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Thursday, July 1, 2010

Guest post: A primer on human IgE antibody serology

Dear Readers:

In response to the concerns about an increase in the remote practice of allergy, which may possibly be influenced by direct allergy laboratory marketing campaigns, the AAAAI and ACAAI, in conjunction with Don Aaronson from the JCAAI formed a joint taskforce in 2006 on allergy diagnostic testing called the Specific IgE Test Task Force (SETTaF) . SETTaF’s purpose has been to develop educational materials that focus on the appropriate diagnostic evaluation of the allergic/suspected patient. In late 2008 SETTaF published a monograph directed at health care professionals, who care for allergic patients entitled the “Pearls and pitfalls of allergy diagnostic testing: report from the American College of Allergy, Asthma and Immunology/American Academy of Allergy, Asthma and Immunology Specific IgE Test Task Force.”(1) The task force is currently engaged in the development of a PowerPoint presentation and several monographs on diagnostic allergy testing that are directed at primary care professionals.

The key message throughout these educational materials is that the allergy evaluation must be initiated by and culminated with the patient's clinical history. It must be directed by a health care professional with sufficient understanding of diagnostic allergy testing to use the information obtained from his/her evaluation of the patient to determine: 1. What diagnostic allergy tests to order. 2. How to interpret the diagnostic allergy test results. 3. How to use the information obtained from the allergy evaluation to develop an appropriate therapeutic treatment plan.

This issue of the Journal of Allergy and Clinical Immunology presents a monograph developed by SETTaF on serological measurement of allergen-specific IgE testing specifically for the North American allergist. Per the protocol of a joint AAAAI/ACAAI task force, the SETTaF’s monographs are reviewed by the Board of Directors/Regents of both organizations. During this review, a question and answer dialogue evolved and the organizations' Boards suggested including the ‘Q&A’ with the document.

The members of SETTaF hope you find the monograph educational. The following questions and answers represent the views of the individuals and not SETTaF or the Board of Directors/Regents of the AAAAI/ACAAI.

Sincerely,
Linda Cox, MD
SETTaF chair


Allergy Diagnostic Testing Primer: Questions and Answers

Below are some questions that were raised by ACAAI reviewers that will highlight some of the questions readers may have and an attempt by the authors to provide answers, where they are available.

Issue 1: Use of serum specific-IgE in clinical decision-making

Dana Wallace , MD (ACAAI president-elect): This report on the evolution of serum specific- IgE (s-IgE) testing is a timely and much needed document for the clinical allergist. While technically well written, it brings up perhaps more questions and confusion than it answers or clarifies. While the authors and many other academicians may find it clear and easy to understand, I am not sure that this will be the case for most clinicians. Particularly difficult will be the translation of this information into clinical decision-making support tools. It would be very helpful if an additional section could be added: “When and how to use specific IgE in vitro tests to improve patient care”. I would suggest that in this section, the authors try to answer the following questions (among others):

Linda Cox, MD ( SETTaF chair): I think one has to consider s-IgE similar to skin testing in terms of when and how it would be used in patient care and the decision on which type of test(s) would vary with the patient and other circumstances.

Brock Williams, PhD (Primer author and SETTaF member): The hard question to answer is when and how to use s-IgE testing to improve patient care. To me, this deals mostly with how to interpret the results and this is very patient dependent. Again the problem stems from the fact that allergic symptoms are variable both within and between individuals. This and the large number of variables (age, gender, exposure, infection, etc.) clearly need to be taken into account for the interpretation of s-IgE tests. We do know that s-IgE is closely linked to symptoms but levels and the allergens it is directed against differ among different individuals. Thus, in today’s world, s-IgE results will best be utilized by considering them as a risk factor rather than an absolute diagnostic fact.

Robert Hamilton, PhD: The ultimate decision of when to use a confirmatory IgE antibody test (skin test or serology) comes down to the physician deciding that there is sufficient clinical evidence to warrant a possible diagnosis of allergic disease. This concept is integral to the diagnostic algorithm built into the diagnostic practice parameters. As such, to try to list all the patient and physician decisions to determine when a diagnostic IgE antibody confirmatory test (skin test or serology) should be run is (in my opinion) out of the intended scope of this article. This article summarizes what we know and what we do not know about the assays used to detect allergen-specific IgE antibody. I agree with Brock that prudent use of a positive specific IgE antibody result is as a risk factor for allergic disease and not as a definitive indicator of the presence of allergic disease.

Issue 2: Which is the ‘best’ specific IgE assay?

Dana Wallace, MD: Which of the three methods of specific-IgE measurement described within the Primer is most beneficial for making clinical decisions or should they all be viewed as equal?

Linda Cox, MD: There is agreement that the results are not assay inter-changeable. One thought is the different assays may be measuring different antibodies.

Brock Williams, PhD: Comparability of different methods – most studies indicate that the Phadia ImmunoCAP is far above the other two tests in overall performance (accuracy, precision, and quantitative ability). The problem is that for certain allergens and levels of s-IgE the assays are somewhat in agreement. For others, they are very different. I find the explanation that these assays are sometimes measuring different populations of antibodies to be rather absurd. To begin with I have seen no proof of this concept and our studies with chimeric antibodies (where the total IgE = specific IgE) indicate that for those allergens investigated the Siemens assay (formerly DPC-Alastat/Immulite) has major problems with its calibration and the Hycor assay (Agilent) has problems with under-representation of allergen on some of their solid phases. The major user of the Hycor assay is Labcorp and we know in the past some have suggested that they have modified this test in house to make it more profitable. The ImmunoCAP results (done in triplicate with blinded samples) was ‘spot on’ in these cases.

Robert Hamilton, PhD: I respectfully disagree with Brock on this issue. The most impartial examination of the inter-assay agreement issue indicates that all three methods display excellent precision, reproducibility and linearity. They do differ in the levels of IgE antibody that they detect and we currently do not know the reason for this. It is possibly a calibration issue, however, if there was a systematic bias caused by a calibration issue, we would see a consistent bias which we do not. My belief is that it has more to do with allergen heterogeneity between the methods. Thus to call the suggestion that the assays are measuring different populations of IgE antibody specificities "absurd" is too ‘heavy handed’. Brock, your data with the chimeric antibody are interesting and informative but not conclusive on a calibration issue.

