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© 2014 Dr Alex Vasquez, www.InflammationMastery.com & www.AntiViralNutrition.com •

Dr Vasquez’s presentation is sponsored by Biotics Research Corporation http://www.bioticsresearch.comPlease contact Biotics Research to register and attend: 800-231-5777 or 281-344-0909

Topics for this Presentation

1. Looking beyond acute infections: Linking viral infections to chronic/degenerative/inflammatory diseases—looking far beyond acute and simplistic disease models.

2. Prediction: Dr Vasquez’s published prediction in 2013: that quantity of viral activity and viral load would correlate positively with chronic disease in general (especially Alzheimer’s disease).

3. Overview and new data: New data published in 2014

4. Apo-E reconciliation

5. Mitochondrial reconciliation

6. Clinical / preventive / treatment implications

What are the major points?1) That we have to consider TVL:

specifically type and level of activity,

2) To review the new 2014 data, 3) To emphasize the importance of

“microbial mitochondriopathy” in the discussion of mitochondrial dysfunction and “mitochondrial nutrition”




1. Overview the Antiviral Strategy

2. Detail the first 2 parts

3. “Stress, Viral Replication, and DNA Methylation”

4. Q and A

Viral Infections: A few examples

1. Herpes type-1: carried by approximately 50% of the adult population worldwide; classic oral lesions; strongly associated with Alzheimer’s disease

2. Herpes type-2: carried by approximately 20% of the adult population worldwide; classic genital infection, but asymptomatic in many carriers; asymptomatic transmission is common

3. Epstein-Barr Virus: pandemic, classic infectious mononucleosis; strongly associated with autoimmune diseases lupus, Sjogren’s syndrome, and scleroderma*

4. Cytomegalovirus: pandemic; causes retinal infections in immunosuppressed patients; contributes to scleroderma*

5. Parvovirus B19: pandemic; can cause persistent arthritis; contributes to scleroderma*

6. Varicella zoster: chicken pox in kids; shingles in adults

7. Human papilloma viruses: many different subtypes; associated with various epithelial cancers

8. Hepatitis B and C: commonly and classically asymptomatic for years before diagnosis

9. Upper respiratory infections: cold, flu, adenoviruses, enteroviruses

10. More serious infections: HIV, Ebola, Dengue

Vasquez A, Antiviral Nutrition, Rheumatology v3.5, 2014



The process of viral infections

1) Attach to cell membrane, 2) enter nucleus, 3) incorporate into DNA and then 4) replicate and then escape and repeat process and spread to other cells

1) Cell attachment 2) Nuclear entry 3) DNA incorporation 4) Replication

2014: Viral Infections in the news daily

What I noticed in all of this discussion is

complete chaos, a lack of organized thought,

and –resultantly– a complete lack of any

effective strategy – everything was just being

piecemealed together.

And by the way, we don’t have a drug or

vaccine for every virus and we never will (not in

absolute terms or in practical terms of

affordability, safety, effectiveness, and

distribution)

The entire approach being used is WRONG.



Digital “Antiviral Nutrition” published 2014.10 and updated regularly

1. Easy to implement: Anyone can do it

2. Concept-based: Provides a framework for understanding a logical approach

3. Evidence-based:All treatments are based on published peer-reviewed research, prioritized and contextualized throughout the discussion

4. Updates: the digital version of AntiViral Nutrition (ASIN: B00OPDQG4W) is updated regularly, and the updates can be delivered directly to your phone, computer, or iPad/tablet

5. Video tutorials, updates, and explanations: The book (in paper and digital versions) provides immediate access to full-text articles and videos, which provide explanations of the concepts and treatments, as well as important updates

6. Most doctors learn and have no overall strategy for treating viral infections—let me show you how important a structured strategy is, and how easy and more effective this can be.

What is your anti-viral strategy?

If you can’t communicate your strategy, then

you don’t have a useful strategy.


Images © 2014 by Dr Alex Vasquez published in Antiviral Strategies and Immune Nutrition (book), Antiviral Nutrition (digital).







Antiviral methods and examples

� Entry inhibitors, fusion inhibitors: blocking viral entry into cells� Maraviroc (Selzentry in USA, Celsentri in other countries) binds to CCR5, preventing an

interaction with gp120. It is also referred to as a "chemokine receptor antagonist" or a "CCR5 inhibitor."

� Enfuvirtide (Fuzeon), a "fusion inhibitor."

� Blocking release: sounds retarded, but this is how some antiviral drugs work� Oseltamivir/Tamiflu: In adult trials, one person was harmed for every 94 treated. This

included events such as nervousness, aggression, hallucinations, psychosis, suicide ideation and paranoia. Benefit is reduction in illness by 1.3 days; imagine multi$BN market for this.

� Tagging: binding directly to virus particles, leads to “inactivation”� Licorice root

� Enzyme inhibition: can’t function or replicate� Papaya leaf

� Most drugs are enzyme poisons

� Blockaide of viral assembly:� Papaya leaf

� Lysine (herpesviruses)

� Antimutagenesis: blocking the viral “strategy” of frequent mutation which promotes drug resistance and immune escape� Selenium

� Vitamin E, and other antioxidants for that matter



What are the criteria for therapeutics?

