Conquer UC said...
2- ONLY 20% of those with UC actually have it in their families: so the MAJORITY of UCers do NOT have a relative with IBD which in turn means that the majority of UC is NOT caused by genes!!! im sick of hearing about the 'Genetics' theory.
@DBwithUC: while your explanation is quite scientific and plausable: i actually disgaree because many of us actually go into remission (meaning our body BOUNCES BACK TO NORMAL if you like the spring theory) and we may be in remission for a long time until we get a flareup again: in my opinion because the underlying infection (whether viral or bacterial) gets the right circumstances for it to resurface; a bit like the Herpex Simplex virus.
Well, you do not seem to understand genetics. The fact that the majority of UCers do not have a relative with IBD does not mean genetics does not have involvement in ALL cases of UC. You are making illogical cause-effect statements. The human immune system is highly individualized, and our genes are the blueprint for the immune system we are born with. Because our immune system can learn, our experiences also help shape our immune systems. While it may turn out that there is some sub-type of UC that does not require genetic pre-disposition (i.e., a trigger/toxin so powerful that it produces UC most of the time no matter what your genetic immune system blueprint), it is still a fact that a number of gene variants related to IBD have been identified. The discussion is no longer whether there is or is-not genetic pre-disposition, but rather on what are the triggers, and what are the treatments. The fact that you could be "sick of hearing about
the genetics theory" shows that you are thinking either/or, and do not have the right handle on the genetic component at all. To insist that IBD can only be genetic if the majority of IBD patients have a close relative with IBD is just illogical and wrong. All the percentages do is speak to the relative importance of the genetic pre-disposition and the environmental trigger - it does not negate the genetic involvement. This is basic logic of causal reasoning, and you plainly do not understand it.
While remission may be a complete (not broken or stretched at all) healing of the immune system, and flares may be the resurgence of an infectious agent that had been hiding in the body, this model requires more assumptions and is inconsistent with things we know about
the way the immune system learns. On the other hand, it seems a better fit with all the facts to say that the immune system (some more genetically vulnerable than others) becomes autoimmune under some combination of environmental triggers and gut flora imbalance (which may or may not include an infectious agent, that may or may not stay around). And, flares after achieving remission, are more likely some broken part of the immune system (which does have Th2 cell memory) getting active again (possibly due to new gut-flora imbalance, or some other stressor), then flares are likely to be caused by an as yet unobserved bacteria resurrecting from some body tissue hiding place. I'm not saying it can't be, but talking about
gut flora without insisting on an undetected infectious agent that can hide between flares, seems to be the more useful discussion.
As for remission, do not confuse examples I gave about
'things that break', with my model of IBD. To point out the illogic of insisting that surely the immune system had to return to normal if a stressor was removed, I gave examples where this does not happen. But I also mentioned the example of the spring that appears to return to normal, but it is still changed, it is weaker and now stretches more easily. I think this is a very useful model for remission. Some broken immune systems return closer to normal than others, and we call this remission instead of cure, because they remain prone to flares when stressed, or sometimes for no apparent reason.
While there may be an unidentified infectious agent that (in many cases) sets off the chain of events called UC, there also may not. Regardless there seems to be some gut-flora imbalance. It is not clear in all cases if UC causes the imbalance or vise versa, but there are at least some cases where the imbalance clearly came first. Also, there are some remissions/therapies that focus on restoring the gut flora balance.
It is not even clear how an infection would cause the gut-flora imbalance. A bacteria that attacks human tissue is unlikely to attack other bacteria. It is after all a bacteria - not an antibiotic. Possibly it destroys other bacteria by outbreeding them and taking all the food. Possibly it alters the function of cells in the mucosa in such a way that environmental conditions in the colon are altered in a manner unfavorable to some good bacteria. Although if it is a matter of crowding the good bacteria out, that bad bacteria would eventually be so abundant that they would be easily detected, and this does not seem to be the case.
Along these same lines (i.e., bacteria are not antibiotics) it is not clear how good bacteria (i.e., probiotic therapy) kills any suspected unidentified infectious agent. At least here the outbreed them and starve it out idea makes some sense - because when probiotic therapy works, tests do show healthy amounts of the good bacteria reestablished. But getting into remission after pushing wild-type bacteria (i.e., fecal) up your colon does not in any way prove that there was an infectious agent present. It only suggests that re-establishing a healthy profile of gut flora and remission are related.
This is why I suggested we focus on gut-flora imbalance for this thread instead of "infectious-agent".
Post Edited (DBwithUC) : 4/30/2012 10:49:26 AM (GMT-6)