We need to construct a better and more relevant experiment with human sera to try to dissect the answer to this question. Possibly this can be done with milk and peanut where we can identify the component specificities of IgE antibody using the ISAC and the components that are available on the ImmunoCAP. Then sera with defined distributions of IgE antibody can be analyzed by all 3 methods. So the binding of a serum containing 95% IgE anti-casein can be compared to a serum that contains 95% IgE anti-alpha-lactalbumin as a limited illustration of this concept. If we characterize many sera with a sufficient number of these component specificity distributions, we can examine this issue for a restricted number of allergen specificities.

In reality, we will probably not be able to definitively answer this question (at least to my satisfaction). So we are left with the conclusion that is stated in the primer article (which I believe is true) that these 3 assays measure different populations of IgE antibody. The causes are almost irrelevant as the 3 manufacturers are not in a position to change their assay formats. I discussed this issue personally with representative of each company during the last AAAAI meeting. At this point, we cannot say for sure which IgE antibody assay result is more "clinically relevant".

Issue 3: Is one assay too sensitive?

Dana Wallace, MD: Should one consider the Immulite too sensitive as it gives a higher reading of specific-IgE than the Hycor or ImmunoCap? Is there any general guide on comparing the results as the graph seems to show a trend?

Linda Cox, MD: One study did suggest Immulite overestimated s-IgE when the results of total IgE were compared with the hybridoma s-IgE results, which were all s-IgE. Brock and Bob are likely to have different answers

Brock Williams, PhD: The idea that if an assay gives a higher result it is better is fallacious. Again, the chimeric antibody results clearly demonstrate this. Accuracy is more important. Again, the calibration curve (total IgE tied to WHO standard) is very different for the Immulite system. This causes the amount of s-IgE measured to be overestimated particular at the high end with a number of different allergens. A requirement for quantification is that different dilutions (corrected for dilution) give you the same answer. In other words, they are linear and we have only seen this with the ImmunoCAP system.

The idea of sensitivity is also an area of great misunderstanding. This is because analytical sensitivity is a very different concept than clinical sensitivity and the two have often been confused. Analytical sensitivity deals with the low end of the assay, before you run into the background and is determined experimentally with statistical analysis in the laboratory. Clinical sensitivity deals with determining what level of s-IgE is capable of causing clinical symptoms upon exposure and in the near future, what particular allergenic substance it is directed against. Since the determination of clinical sensitivity depends upon the comparison to standards (patient history, puncture skin test, allergen organ challenges, etc.), which themselves have not been standardized and many of the cutoffs are arbitrary. In addition, the studies are dependent on the patient population studied so we really have very poor information in this area. Nevertheless, we mistakenly continue to use this concept to describe how well in a clinical sense these assays work. The same arguments can be used with regard to clinical specificity and, in my opinion, this has been very misleading in this field for quite some time.

Robert Hamilton, PhD: I agree with Brock that higher results produced by any one of the 3 assays are not more clinically relevant. The predictive power of the quantitative level of IgE antibody is discussed in the Primer article, with a caution that these published values need to be used judiciously. . On this issue I agree with what Brock has said about analytical versus clinical sensitivity. Analytically, all three assays can technically detect IgE antibody levels down to 0.1 kUa/L. Historically, the 0.35 kUa/L positive cutpoint was set based on the fact that levels above 0.35 had some clinical significance. We do not know and may never know the clinical significance of levels between 0.1 and 0.35 kUa/L. Interpretation also differs by allergen specificity as some clinicians judge low level Hymenoptera or peanut specific IgE levels differently than a ragweed specific IgE of the same level, because of their clinical relevance in relation to systemic reactions. Thus, a specific IgE level between 0.1 and 0.35 kUa/L needs to be cautiously and judiciously interpreted within the context of the patient’s clinical history.

Issue 4: Can the clinician compare a patient’s s-IgE if they were performed utilizing different assays?

Dana Wallace, MD: If one needs to compare levels of s-IgE and different methods have been used, should the clinician insist that they be repeated so that at least the methods match?

Recognizing that the ImmunoCap has the most published literature in food allergy and predictive levels for a negative food challenge, the clinician has often looked to this as preferred method. Is this still correct?

Linda Cox, MD: Yes. When the laboratory findings are inconsistent with the clinical history, it is recommended to repeat the analysis at the same or a different laboratory. If the results are different, how does the clinician interpret this data? Also recommend repeating with a different method-skin test if sIgE or vice versa. Clinical history is generally the deciding factor. This was a key message in the first SETTaF paper.

I believe the predictive value established in the earlier studies were somewhat specific to a particular population and cannot be universally applied across other age groups/disease.

Robert Hamilton, PhD: We know from the College of American Pathologists Proficiency Survey data that all 3 assay methods from 90% of the laboratories agree well in producing dichotomous measures of IgE antibody (presence/positive vs absence/negative). Therefore, if you are using IgE antibody measurements as a “risk factor” to consider with all the other variables in making the diagnosis, then the Immulite can detect the presence of IgE anti-peanut in a serum as well as an ImmunoCAP. So, if you are asking about the presence of IgE antibody as a risk factor, then “No”, re-analysis by a second assay method is not necessary.

However, there are the occasional spurious results generated by the occasional laboratory or spurious skin test results generated by the occasional clinic. These do occur. So, if the IgE antibody result (skin test or serology) is inconsistent with the clinical history, then it should be repeated, possibly with a different method. We learned this from Dr. Shapiro’s legal case involving Hymenoptera venom sensitivity.

If you are attempting to use the quantitative level to make a prediction about the presence of a clinically evident food allergy or wheeze in an asthmatic child, then published data will dictate what assay needs to be used. In this case the published quantitative predictive data to date are all from the ImmunoCAP. One cannot use the Immulite or Hycor data to make a decision based on published criteria generated with the ImmunoCAP. This will change if new published data are generated with the other two IgE antibody methods.

Issue 5: How important are patient characteristics (age, disease state, etc.) in interpreting s-IgE results?

Dana Wallace, MD: However, the article seems to imply that without knowing the age of the patient, the disease state, the allergen exposure mode and extent, and ratio of Specific IgE/Total IgE that was used in the published research studies and in the individual patient, these published guidelines may be inaccurate and perhaps useless. If this is the correct interpretation, it should be more clearly stated.

Just how important are the lack of affinity and clonality measurements in the overall clinical usefulness of interpreting the results of specific-IgE measurements?

Should we be dividing patient into groups below and above the 4% specific- IgE/Total IgE ratios? Would this help to predict severity of allergic reaction and/or response to treatment?

