Managing Heart Attack Risk: Autophagy, Fasting & Plaque/ Inflammation

Managing Heart Attack Risk: Autophagy, Fasting & Plaque/ Inflammation

August 28, 2019 33 By Bertrand Dibbert


So I was out working out of the gym last
week and YouTube flipped up a video on Autophagy. I was a little bit surprised.
I usually end up talking about Autophagy with most of my cardiovascular
prevention patients but you can usually see it – sort of like a “Yeah, I’ve heard of
it but I don’t know what that means” so again, I was surprised (very pleasantly)
that it’s now hitting the YouTube vocabulary. This doc is Dr. Boz. She’s
got a great YouTube channel community focusing on low-carb and fasting. it
turns out just a few years ago she was an old style internist – didn’t know
anything about either of those topics until her mother got very ill, she ended
up studying these and she and her mother got into low carb and fasting and had a
significant positive impact on her health. Now the rest of her family’s into
it. She’s got a large community doing it. Anybody that spends any time on internet
and health related topics usually ends up seeing some of the usual suspects -Joe Mercola, Erik Berg. I found that (sure enough) Erik Berg has a video on
autophagy and he’s got a lot of the concepts right. Autophagy –
I’ll explain. We’ll go into the details of what that means in a few minutes but
it’s garbage recycling – just like he says there. I’m gonna go – I’m gonna describe a
Nobel Prize that I think created a lot of the recent awareness. It was Nobel
Prize for medicine in 2016. It was for autophagy Some work a fella (named)
Yoshinori Osumi did, but I’ll cover that and then I’ll talk about a great
reviewer article in the New England Journal which goes a little bit more
into the detail and gives some good pictures.
Everybody loves pictures – makes it easier to understand what’s going on but
before we do – just a brief introduction: My name is Ford brewer F-O-R-D Brewer B-R-E-W-E-R.
I started off as an ER doc in the panhandle of Florida but got frustrated
very quickly because the vast majority of things that people – that bring people
into the ER are things that should have been prevented. I decided to go get more
training. There weren’t a lot of places in the country that trained in
preventive medicine. Most of its just focusing on a cure. I went to Hopkins,
ended up running the program and still am loving doing prevention. This channel
is a – is a way of sharing prevention with anybody that’s interested and giving
– hopefully, arming you with the information that you need to impact your
own health. Of course, you need a – You often need a doc to help but when you start talking about prevention, the vast majority of these issues – you don’t need
a doc to do. So anyway, back to Autophagy and the 2016 Nobel Prize. the winner was
– for medicine, the winner was Yoshinori Ohsumi and the the work
that he did started in the early 90s and went mostly through the 90s, so he got
his Nobel Prize 20 years later. He was working – he started his work with baker’s
yeast. He first identified the genes essential for Autophagy, then the enzymes and went on to elucidate the mechanisms in yeast and then showed that there’s similar machinery and processes and mechanisms within
ourselves so this led to a new paradigm in our understanding of how cells
recycle junk, worn-out mit- anything from worn-out mitochondria to viruses
that have invaded us to torn bits of protein. So cancers, neurological diseases and, as some people like Brad Bale and Amy Dineen and some others have been
saying for decades, also cardiovascular disease. All of these things are very
much related to to cleaning up junk in our cells. So, how can that be?
Well again, we’ll get a little bit more into detail on this. This is one of the first – I’m
just gonna go through the pictures for the most part on that New England
Journal article and I’ll give you a link to that article under the video.
This is first – this goes into the process and again as you start looking at it,
it’s very, very helpful. The first part is called an autophagosome or a phagophore. its vesicle elongation, in other words, there’s a – there’s a phagophore.
this is a little pocket here in the cell This green thing is a mitochondria
that’s broken. It’s not working very well The cell recognizes that and this phagophore begins to encircle it. Then it completely engulfs it. at that point, it’s
called a mature autophagosome. again “Auto” – meaning self; “phage” – meaning to eat; and “some” – meaning a body. So a body used to eat the part of itself within the
cell. Now, lysosome – remember “some” means a little body. “Lyso” means to split. So
you’ve got the damaged mitochondria isolated in autophagosome, then you
