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The Dr Bruce Patterson Protocol



I have been following Dr Patterson's work with Long Covid for over a year. I remember at some point last year watching an interview with him and Dr Been (another LC advocate) about Long Covid and thinking "finally a doctor understands what we are going through".

I remember him saying that those of us with Long Covid were being disbelieved and stigmatised just the same as AIDS sufferers were in the 1980's. COVID Long Haulers - Discussion with Dr Bruce Patterson. He described it as "heart breaking".

He has to date, with his interviews and talks on Long Covid, attracted more than 400,000 views on YouTube.


So far the ability to undertake his tests and be treated via his protocol has only been available to those in the USA -and for a few in the UK/Europe as part of a trial. The clinics are going to become available in the UK at some point and as part as my advocacy, and own personal interest, I have put myself on a wait list. My overriding concern is that I am 18/12 in and all my standard blood tests have been mostly normal - what could they possibly uncover now? So I have a degree of skepticism. You may remember a few weeks ago I put out on my stories if anyone had been tested and treated under the care of incellDx diagnostic laboratory ? A few of you kindly responded and in later posts I will go through their Long Covid journeys and how incellDX influenced this. Firstly there is a lot of science to digest!

This is a quick watch video for those of you with brain fog https://www.youtube.com/watch?v=IvWPT3YA5uY&t=182s

The source for my blog is from Health Rising "Has Bruce Patterson Cracked Long COVID?"



Dr Bruce Patterson is a former Stanford researcher and was previously the Medical Director of Diagnostic Virology at Stanford University Hospitals. He left the University and created the incellDx Diagnostic Laboratory. Over the past ten years, incellDx has focused mostly on cancer screening and has produced products to test for HPV, CMV, antibodies, and others. Over the past two years, though, Patterson has jumped back into the publication field, co-authoring 7 papers on COVID-19 with more to come.


The theory/evidence

In June of 2020, Patterson reported that he’d identified the cause of the so-called “cytokine storm” in COVID-19.

“When we were developing a cytokine quantification assay for possible COVID trials in China, we discovered that infected patients had consistently high levels of CCL5/RANTES in plasma which in some cases was 100 times normal depending on the severity of the disease.”

The very high levels of the chemokine CCL5/RANTES were directing immune cells to go on the attack.

Patterson and incellDx filed a patent in June 2020 for its CCL5/RANTES diagnostic test for COVID-19. In October, incellDx reported that it was collaborating on a COVID-19 clinical trial using Pfizer’s CCR5 antagonist Maraviroc – a key part of Patterson’s Long COVID protocol.

Dr Patterson's first paper - Immune-Based Prediction of COVID-19 Severity and Chronicity Decoded Using Machine Learning

They found the immune signatures of cytokines and chemokines were associated with acute and Long COVID patients.

The study found that CCL5/RANTES, IL-2, IL-4, CCL3, IL-6, IL-10, IFN-γ, and VEGF were all significantly elevated (all P<0.001) while GM-CSF and CCL4 were significantly reduced in COVID patients in general.

These cytokines puts the T and B lymphocyte cells out of action which meant that an inadequate antiviral response occurs in Long Covid patients. This meant that the virus persisted longer in us.

The immune system then compensated by recruiting monocytes to try to fight off the virus.


In their second paper Persistence of SARS CoV-2 S1 Protein in CD16+ Monocytes in Post-Acute Sequelae of COVID-19 (PASC) Up to 15 Months Post-Infection“ -


"they found that a certain kind of monocyte (called non-classical monocytes) were carrying COVID-19 proteins over a year later in most Long COVID patients".

The authors proposed those monocytes had responded to the initial infection by grabbing pieces of the virus and displaying it on their surface for the immune system to respond to. Monocytes usually only survive a couple of days but the authors proposed that an interaction with fractalkine gave them much longer lifespans and caused them to start pumping out proinflammatory cytokines.


"These monocytes appear to be emitting high levels of CCL5/RANTES – a chemokine that directs them to the endothelial cells in the blood vessels where they are causing inflammation and causing the blood vessels to dilate"

The many Long COVID symptoms found they believe, are caused by inflammation in different blood vessels across the body and brain. Since exercise mobilizes these monocytes, this process is exacerbated when people with long COVID exercise.


