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Eczema, and
Enzyme Potentiated Desensitisation
by
Jennifer Worth SRN, SCM
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Ten years ago I was covered in eczema from head to foot. My skin was cracking and weeping all over
my body, and the itching nearly drove me mad. I discovered, by accident, that it was caused by food
allergy, and a strict elimination diet cured the eczema. But then I was left with hardly anything to
eat! Professor Jonathan Brostoff advised EPD, and referred me to Dr. L. E. McEwen. I have now had five
years of treatment and can eat everything with no return of the dreaded eczema.
Enzyme Potentiated
Desensitisation (EPD) is very effective in the treatment of eczema. A young child will respond rapidly
and usually permanently. An adult with eczema will take longer to respond. EPD is not available on
the NHS.
Eczema is an allergic disease, related to asthma, hay fever, rhinitis, itchy eyes, and many
other inflammatory conditions known as the 'classical allergic diseases'.
Allergic people have a disfunction
of the immune system and a low tolerance level to allergens. To avoid all the allergens in the environment
is impossible, so the only way to minimize the allergic reaction is to reduce the sensitivity to allergens.
This is where EPD is effective. It is not a drug; it is a vaccine.
Most great discoveries are made
by chance, and EPD is no exception. In the 1960s, at St. Mary's Hospital Medical School in London, Dr.
L. E. McEwen was a member of an allergy research team. He observed, by chance, that when a minute dose
of an allergen is combined with the enzyme beta-glucuronidase, the combination will potentiate, or induce,
desensitisation. Thus we have the tongue-twisting name!
EPD has been extensively refined during the
last thirty-five years, and is now used in many countries. The effect is like that of any vaccine -
to build up the body's resistance over a period of time. The safety record is impressively high.
EPD
is often confused with the old-fashioned form of desensitisation called Incremental Immunotherapy (I.I.T.),
which was never very effective and has now been withdrawn from use in the UK. There is no connection
between the two. I.I.T. uses large doses of allergen while EPD uses minute doses; and I.I.T. does not
enhance the performance with the enzyme.
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But first of all what is an 'enzyme'?
The official definition is: 'a specialised protein molecule that acts as a catalyst for the biochemical
reactions that occur in living cells.' In other words an enzyme is something that enables other things
to happen.
Beta-glucuronidase is an enzyme present in all parts of the body, and is released into
the tissues during an allergic reaction to an allergen. EPD exploits this natural phenomenon by combining
a minute dose of beta-glucuronidase with a minute dose of allergens. The combination produces an effective
desensitisation technique, which has now been adapted to give an efficient treatment for most allergic
diseases.
EPD has been used successfully in the treatment of:
* Asthma, eczema, hay fever, chronic
rhinitis and urticaria, (known as The 'classical allergic diseases').
* Irritable bowel syndrome,
ulcerative colitis and Crohn's Disease.
* Some forms of rheumatoid arthritis.
* Aching limbs, stiffness,
heavy feeling, fatigue.
* Migraine, headaches, fuzzy-head feeling, memory loss and brain block.
*
Chronic Fatigue Syndrome, or M.E.
* Childhood hyperactivity and some cases of autism.
EPD is particularly
effective for the treatment of eczema. Children seem to respond after just a few doses.
________________________
I have said that minute doses are used. This is important. EPD is an extremely low-dose method of desensitising.
The actual amount of beta-glucuronidase is less than that to be found in 1cc of blood of the average
person; the amount of allergen injected is less than that used for a standard skin prick test. The dose
of allergen does not increase. Such a minute dose means that a wide range of allergens can be included
in each treatment. In fact about seventy different things are usually incorporated in one dose. The
range can be from foods, food additives, dust, pets, tobacco, pollens, grasses, moulds, gut micro-organisms
and some chemicals. The dose of each is microscopic, and alone would have no effect upon the immune
system, but when combined with the enzyme the vaccine is effective.
Dealing with so many allergens
at once means that the total allergy load will be treated. This is unique to EPD, and therefore the
patient will not need to be tested for specific sensitivities. Most allergens cross-react with each other,
and most atopic people are allergic to a wider range of allergens than they think. It follows that when
EPD is used, many allergens will be cross-desensitised in groups, and unsuspected allergies will be treated.
