A Ray of Hope

[tex]

Ant,

I'm not very well acquainted with the science of wound healing, but my initial thoughts on this are that without sufficient numbers of regulatory T-cells, the process gets stuck in the inflammation stage, and adequate numbers of macrophages never arrive to take care of the "cleanup" and healing work. During the inflammation stage, (which is a destructive stage), no constructive healing can take place - it merely sets the stage for healing, by destroying diseased or infected tissue, and normally, it should result in a summons of macrophages, (which do most of the actual work of healing). If inadequate numbers of macrophages arrive, no significant healing can take place, because there are no mechanisms present to clean up the mess, so that new tissue can be formed. There's surely a lot more to the process than what I've described here, but I believe that this is the basic problem that exists with the IMDs.

IOW, if regulatory T-cells are not available in sufficient numbers, then the killer T-cells continue to be generated, and the inflammation process goes on indefinitely. Because of that, the macrophages are never ordered to report for duty at the site, and so the healing process is stuck in the inflammation stage, (the destructive stage).

This is similar to the problem with jaw disease that the bisphosphonates cause for some people, when they prevent the destruction of dead bone tissue. As long as that debris is still in place, no new tissue formation can take place, (at least not in a normal fashion), and if a tooth should become infected, for example, the result can be a serious case of bone disease, because the bisphosphonates prevent the immune system from carrying out their normal cycle of destroying diseased tissue, removing it, and then generating new replacement tissue.

At least that's how I see it.

Tex