Hypersensitivity Megathread

[Muon]

Discussion about hypersensitivity in POIS. https://en.wikipedia.org/wiki/Hypersensitivity

A quote from Waldinger's paper: ''The combination of allergic and systemic flu-like reactions post-ejaculation together with a positive skin-prick test in the majority of males underscores the hypothesis of an "immunogenic" etiology of POIS, e.g., that POIS is caused by Type-1 and Type-IV allergy to the males' own semen, as soon it is triggered by ejaculation.'' https://www.ncbi.nlm.nih.gov/pubmed/21241453

Didn't he mean a type I hypersensitivity, which is an allergy, and type IV hypersensitivty (which is not an allergy)? A type IV hypersensitivity reaction takes place over the course of days and is of the delayed type and is not mediated by antibodies. Type IV hypersensitivity is mediated by T-cells. Th1 cells and interferon gamma are involved in such reactions. Macrophages could produce hydrolytic enzymes like, for example, acetylcholinesterase: https://en.wikipedia.org/wiki/Type_IV_hypersensitivity

Now when you look at my case you will notice the following:

1) IFN-g decreases after orgasm
2) IFN-g has increased 24 hours after orgasm if you compare the value before orgasm and 24h after

I do think point 1 might be a natural process which is related to orgasm and competes with the tendency of IFN-g to increase due to POIS. On short term after orgasm point 1 may dominate point 2, meaning a decreasing trend. As time goes by this may switch up and be reversed, meaning a dominant increasing trend. Orgasm itself might interfere with type IV Hypersensitivity measurements shortly after orgasm.

09-07-2015: IFN-g (Th1) 1806 pg/ml RR: 374 - 1660 pg/ml (just before orgasm)
10-07-2015: IFN-g (Th1) 1965 pg/ml RR: 374 - 1660 pg/ml (24h later relative to the 09-07-2015 data point, after orgasm)

13-08-2015: IFN-g (Th1) 1315 pg/ml RR: 374 - 1660 pg/ml (just before orgasm)
14-08-2015: IFN-g (Th1) 3053 pg/ml RR: 374 - 1660 pg/ml (24h later relative to the 13-08-2015 data point, after orgasm)

When looking at the data, it's possible IFN-g is still rising >24h after orgasm meaning it should be measured longer than I have done. My brother has measured Interferon gamma only once, which doesn't tell us anything about its dynamics in time. Suggestion for POIS research: IFN-g measurements during an interval of just before orgasm up to a few days after orgasm. Different subtypes can be distinguished, see below.

Subtype IVa: with Th1 and monocyte directed and cytokines: IFNgamma, IL-1, IL-2.

Subtype IVb: with Th2 and eosinophils directed and cytokines: L-5, IL-4, IL-13.

Subtype IVc: with T CD8+ directed and cytokines: perforin, granzyme B, Fas Ligand.

Subtype IVd: with T CD4+, CD8+ and neutrophil directed and cytokines: IL8, GM-CSF.

Source: [Type IV of hypersensitivity and its subtypes]

LTT and seminal fluid

The lymphocyte transformation test might be a method for measuring a cellular T-cell response to seminal fluid. Even more interesting is to combine this with gel electrophoresis.

https://www.imd-berlin.de/en/special-areas-of-competence/lymphocyte-transformation-test-ltt.html
https://en.wikipedia.org/wiki/Gel_electrophoresis

[Vandemolen]

That is interesting. Interferon-beta is a medicine that is used for MS-patients. But in your case your Interferon-gamma has rised after sex. So maybe it is not usefull? But if Interferon-beta brings the IFN-g down...
And Interferon-alfa is used against hepatitis.

[Muon]

That is interesting. Interferon-bèta is a medicine that is used for MS-patients. But in your case your Interferon-gamma has rised after sex. So maybe it is not usefull? But if Interferon-bèta brings the IFN-g down...
And Interferon-alfa is used against hepatitis.

I don't understand a word of what you have said. Do you mean I can lower my IFN-g by injecting myself with another IFN type? Do you mean that MS is related to type IV by increased IFN-g so medicine used for MS might help against POIS? IFN-gamma has risen because my assumption in this thread is that POIS is a type IV hypersensitivity reaction. Btw I can't read those symbols you have typed after the word interferon, it doesn't show up for me, maybe you could use the words alpha, beta, gamma etc.

[Vandemolen]

Never mind. I just wanted to say that there are medicines with Interferon. But as I said it is useless because your level rised. And taking Interferon will only make the level higher.

But when I read Wikipedia I think Waldinger means type-4 hypersensitivity.

[Vandemolen]

Perfume allergy is also a type 4 allergy reaction. I have perfume allergy. It got it exactly at the same time I got POIS. I wonder if there are more POIS-patients who have a perfume allergy.

[Muon]

Perfume allergy is also a type 4 allergy reaction. I have perfume allergy. It got it exactly at the same time I got POIS. I wonder if there are more POIS-patients who have a perfume allergy.

From my understanding a type IV hypersensitivity is not an allergy (someone should correct me if I'm wrong about that). I can react to parfums as well.

[Vandemolen]

Yes you are right. Perfume allergy is not the correct term, but a lot of people use this term. It is just a sensitivity to perfume. I also have this sensitivity to cigarette smoke. Before the smoke ban in The Netherlands I used to have red eyes and a runny nose after I visited a bar or a restaurant. So when Waldinger used type 4 in his paper then he meant that POiS-patients have a sensitivity to their own semen?

