If you hadn't heard of C3a last week, you don't know about C4a either. It's another member of the complement system, that basic process that kills invading bacteria with nonspecific chemicals. The complement system is a cascade like multiplying dominoes that rapidly magnify your immune response. C4a is an activationanaphylatoxin that can rapidly ramp up trouble. It's one step up from C3a. . There are three pathways of complement activation, but mold illness tends to use the MBL (mannose binding lectin) pathway. This pathway is designed to recognize specific shapes, mannose and n-acetylglucoseamine in particular. When MBL sees those shapes, it turns on the heavy duty MBL Associated Serine Proteinases - or MASPS. There are several MASPs but MASP-2 is the wicked one that keeps making more C4a. C4a only lasts a few seconds, but MASP-2 keeps turning it on. Turn off MASP-2 and the whole show stops. Did you get that?
One of the peculiar effects of C4a is that it blocks the assembly of "multimer's" that allow blood clotting. With a blasting off cascade of higher C4a, your blood becomes anti-coagulated and mold folks start having nosebleeds like crazy. Fortunately, ddavp works on helping assemble multimers and works like a little charm at stopping nose bleeds. You learn to carry your ddavp with you.
If C4a is elevated, you get cognitive dysfunction, increased smooth muscle contraction, blood vessels leaking fluid, release of chemotactic factors followed by capillary hypoperfusion and low tissue oxygen. It's normal range is 0-2830 but you will see folks with levels of 18,000, rising higher and higher after each exposure. The average level of C4a in CIRS or biotoxin illness is at least 10,000, but it's not uncommon to have 20,000 on the second exposure, 50,000 the third, 150,000 the fourth and too high to measure on the fifth. The phrase "sicker, quicker" really applies here and C4a becomes one of the cardinal tools to see how sick someone is. For folks with re-exposure to a toxic environment, C4a will explode the first day as a strong marker of immediate toxicity. (Leptin rises on day 2 and MMP9 rises on 2-3 and TGF-beta 1 will vary depending on your genetic variability.) You have about 5 minutes in a "toxic" environment before you start activating C4a and 10 minutes is your maximum time before you better get out.
C4a makes such a dramatic decrease in blood flow to brains that you can measure the toxic effect of mold illness on MRI scans on your brain where computer algorithms can generate a test called NeuroQuant. It is all computer managed so doesn't take a radiologist to read, so costs less (or should). C4a has such an effect on brains, it's not a far reach to understand Bredesen's claim that 500,000 Americans are developing Alzheimer's because of this inflammatory effect.
What is the most effective way to lower C4a? Turn off MASP-2. What does that the best? Erythopoeitin. "Epo". So called Procrit is used extensively in America for cancer patients with low blood counts. It boosts their ability to make more blood. But it also blocks the MASP-2 nightmare in its tracks. Now that's handy. It's also tricky. In fact, so tricky that there is a lot of pushback to using EPO for this and regulatory bodies don't like it much. (Beyond the scope of this note.)
How can I summarize all this confusing stuff? Forget the confusion. The simple facts for you to remember is that you have 10 minutes to get out of a bad place if you are mold sensitive. If you are a nosebleed victim, you need to carry DDAVP around with you. If you know your C4a, you can have a sense of how serious your mold illness is: 10,000 is awful, 2100 is ok, 180,000 is "I gotta get outta here". Erythropoetin is a miracle worker at allowing your energy level to return, your brain to fix and your nosebleeds to get better, but you may not be able to get it.
And then there is VIP. Like the Lone Ranger riding the rescue, VIP can work to resolve high C4a when you can't use EPO. The nasal spray of VIP fixes elevated C4a like a charm. It's much safer than epo, and much easier to give.
How does all this fit together? It's complex but then again, simple. All the cytokines and inflammogens are all on the same team and pushing in the same direction. So, they are all linked and all work together to make the same mess, or the symphony. Shoemaker references Beethoven's 9th when everything is working well. Folks with mold illness, have everything working badly. If you had heard me on the bassoon in10th grade, trying to play Peter and the Wolf, that's what happens in mold illness. It all goes badly.
www.What Will Work for me. I'm in a quandary finding a reliable place to measure c4a. We are working on it. I have some folks who tell me they are fatigued all the time and have nosebleeds and don't know why. Our local labs can't do C4a yet. Most folks reading this blog will be in places where it can't be measured yet. As more doctors learn this method, they will develop more demand for it. Someday it will be as important a test for you to know as your cholesterol, as least if you want to know why your memory is slipping, your joints ache, you are tired after walking up stairs.....
1. C4a is part of the complement cascade the complements your good looks? T or F Answer: Pardon the tongue in cheek. This system of complement is your basic innate immune system that generates the inflammation that nonspecifically attacks invading bacteria, punching a hole in their walls and killing them.
2. In biotoxin illness, what gets messy that keeps C4a so elevated? Answer: Your MASP-2 protein gets elevated and keeps generating new C4a endlessly. You can measure C4a
3. What is the best way to turn off MASP-2? Answer: Erythropoietin or EPO or branded as Procrit. But VIP is probably just as good, and much easier and safer.
4. You can show the damage of biotoxin illness on your brain with a radiology test called what? Answer: Neuroquant, 15 minutes in an MRI, if you can get it.
5. How much time do you have if you sit down at a wedding in a moldy church before your C4a fires off? Answer: 5 minutes