PDR Information

The PDR or Physicians’ Desk Reference is published yearly and is
distributed to American Physicians and Pharmacists. Although Immunocal is a
natural, non-drug supplement, it has appeared in the PDR every year since 2001.
It is a honor to appear in this prestigious publication.
Description
Immunocal is a patented natural food supplement which assists the body in
maintaining optimal concentrations of glutathione (GSH) by supplying the
precursors required for intracellular glutathione synthesis. These precursors
are derived from a specially prepared bovine whey protein isolate. Glutathione
(L-gamma-glutamyl-L-cysteinylglycine) is the major endogenous antioxidant
produced by the cell. Glutathione participates directly in the neutralization of
free radicals, reactive oxygen compounds, and maintains exogenous antioxidants
such as vitamins C and E in their reduced (active) forms. In addition, through
direct conjugation, glutathione plays a role in the detoxification of many
xenobiotics (foreign compounds) both organic and inorganic. Glutathione
availability is an essential component of the humoral immune response by
offsetting oxidative damage resulting from the clonal expansion and inherent
metabolism of lymphocytes.
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Clinical Pharmacology
The systemic availability of oral glutathione is negligible, the vast
majority of it must be manufactured intracellularly. Glutathione (GSH) is a
tripeptide made up of the three amino acids cysteine, glycine and glutamate.
Glutamate and glycine are readily available in most North American diets, but
the availability of cysteine tends to be the rate-limiting event for the
synthesis of glutathione within the cell. It is the sulfhydryl (thiol) group
(SH) of cysteine that serves as protein-donor and is responsible for the
biochemical activity of glutathione. The free amino acid cysteine does not
represent an ideal delivery system to the cell. It is potentially toxic and is
spontaneously catabolized in the gastrointestinal tract and blood serum.
Conversely, cysteine present as cystine (two cysteine molecules linked by a
disulfide bond) released during digestion in the gastrointestinal tract is more
stable than the free amino acid cysteine: the disulfide bond is pepsin- and
trypsin-resistant, but may be split by heat and mechanical stress. In this way,
cystine travels safely through the GI tract and blood serum and is promptly
reduced to the two cysteine molecules on cell entry. Immunocal can thus be
viewed as a cysteine delivery vehicle.
Specially prepared whey protein isolates contain the thermolabile proteins
serum albumin, alpha lactalbumin and lactoferrin. These proteins contain high
levels of cystine residues that could be denatured by heat or mechanical stress
(unfortunately inherent to most extraction processes). Hence, in serum albumin
there are 17 cysteine residues and 6 glutamylcystine (Glu-Cys) dipeptides; in
lactoferrin 17 cystine residues and 4 Glu-Cys dipeptides; and in
alpha‑lactalbumin 4 cystine residues. In particular, the Glu-Cys dipeptides very
readily enter the cell to be synthesized into GSH. Of interest, the Glu-Cys
dipeptide is an exclusive feature of the only obligatory foods in the early life
of mammals and oviparous species, those being milk and egg white respectively.
When subject to heat or shearing forces, the fragile disulfide bonds within
these peptides are broken and the bioavailability of the glutathione precursors
is greatly diminished.
As an antioxidant, glutathione is essential for allowing lymphocytes to
express their full potential, without being hampered by oxyradical accumulation
during the oxygen-requiring development of the immune response. In a similar
fashion, GSH delays the muscular fatigue induced by oxyradicals during the
aerobic phase of strenuous muscular contraction.
As a detoxification agent, glutathione has been demonstrated to be effective
against chemical pollutants, various carcinogens and ultraviolet radiation.
Glutathione is a tightly regulated intracellular constituent and is limited
in its production by negative feedback inhibition of its own synthesis through
the enzyme gamma-glutamylcysteine synthetase.
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Indications and Usage
Immunocal is a natural food supplement and, in the U.S., a dietary
supplement, and, as such, medical claims per se are limited. Statements have not
been evaluated by the FDA. This product is thus not intended to diagnose, cure,
prevent or treat any disease.