combine it with a lysosome. Now, how do the lysosomes releases enzymes which
digest the defective, beaten up, worn-out broken mitochondria and, again, that’s
what lysosomes are – are basically pockets of enzymes which are used to digest
trash material. So you put that lysosome with the enzymes – the digestive enzymes
together with the autophagosome with the junk in it and it begins – the
digestive enzymes begin to digest and end up digesting the junk. That junk
is then reused after it’s been digested by the cell to rebuild new organelles.
Now, I’m not going to go into this very deeply. It’s difficult to see but there’s
just a couple of components here that help you begin to think about some of
the lifestyle issues that we’ve been – we’ve been hearing a lot about recently.
Let me just read a couple of things: nutrients signals modulated signaling
process depending on mammalian – the target rapamycin mTOR. You’ve heard that a lot. AMPK you’ve heard a lot. now what you have – and here’s another thing that
you’ve heard: insulin has a negative impact on this process: fasting,
starvation Here you see (that) starvation and rapamycin increase this process. So, again, you see this mentioned multiple times in
this article how starvation or fasting increases autophagy and how insulin
decreases autophagy. Again, so now you’re beginning to connect the dots.
Cardiovascular disease like many other diseases of aging tends to be a disease where you get a lot of buildup of junk in the cells
because as we develop insulin resistance, you get
higher and higher levels of basal insulin and that basal insulin just
slows down and stops the autophagy process. In addition, being overweight, we
start getting into a vicious spiral of gaining weight. Our blood sugar is too high, our insulin gets too high and stays too high trying to push that blood sugar
down and, again, in multiple ways we’re not – we’re not stimulating autophagy. Now, what does autophagy got to do with this? This shows the impact of autophagy on several different types of diseases. Infectious diseases is the
first and easiest to show and (I recopy this a little bit larger so you can see
it) the one down at the bottom is showing infectious disease.
Xenophages. “xeno”- means outside so these are viruses and bacteria that have
been caught and engulfed into an autophagosome and then the lysosomes have
been combined with this autophagosome to digest the bacteria and viruses. So
again, these are some of the things that autophagy does with infectious
diseases – up here with cancer, again similar process. You get cell death, chemo sensitization, and tumor suppression. – suppression. In other words, you kill
cancer cells. I’ll just give you a brief {pardon the skin there) but you see, I’ve
got basal cells and I’ve been using a medication which stimulates the
inflammation process and autophagy again, that’s this process going on with
cancer. I’ll do another video on that – it actually makes the point that
inflammation is not always bad. Sometimes, you need inflammation to kill
cancer cells. Now (but that’s not what this video is about) this video is
connecting that – it’s showing some of the visual processes associated with
autophagy and what they have to do with plaque, cardiovascular disease…
Unfortunately, the bottom of this is cut off but this lower left-hand corner
talks about vascular disease, plaque stabilization, regulation and
proliferation. As you see here, this is an arterial – an artery on cross-section.
Down in the bottom, they’ve got a plaque Now, what’s this apoptosis? Actually, apoptosis is cell death. Well, what does cell death
got to do with this? If the inflammatory process that we’re talking
about is mast cells going in and polymorphs – the two types of cells that
we know that will eat plaque, then you can get a cell death. These cells can get
too busy, too active. The lysosomes actually pop within the cell and there’s
too many of them and kill the cell itself. That results in hot liquid plaque.
So, again I hope this helps to connect some of the dots between our immune
system attacking our plaque and the role of autophagy. Autophagy is very – it’s
critical to getting rid of plaque stabilizing it, but if we have too much
of it going on too quickly, it can cause danger by apoptosis – killing cells. I hope this has been helpful. I’m not going to
go into some of the other details in this review article. there’s a lot of
diseases which we’ve discovered which are related to problems with autophagy –
inflammatory diseases, Crohn’s disease, actually Parkinson’s disease, Paget’s
disease, ulcerative colitis – again, if you’ve made it this far thank you very
much for your interest