Diagnosis

Patterson has created a "LONG HAULER INDEX" and algorithm which he reports is able to successfully identify Long COVID patients. Long COVID patients are able to sign up for these incellKINE tests, get an evaluation, and get referred to doctor.


Treatment Theory

They started treating long-COVID patients in September 2020. Patterson’s protocol has two main goals:

  1. Use CCR5 antagonists to reduce CCL5/RANTES levels, and therefore prevent the monocytes from getting to the blood vessels.

  2. Damp down the CX3CR1/fractalkine pathway in order to turn off the long term monocyte survival mechanism that’s allowing them to survive longer than usual. Over time, the monocytes carrying the coronavirus protein will die off.


The Treatment Protocol

Patterson’s three-drug therapy takes 4-6 weeks to work. It aims to kill off the long-lived monocytes carrying the COVID protein and stop those monocytes from migrating to the blood vessels.

  • CCR5 antagonistMaraviroc: is in an antiretroviral drug used in combination with other drugs to treat HIV. (HIV can use the CCR5 receptor to enter the cell). Its efficacy against the coronavirus is also being explored. Maraviroc also stops monocytes from moving around the body in response to CCL5/RANTES – a chemokine which is produced in endothelial cells. Maraviroc comes with plenty of warnings, including a black box one, but Patterson says its is safe – and has two papers coming out on it. Most long haulers are on for 2-4 weeks and the longest has been 8 weeks. Maraviroc, he said, was incredibly effective in relieving tinnitus and brain fog and typically did do so in 3-5 days. He said “we see it (tinnitus) a lot, and treat it a lot and are very good at eliminating it.” {R.C.D.B ok I have had brain fog and tinnitus for 16 months - I'm in!}

  • Statins – by inhibiting fracktalkine, it stops the monocyte cells from attaching to endothelial cells on the blood vessels.

  • Ivermectin -an immunomodulator and anti-parasitic drug is used because of its persistent antiviral properties. It also affects cell membranes. A meta-review of 11 randomized Ivermectin COVID-19 trials found a significant reduction in hospitalization and and 56% reduction in death. Many of the trials were not peer-reviewed, and a wide range of doses was used. A placebo-controlled Ivermectin COVID-19 study is underway at the University of Oxford.


The Results

" Maraviroc, a statin and Ivermectin, all readily available, returns immune systems to normal and alleviate most symptoms"

The majority of patients see some improvement in two weeks. After 4 weeks, more improvement is seen and the labs are repeated to see if the immune system has been restored. Weeks 4-6 typically see the immune systems returning to normal and people getting back to normal lives with most of their symptoms gone. The 5-10% of the symptoms left at this point were, he thought, probably to being sedentary or bedridden for so long. He slowly starts them off on exercise during this period.

Serial monitoring of some patients has shown that the levels of the monocytes carrying the SARS-CoV-2 protein are declining. He believes eventually these cells will get cleared, and when they do, the disease is apparently over.


What about ME/ CFS/ Lyme?

Patterson believes a similar “antigen-driven response” is at play in ME/CFS, FM, and Lyme disease and wants to “aggressively” move into those diseases. Thus far similar findings have not shown up in ME/CFS. The one intriguing possibility that has involves the focus on the blood vessels.


The Controversy

Patterson’s results need to be validated by outside labs. Until this is done they are still considered theories. Treatment studies comparing those on the protocol compared to those not are also needed to make this evidence based medicine. It will also be self funding, - ie not available on the NHS, until the validation and treatment studies are done.

But as you can see by my comment about brain fog and tinnitus - for a 3-4 week protocol with no serious side effects would I take a punt on it - at 18 months down the line I probably would.....


Looking forward to sharing two lovely long hauler stories of how they signed up with incellDx for the Long Hauler Index test and what happened next.


References

https://www.healthrising.org/blog/2021/07/21/patterson-cracked-long-covid/

https://www.youtube.com/watch?v=9HSKceCt8tQ

Immune-Based Prediction of COVID-19 Severity and Chronicity Decoded Using Machine Learning

Persistence of SARS CoV-2 S1 Protein in CD16+ Monocytes in Post-Acute Sequelae of COVID-19 (PASC) Up to 15 Months Post-Infection


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