Gadolinium Deposition Disease: a Family of Disorders?
The first article I ever wrote that included the description of GDD was describing Gadolinium in Humans as a Family of Disorders. As years have past studying GDD, it now seems most likely that GDD itself is a family of diseases. This is not uncommon and should not be surprising. Many diseases as first described were considered one entity, and with further research are shown to be multiple entities with one final end result. 30 years ago dementia was considered one or few entities, now it is shown to be many, probably in the hundreds. Same is true of Multiple Sclerosis, where there are probably a number of causes but with a shared end result of nerve sheath demyelination; asthma with shared end result of immune bronchospasm, and the other metal disease, I often refer to: Genetic Hemochromatosis, where there is one most common gene abnormality, but now there are additional genes observed that can result in this.
The shared end result may be Tissue Resident memory Tcell dysregulation , or something more purely biochemical such as specific protein-folding abnormality, but there are a number of root causes to get to that point. I have focused on the Tissue Resident memory Tcell dysregulation, but there may be a number of pathways that get there, such as Mast Cell Activation Syndrome (I have described for some months), Macrophage Activation Syndrome (I just recently described), and Dendritic Cell - Tcell communication error (which I have thought about for months but have written here for the first time), or Parasite-Induced Tcell dysfunction (that I thought of in writing this blog).
The fact that I now consider there may be a number of pathways to get to GDD, may cause many to panic, thinking "Oh God, now what do we do". But despite this complexity the initial treatment goals remain the same, and will likely always remain the same, but we hopefully have better tools as we go along.
So the initial treatment goals remain: 1. do not add more Gd into the body, and 2. get out as much Gd as reasonable that is already there.
It is likely in the future there will be adjunct treatments that will address the root causes. Some of these treatments may be STEM cells or CRISPR gene insertions; others targeted DMARD drugs that will either: i) lock down the cytokine response to elaborate the inflammation, or ii) unlock the defensive cytokine response that GSC subjects possess, or both; or specific more effective treatment of source infections such as viruses (for example Epstein-Barr) or parasites (Lyme and others); or specific treatment of other related IMIDs or genetic diseases.
So I am beginning to think that GDD itself is a family of disorders. I do see the dark humor that sometime in the future one time skeptics/critics will say, 'well if Dr Semelka had said to begin with that GDD is a communication error between Dendritic cells and T cells, and not focused on Tissue Resident memory Tcell dysregulation, then we would have believed him from the start in 2016'.
But despite the gale force winds swirling around the possibility of many root causes, the primary treatment for GDD will remain the same: no more GBCAs for that individual, and get as much Gd out as is reasonable. Keep it simple, stupid.
Richard Semelka, MD.