Linda Cox, MD: I not sure how important sIgE/total IgE. Again Bob and Brock can comment further. I think the importance of affinity and clonality is still be elucidated. This is an area that needs further research but an area of particular interest for Bob.

Brock Williams, PhD: I agree with Linda, that affinity and clonality are parameters that still need to be evaluated. I believe that the realization that certain allergens are much more relevant to symptom production (component resolved diagnosis) is likely to rectify this.

Robert Hamilton, PhD: Four variables contribute to the effectiveness of the IgE antibody response in inducing effector cell function: IgE antibody concentration, affinity, epitope clonality and specific to total IgE ratio or IgE specific activity. This has been clearly shown by the Christensen et al article in the JACI.2 All of these variables are important and constantly changing as the humoral immune response matures with continuing allergen exposure. And one of these alone cannot be shown at present to be an exclusive risk factor for interpreting IgE antibody results in the diagnostic decision process. I agree with Brock that future modifications to our serological assays (e.g., use of components, microarrays) may help us understand this better at the time of interpreting the diagnostic data. The patient demographics will always be critical to the interpretation of the IgE antibody serology as the clinical history is the final arbiter of the definitive diagnosis.

Issue 6: Is the significance of the s-IgE level different when the total IgE is low vs. high?

Dana Wallace, MD: Is it fair to say that when the total IgE level is very high, a high specific-IgE has limited meaning while a high specific-IgE with a low total IgE level is very significant?

Linda Cox, MD: Probably.

Brock Williams, PhD: Specific activity (s-IgE/T-IgE). While this concept makes some intuitive sense, it hasn’t yielded any concrete benefits. This is likely to be important when low levels of t-IgE are seen but really falls apart when multiple allergens and higher levels of s-IgE are seen. While this could be important in immunotherapy, presently it is an area for investigation and not ready for prime time in my opinion. This is particularly true when you investigate monosensitized patients, which is a rare situation for U.S. allergists. Again, I believe we have to further evaluate this concept in lieu of s-IgE to the allergens that actually are relevant (component resolved diagnosis).

Robert Hamilton, PhD: I agree with you all. The IgE specific activity has its most relevance when the total IgE is low and the % specific to total IgE is high. Use of the 4% IgE specific activity as a general criterion can be useful for evaluating patients on Xolair as Johannson et al have shown. However, we need more data to confirm its utility in applying it across the board in the general interpretation of IgE antibody data.

Issue 7: Can the clinician use the s-IgE/t-IgE ratio to predict response to allergen immunotherapy?

Dana Wallace, MD: Is there enough data for the clinician to calculate the specific IgE to total IgE ratio and predict the response to specific immunotherapy? If so what is the magic ratio? If not is there ongoing research that will answer this question? One paper looked at this and 16% was ≥16% was the magic number.3

Robert Hamilton, PhD: No. we need more data to show the utility of this measure in assessing immunotherapy efficacy. It should however be computed to evaluate its utility in future immunotherapy studies.
Brock Williams, Ph.D: I agree with Bob that it is premature to use s-IgE results to guide immunotherapy. This area certainly needs more study and again will probably be better understood when patients and their responses are understood in terms of the specific allergen components that are responsible for symptoms.

Issue 8: Can s-IgE be measured in a patient on Xolair® (omalizumab)?

Dana Wallace, MD: Should the clinician be using ImmunoCAP s-IgE when assessing the patient onXolair? What would be the utility of doing so?Is one looking for a defined endpoint?

Linda Cox, MD: I believe one can get reliable results with ImmunoCAP on s-IgE testing in patients on Xolair, which might be useful in determining if you are adequately dosing (i.e., under) but again Bob is the better person to answer this question

Brock Williams, PhD: Bob has shown quite clearly that the ImmunoCAP can be used with confidence in patients on Xolair.

Robert Hamilton, PhD: The article Brock is referring to clearly shows that IgE (total and allergen specific) can be accurately measured in patients on Xolair with the ImmunoCAP and not with the other two assay methods.4 The important questions are (1) what utility does the measurement of total IgE and specific IgE provide for a patient on Xolair? and (2) where do “free IgE” measurements (IgE not bound with Xolair) fit into the evaluation of the Xolair patient? Examine the Primer article as it addresses these questions.

Issue 9: Will ImmuoCAP rapid®, a non-quantitative allergy test designed for the office setting useful tool for primary care professionals?

Dana Wallace, MD: Will the ImmunoCAP rapid be a good tool for primary care physicians? Should we embrace it?

Linda Cox, MD: The rapid screen office allergy test, which is similar to a pregnancy test is intended for the primary care office. It will likely bring more attention to allergy and to the allergist. Thus, indirectly, I think it is good for the specialty, but there needs to be some education about appropriate use and referral.

Robert Hamilton, PhD: The ImmunoCAP rapid is FDA cleared and we will see how it fits into the overall diagnostic process in the USA. It is too early to tell if it will be useful or abused. The Primer article simply introduces the ImmunoCAP rapid . Allergists need to know that the ImmuoCAP rapid®, data may be introduced by the patient at an allergist’s office visit.
Brock Williams, Ph.D. The ImmunoCap rapid is much like a laboratory test for cholesterol in that it can be interpreted as a measure of risk. The caveats mentioned above in interpreting the results in lieu of the patient’s history most certainly will have to be evaluated on a case by case basis.

References:
1. Cox L, Williams B, Sicherer S, et al. Pearls and pitfalls of allergy diagnostic testing: report from the American College of Allergy, Asthma and Immunology/American Academy of Allergy, Asthma and Immunology Specific IgE Test Task Force. Ann Allergy Asthma Immunol 2008;101:580-92.
2. Christensen LH, Holm J, Lund G, Riise E, Lund K. Several distinct properties of the IgE repertoire determine effector cell degranulation in response to allergen challenge. J Allergy Clin Immunol 2008;122:298-304.
3. Di Lorenzo G, Mansueto P, Pacor ML, et al. Evaluation of serum s-IgE/total IgE ratio in predicting clinical response to allergen-specific immunotherapy. J Allergy Clin Immunol 2009;123:1103-10, 10 e1-4.
4. Hamilton RG. Accuracy of US Food and Drug Administration-cleared IgE antibody assays in the presence of anti-IgE (omalizumab). J Allergy Clin Immunol 2006;117:759-66.

