Sunday, January 23, 2022

HEALING 101: KREBS CYCLE AND THE SCIENCE OF SELF REGENERATION

 Written By: Josh Schueller, PT

As a Physical Therapist and a patient analyst, I find myself constantly referencing course work from my college days to explain to patients how modern therapy actually works.  Today's patient has a hungry mind equipped to handle deeper explanations about how their therapies actually affect them.  Because of this, it behooves me to share content from my own medical texts to explain how the latest "invisible" therapeutic innovations work on them.   Such modern breakthroughs include: Stem Cell & PRP therapies, PEMF & Biofeedback technologies, Transcranial Stimulation, Laser Acupuncture, Neurostim therapeutics etc-- just to name a few. Meanwhile, I am equally impressed at our Google surfing community that can retain much of the same medical information my career was founded on.  

Just the other day, a 21 year old patient with spinal cord injury actually started asking me how my neurostim device affects cellular regeneration and THE KREBS CYCLE.  

So my presentation begins.


HOW THE BODY ACTUALLY HEALS
From burns to infections, inflammation to tears and breaks, the body's regenerative qualities can be  best illustrated through its metabolic design - mitigating its ability to heal itself on a cellular level.  Upon physical damage or disease, self recovery involves the regeneration and repair of living tissue(s), organs and its functions.  THERAPY covers external influences on the body's cellular performance to restore damaged areas either by replacing worn/dead tissue with new ones. [1]

For something like the KREBS CYCLE, I usually start such complex scientific explanations with my patients using metaphors and analogies.   


"Krebs cycle (otherwise known as citric acid cycle) is like the process of converting your paycheck into cash and going shopping with it. When you receive a paycheck (glucose) through direct deposit that paycheck is deposited into the bank (mitochondria).  Throughout this process there are fees (byproducts) that must be paid in order to receive the money.  These fees (NADH, GTP, CO2 etc.) are an essential part of the process.  The result is currency. In order to receive the money (ATP) it must go through to the ATM (electron transport System).  When you withdraw the money (ATP) you can spend on goods or services (energy production). As money is essential to the survival of the economy the Krebs Cycle is essential to the survival of the organism."


Academic Breakdown: Krebs Cycle 
By:  IPHA/Pain Healers Alliance newsletter

The Krebs’s Cycle is a multi-step chemical reaction that is the main source of energy for cells during Aerobic respiration.  Also called the TCA (T
riCarboxylic Acid) Cycle or Citric Acid Cycle, the Krebs cycle occurs in eukaryotes (cells with a nucleus) in the matrix of the mitochondria and the cytosol of prokaryotes (no distinct nucleus).   In a living organism, the TCA cycle is a series of reactions in which oxidation of Acetic Acid/glucose provides energy for storage in phosphate bonds (ATP).  Fuel for this comes from lipids and carbohydrates, which produce Acetyl-CoA.  These reactions are the major source of energy in all living organisms. 

Critical in the building blocks for synthesis of fatty acids, steroids, cholesterol, amino acids for building proteins and purines and pyrimidines used in the synthesis of DNA. The byproducts of the Krebs’s Cycle are 3 NADH, 1 FADHL, 1 GTP, and 2 CO2. (3)  The cycle runs twice for glucose and then the electron transport chain produces ATP. The electron transport chain is a series of reactions inside the cell whose purpose is the formation of ATP.  By studying the rates, by-products, enzymatic activity and qualities in the processes of metabolism the potential to draw conclusion about and investigate the efficiency of therapies. 

Glucose into mitochondria to go through Krebs Cycle (NADH, FADHL, GTP, CO2 byproducts) electron transport chain into ATP (energy)

Disorders of the Krebs Cycle such as 2-Oxoglutaric aciduria and fumarase deficiency affects mitochondrial function and maintenance.  This can cause developmental delays, severe neurologic problems in infants like mental retardation.  Clinical presentation of mitochondrial depletion syndrome is hypotonia, progressive dystonia, muscle atrophy and hearing impairments. (5)



TCA & CANCER
Traditional cancer treatments have been relatively effective, but with significant side effects and a high reoccurrence rate.  Alternative treatment approaches are gaining in medical significant and are becoming increasingly more difficult to ignore.  Identifying changes in the Krebs cycle could hold the key to early detection of chronic diseases, including cancers.  Early detection is significant in establishing more efficient treatment programs with less side effects.  Establishing safe and effective treatments for chronic disease can improve survival, but can also improve the quality of life for many.  In the future, dying with cancer not from cancer is becoming more likely.  

Emerging evidence that certain cancer cells rely heavily on TCA cycle for energy production and macromolecule synthesis has been discovered. Alterations of the TCA cycle play a pivotal role in oncogenesis and inflammation.  The hypothesis is mitochondrial dysfunction is a pre-curser for chronic disease such as cancer. Oncogenic mutation in TCA cycle can produce altered mitochondrial metabolism as a mechanism for cancer initiation.  Targeting cancer metabolism with potential therapy drugs that interfere with glycolysis, TCA cycle, lipid biosynthesis and other pathways that tumor cells overuse vs normal cells could be instrumental in solving the cancer puzzle. Majority of cancers generate ATP through the mitochondria.  Increase in mitochondrial dysfunction can be an early indication of disease or cancer. The TCA cycle is being recognized as a key player in certain cancers involving enzyme dysfunction. 

