Follow up thread...
This thread is proudly brought to you by @ChaserTechAu The enabler.
The husband of the mad creative vet and scientist... 👩🏽🔬💃🏻🍞🐕🦺🧬
Give him a follow. He’s new here and has a different brain and skill set. Wears an N95.
Here goes (today’s) Warren.
1/23
This thread is proudly brought to you by @ChaserTechAu The enabler.
The husband of the mad creative vet and scientist... 👩🏽🔬💃🏻🍞🐕🦺🧬
Give him a follow. He’s new here and has a different brain and skill set. Wears an N95.
Here goes (today’s) Warren.
1/23
Thanks to Twitter legend brains, who mistakenly call themselves ‘lay people’, Pandora’s box of CFS/ME/Long Covid/Low Cortisol/Adrenals has been opened...
💎
2/23
💎
2/23
Inside this box we find:
🧠 Low Cortisol and HypoA
🧠 Anecdotal bilateral adrenal enlargement
@respphysio
🧠 The hypothalamic–pituitary–adrenal (HPA) axis and CFS/ME & LC
@shellchat
🧠 Animals
🧠 Amyloid
3/23
🧠 Low Cortisol and HypoA
https://twitter.com/ashfwh/status/1559894816569556992?s=21
🧠 Anecdotal bilateral adrenal enlargement
@respphysio
🧠 The hypothalamic–pituitary–adrenal (HPA) axis and CFS/ME & LC
@shellchat
🧠 Animals
🧠 Amyloid
3/23
Background
Starting with low cortisol and bilateral adrenal enlargement, think...
👂 Adrenal incidentalomas like Amylodosis
👂 Primary aldosteronism (results in hypertension)
👂 Addison’s with infectious aetiology (?)
👂 Infection (histoplasmosis)
👂 Haemorrhage
4/23
Starting with low cortisol and bilateral adrenal enlargement, think...
👂 Adrenal incidentalomas like Amylodosis
👂 Primary aldosteronism (results in hypertension)
👂 Addison’s with infectious aetiology (?)
👂 Infection (histoplasmosis)
👂 Haemorrhage
4/23
pubmed.ncbi.nlm.nih.gov/1144751/
The Adrenal incidentalomas list is long but let’s focus on amyloidosis - cause we can and that’s why I started this dang thread....
www1.racgp.org.au/ajgp/2021/janu…
5/23
The Adrenal incidentalomas list is long but let’s focus on amyloidosis - cause we can and that’s why I started this dang thread....
www1.racgp.org.au/ajgp/2021/janu…
5/23
Amyloid
‘Amyloid A (AA) amyloidosis is a result of the deposition of serum amyloid A (SAA) protein fragments and related to a chronic inflammatory disease of either infectious or noninfectious aetiology’
6/23
ncbi.nlm.nih.gov/pmc/articles/P…
‘Amyloid A (AA) amyloidosis is a result of the deposition of serum amyloid A (SAA) protein fragments and related to a chronic inflammatory disease of either infectious or noninfectious aetiology’
6/23
ncbi.nlm.nih.gov/pmc/articles/P…
Primary aldosteronism (PA)
‘PA, affects 5–10% of patients with hypertension in primary care, & up to 30% of patients with resistant hypertension. PA is rarely screened for and was diagnosed in <0.1% of patients with hypertension in a survey...’
7/23
www1.racgp.org.au/ajgp/2021/janu…
‘PA, affects 5–10% of patients with hypertension in primary care, & up to 30% of patients with resistant hypertension. PA is rarely screened for and was diagnosed in <0.1% of patients with hypertension in a survey...’
7/23
www1.racgp.org.au/ajgp/2021/janu…
Animals & amyloid
Basic knowledge from vet school:
🦴 hereditary component
🦴As with most things, could be a result of infection, inflam, immune-mediated or neoplasia.
🦴 Never actually diagnosed it personally but reading what I have today it’s probably under Dx.
8/23
Basic knowledge from vet school:
🦴 hereditary component
🦴As with most things, could be a result of infection, inflam, immune-mediated or neoplasia.
🦴 Never actually diagnosed it personally but reading what I have today it’s probably under Dx.
8/23
🦴I never tested for it in general practice.
🦴I treated a helluva lot of renal and hepatic disease without invasive diagnostics
🦴There doesn’t appear to be cure for it so support was probably not too bad for any I missed.