Atopic people tend to develop new allergies all the time. This can be maddening; just when you think
you have cracked one problem, another rears its ugly head. There is good evidence to suggest that, because
of the wide range of allergens used, EPD protects against this problem. In other words the total allergy
load has been treated, and the immune system has been strengthened overall. From personal experience
I can verify this; I used to be allergic to almost everything, and now, after five years of EPD treatment,
very little affects me adversely.
_____________________
Most allergens are absorbed into the
body by inhalation, ingestion, or contact.
The vaccines used for EPD treatment are:
Inhaled and
contact vaccine (the IC Mix)
Food, drink, and food additives vaccine (The Food Mix)
Special vaccines
for rare allergies (The Specials Mixes)
Inhaled and Contact Mix (the IC Mix)
House dust mites,
and other mites
Tobacco, dust, and mould spores
Grasses
Tree, flower, weeds, and shrub
pollens
Cat, dog and other animal fur and dander
Respiratory tract micro-organisms
The Food
Mix contains:
All of the above under heading IC Mix
A wide range of common foods and drinks in
the average diet
Gut micro-organisms, including Candida
Many of the commonly used food additives
(over 4000 food additives are currently being added to food production, and EPD cannot cover them all)
Special EPD Mixes
In addition to the above IC Mix and Food Mix, special vaccines have been prepared
to cover certain rare allergies, such as:
Cement or building dust
Wood dust
Algae or rare moulds
or fungi
Mosquito and some other insect bites (but not wasp or bee stings)
Some volatile chemicals
Some types of latex allergy
EPD is not effective where the specific allergen cannot be identified
and isolated and the last two mentioned, chemicals and latex, are examples.
Some chemicals can be
identified and an EPD vaccine prepared to cover them. But over five million chemicals are now recognised
as being present in our environment, and they cannot all come within the ambit of EPD. A person unfortunate
enough to have developed Multiple Chemical Sensitivity is unlikely to be helped by EPD.
The specific
allergen to latex rubber has not yet been identified and therefore it has not been possible to prepare
a vaccine to cover it (see my paper Neo-Natal Sensitisation to Latex, available on www.allergicdiseases.co.uk).
Also drug allergy is not covered by EPD.
However, by strengthening the immune system overall, even
allergic reactions to substances not specifically covered may be improved.
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Preparations
before, and precautions after each dose of EPD vaccine are vitally important. If the instructions of
your EPD doctor are not followed, the dose could fail, and the eczema could get worse. The principle
is that exposure to allergens must, as far as possible, be avoided for one week before and three weeks
after the vaccine. Each dose will affect the most subtle and complex part of your body chemistry - the
immune system. If the body is bombarded with a high exposure to allergens just before or after the EPD
dose, the immune system will react violently. Here is an example, from personal experience: I was in
my second year of treatment, and had a dose of EPD in May. This is the time of year when gardeners spray
their roses for fungus and black spot. A few days after the treatment, without thinking of the consequences
I sprayed my roses. Later my skin, which had been perfect for about three years, broke down completely
all over my body, in some parts cracking and weeping, and the itching nearly drove me mad again. My
initial food allergy, which had been so much better, became worse again. It took about six months to
clear up. So you can see how careful you have to be!
Food allergy contributes far more to eczema than
is generally realized. You will be put onto a strict diet for at least three weeks before and three
weeks after an EPD dose, (and possibly much longer), and this diet must be scrupulously followed. A
strict anti-allergic diet can be the hardest part of all, especially for young children or teenagers
who are growing and are hungry all the time. Mothers will have to be terribly careful about this and
follow the doctor's instructions closely, because the wrong diet could 'blow' the whole thing, (just
like my rose-spraying did for me!)
A very mixed diet is the best. It consists of small amounts of
very many foods at each meal. Treating food allergy is a very complex business, and cannot be dealt
with in this paper. I recommend my own book Eczema and Food Allergy, published by Merton Books. Action
Against Allergy (e-mail AAA@actionagainstallergy.freeserve.co.uk), and National Society for Research
into Allergy (e-mail nsra.allergy@virgin.net), give excellent advice on diets. Dr. McEwen's booklet
on EPD gives detailed instructions. It is available from AAA.
A surprisingly large number of people
with eczema, including children, have a fungal disbalance of gut micro-organisms (usually called candida).
Some doctors even say it is responsible for most allergies. Whether this is so or not, it is necessary
for the fungal infestation to be treated before the EPD dose is given, and an anti-fungal drug will be
prescribed, usually Diflucan or De-nol.
Many drugs and proprietory medicines will have to be avoided
before and after EPD, and a list of instructions cannot be given here. Each patient is different and
will have to follow the instructions of the EPD specialist.
