AnUser
#2
Kaeberlein isnāt taking any other prescription medication, nothing to lower apoB, I donāt agree with that as cardiovascular disease is the primary cause of death and causes lots of disability. Rapamycin can in cases increase apoB as well.
I wonder what the reasoning is for continuing to take rapamycin despite having a bacterial infection requiring an antibiotic. I donāt think itās a good idea as it is an immunosupressant.
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Only the 2nd time he has taken antibiotics in his adult lifeā¦? Wow. Last year I worked with a German guy who said he had never had a cold or flu in his life. I guess these people are out there.
I wonder how many people are living for 000ās of years but hiding it from us regular folks, Highlander-like?
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A skin allergic reaction to an antibiotic is usually widespread rather than confined to a small area. The rash or hives typically affect large areas of the body rather than just one localized spot.
There are numerous ways to get contact dermatitis. You can get it from handling certain animals such as cats or dogs. You can get it from trail hiking, transferring allergens that your hands have touched, and then transferring to your skin from touching your hands to your face or other parts of the body.
Whatever the cause, it would be a rare case indeed for an antibiotic allergic reaction to be confined to such a localized area.
Vitamin B6 (Pyridoxine)
High doses have been linked to skin lesions, dermatitis, and acneiform eruptions.
Vitamin B12
May cause acneiform eruptions, urticaria, and pruritus in some people.
Biotin
High doses have been associated with skin rashes and acneiform eruptions.
Maybe some of our doctors have some experience in this and can comment.
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I find it unlikely that mega-centarians exist and literally all of are somehow interested and capable of avoiding detection in modern society.
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Classis drug eruption, seen tons of these. Probably took a cephalosporin or some penicillin family abx.
This is not at all the surprising. Rapamycin probably dampened the reaction.
The most interesting part here is what kind of infection did he develop while taking Rapamycin? I think it was cellulitis on his elbow, but that is very uncommon in normal healthy people unless he injured his elbow. Just to put that in context I had good number of crashes on my MTB, super dirty wounds with dirt embedded in to my skin. Sometimes up to my bone. Never had cellulitis and never needed oral antibiotics. I did disinfect the wounds and used topical antibiotics. Well functioning immune system is a beautiful thing.
Itās one thing to get some oral ulcers with rapamycin but cellulitis especially without injury is very worrisome. Those can lead to sepsis if not detected early and progress quite fast with S. Pyogenes. I am surprised he decided to continue it especially at the same dose. Maybe there is more to this story that heās not sharing.
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Neo
#7
Knock on wood, if never needed it in my adult life
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MK and other rapamycin researchers would say it is immunomodulator.
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L_H
#9
Yes me too, not for 20+ years. How unusual is that? I assumed it was relatively normal. Iād guess that 50% of say 30/40somethings donāt have antibiotics in a given decade?
AnUser
#10
And they are biased.
If everyone says it is an immunosupressant and few hardcore rapamycin researchers says otherwise, that should make your ears perk up.
In Kaeberleinās review of Dr. Greenās patients on the survey, bacterial infection seemed to be higher by 50%. This is why I give an Rx for an antibiotic that has reasonable respiratory and skin coverage when I have someone on Rapamycin. Now if this is used, and I give clear instructions, so it isnāt used for colds and fluās, I need to evaluate what is going on immediately.
I do agree that being on an immunomodulatory agent will absolutely modify how a rash appears.
Ultimately, in the first couple of days while under high degree of MTORC1 inhibition, humoral immunity is likely to be impaired. Simultaneously, it would seem likely that risk of getting seriously ill from viral infections is decreased.
Older people are at risk of both - but if vigilant, the bacterial stuff can be treated - the viral stuff, often not so much. So in the vigilant individual Iām not too worried about this. In the individual (as I see in the ER frequently) who sits for days watching their soft tissue infection get worse, and having an abscess developed which now we have to drain ā¦ those people are clearly not ones who should be anywhere near rapamycin.
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Can you share this review or source?
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A surprising tidbit from the study: āRapamycin users reported consuming more alcohol than non-usersā I would never have thought that. It would be interesting to know how much and what type.
@John Hemming. You may be in āgood companyā
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every immunosuppressant is an immunomodulator, not every immunomodulator is clinically immunosuppressive
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Arhu
#16
I have a funny anecdote, this happened in 2021, so during the height of the pandemic. I told my girlfriend I was thinking about starting rapamycin. She called me crazy wanting to take an immunosuppressant in the middle of a pandemic.So I said to her rapamycin is not an immunosuppressant but modulator. Then she said wait a minute, this rings a bell. Turned she had actually published a paper herself about the immunomodulating effects of everolimus and sirolimus but had complications forgotten about itā¦
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L_H
#17
Yes, the nuanced impact of rapamycin on immune response is much better understood now. It both enhances and inhibits different aspects. The interesting thing is the ways it may remodel towards a younger immune response. Immunosuppressive potency of mechanistic target of rapamycin inhibitors in solid-organ transplantation - PMC
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I listened to Dr K discuss this and the numbers were small, thus no statistical significance. The case rate was low in both controls and treatmentā¦ so there may be no difference, but his comments were around 50% difference as I recall. Iāve not recently reviewed the data on the paper itself.