81 comments:

  1. Quest 1. Literature clearly shows that having s-IgE compared to not having s-IgE at a certain level does not prove that there is an allergy present. However, all studies clearly demonstrate that the likelyhood of having allergy increases in an individual having a certain level of s-IgE compared not to have that particular level. For instance having 10 kUA/L gives higher likelyhood than having 3 kUA/L. If the individual has increased s-IgE to several allergens tnis increases the likelyhood even further Such liklyhood further increases if the individual is of low age, eg a child, of male gender, has allergy or asthma in the family etc.
    Quest 2. The question has to be broken down to two different issues: Technical and clinical. Technically the methods need to have high precision and reproducably give whatever value they show from time to time. All three methiods do that as stated by Brock and Bob. However a given value by on of the methods may not be the same as by another of them. The best test of what is accurateis the study perfomed by Wood, Williams and others utilising chimeric antibodies and refered to by Brock. The reason for this is probably how the assays are calibrated. The easy way to demonstrate any discrepancies is to run the calibraors from one assay by the other. This has been done but has never been published since it clearly demonstrated flaws and this is senstive to the manufacturers objecting to publications. Again ImmunoCAP was shown to be accurate. Clincially, there was on study by Wang et al JACI 2007, analysing clincial samples and comparing the results to the clinical usefulness or "correctness" of the methods again speaking to the advantage of ImmunoCAP. Whether antibody affinity is important in this is tisll fairly open. The study refered to by Christensen et al needs to be confirmed.
    Quest 3.
    No assay is too sensitive, since it is more a question of risk assessment. If a test overestimate for one allergen and underestimate for another it is difficult to judge. See also above.
    Quest 4. The assays have been calibrated against each other by their manufactures (ie compared with ImmunoCAP) to show the similarity at 0.35. Since that is an artifical cut off that really does not mean a lot results from one assay can not be used and comared with another. Contrary, a result with on method at one laboratory should be possible to compare with the same mthod at a different laboratory.
    Quest 5. They are crucial. See quest 1.
    Quest 6. This is a difficult issue. I think it depends on the allergen and also of the population. Studies by Platts-Mills in colaboration with differnt groups has shown that cat in Swden is an important allergen in childhood wheeze and asthma and consititutes to a certain extent to the t-IgE. Mite is not important at all. In contrast in New Zealand mite is so important as an allergen with much higher s-IgE levels and also contributing very much to the t-IgE, whereas cat does not seem to give a significant contribution. Further in AD in childhood there are very high t-IgE and also very high s-IgE which are dfficult to interpret, but seemingly casting doubt to the improtance of s-IgE. To try to calculate some ratios is to date not plausible without having much more insight into different allergens and how they affect the immune system and also the allergic response.
    Quest 7. No further comments.
    Quest 8. Nothing further
    Quest 9. Good answers by Brock and Bob. Nothing further

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  2. Sten Dreborg, MD, PhDJuly 19, 2010 at 2:13 PM

    Dear Bob H,
    Thank you for your comment on Issue 2.

    I totally agree, IgE tests from different manufacturers – and sometimes even different batches from the same manufacturer – measure IgE-antibodies against different epitopes, i.e. thos represented on the surface of the allergen attached to the solid face.

    I have had some insight in several companies.
    The source material has been shown to differ between manufacturers regarding the content of common allergens. Der p 1 and Der p 2 has – at least earlier – differed in amount between the source materials used by different manufacturers. Similarly, the content of dog serum albumin has been dominating in the sources used by other manufacturers.
    For more complicated allergens, e.g. moulds, it is very difficult to obtain a similar result from growing the same strains under the same conditions. Thus, when I worked with others on the standardization of mould extracts for diagnosis and immunotherapy, we grow the same ten strains (frozen in small aliquots) every time, to obtain similar composition of the extracts. Since mould extracts are also extremely sensitive to degradation by their own enzymes (Cladosporium in aqueous solution is deranged after one week and not fulfilling stability criteria in glycerol 50 % after three months, IgE data on mold sensitization disagree to a high extent between manufacturers of IgE tests.

    My conclusion is that as long as we do not know the total composition and can prescribe the content of single allergens, it will be impossible measure IgE antibodies with assays designed to measure “total” specific IgE of one species in a meaningful way – that can be repeated with tests from another manufacturer or even a new batch from the same manufacturer.

    I would suggest to measure the content of different allergens on the solid phases of different manufacturers test material, to document this fact (hypothesis).

    Do you agree – or am I wrong?

    Sten Dreborg

    ReplyDelete
  3. Dr. Hamilton responds to the question from Dr. Dreborg:

    Dear Dr. Dreborg:

    Thank you for your insight into this issue of the cause(s) for the differences in the levels of IgE antibody that are measured (and reported) by the 3 commonly used assay methods in North America from Phadia, Siemens and Hycor. Your extensive experience with the allergen component portion of the IgE antibody assays provides you a unique experience that can add perspective to this issue.

    While Brock Williams currently adheres to the thought that it is principally the calibration portion of the assay that causes the different reported results among IgE antibody methods, I personally agree with you that it is the allergen reagent portion of each assay that differs in its composition and that causes each assay to bind different portions of IgE antibody of a given allergen specificity from any given patient's serum.

    Yes, one way to document this would be to measure IgE antibody levels to the same allergen components of a defined specificity in all 3 assays and examine the results for agreement and trends. I would predict that the levels of IgE antibody would agree within acceptable tolerance ranges for clinical assays if IgE anti-component measurements were done instead of using allergen extracts in the assays. Unfortunately, this analysis has not been possible at present because the same component allergens are not available in all three assays from Phadia, Siemens and Hycor.

    A second approach would be to examine the IgE anti-component patterns with one assay and then examine them for trends or patterns of reactivity that associate with either elevated or equivalent IgE antibody results between the various assay methods. We have begun such a study using peanut as a test allergen system, however, as I mentioned, it is currently not possible to measure Ara h 1, 2, 3, 8 and 9 specific IgE in all 3 assay systems used in North America. We hope that by examining a population of peanut allergic sera that have some sera produce IgE anti-peanut levels which agree and others that disagree among methods, that we will see patterns of specific IgE to defined components. This is an ongoing project and I hope it will partly clarify this issue.

    Ultimately, again I agree with you that we should not expect to see inter-method agreement of IgE antibody assays until we measure antibody using the identical allergen components in all 3 assay systems. Thank you sharing for your perspective on this issue with the community at large.

