified image characteristics of the liquid drops (form coefficient, area, and brightness) from the resultant burst of electron-ion emission and optical radiation in the visual and ultraviolet ranges.

RESULTS

The procedure generated measurable images at the two highest voltage levels. At 17 kV, the remedies exhibited overall lower image parameter values compared with solvents (significant for Pulsatilla and Lachesis), as well as differences from solvents in fluctuations over repeated images (exposures to the same voltage). At 24 kV, other patterns emerged, with individual remedies showing higher or lower image parameters compared with other remedies and the solvent controls.

CONCLUSIONS

GDV technology may provide an electromagnetic probe into the properties of homeopathic remedies as distinguished from solvent controls. However, the present findings also highlight the need for additional research to evaluate factors that may affect reproducibility of results.

Controlled clinical trials evaluating the homeopathic treatment of people with human immunodeficiency virus or acquired immune deficiency syndrome

CONTEXT

Homeopathic medicine developed significant popularity in the nineteenth century in the United States and Europe as a result of its successes treating the infectious disease epidemics during that era. Homeopathic medicine is a medical system that is specifically oriented to using nanopharmacologic and ultramolecular doses of medicines to strengthen a person's immune and defense system rather than directly attacking the microbial agents.

OBJECTIVES

To review the literature referenced in MEDLINE and in nonindexed homeopathic journals for placebo-controlled clinical trials using homeopathic medicines to treat people with AIDS or who are human immunodeficiency virus (HIV)-positive and to consider a different theoretical and methodological approach to treating people with the viral infection.

FINDINGS

A total of five controlled clinical trials were identified. A double-blinded, placebo-controlled study was conducted on 50 asymptomatic HIV-positive subjects (stage II) and 50 subjects with persistent generalized lymphadenopathy (stage III) in whom individualized single-remedy homeopathic treatment was provided. A separate body of preliminary research was conducted using homeopathic doses of growth factors. Two randomized double-blinded, placebo-controlled studies were conducted with a total of 77 people with AIDS who used only natural therapies over a 8-16-week period. Two other studies were conducted over a 2.5-year period with 27 subjects in an open-label format.

SETTINGS

The first study was conducted by the Regional Research Institute for Homeopathy in Mumbai, India, under the Central Council for Research in Homeopathy, with the approval of the Ministry of Health and Family Welfare, Government of India. The second body of studies was conducted in clinic settings in California, Oregon, Arizona, Hawaii, New York, and Washington.

RESULTS

The first study found no statistically significant improvement in CD4 T-lymphocytes, but did find statistically significant pretest and post-test results in subjects with stage III AIDS, in CD4 (p = 0.008) and in CD8 (p = 0.04) counts. The second group of studies found specific physical, immunologic, neurologic, metabolic, and quality-of-life benefits, including improvements in lymphocyte counts and functions and reductions in HIV viral loads.

CONCLUSIONS

As a result of the growing number of people with drug-resistant HIV infection taking structured treatment interruptions, homeopathic medicine may play a useful role as an adjunctive and/or alternative therapy.

Non-linear effects of cycloheximide in glutamate-treated cultured rat cerebellar neurons

Multiple cell types and organisms across a wide array of phyla and a variety of toxins demonstrate non-linear dose responses to low-level chemical exposures with high doses inhibiting cellular function and low doses stimulating function. We tested whether such non-linear responses to low and ultra-low dose N-methyl-D-aspartate (NMDA), 1-methyl-4-phenylpyridinium (MPP+) or cycloheximide moderated toxic glutamate exposure in cultured cerebellar granule cells. Neurons were incubated over 72 h with successive NMDA, MPP+ iodide or cycloheximide additions producing specified low (10(-5), 10(-7), 10(-9), 10(-11), and 10(-13) M) and ultra-low (10(-27),10(-29), 10(-63), and 10(-65) M) concentrations. Subsequently these neuronal cells were exposed to a 50% excitotoxic concentration of glutamate for 24 h. Neuronal viability was significantly reduced in neurons treated with micromolar (10(-5) M) cycloheximide whereas viability was enhanced in neurons treated with an ultra-low dose exposure of 10(-27) M cycloheximide. Neither NMDA nor MPP+ elicited harmful or protective responses. This is the first report demonstrating non-linear dose-response effects of cycloheximide in low and ultra-low concentration ranges.

Cross-tolerance to otherwise lethal N-methyl-D-aspartate and oxygen-glucose deprivation in preconditioned cortical cultures

In vitro ischemic preconditioning induced by subjecting rat cortical cultures to nonlethal oxygen-glucose deprivation protects against a subsequent exposure to otherwise lethal oxygen-glucose deprivation. We provide evidence that attenuation of the postsynaptic N-methyl-D-aspartate (NMDA) receptor- and Ca(2+)-dependent neurotoxicity underlies oxygen-glucose deprivation tolerance. It is demonstrated that extended tolerance to otherwise lethal NMDA or oxygen-glucose deprivation can be induced by either of their sublethal forms of preconditioning. These four pathways are linked, since NMDA receptor blockade during preconditioning by oxygen-glucose deprivation eliminates tolerance. These results suggest that NMDA tolerance, induced by nonlethal activation of these receptors during oxygen-glucose deprivation preconditioning, underlies oxygen-glucose deprivation tolerance. Several neurotoxic downstream Ca(2+)-dependent signaling events specifically linked to NMDA receptor activation are attenuated during otherwise lethal oxygen-glucose deprivation in preconditioned cultures. Specifically, calpain activation, as well as degradation of microtubule-associated protein-2 and postsynaptic density-95, are attenuated 2 h following otherwise lethal NMDA treatment alone or oxygen-glucose deprivation in preconditioned cultures. Formation of microtubule-associated protein-2-labeled dendritic varicosities is also attenuated in preconditioned cultures within 1 h of lethal oxygen-glucose deprivation or NMDA application. Intracellular Ca(2+) levels, measured using the high- or low-affinity dyes Fluo-4 (K(d) approximately equal 345 nM) or Fluo-4FF (K(d) approximately equal 9.7 microM) respectively, are markedly attenuated during lethal oxygen-glucose deprivation in preconditioned cultures.Collectively, the results suggest the attenuation of the postsynaptic NMDA-mediated component of otherwise lethal oxygen-glucose deprivation through the suppression of Ca(2+)-dependent neurotoxic signaling, a mechanism that is initially induced by transient nonlethal activation of this receptor during ischemic preconditioning.