9/23
ncbi.nlm.nih.gov/pmc/articles/P…
🦴I treated a helluva lot of renal and hepatic disease without invasive diagnostics
🦴There doesn’t appear to be cure for it so support was probably not too bad for any I missed.
9/23
ncbi.nlm.nih.gov/pmc/articles/P…
So.
What if we can think about how these things might be linked.
What pathways could there be?
Let’s try my Ashleyland hardest to do a @fitterhappierAJ and then we ask @crwequine for help so we can get closer or she can pull me up. Best & coolest brain I know.
10/23
What if we can think about how these things might be linked.
What pathways could there be?
Let’s try my Ashleyland hardest to do a @fitterhappierAJ and then we ask @crwequine for help so we can get closer or she can pull me up. Best & coolest brain I know.
10/23
Dot to dots. Many gaps.
SARSCov2 and amyloid
biorxiv.org/content/10.110…
‘A marker for the severeness and disease progress of COVID-19 is overexpression of serum amyloid A (SAA) to levels that in other diseases are associated with a risk for SAA amyloidosis’
11/23
SARSCov2 and amyloid
biorxiv.org/content/10.110…
‘A marker for the severeness and disease progress of COVID-19 is overexpression of serum amyloid A (SAA) to levels that in other diseases are associated with a risk for SAA amyloidosis’
11/23
‘This secondary illness is characterized by formation and deposition of SAA amyloids in blood vessels, causing inflammation, thrombosis and sometimes organ failure...’
Galkin theorised here...
pubmed.ncbi.nlm.nih.gov/33876719/
Latest on SARS & amyloid
pubs.acs.org/doi/10.1021/ja…
12/23
Galkin theorised here...
pubmed.ncbi.nlm.nih.gov/33876719/
Latest on SARS & amyloid
pubs.acs.org/doi/10.1021/ja…
12/23
So...
Then there’s
👃 Olfactory damage & dementia to consider
journals.physiology.org/doi/full/10.11…
🧠 Dementia and amyloid
nia.nih.gov/health/what-ha…
And
🦠 Sarscov2, Amyloid and neuro effects...
14/23
nature.com/articles/s4146…
Then there’s
👃 Olfactory damage & dementia to consider
journals.physiology.org/doi/full/10.11…
🧠 Dementia and amyloid
nia.nih.gov/health/what-ha…
And
🦠 Sarscov2, Amyloid and neuro effects...
14/23
nature.com/articles/s4146…
And this is where we bring in...
The hypothalamic–pituitary–adrenal (HPA) axis
en.m.wikipedia.org/wiki/Hypothala…
Just to make things extra fun.
🧠 Long Covid and HPA
healthrising.org/blog/2020/05/2…
Which references this ...
ncbi.nlm.nih.gov/pmc/articles/P…
15/23
The hypothalamic–pituitary–adrenal (HPA) axis
en.m.wikipedia.org/wiki/Hypothala…
Just to make things extra fun.
🧠 Long Covid and HPA
healthrising.org/blog/2020/05/2…
Which references this ...
ncbi.nlm.nih.gov/pmc/articles/P…
15/23
Low cortisol and HPA mentioned here:
“Low cortisol levels may reflect adrenal insufficiency due to either adrenal failure, where ACTH levels will be elevated, or secondary to hypothalamic–pituitary dysfunction resulting from structural lesions or, increasingly,..”
RACGP
16/23
“Low cortisol levels may reflect adrenal insufficiency due to either adrenal failure, where ACTH levels will be elevated, or secondary to hypothalamic–pituitary dysfunction resulting from structural lesions or, increasingly,..”
RACGP
16/23
Then we bring HPA and amyloid together and of course we need @crwequine
Cause they mention IL and she’s all over this...
scholar.google.com.au/scholar?q=hypo…
17/23
Cause they mention IL and she’s all over this...
scholar.google.com.au/scholar?q=hypo…
17/23
And of course...
In all of this we find the lost mittens..
Or post mortems. 😢
‘patients who died as a result of COVID-19 exhibit large amounts of focal β-amyloid deposits in their neocortical tissues upon autopsy’
news-medical.net/amp/news/20220…
😞
18/23
In all of this we find the lost mittens..