    Respectfully submitted.

    Robert Hamilton

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    ReplyDelete
  12. my health restore
    i am so happy to share this testimony with the world because generally there are so many doubts about the cure of hpv and cancer This is real take it serious, i am so happy that today i can give this testimony to the world and also help in savinglife of people who has been condemned for death just as i was ,who will believe that a herbs can cure hpv and cancer completely from thebody, i never believe that this will work, i have spend a lot of money getting drugs from the hospital to keep me healthy, it got to a time that all i was waiting for is death to come because i was broke and i already have strong outbreaks from the hpv, one day i was going through the internet asking questions online just to know more about the latest development in the medical sector to see if there is still hope then i stumbled on a post about about this great man called Dr. Ehiagwina through a publicly made a testimony on how she was also cured of ALS by this herbal doctor who is well known for his strong ancient herbal practice at first i doubted both the woman and the doctor just as so many that see's this post would doubt because medically it has been proven impossible but later i decided to give him a try so i emailed him I did not believe him that much, I just wanted to give him a try, he replied my mail and Needed some Information about me, then I sent them to him, he prepared a herbal medicine and sent it through Courier Service for delivery, he gave my details to the Courier Office. they told me that 3-5 days I will receive the package and after receiving it, i took the medicine as prescribed by him at the end of 13days that the medicine lasted, he told me to go to the hospital for a test, and i went, surprisingly after the test the doctor confirm me hpv negative and cancer disappear i thought it was a joke, i went to other hospitals and was also negative the doctors were speechless and i said it was a miracle, thank you sir for saving my life even if you cannot see this post i shall never stop testifying the impact you made in my life by restoring back my life when i was being stigmatized and even avoided by family and friends , I promise I will always testify of your good works. Dr. Ehiagwina contact: ehiagwinaherbalhome@gmail.com OR call +2348162084504 you can also add him on whatsapp.

    ReplyDelete
  13. I was diagnose with hpv virus for 5years i broke up with my boyfriend because i contracted the virus from him, luckily i found a herbalist name Dr. onokun everyone testify good of his natural treatment i picked up his address and contacted him. he truly treated me with natural herbs in a week and i got cured. i share this post because ever since i got this treatment I'm perfectly ok with my health. i contacted him through this email.. dronokunherbalcure@gmail.com

    ReplyDelete
  14. I am so happy, i never believe i will be this happy again in life, I was working as an air-hoster ( cabby crew ) for 3years but early this year, i loose my job because of this deadly disease called Herpes virus (HSV), I never felt sick or have any symptom, till all workers were ask to bring their doctors report, that was how i got tested and i found out that am HSV positive that make me loose my job, because it was consider as an STD and is incurable disease, i was so depress was thinking of committing suicide, till i explain to a friend of mine, who always said to me a problem share is a problem solved, that was how she directed me to Dr Isibor, that was how i contacted him and get the medication from this doctor and i got cured for real, I just went back to my work and they also carry out the test to be real sure and i was negative. Please contact this doctor if you are herpes positive diseases his email is: drisiborspellhome@gmail.com or you can call or whatsApp his mobile number on +2348107855231.

    ReplyDelete
  15. I am so happy, i never believe i will be this happy again in life, I was working as an air-hoster ( cabby crew ) for 3years but early this year, i loose my job because of this deadly disease called Herpes virus (HSV), I never felt sick or have any symptom, till all workers were ask to bring their doctors report, that was how i got tested and i found out that am HSV positive that make me loose my job, because it was consider as an STD and is incurable disease, i was so depress was thinking of committing suicide, till i explain to a friend of mine, who always said to me a problem share is a problem solved, that was how she directed me to Dr Isibor, that was how i contacted him and get the medication from this doctor and i got cured for real, I just went back to my work and they also carry out the test to be real sure and i was negative. Please contact this doctor if you are herpes positive diseases his email is: drisiborspellhome@gmail.com or you can call or whatsApp his mobile number on +2348107855231.

    ReplyDelete
  16. God bless Dr LUCKY for his marvelous work in my life, I was diagnosed of
    HERPES virus since 2013 and I was taking my medications, I wasn't satisfied i
    needed to get the HERPES out of my system, I searched about some possible
    cure for HERPES i saw a comment about Dr LUCKY, how he cured HERPES with
    his herbal medicine, I contacted him and he guided me. I asked for
    solutions, he started the remedy for my health, he sent me the medicine
    through UPS SPEED POST. I took the medicine as prescribed by him and 14
    days later i was cured from HERPES, Dr LUCKY truly you are great, do you
    need his help also? Why don't you contact him through. (
    drluckyherbalcure@gmail.com) or you can also reach him on phone or
    whatsAPP: +2348154637647

    ReplyDelete
  17. I got diagnosed with hpv, i have be dealing with this mess for the past 7yrs. On till i got review online about natural cure people testifies how they got cured with natural treatment. And i order the treatment, after taking it for two weeks i totally got cured with herbal treatment. I'm recommending you diagnosis with hpv should get this treatment via; dronokunherbalcure@gmail.com or whatsapp call.. +2349064844957

    ReplyDelete
  18. I has suffered for Human papillomavirus HPV) for 2years, I was given some tablets at the hospital but I refused to take it, They said I have to be on it for life so I don't want take a drugs everyday for life. No point in taking medicine everyday when u won't get cure from it and I was advice to seek for natural herbal cure, after some time I found dr onokun is the most trustful herbalist that have herbs to cure wicked symptom's,I emailed dr onokun, for 2weeks been his patient he cured my (HPV) with his herbal. I only used his natural herbs for two weeks it was 100% cure. I'm not (HPV) patient anymore. I'm happy about it i finally got cured out of this mess been in my body for 2years. I also recommend you if you're living with (HPV) or herpes symptoms i also want you to be free contact dr onokun with the email attach to my post. dronokunherbalcure@gmail.com

    ReplyDelete

  19. I’m from USA am here to give my testimony about Dr Robinson who helped me cure my HERPES (HSV), i want to inform the public how i was cured from (HERPES SIMPLEX VIRUS), i visited different hospital but they gave me list of drugs like Famvir, Zovirax, and Valtrex which is very expensive to treat the symptoms and never cured me. Three months ago a friend suggested that I try herbal medicine; from a very powerful herbal doctor called (Dr.Robinson) I looked up his blog on the internet site and indeed he have had immense success with his product. There were lot of persons posting their testimony about how he cured them. when i contacted him he gave me hope and send a Herbal medicine to me that i took and it seriously worked for me, my HERPES result just came out negative. (Robinson.buckler (@ yahoo). com 🙂🙂🙂🙂🙂🙂🙂🙂🙂🙂🙂🙂🙂🙂🙂 I must admit ( ( Robinson.buckler) ) is really a genuine man when it comes to getting an ex lover back