� Availability

� Justice, distributive justice

� Safety, danger, risk, maleficence

� Effectiveness, beneficence

� Risk:benefit ratio

� Cost

� Cost-effectiveness

� Autonomy

� Only nonprescription nutrients meet all these criteria



Main antiviral strategies

1. Target the virus:1. Selenium and antioxidants: blocks viral replication and mutagenesis

2. Licorice and other botanicals

3. Lysine

2. Block replication:1. NF-kappaB inhibition: blocks viral replication

1. Lipoic acid: blocks viral replication

2. NAC: blocks viral replication

2. DNA methylation: folinic acid/ methylfolate, betaine/SAMe, vitamin D

3. Support immunity: 1. Vitamin D to support production of AMP: antimicrobial peptides

2. Vitamin A: immune support

3. Zinc

4. Lessen the effects and support recovery:1. Probiotics: reduce systemic inflammation and reduce symptoms of infection

2. CoQ10: promote recovery and protection of mitochondria

Lysine (specific for herpesviruses)

� Most common: HSV-1, HSV-2, Varicella zoster virus (VZV), EBV, CMV– are extremely widespread among humans. More than 90% of adults have been infected with at least one of these

� 3 more: human herpesvirus 6, human herpesvirus 7, and Kaposi's sarcoma-associated herpesvirus.

� Mechanism of action: "Proteins of the herpes simplex virus are rich in L-arginine, and tissue culture studies indicate an enhancing effect on viral replication when the amino acid ratio of L-arginine to L-lysine is high in the tissue culture media. When the ratio of L-lysine to L-arginine is high, viral replication and the cytopathogenicity of herpes simplex virus have been found to be inhibited." The Metabolomics Innovation Center

� Dose : 1 gram 3 times per day between meals



Lysine use

� It is simple: 1 gram 3 times per day between meals

� Nearly all studies show benefit

� Benefit is dependent on proper dosing

� 3 grams per day in divided doses

� Must reach sufficient serum level so that ratio of lysine to arginine is increased

� Insufficient dosing = lack of response

� Probably some people have lysine malabsorption, or lysine hyperutilization and might therefore need more

Selenium and antioxidants: blocks viral

replication and mutagenesis



Selenium use

Selenium

� 200 mcg per day is common for supplementation

� Up to about 1,000 mcg daily is reasonably safe for most people for long term use (note qualifiers), and 600-800 mcg is GRAS

� I use 600-800 for acute viral infections

Licorice and other botanicals



NF-kappaB inhibition: blocks viral replication

Lipoic acid: blocks viral replication



Lipoic acid: use

� Mechanisms: antioxidant, anti-inflammatory, NFkB inhibitor

� Dose range: 200-400 mg QID, CC or IC

� Risks: theoretical risk with B1 deficiency, hence the foundational use of MV/MM for all patients; anti-lipoate antibodies have been noted in patients with autoimmune-hepatitis but the significance is not clear and might be analogous to anti-biotin antibodies in other autoimmune disorders

NAC: blocks viral replication



NAC: blocks viral replication

� Mechanisms: mTOR inhibition, antioxidant per GSH, chelating benefits, NFkbinhibition

� Dose range: 500-1,500 mg TID IC

� Risks: mucosal irritation generally avoided by smaller doses or drinking with sufficient water

DNA methylation

� "The number of sexual partners, parity, oral contraceptive use, and HPV-16 infection were significantly associated with cervical dysplasia. Plasma nutrient levels were generally not associated with risk. However, red blood cell folate levels at or below 660 nmol/L interacted with HPV-16 infection. The adjusted odds ratio for HPV-16 was 1.1 among women with folate levels above 660 nmol/L but 5.1 (95% confidence interval, 2.3 to 11) among women with lower levels." Butterworth et al. Folate deficiency and cervical dysplasia. JAMA. 1992 Jan 22-29;267(4):528-33



Folinic acid and methylfolate

� Mechanisms: provides methyl groups for DNA…

� Dose range: 2-5 mg is common

� Risks: concomitant administration of B12 is expected; caution with antiseizure drugs

Zinc: immune support



Zinc: immune support

� Mechanisms: multifactorial immune support plus direct virucidal action in the ionized form plus inhibition of NFkB

� Dose range: 10-50 mg is generally sufficient

� Risks: balance long-term use with copper; avoid in patients with Alzheimer’s disease unless deficiency is significant

Vitamin D to support production of AMP:

antimicrobial peptides




� Mechanisms: multifactorial immune support plus direct virucidal action via plus inhibition of NFkB

� Dose range: 4,000 IU/d is common

� Risks: only hypercalcemia in patients with predisposition




Main antiviral strategies

1. Target the virus:1. Selenium and antioxidants: blocks viral replication and mutagenesis

2. Licorice and other botanicals

3. Lysine

2. Block replication:1. NF-kappaB inhibition: blocks viral replication

1. Lipoic acid: blocks viral replication

2. NAC: blocks viral replication

2. DNA methylation: folinic acid/ methylfolate, betaine/SAMe, vitamin D

3. Support immunity: 1. Vitamin D to support production of AMP: antimicrobial peptides

2. Vitamin A: immune support

3. Zinc

4. Lessen the effects and support recovery:1. Probiotics: reduce systemic inflammation and reduce symptoms of infection

2. CoQ10: promote recovery and protection of mitochondria


Images © 2014 by Dr Alex Vasquez published in Antiviral Strategies and Immune Nutrition (book), Antiviral Nutrition (digital).








1. Overview the Antiviral Strategy

2. Detail the first 2 parts

3. “Stress, Viral Replication, and DNA Methylation”

4. Q and A

Thanks,

Alex Vasquez DC ND DO FACN

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