There are many other things that must
be avoided: perfumes, hairdressing salons, air fresheners (i.e. air polluters!), lavatory cleaners, and
chemical perfumes/odours of all kinds, deodorants, after shave - the list could go on. Avoid dust, animals,
tobacco smoke, damp buildings and mould, new paintwork, petrol fumes, and many other things.
It seems,
from this recital, that life would not be worth living, and the best thing would be to go and live on
a raft in the middle of the sea for a few weeks! But, I assure you, it's not as bad as all that. Most
allergic people know already many allergens which they have to avoid, and the additional ones are not
going to be a great hardship for a few weeks. The main thing is to understand the importance of the
philosophy, that whilst your immune system is responding to the EPD vaccine, contact with known or suspected
allergens must, as far as possible, be avoided.
______________________
EPD has to be administered over a period of time. Several months must elapse between each dose. The
number of doses will depend on the age of the patient and the severity of the condition. Most adults
need three to five years to be effectively desensitised. Children respond a great deal more quickly,
and the younger the child the quicker the response.
Treatment is given by cupping or by injection.
Cupping consists of scratching the skin to remove the outer epithelia, and covering the scratched area
with a small cup (rather like a shallow egg-cup) which is stuck onto the arm or leg. The EPD dose is
then injected into the cup and left to be absorbed slowly into the body through the scratched area of
skin. The advantage of cupping is, that if an adverse reaction occurs, the cup can immediately be pulled
off and absorption of the vaccine will be discontinued. Treatment is given at intervals of eight weeks,
twelve weeks, three months, and six months progressively.
EPD is not available on the National Health
Service and I doubt if it ever will be, because it is too individualistic. Therefore you will have to
pay for treatment. A full adult course over five years will cost around three to four thousand pounds;
a child or baby will cost less than half that figure. This may seem a lot, but believe me - and I speak
as one who has endured the sheer hell of itching all over all the time - EPD is worth a second mortgage!
Before you can see an EPD specialist you will have to be referred by your own doctor. This is required
procedure within the NHS, and no allergy specialist will be able to see you without a referral. If your
own doctor has never heard of EPD, or refuses to refer you for any reason, ask to see another doctor
in the practise. You may have to work hard at getting a referral and persistence may be necessary.
All EPD consultations and treatment will have to be recorded and the details sent to your own doctor.
This, again, is standard procedure.
There are about twenty practitioners of EPD in all parts of Great
Britain. AAA can supply names and addresses, or you can contact Dr. L. E. McEwen direct at Weir View,
Wargrave Road, Henley-on-Thames, RG9 3HX.
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EPD is a highly individualised
form of treatment in the way it is prescribed and administered. Nothing can be standardized. For this
reason it cannot be given a 'Full Product' license by the Medicines Control Agency under the Medicines
Act. It has a 'Special License' of the MCA. This means that it is only available on a 'named patient'
basis (as covered by the Medicines Act). The vaccine is only available to a registered doctor who is
an allergy specialist, and who has in addition undergone a special training in the administration of
EPD. The vaccine is not available to a doctor who has not been accredited , nor to a patient who does
not come within the 'named patient' license of the MCA. The control of the supply of the EPD vaccine
is very strict.
The future of allergen immunotherapy is precarious and more research is needed. A
large scale trial in the use of EPD in hay fever was completed in the summer of 2001 at Southampton University
Medical School. The results are being analysed and will be published in 2002. Double blind trials into
the performance of EPD in eczema is urgently needed. It is hoped that a similar trial can be carried
out in Southampton in 2003, but as yet this is only in the planning stage and funding is still in question.
Just as the medical profession is suspicious of the claim that allergic diseases exist at all, so the
Medical Control Agency is reluctant to validate the use of EPD, and critical research is urgently required
before it will get the backing of the regulating bodies. I know and have seen that eczema responds extremely
well to EPD. In babies and children the response is rapid and lasting. Over the next few years I intend
to compile a case book of people whose eczema has been treated by EPD. When I have collated a substantial
number of personal stories I will present them to the National Eczema Society and the Secretary of Sate
for Health and will publish the information. I seek stories adverse to the results of EPD in eczema
as well as those who have benefited from it, and I invite anyone to contact me.
The White
House, Jennifer Worth, SRN, SCM
St. John's Road,
Boxmoor,
November 2002
Herts HP1 1QG
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