    ReplyDelete
  20. I am so happy, i never believe i will be this happy again in life, I was working as an air-hoster ( cabby crew ) for 3years but early this year, i loose my job because of this deadly disease called Herpes virus (HSV), I never felt sick or have any symptom, till all workers were ask to bring their doctors report, that was how i got tested and i found out that am HSV positive that make me loose my job, because it was consider as an STD and is incurable disease, i was so depress was thinking of committing suicide, till i explain to a friend of mine, who always said to me a problem share is a problem solved, that was how she directed me to Dr Isibor, that was how i contacted him and get the medication from this doctor and i got cured for real, I just went back to my work and they also carry out the test to be real sure and i was negative. Please contact this doctor if you are herpes positive diseases his email is: drisiborspellhome@gmail.com. or you can call or whatsApp his mobile number +2348107855231.

    ReplyDelete

  21. I have been suffering from HIV and Genital Herpes for the past 3 years and 8 months, and ever since then i have been taking series of treatment but there was no improvement until i came across testimonies of Dr TAKUTA on how he has been curing different people from different diseases all over the world, then i contacted him as well. After our conversation he sent me the medicine which i took according to his instructions. When i was done taking the herbal medicine i went for a medical checkup and to my greatest surprise i was cured from Herpes. My heart is so filled with joy. If you are suffering from Herpes or any other disease you can contact Dr TAKUTA today on this Email address: takutaspellalter@gmail.com or WhatsApp him on this Tell.Number +27788634102....

    Dr.TAKUTA also cures:
    1. HEPATITIS A,B,C
    2. HERPES 1/2
    3.DIABETES
    4.STROKE.
    5.STDS and STI
    6. MARRIAGE COUNSELLING
    7.LOVE SPELL CASTING
    8.JOB PROMOTION SPELLS
    9.MARITAL PROBLEM
    10.MAGIC MONEY SPELLS

    ReplyDelete

  22. I have been suffering from HIV and Genital Herpes for the past 3 years and 8 months, and ever since then i have been taking series of treatment but there was no improvement until i came across testimonies of Dr TAKUTA on how he has been curing different people from different diseases all over the world, then i contacted him as well. After our conversation he sent me the medicine which i took according to his instructions. When i was done taking the herbal medicine i went for a medical checkup and to my greatest surprise i was cured from Herpes. My heart is so filled with joy. If you are suffering from Herpes or any other disease you can contact Dr TAKUTA today on this Email address: takutaspellalter@gmail.com or WhatsApp him on this Tell.Number +27788634102....

    Dr.TAKUTA also cures:
    1. HEPATITIS A,B,C
    2. HERPES 1/2
    3.DIABETES
    4.STROKE.
    5.STDS and STI
    6. MARRIAGE COUNSELLING
    7.LOVE SPELL CASTING
    8.JOB PROMOTION SPELLS
    9.MARITAL PROBLEM
    10.MAGIC MONEY SPELLS

    ReplyDelete

  23. I have been suffering from HIV and Genital Herpes for the past 3 years and 8 months, and ever since then i have been taking series of treatment but there was no improvement until i came across testimonies of Dr TAKUTA on how he has been curing different people from different diseases all over the world, then i contacted him as well. After our conversation he sent me the medicine which i took according to his instructions. When i was done taking the herbal medicine i went for a medical checkup and to my greatest surprise i was cured from Herpes. My heart is so filled with joy. If you are suffering from Herpes or any other disease you can contact Dr TAKUTA today on this Email address: takutaspellalter@gmail.com or WhatsApp him on this Tell.Number +27788634102....

    Dr.TAKUTA also cures:
    1. HEPATITIS A,B,C
    2. HERPES 1/2
    3.DIABETES
    4.STROKE.
    5.STDS and STI
    6. MARRIAGE COUNSELLING
    7.LOVE SPELL CASTING
    8.JOB PROMOTION SPELLS
    9.MARITAL PROBLEM
    10.MAGIC MONEY SPELLS

    ReplyDelete
  24. Hello! I'm very excited to inform everyone that I'm completely cured from my HSV 1&2 recently. I have used Oregano oil, Coconut oil, Acyclovir, Valacyclovir, Famciclovir, and some other products and it's really help during my outbreaks but I totally got cured! from my HSV with a strong and active herbal medicine ordered from a powerful herbalist and it completely fought the virus from my nervous system and I was tested negative after 12 days of using the herbal medicine. I'm here to let y'all know that herpes virus has a complete cure, I got rid of mine with the help of Dr Willams and his herbal exploit. Contact him via email: dr.harrissonwillams@aol.com and as well write him on WhatsApp +1 (213) 349-2159.

    ReplyDelete
  25. I am so glad to write this article today to tell the world how Dr Isibor cured me from HPV virus that have been in my body since five years ago, ever since then my life has been incomplete, i have used so many drugs that was prescribed to me by several doctors, but it didn’t cure my HPV VIRUS neither did it reduce the pain, i was checking for solution on the internet then miraculously came across Dr Isibor the powerful herbalist that cure HPV INFECTION, then i contacted his email, i explained everything to him and he prepared a herbal medicine and send it to me that was how i use it and got cured from HPV disease totally after receiving his herbal medicine, so my friends viewers why waiting and be suffering with this HPV virus when there is someone like Dr Isibor that can cure any kinds of disease such as HIV, CANCER, HEPATITIS C VIRUS, GENITAL HERPES VIRUS, PAPILLOMA, ALS VIRUS, MENOPAUSE SYMPTOMS. you can contact him via email: drisiborspellhome@gmail.com.