Currently, regenerative medicine is becoming more and more mainstream.  Traditional surgery and chemotherapy and radiation show a high reoccurrence of cancer.  Stem cells are showing good promise in treatment of many cancers. Stem Cells function serves as novel delivery platform by targeting primary metastatic tumors. Stem cells have shown to decrease tumor volume and extend survival in preliminary studies. Unique properties are found in regenerative medicine such as immunosuppression and mitigation towards cancer can assist in gene therapy applications.  Many regenerative medicines have anti-tumor properties.  Natural killer (NK) cells may have the ability to attack tumor/cancer cells/infected cells at the early stage.  


VIEWPOINTS

ROBERT KORNFELD, D.P.M.
 - Founder at Chronic Foot Pain Center, NY
When considering energy production and utilization, we must first look to the immune system and its ability to detoxify, repair, replace and replenish. This means a thorough understanding of our patient’s epigenetics and how their unique diet, lifestyle and environment influence their genes. The elimination of refined foods, preservatives and chemicals can assist in minimizing toxicity. Movement and exercise can assist in speeding up the basal metabolic rate, thereby shortening the time the body needs to work daily on working toward homeostasis. Minimizing toxicity and speeding up the basal metabolic rate is energy-preserving. In addition, stress management can help to dampen the adrenal response which has been shown to be a direct inhibitor of immune function. Also, sleep hygiene is critical for our patients as it is in deep states of sleep that the body does its best work to achieve homeostasis.

Disclaimer: The opinions expressed by submissions in this VIEWPOINTS section are theirs alone, and do not necessarily reflect the opinions or policies of NYCRA, Prevention101.org or our affiliate organizations supporting this publication. 



ON RESEARCH
By: Dr. Robert L Bard (An excerpt from "The Modern Patient" - (c) 2021 IPHA/Pain Healers Alliance newsletter

Since the advent of the information age, today's highly self-educated patient holds the keys to accessing the widest collection of available health solutions - and the power to decide what is truly right for them. Everything from the latest in diagnostic and treatment modalities to the vast encyclopedia of alternative solutions (ie. holistic, naturopathic and integrative), WEB RESEARCH forever changed the world of health, wellness and medicine, availing review of top educators and experts sharing their insight about the latest innovations, protocols and strategies.  This comprises the personal course of our 'research-happy' culture and the patient's FREEDOM OF CHOICE.  

To "captain one's own ship" is to make smarter decisions on who to listen to and to commit to a plan that works best for you. In a 2019 Cancer RMA Firefighters Conference, clinical immunologist Dr. Jesse Stoff stated a powerful message that “...there is no one answer to cancer! There are many different strategies for approaching and dealing with cancer [aside from] chemo, radiation & surgery. Other proven options like Immunotherapy have been around for decades too‐ performing in many cases with lightning‐fast response, much less toxicity, and much better overall survival.” (source link)  This resounding statement holds true for the importance of personal leadership with educated patients and putting us all in the drivers' seat of our destiny.




ABOUT THE AUTHORS


JOSH SCHUELLER
 has dedicated his life's work to the support and treatment chronic pain and disorders with non-invasive, safe, effective treatment solutions. He is the current VP of Clinical Operations and Business Development at AxioBionics LLC. and the Clinical Director for Orthopedic Physical Therapy Clinics (Rockford, MI).  As an active member of APTA, he holds advanced certification in Physical Therapy treatment techniques including the McKenzie method of patient empowerment.  He has over 20+ years experience in the treatment of neurological conditions such as Spinal Cord Injury, Traumatic Brain Injury, CVA, Cerebral Palsy etc.  In 2021, Josh is elected a clinical advisory role and educational advocacy for IPHA (Integrated Pain Healers Alliance) and has published research articles in pain management while pioneering the establishment of   Today, Josh continues to support patient suffering from disabilities and has expanded his focus to contribute his expertise in treatment programs for Veterans and first responders. 

ROBERT L. BARD
, MD, PC, DABR, FASLMS - Advanced Imaging & Diagnostic Specialist
Having paved the way for the study of various cancers both clinically and academically, Dr. Robert Bard co-founded the 9/11 CancerScan program to bring additional diagnostic support to all first responders from Ground Zero. His main practice in midtown, NYC (Bard Diagnostic Imaging- www.CancerScan.com) uses the latest in digital Imaging technology has been also used to help guide biopsies and in many cases, even replicate much of the same reports of a clinical invasive biopsy. His most recent program is dedicated to the reporting of mental health diagnostic and innovative solutions including the use of modern neuromagnetic technologies and protocols in his MEDTECH REVIEWS program.



REFERENCES

1) https://en.wikipedia.org/wiki/Healing

2).Scaglioa et. Al. March 2020 “The Tricarboxylic Acid Cycle at the Crossroad Between Cancer and Immunity”. Mitochondria and Mitophagy . Antioxidants and Redox Signaling Vol 32, No 12

3) Zhang et. Al. Sept 2017 “ Stem Cells in Cancer Therapies: opportunities and challenges” Oncotarget 8 (43) 75756-75766

4)   Millipore Sigma “ The Krebs Cycle- Harnessing Chemical Energy for Cellular Respiration”

www.sigmaaldrich.com

4.     Bachanova and Miller 2014. “NK Cells in Therapy of Cancer” Crit Rev Oncog; 2014 19(0) 133-141

5.     Morava and Carrozzo. January 2014. “Disorders of the Krebs Cycle”. Physicians Guide to Diagnosis, Tretment, and Follow-Up of Inherited Metabilic Diseases- pp313-322

6.     Vadala et. Al. “Mechanisms and therapeutic effectiveness of pulsed electromagnetic field therapy in oncology” Cancer Medicine 2016; 5 (11) 3128-3130

Mansouri et. Al. “Recent advances in regenerative medicine strategies for cancer treatment” Biomedicien and Pha


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