Or post mortems. 😢
‘patients who died as a result of COVID-19 exhibit large amounts of focal β-amyloid deposits in their neocortical tissues upon autopsy’
news-medical.net/amp/news/20220…
😞
18/23
And then we get a nice little yellow ribbon and we bring it all together with an animal model, cause, One Health.
Conclusion from this one ‘Taken together, our data suggest that BA exerts an inhibitory effect on HPA axis activation’
pubmed.ncbi.nlm.nih.gov/23859549/
19/23
Conclusion from this one ‘Taken together, our data suggest that BA exerts an inhibitory effect on HPA axis activation’
pubmed.ncbi.nlm.nih.gov/23859549/
19/23
So.
How do I link it all together?
The answer is, I can’t. But of course, I can ask some questions...
Most importantly, we must work together. This pandemic hole is deep and wide. Go team!
20/23
How do I link it all together?
The answer is, I can’t. But of course, I can ask some questions...
Most importantly, we must work together. This pandemic hole is deep and wide. Go team!
20/23
Questions.
Amyloid? Is it like Covid? Everywhere?
It’s starting to seem like it.
So... how do we find out more?
Could the low cortisol be linked to local effects of amyloid on the adrenals (bilat?) or manifestations through the HPA? Does amyloid play a role here?
21/23
Amyloid? Is it like Covid? Everywhere?
It’s starting to seem like it.
So... how do we find out more?
Could the low cortisol be linked to local effects of amyloid on the adrenals (bilat?) or manifestations through the HPA? Does amyloid play a role here?
21/23
Is it both? Is it neither?
What’s the hereditary role with amyloid and covid?
Is there a hereditary role with Long Covid and amyloid?
Always more questions than answers from clinicians but thanks everyone for playing...
Looking forward to the next instalment already.
22/23
What’s the hereditary role with amyloid and covid?
Is there a hereditary role with Long Covid and amyloid?
Always more questions than answers from clinicians but thanks everyone for playing...
Looking forward to the next instalment already.
22/23
@crwequine @NjbBari3 @VirusesImmunity @ToshiAkima @C_A_Gustave @shellchat @respphysio @JayneFlan @PMGPSC @EmergeAus @TraceySpicer @MackayIM @YouAreLobbyLud @DRTomlinsonEP @ColinKinner @annikalmoksa @Littlefishb1ue @ProfPCDoherty @fitterhappierAJ @DrEricDing @yaneerbaryam
23/23
23/23
By the way... this stuff is getting more interesting by the second... dammit!
nature.com/articles/s4158…
nature.com/articles/s4158…
Soz... this thread may go 4eva...
‘Most of the distinct amyloidosis syndromes are named after the fibril forming protein, e.g. AL (amyloid derived from immunoglobulin light chain) amyloidosis (localized or systemic), AA amyloidosis (amyloid derived from SAA – serum amyloid A...’
‘Most of the distinct amyloidosis syndromes are named after the fibril forming protein, e.g. AL (amyloid derived from immunoglobulin light chain) amyloidosis (localized or systemic), AA amyloidosis (amyloid derived from SAA – serum amyloid A...’
‘protein), wild type (wt) ATTR (amyloid derived from TTR [transthyretin]) amyloidosis or hereditary ATTRV30M amyloidosis. However, some amyloid fibril proteins such as Aβ, ATau, Aα-Syn and AIAPP play a pathologic role in neurodegenerative or...’
‘endocrine diseases that are not clinically classified as amyloidosis. The three most common types of systemic amyloidosis are AL, AA, and ATTR amyloidosis.’
isaamyloidosis.org/about-amyloido…
Welcome @ISA_Amyloidosis
Got any broken down language for us... :)
isaamyloidosis.org/about-amyloido…
Welcome @ISA_Amyloidosis
Got any broken down language for us... :)
🎶 This is the thread that never ends... 🎶
cardiab.biomedcentral.com/articles/10.11…
This is where I say
Prevent infection, reduce transmission, the science is still catching up....
#weararespirator
#COVIDisAirborne
@JohnSnowProject
cardiab.biomedcentral.com/articles/10.11…
This is where I say
Prevent infection, reduce transmission, the science is still catching up....
#weararespirator
#COVIDisAirborne
@JohnSnowProject
• • •
Missing some Tweet in this thread? You can try to
force a refresh