Glutathione augmentation is a clinical strategy to address states of
glutathione deficiency, antioxidant deficiency, high oxidative stress, and
certain toxic overloads in which glutathione plays a part in the detoxification
of the xenobiotic in question. Glutathione deficiency states include, but are
not limited to: AIDS and cancer cachexia, chemical and infectious hepatitis,
radiation poisoning, malnutritive states, arduous physical stress, and
acetaminophen toxicity. Many pathologies are associated with oxidative stress
and are elaborated upon in numerous medical references.
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Contraindications
Immunocal is contraindicated in individuals who develop or have known
hypersensitivity to specific milk proteins.
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Precautions
Each sachet of Immunocal contains nine grams (9 g) of protein. Patients on a
protein-restricted diet need to take this into account when calculating their
daily protein load. Although a bovine milk derivative, Immunocal contains less
than 1% lactose and therefore is generally well tolerated by lactose-intolerant
individuals.
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Warnings
Patients undergoing immunosuppressive therapy should discuss the use of this
product with their health professional.
Heating or adding Immunocal to a hot liquid, or use of a power blender to
reconstitute it will significantly decrease the effectiveness of the product.
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Adverse Reactions
Gastrointestinal bloating and cramps if not sufficiently rehydrated.
Transient urticarial-like rash in rare individuals undergoing severe
detoxification reaction. Rash abates when product intake stopped or reduced.
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Overdosage
Overdosing on Immunocal has not been reported. Unless hypersensitive to the
constituents, no toxicity of milk proteins has been described.
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Dosage and Administration
Maintenance dose is one sachet (10 grams) per day. For mild to moderate
health challenges, higher doses are recommended. Clinical trials in patients
with AIDS, cancer and chronic fatigue syndrome have used 30 – 50 grams per day
without ill effect.
Immunocal is best administered on an empty stomach or with a light meal.
Concomitant intake of another high protein load may adversely affect absorption.
RECONSTITUTION: Immunocal is a dehydrated powdered protein isolate. It must
be appropriately rehydrated before use. If left standing too long after
rehydration, activity of the product may be reduced. Times vary depending on
temperature and pH of the liquid used. It is generally recommended to ingest the
product within 30 minutes of reconstitution. DO NOT heat or use a hot liquid to
rehydrate the product or use a high-speed power blender for reconstitution.
These methods will decrease the activity of the product. Special low-speed
blenders or mixing cups can be made available through Immunotec Inc.
distribution networks.
Method 1) Pour the powder into your Immunocal mixing cup. Add 6-8
oz. of water, milk or juice. Snap lid on tightly and shake for 10-20 seconds.
Let stand for 5-10 minutes. Shake again and drink.
Method 2) Pour the powder into your Immunocal blender. Add 6-8 oz.
of water, milk or juice. Snap lid on tightly. Mix using short bursts of power
until powder dissolved and drink.
Method 3) Pour the powder into a tall glass. Add only one tablespoon
of water, milk or juice. Stir with a fork until consistency of a gravy or paste.
Add 6-8 oz. more of the liquid and stir. Let stand for 5-10 minutes and drink.
Method 4) Pour the powder over apple sauce, other fruit compote,
yogurt or cereal with milk. Stir until dissolved and eat.
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How Supplied
10 grams of bovine milk protein isolate powder per sachet.
30 sachets per box.
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Storage
Store in a cool dry environment. Refrigeration is not necessary.
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References
- Meister A. Glutathione. Ann Rev Biochem
52:711-60, 1983.
- Kaplowitz N, Aw T, Ookhtens M. The regulation of hepatic
glutathione. Ann Rev Pharmacol Toxicol 25:715-44, 1985.
- Witschi A, Reddy S, Stofer B, Lauterberg B. The systemic
availability of oral glutathione. Eur J Clin Pharmacol
43:667-9, 1992.
