Chronic Inflammatory Response Syndrome Profile
Chronic Inflammatory Response Syndrome (CIRS) describes a constellation of symptoms, associated laboratory findings and test results associated with biotoxin exposure in genetically susceptible individuals.
The diagnosis of CIRS relies on four major criteria:
Clinical picture consistent with biotoxin exposure
Symptoms of biotoxin-related illness
- Abnormal Visual Contrast Sensitivity (VCS)
Abnormal laboratory results and clinical tests consistent with CIRS
The following biomarkers are measured in this CIRS panel:
MSH, VIP, VEGF, C4A, TGF B, MMP 9
Optional Molds IgG profile and Pro-inflammatory Cytokines can also be added to this profile.
In mold illness, MSH will be too low in over 95% of patients. This means increased susceptibility to mold illness, ongoing fatigue, pain, hormone abnormalities, mood swings, and much more. MSH is a hormone, called a regulatory neuropeptide, and it controls many other hormones, inflammation pathways, and basic defences against invading microbes. Without MSH, bad things happen; chronic sleep disorders with non-restful sleep develop, and endorphin production is reduced, so chronic pain follows.
VIP: Vasoactive intestinal polypeptide (VIP) is a neuroregulatory hormone with receptors in the hypothalamus. This hormone/cytokine regulates peripheral cytokine responses, pulmonary artery pressures, and inflammatory responses throughout the body.
Low VIP levels are present in mold illness patients. This leads to unusual shortness of breath, especially in exercise. To date, every multiple chemical sensitivity patient Shoemaker has seen (over 500) have had low VIP. VIP plays a role similar to MSH in regulating inflammatory responses.
With respect to the digestive system, VIP seems to induce smooth muscle relaxation (lower esophageal sphincter, stomach, gallbladder), stimulate secretion of water into pancreatic juice and bile, and cause inhibition of gastric acid secretion and absorption from the intestinal lumen, which can lead to chronic, watery diarrhea.
VEGF: Vascular endothelial growth factor (VEGF) is a substance made by cells that stimulates new blood vessel formation and increases blood flow in the capillary beds. VEGF is a polypeptide. Deficiency of VEGF is quite common and is a serious problem in biotoxin illness patients that must be corrected. If you don’t have blood flow, cells begin starve and don’t work properly.
MMP-9: Matrix metallopeptidase 9 (MMP-9) is an enzyme that in humans, is encoded by the MMP9 gene. Proteins of the MMP9 family are involved in the breakdown of extracellular matrix in normal physiological processes, such as embryonic development, reproduction, and tissue remodeling, as well as in disease processes.
It has been implicated in pathogenesis COPD by destruction of lung elastin, in rheumatoid arthritis, astherosclerosis, cardiomyopathy, and abdominal aortic aneurysm.
MMP-9 delivers inflammatory elements of of blood into subintimal spaces, where further delivery into solid organs (brain, lung, muscle, peripheral nerve and joint) is initiated.
C4a: C4a has become the inflammatory marker of greatest significance looking at innate immune responses in those with exposure to Water Damaged Buildings (WDB).
The complement system is a group of proteins that move freely through your bloodstream. The proteins work with your immune system and play a role in the development of inflammation.
Each complement activates inflammatory responses, with spillover of effect from the innate immune response to acquired immune response and hematologic parameters.
These short-lived products are re-manufactured rapidly, such that an initial rise of plasma levels is seen within 12 hours of exposure to biotoxins, and sustained elevation is seen until definitive therapy is initiated.
TGF-B1: TGF Beta-1 is a protein that has important regulatory effects throughout innate immune pathways. This protein helps control the growth and division (proliferation) of cells, the process by which cells mature to carry out specific functions (differentiation), cell movement (motility), and the self-destruction of cells (apoptosis). The TGF Beta-1 protein is found throughout the body and plays a role in development before birth, the formation of blood vessels, the regulation of muscle tissue and body fat development, wound healing, and immune system function (especially regulatory T-cells).
TGF Beta-1 can impair T-regulatory cell function, which in turn contributes to the activation of autoimmunity, yet TGF Beta-1 also plays a role in suppressing autoimmunity(!). TGF Beta-1 has become important in the exploding incidences of childhood asthma, raising the tantalizing issue of remodeling due to biotoxin exposure. The EPA says that 21% of all new cases of asthma are due to exposure to Water Damaged Buildings. If an individual develops wheezing after exposure to a water damaged building, look for remodeling to be the cause. Remodeling means "something" happens that the airway changes to be more reactive and in need of medications to reduce wheezing. Neurologic, autoimmune and many other systemmic problems also are found with high TGF Beta-1.