    ReplyDelete
  26. Thanks to great Dr Isibor that i met on this site. i am dana guerrie from California. i was an HPV victim. i had it for over four years i do visit hospital always before. I was just at the point of death with shame after i have lost everything in life even my love one until my close relative direct me to this site to look for great Dr Isibor . It so amazing to see my self back to my feet with everything i have lost. i am very happy because Dr Isibor did not only cure my sickness but he restructure my life by bringing back my ex and every thing i lost to the course of this sickness(HPV). i do not really know where to start from in appreciating you Dr Isibor. please my people out there do not play with your problem go out and seeks for the help of great Dr Isibor herbal healing, he healed me without future problem or hidden charges. now i am free from HPV and My husband, my joy and happiness are back. please with out a second choice go contact great Dr Isibor for the betterment of your life. CONTACT HIM VIA EMAIL;drisiborspellhome@gmail.comor whatsapp number +2348107855231

    ReplyDelete
  27. I am so happy, i never believe i will be this happy again in life, I was working as an air-hoster ( cabby crew ) for 3years but early this year, i loose my job because of this deadly disease called Herpes virus (HSV), I never felt sick or have any symptom, till all workers were ask to bring their doctors report, that was how i got tested and i found out that am HSV positive that make me loose my job, because it was consider as an STD and is incurable disease, i was so depress was thinking of committing suicide, till i explain to a friend of mine, who always said to me a problem share is a problem solved, that was how she directed me to Dr Isibor, that was how i contacted him and get the medication from this doctor and i got cured for real, I just went back to my work and they also carry out the test to be real sure and i was negative. Please contact this doctor if you are herpes positive diseases his email is: drisiborspellhome@gmail.com. or you can call or whatsApp his mobile number +2348107855231.

    ReplyDelete
  28. Am very glad to share this testimony with everyone for the marvelous work Dr Isibor has done for my life, 5months ago i was diagnosed with herpes virus and ever since then i have been very unhappy, i was so down broken everyday, until one day when i came across a shocking testimony about how Dr Dr Isibor cured someone of his herpes virus, without wasting much time i contacted him immediately on his email address: drisiborspellhome@gmail.com and after i explain myself to him about how terrible i have been, and he assure me that he will help me to cure my herpes virus,after he has prepared the herbal medicine he sent it to me and when i have received it and started using it i was totally cure within 2weeks, i am forever grateful to Dr Dr Isibor for helping me out with his herpes prescription that cured my virus. contact his email address: drisiborspellhome@gmail.com or you can call or whatsApp his Mobile number:+2348107855231

    ReplyDelete
  29. I still don’t know the right words to express my gratitude to this great man Dr Isibor. After been diagnosed of HERPES SIMPLEX VIRUS in 2months ago, i was given so many health prescription and advice with no improvement, I totally lost hope, until i found testimonies of Great Dr Isibor online research and on Facebook, Like anybody would be, I was very skeptical about contacting him, but i later did and he opened up to me and told me what was involved and he started the remedies for my health. Thank God, i was cured from herpes by the herbal medication I received from him. I never thought that herpes can be cured, from the bottom of my heart I'm truly grateful,i pray you have long life so you can help many more people on earth with your herbal medical support, You can Email him via email drisiborspellhome@gmail.com or for easy and fast communication you can also call or add him on whats-app with this mobile number +2348107855231, one thing i love most about DR Isibor is honestly, and he is very polite with his patience, everything he told me what he did, and his herbal medicine are very affordable.

    ReplyDelete
  30. 2 WEEKS AGO I ENDED NATURAL HERBAL TREATMENT FROM TRADITIONAL HEALER WHO IS IN AFRICAN, I GOT RID OF HPV VIRUS OUT OF MY BODY WITH HIS HERBAL TREATMENT. It SO AMAZING I'M FREE FROM THIS VIRUS FOREVER. YOU CAN REACH HIM ON; DRONOKUNHERBALCURE@GMAIL.COM

    ReplyDelete
  31. I was cured from my herpes Diseas. after suffering since 4years ago. but when i contact Dr uza on the internet. he gave me a Natural cure that ended my suffering after using it for two weeks. i went to check myself on the hospital and i was tested negative. I can't more happier but to say thank you sir and i use this medium to say to everyone don't waste any time to contact this powerful herbal Dr uza On any Kind of Disease he is Ready to help yeou. You can reach him through his email: druzaherbalcure@gmail.com

    ReplyDelete
  32. I am so happy, i never believe i will be this happy again in life, I was working as an air-hoster ( cabby crew ) for 3years but early this year, i loose my job because of this deadly disease called Herpes virus (HSV), I never felt sick or have any symptom, till all workers were ask to bring their doctors report, that was how i got tested and i found out that am HSV positive that make me loose my job, because it was consider as an STD and is incurable disease, i was so depress was thinking of committing suicide, till i explain to a friend of mine, who always said to me a problem share is a problem solved, that was how she directed me to Dr Isibor, that was how i contacted him and get the medication from this doctor and i got cured for real, I just went back to my work and they also carry out the test to be real sure and i was negative. Please contact this doctor if you are herpes positive diseases his email is: drisiborspellhome@gmail.com. or you can call or whatsApp his mobile number +2348107855231.

    ReplyDelete
  33. I am here to give my testimony about Dr LUCKY for his marvelous work in my life, I was diagnosed of Herpes Virus since over a month now and I was taking my medications, I wasn't satisfied i needed to get the Herpes virus out of my system, I searched about some possible cure for Herpes i saw a comment about Dr LUCKY ,how he cured Herpes with his herbal medicine, I contacted him and he guided me. I asked for solutions, he started the remedy for my health, he sent me the medicine through UPS office I took the medicine as prescribed by him and 14 days later i was cured from Herpes ,thank you for anyone that may need the medication you can contact him for your urgent cure

    EMAIL: drluckyherbalcure@gmail.com or
    WHATSAPP +2348154637647.

    ReplyDelete
  34. I am so happy, i never believe i will be this happy again in life, I was working as an air-hoster ( cabby crew ) for 3years but early this year, i loose my job because of this deadly disease called Herpes virus (HSV), I never felt sick or have any symptom, till all workers were ask to bring their doctors report, that was how i got tested and i found out that am HSV positive that make me loose my job, because it was consider as an STD and is incurable disease, i was so depress was thinking of committing suicide, till i explain to a friend of mine, who always said to me a problem share is a problem solved, that was how she directed me to Dr Isibor, that was how i contacted him and get the medication from this doctor and i got cured for real, I just went back to my work and they also carry out the test to be real sure and i was negative. Please contact this doctor if you are herpes positive diseases his email is: drisiborspellhome@gmail.com. or you can call or whatsApp his mobile number +2348107855231.