[Muon]

Vandemolen, yes I do think Waldinger made a mistake for calling it a type 4 allergy in his paper instead of a type 4 hypersensitivity. An allergy assumes allergic mechanism where antibodies are involved, check the first wikipedia link for the distinction. The weird thing is that I can react to cigarette smoke as well but not consistently, it's quite variable.

[Vandemolen]

Check the Dutch Wikipedia about the term allergy. There are two kinds in type 4: one where T helper is involved and the delayed kind (perfume sensitivity).

https://nl.m.wikipedia.org/wiki/Allergie

In English (Google Translate):
https://translate.google.com/translate?hl=nl&sl=nl&tl=en&u=https%3A%2F%2Fnl.m.wikipedia.org%2Fwiki%2FAllergie

[Muon]

I'm confused, so the dutch page tells us there are two type 4 hypersensitivity mechanisms, an allergic one and non-allergic one. The english page just calls it type 4 hypersensitivity and doesn't mention this. The Dutch wiki pages aren't always that accurate compared to the english versions though. I could be wrong about the terminology. What we can say is that there is no evidence for his type I allergy claim because there hasn't been a group study showing positive IgE results (a lot of patients have been tested for this outside of studies). Cytokines haven't been explored yet, these are playing a role in type 4 HS, so his type 4 claim could still be true. My data supports that possibility. Read the chapter about history: https://en.wikipedia.org/wiki/Allergy#History

Cytokines from mast cells and/or T-helper cells could be explored. Eosinophils could play a role in delayed phase reactions as well, so unique mediators from that cell type is something to think about in further POIS research. 

[Nas]

We shouldn't assume that POIS is type 4 hypersensitivity just by Wladinger's skin prick test; semen in the body is usually protected by many epithelial cells which is a different environment than a skin prick test's environment.

[Muon]

We shouldn't assume that POIS is type 4 hypersensitivity just by Wladinger's skin prick test; semen in the body is usually protected by many epithelial cells which is a different environment than a skin prick test's environment.

You got to start somewhere. The duration of symptoms are in line with type 4 HS and some of them are 'allergic-like'. Aside from that my data could be an indication for this assumption. In my opinion this should be explored by a group study (cytokines), if this will give negative results we can scratch it of our list. I don't see a reason why you shouldn't explore this.

[Nas]

You got to start somewhere. The duration of symptoms are in line with type 4 HS and some of them are 'allergic-like'. Aside from that my data could be an indication for this assumption. In my opinion this should be explored by a group study (cytokines), if this will give negative results we can scratch it of our list. I don't see a reason why you shouldn't explore this.

What intrigues me is the cause of the brain symptoms? If we have type 4 hypersensitivity, how does that lead to brain fog and cognitive issues? I think that's the main part of POIS that I'm trying to explore. Because I pretty much believe that the auto-immune part of POIS is close to unsolvable. 

[Wolf berry]

Perfume allergy is also a type 4 allergy reaction. I have perfume allergy. It got it exactly at the same time I got POIS. I wonder if there are more POIS-patients who have a perfume allergy.

Yes, I have perfume allergy. but only in POIS out of POIS the perfume smells good!!!

[Muon]

What intrigues me is the cause of the brain symptoms? If we have type 4 hypersensitivity, how does that lead to brain fog and cognitive issues?

Th1 activation ---> interferon gamma release ---> increased macrophage activity ---> release of hydrolytic enzymes ---> affecting neurotransmitter metabolism ---> cognitive dysfunction

Perhaps POIS symptoms are being caused by the release of a bunch of enzymes damaging tissue which mimicks inflammation or altering enzyme activity in general.

[Nas]

Perhaps POIS symptoms are being caused by the release of a bunch of enzymes damaging tissue which mimicks inflammation or altering enzyme activity in general.

Any idea on which possible enzymes? What do you think about cortisol?

[Muon]

Perhaps POIS symptoms are being caused by the release of a bunch of enzymes damaging tissue which mimicks inflammation or altering enzyme activity in general.

Any idea on which possible enzymes? What do you think about cortisol?

I haven't looked into what types of enzymes macrophages are able to produce. As far as cognitive symptoms acetylcholinesterase. For joint pain, eye floaters, blood vessel wall integrity and neuroinflammation: https://en.m.wikipedia.org/wiki/Matrix_metalloproteinase
They can also produce Lp-PLA2 leading to cardiovascular problems. I haven't looked into cortisol related stuff. My aunt got elevated cortisol btw, she told me years ago that this was tested multiple times and always elevated. She has health problems as well.

[Nas]

I have tried many Acetylcholine medications but they don't seem to work. About macrophages, you should also consider that this only happens in POIS; not when you have any other illness. I think that this is a crucial point if we want to figure out the cause of brain symptoms. I don't think it's brain inflammation since NSAID do little to nothing. It must be either neurotransmitters imbalance or potentially brain damage. I've read that cortisol can stimulate the production of white matter between neurons; hindering communication. I don't know if it applies to the almost instant reaction we get when we orgasm

[Muon]

I have tried many Acetylcholine medications but they don't seem to work.

Like what?

[Nas]

I have tried many Acetylcholine medications but they don't seem to work.

Like what?

Mestinon for example.