Fairfield County Edition

Low Dose Immunotherapy for Autoimmune Conditions

Treatment Offers Hope for What Ails Many

When our immune system does not tolerate the external environment, symptoms such as food allergy, chemical sensitivity, and inhalant or seasonal allergy ensue. When the immune system no longer tolerates the internal environment of the body, autoimmune disease develops, frequently causing debilitating and chronic symptoms. Diagnoses of autoimmune diseases have been increasing in prevalence and intensity in recent years. The NIH estimates up to 23.5 million Americans suffer from autoimmune disease; a safe, effective treatment raises hope of relief for many. Seeking ways to relieve patients’ suffering when conventional methods seem inadequate has become a priority for many physicians and researchers.

Treatment of various allergies and inflammatory diseases with ultra-low dose enzyme-activated immunotherapy, also known as LDA, has been used successfully for many years by trained physicians in the United States, Canada and other countries. As experience with the therapy has evolved, the term low dose immunotherapy (LDI), has been adopted.

As is the case with many medical breakthroughs, the potential for this therapy was discovered almost by accident. A British ear, nose and throat physician, S. Popper, was treating a patient with nasal polyps by injecting them with the enzyme hyaluronidase. The patient noticed after treatment that his respiratory allergy symptoms improved. Leonard McEwen, MD, discovered the enzyme responsible for the symptom improvement was actually a contaminant in the enzyme mixture. McEwen, working in England in the 1960s, called his therapy EPD or enzyme-potentiated desensitization. EPD helped mitigate and, in many cases, eliminate the inappropriate immune response commonly known as allergy.

In the early 1990s, William Shrader, MD, created an American version of EPD and named it LDA. In his protocol, an enzyme is added in a minute dose to a group of extremely dilute allergens, also known as antigens. Combined with a tiny amount of sterile water, a dose as little as one part in ten million to one part in one quadrillion is injected under the skin with a tiny needle or dripped under the tongue.

In general, there are two categories of immune reaction, one involving B cells which make immunoglobulins, called humoral immunity, and the other involving T cells, the effector cells of what is known as cell-mediated immunity. The latter is involved in LDI. When antigens are presented to immune cells just under the superficial layer of skin or under the tongue, the enzyme potentiates the production of large numbers of T regulator cells in the lymph nodes. T regulator cells are responsible for restoring “tolerance”. They do this by suppressing other types of T cells that cause an exaggerated reaction. These invaders may be external to the body or they may be self-antigens, which are internal to the body. Low dose immunotherapy uses a natural, physiological pathway of immune modulation.

In contrast, standard escalating dose immunotherapy (conventional allergy shots), where the doses start much higher and are increased over time, is mediated by immunoglobulins produced by B cells in the lymph nodes. The higher the blocking antibody made, the more successful the therapy. Unfortunately, very high doses of allergens are required over shorter periods of time for this to work and intolerable symptoms from the therapy may occur. These can range from itching and swelling­—sometimes severe—to, in rare instances, anaphylaxis. Anaphylaxis is a total body allergic reaction that can lead to death if not treated rapidly. The doses of antigens used in LDI are so miniscule that in the nearly 50 years since the discovery of EPD in England, and in the years since Shrader pioneered the use of LDA in the U.S., there has not been one reported case of anaphylaxis.

Since T regulator cells are so long-lived, doses are needed less frequently. Initially doses are given every seven weeks. Often after six-eight treatments, doses may be given every three-four months, and the ideal outcome is dosing only once or twice per year. Some patients’ symptoms improve permanently and they may be able to discontinue the treatment altogether while remaining symptom-free.

As a fellow of the American Academy of Environmental Medicine, Shrader has taught numerous physicians over the years. Ty Vincent, MD­, who coined the phrase “LDI”, is now training many physicians in the use of LDI to treat various conditions, including chronic Lyme disease and other tick-borne illnesses. At this time approximately 150 physicians now offer LDI in 17 different states. Several compounding pharmacies in the U.S. distribute the antigens and enzyme for LDA for use in this country.

While LDI has been extensively studied­—a study conducted in the U.S. from 1993-2001 included approximately 10,500 patients with 65 different conditions—and has been demonstrated to be safe and effective, as presently designed it does not qualify for evaluation by the Food and Drug Administration (FDA) because of its formulation process.

The practitioners currently trained to administer LDA therapy in Connecticut are Vicki Sara Blumberg, MD, in Ridgefield (203-403-3907) and Perry Perretz, DO, in Redding (203-544-9090).

For more information about LDA/LDI or to find trained physicians in other states, visit DrSchrader.com.

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