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Discussion Starter · #1 ·
HI Ladies,

Sorry another results help question - Am slightly concerned and confused at my levels:-

TH1;TH2 Cytokine Ratio
TNF Alpha IL-4 (CD3,4&T Helper cells) - 31.4
IFN Gamma IL-4 (CD3,4&T Helper cells) - 13.4
TNF Alpha IL-10 (CD3,4&T Helper Cells) - 77.7
IFN Gamma (CD3,4&T Helper Cells) - 33.2

NK Cell 50:1 - 34%
NK Cell 25:1 - 28%
NK Cell 12.5:1 - 14%

NK IVIG 12.5:1 - 20% (41% reduction)
NK IVIG 50:1 - 11% (68% reduction)

Pred 50:1 10mg - 10% (71% reduction)
Pred 50:1 5mg - 14% (69% reduction)

Intralipid 50:1 - 28% (18% reduction)
Intralipid 25:1 - 21% (25% reduction)

CD3% = 62.....CD19% = 10.....CD16/56% = 21.....CD5+CD19+ = 2

Lympocycles Total NK = 18.4%
Total NK (DIM) = 94.6%
Total NK (Bright) = 5.4%

Lymhocyte Count = 1.089

I have an appointment with Dr.Gorgy on the 6th of Jan but am concerned as these results seem high.

Any help would be much appreciated. xxx
 

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I guess those are results from RIC rather than from RFU?  would it be possible to post the reference ranges because I'm not sure what the ranges are for RIC.  thanks
 

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Discussion Starter · #3 ·
Hi Agate,

Thanks for responding again you are a star!!

My results are from RIC and the only ranges I have are for my th1:th2 Ratio -

TNF Alpha IL:4 = 31.4 Range (19-57.6) so looks ok I think?
IFN Gamma IL:4 = 13.4 Range (8.6-21.0) so again looks ok?

TNF Alpha IL:10 = 77.7 Range (13.2-31.0) Very high can this be right?
IFN Gamma IL:10 = 33.2 Range (6.1-14.8) Again out of range!!

My NK Cells at 50:1 are 34% and am assuming as I have no ranges for this that these are high and should be 15%?

Also my CD16/56 = 21 Range (2-12) So again high?

According to my NK assay pred works best at reducing my killing power by reducing to 10% is this right??

Sorry for the all the questions but I am slightly worried to how high some of these results are!!

Thanks again agate.xxx
 

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ok... i'll give it a go....

for cytokines, the one RFU normally look at is the TNFa:IL10... and the cutoff for the normal range is about 30 on RFU's scale, so RIC's seems to be similar - but your result does look very high, as you mentioned - I don't know if there is any chance its wrong or not as I don't know how reliable RIC is (these cytokines are very difficult to measure, so most of the immune docs seem to prefer using only RFU or RIA in the US).  If it is that high, then Dr G would definitely be suggesting humira to you, but it may take more than 2 shots to get it down. 

Your NK cytoxicity also appears to be pretty high - but at least it comes down with all the different meds tried (at least in the test tube tests - reality can be a bit different because you are looking at what happens over the course of several weeks rather than a couple of hours in a test tube).  It sounds like you have a high NK population (CD56) as well as activity.

I'm guessing that Dr G won't want to leave it at just steroids (plus clexane) partly because your results are quite high but also because if your TNFa ratio is that high, ivig/ils might help to get that down too (as well as humira). 

Is there an obvious reason from your medical history that explains why your TNFa and NKa might be expected to be high?  e.g., endometriosis, an autoimmune disease, an IBD, immune thyroiditis or something like that?  otherwise, the other possibilities that I'd guess Dr G would want to check into would be whether you have a DQa match or maybe grumbling infection e.g., chlamydia?  Sometimes, there isn't a reason that you can pin down, but if you can get an idea of the cause, it might make the treatment a bit more obvious.... or if its something like an infection or an autoimmune disease if you can treat that specifically, you might need less immune fertility tx - so it might be cheaper in the long run to try to identify and treat the cause if you can.

I'm not sure where you are in your testing with Dr G, but I'm guessing he will suggest getting DQa and LAD run and also the greek chlamydia test (and mycoplasma and ureaplasma tests) - and filling in any gaps in your level 1, karyotyping and clotting tests, hopefully with your GP.

Then, if its an infection, you'd aim to treat that and consider LIT depending on the LAD result, then 2 shots of humira followed by a retest to see how far down you've got your TNFa:IL10, with possibly another 2 shots before you cycle (with prednisolone, clexane, aspirin and maybe ILs or IVIG) ... something a bit like that anyway.

hope this helps
 

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Discussion Starter · #5 ·
Thanks Agate for taking the time to answer all my questions!!!

I assumed Dr.G would prescribe me Humira with my TNF being that high, I just panicked yesterday when I saw my result as I don't think I have seen that many people with a result of 77.7 on here. I am goint to be prescribed Thyroxine for antibodies and I also suffer from IBS so this may affect my results?

I am also going to be tested for hidden C as I also suffer from re-current vaginal infections. xxx
 

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Nancy Noo said:
Thanks Agate for taking the time to answer all my questions!!!

I assumed Dr.G would prescribe me Humira with my TNF being that high, I just panicked yesterday when I saw my result as I don't think I have seen that many people with a result of 77.7 on here. I am goint to be prescribed Thyroxine for antibodies and I also suffer from IBS so this may affect my results?

I am also going to be tested for hidden C as I also suffer from re-current vaginal infections. xxx
from memory, bacterial vaginosis can sometimes be due to mycoplasma or ureaplasma - so I assume he will screen for those? One of can often occur with C but I can't remember which one.

IBD e.g., coeliac, crohn's, UC etc can certainly cause high TNFa but I don't know if IBS can - although sometimes, I don't know how easy it is to get the right diagnosis - as I think that IBS is the diagnosis you are given after the doc is supposed to have excluded everything else including IBDs.

High NKa is apparently often seen with immune thyroiditis but your pg chances go up a lot if you are treated to get your TSH in the right range (close to 1) and have steroids and aspirin/clexane - I think I put a link to an article about it somewhere in the FAQ.
 

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Discussion Starter · #7 ·
Thats great thanks agate... I think you need to start charging for this  :)
 
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