- Meister A. New aspects of glutathione biochemistry and transport,
selective alteration of glutathione metabolism. Nutr Rev
42:397-410, 1984.
- Bray T, Taylor C. Enhancement of tissue glutathione for
antioxidant and immune functions in malnutrition. Biochem
Pharmacol 47:2113-23, 1994.
- Lomaestro B, Malone M. Glutathione in health and disease:
Pharmacotherapeutic Issues. Ann Pharmacother 29:1263-73,
1995.
- Bounous G., Gold P. The biological activity of undenatured whey
proteins: The role of glutathione. Clin Invest Med
14:296-309, 1991.
- Bounous G., Kongshavn P. Influence of dietary whey proteins on the
immune system of mice. J Nutr 112:1747-55, 1982.
- Bounous G., Letourneau L., Kongshavn P. Influence of dietary
protein type on the immune system of mice. J Nutr
113:1415-21, 1983.
- Bounous G., Kongshavn P. Influence of protein type in
nutritionally adequate diets on the development of immunity.
Absorption and utilization of amino acids 2:219-32, 1989.
- Bounous G., Batist G., Gold P. Immuno-enhancing property of
dietary whey protein in mice: Role of glutathione. Clin Invest
Med 12:154-61, 1989.
- Bounous G., Shenouda N., Kongshavn P., Osmond D. Mechanism of
altered B-cell response induced by changes in dietary protein type in mice.
J Nutr 115:1409-17, 1985.
- Bounous G., Papenburg R., Kongshavn P., Gold P., et al. Dietary
whey protein inhibits the development of DMH-induced malignancy.
Clin Invest Med. 11:213-17, 1988
- Bounous G., Gervais F., Amer V., Batist G., et al. The influence
of dietary whey protein on tissue glutathione and the diseases of aging.
Clin Invest Med 12:343-9, 1989.
- Baruchel S., Viau G., Olivier R., Bounous G., Wainberg M.A.
Nutriceutical modulation of glutathione with a humanized native milk serum
protein isolate Immunocal: Application in AIDS and cancer. In:
Oxidative stress in Cancer AIDS and Neurodegenerative Diseases. Ed.;
Montagnier L., Olivier R., Pasquier C. Pub.; Marcel Dekker Inc. New York,
1996.
- Kennedy R., Konok G., Bounous G., Baruchel S., Lee T. The use of a
whey protein concentrate in the treatment of patients with metastatic
carcinoma: A phase I-II clinical study. Anticancer Research
15:2643-50, 1995.
- Baruchel S., Bounous G., Gold P. Place for an antioxidant therapy
in HIV infection. Oxidative stress, Cell activation and viral
infection 311-21, 1994.
- Bounous G., Baruchel S., Falutz J., Gold P. Whey proteins as a
food supplement in HIV-seropositive individuals. Clin Invest
Med. 16:3; 204-209.
- Baruchel S., Viau G. In-vitro selective modulation of cellular
glutathione by a humanized native milk protein isolate in normal cells and
rat mammary carcinoma model. Anticancer Research.
16:1095-1100, 1996.
- Bounous G., Batist G., Gold P. Whey proteins in cancer prevention.
Cancer Letters. 57:91-94, 1991.
- Watanabe A., Higuchi K., Yasumura S., Shimizu Y., Kondo Y., Kohri H.
Nutritional modulation of glutathione level and cellular immunity in chronic
hepatitis B and C. Hepatology. 24:597A, 1996.
- Lothian B., Grey V., Kimoff R.J., Lands L.C. Treatment of
obstructive airway disease with a cysteine donor protein supplement: A case
report. Chest 117:914-916, 2000.
- Cross C.E., Halliwell B., Borish E.T., et al. Oxygen radicals and
human disease. Annals of Internal Medicine 107:526-545,
1987.
- Lands L.C., Grey V.L., Smountas A.A. Effect of supplementation
with a cysteine donor on muscular performance. J. Appl.
Physiol. 87:1381-1385, 1999.
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