    ReplyDelete
  35. Am really happy that i and my husband are cured of (HERPES SIMPLEX VIRUS) with the herbal medicine of Dr Isibor, i have been suffering from this disease for the past 3 years without solution until i came across his email of this doctor who have cure so many people with his herbal medicine, i also choose to give him a chance to help me and my husband, he told me what to do and i kindly did it, and he gave us his herbal medicine and direct me on how to use it, i also follows his instruction for use and he ask us to go for a check up after 3 weeks and which i did, to my greatest surprise our result came out as negative, we are really happy that there is someone like this DR Isibor who is ready to help anytime any day. to all the readers and viewers that is doubting this testimony stop doubting it and contact this Dr and see if he will not actually help you. i am not a stupid woman that i will come out to the public and start saying what someone have not done for me .contact him now if you are also in need of help via email drisiborspellhome@gmail.com or call or text him on WhatsAPP +2348107855231

    ReplyDelete
  36. I am forever grateful to Dr Ojogun for his help on my life, i have been battling with Herpes Simplex Disease for 14 years and 7 month until i found Dr Ojogun who cured me of my disease, after i found someone talk about Dr Ojogun curing him of Herpes disease on Jesse Lenat Guestbook? I quickly contact Dr Ojogun with the Provided information and then i was told how i would be cured and thereafter told to provide for the herbs that would be needed for my medicine and less than 4days i got my herbal medicine and i used it for 2weeks as instructed and i went to check up and i was confirmed negative. Dr Ojogun cure all various illness..CALL/WHATAPP: +2347059015454 OR Email: drojogunherbalmedicine@gmail.com

    ReplyDelete
  37. I am so happy, i never believe i will be this happy again in life, I was working as an air-hoster ( cabby crew ) for 3years but early this year, i loose my job because of this deadly disease called Herpes virus (HSV), I never felt sick or have any symptom, till all workers were ask to bring their doctors report, that was how i got tested and i found out that am HSV positive that make me loose my job, because it was consider as an STD and is incurable disease, i was so depress was thinking of committing suicide, till i explain to a friend of mine, who always said to me a problem share is a problem solved, that was how she directed me to Dr Isibor, that was how i contacted him and get the medication from this doctor and i got cured for real, I just went back to my work and they also carry out the test to be real sure and i was negative. Please contact this doctor if you are herpes positive  diseases his email is: drisiborspellhome@gmail.com 
    or his WhatApp contact +2348107855231

    ReplyDelete
  38. All thanks to Dr Ojogun, I am here to share a good
    testimony of my self on how i came in contact with
    a real herbalist who helped me. i appreciate
    everyone for taken their precious time to read my
    testimony, 6 months ago i was diagnosed of
    HERPES, this means that 6months ago i was
    HERPES positive when i told one of my good friend
    about this, she sympathized with me and then she
    said that she was going to help me out, she told
    me that we should do some research on the
    internet, we came across Dr Ojogun, and my friend
    said that she has come across a lot about him and
    said that he is a real herbalist remedy to all illness,
    i was really surprised on this and confused as well,
    I was so speechless and quickly i contact him to
    help me and he prepared some herbs for me and
    send it across to me and he told me the way i was
    going to be taken the medicine which i did, and in
    the next 2 weeks i went to the hospital and they
    said that i am now HERPES negative, i am very
    happy about this, when i contacted Dr Ojogun again
    to tell him the good result , i asked him how he
    was able to help me, and he said that he was gifted
    with it that he can cure illness like email him via
    ( drojogunherbalmedicine@gmail.com ) or WhatsApp him +2347059015454 Good Luck    

    ReplyDelete
  39. Thank you for posting such a great article! I found your website perfect essay writing service of needs. It contains wonderful and helpful posts. Keep up the good work. Thank you for this wonderful. Also check Dell Gift Card

    ReplyDelete
  40. HELLO EVERYONE.. FEW MUNINETS TO REDY THIS INFOR ON HERPES CURE 2018..
    2017 MY MOTHER WAS DIAGNOSED OF HERPES/ KNOWN AS GENITAL WARTS ,I SPENT A LOT OF MONEY ON HER MEDICATION TILL A POINT I EVEN LOST HOPE,BECAUSE MY MOTHER WAS GRADUALLY DYING AND LOST HER MEMORY TOO, I WAS SO DESPERATE TO GET MY MOTHER BACK TO NORMAL, ONE DAY MY UNCLE WHO LIVES IN LONDON UNITED KINGDOM TOLD ME ABOUT DR OLIHA ,WHO HELPED HIM GET RID OF HERPES /GENITAL WART WITH HERBAL MEDICINE AND HIS HERBAL SOAP ,I WAS SO SHOCKED WHEN HE TOLD ME ABOUT THIS ,ALTHOUGH I NEVER BELIEVE IN HERB BUT, I KEEP TO BELIEVE BECAUSE MY UNCLE CAN'T TELL ME LIES WHEN IT COMES TO HEALTH CONDITION I CONTACTED DR OLIHA VIA HIS EMAIL; OLIHA.MIRACLEMEDICINE@GMAIL.COM , YOU CAN TALK TO HIM VIA CALL OR WHATSAPP MESSENGER ON +2349038382931 , HE REPLIED AND ASK ME TO SEND MY HOME ADDRESS AND MY MOTHER'S DETAIL AND THEN I PURCHASED THE HERBAL MEDICINE,SENT ME THE HERBAL MEDICINE THROUGH COURIER SERVICE, WHEN I RECEIVED THIS HERBAL MEDICINE USED IT FOR 2 WEEKS, AND 4 DAYS OF USAGE THE WARTS FELL OFF, MY MOTHER I NOW TOTALLY CURED AND MY MOTHER IS LIVING FREE AND HAPPY AGAIN. YOU CAN TALK TO DR VIA HIS MOBILE NUMBER OR WHATS APP HIM ON +2349038382931.ALL THANKS TO DOCTOR DR OLIHA  

    ReplyDelete
  41. i am ERIC BRUNT by name. Greetings to every one that is reading this testimony. I have been rejected by my wife after three(3) years of marriage just because another Man had a spell on her and she left me and the kid to suffer. one day when i was reading through the web, i saw a post on how this spell caster on this address AKHERETEMPLE@gmail.com have help a woman to get back her husband and i gave him a reply to his address and he told me that a man had a spell on my wife and he told me that he will help me and after 3 days that i will have my wife back. i believed him and today i am glad to let you all know that this spell caster have the power to bring lovers back. because i am now happy with my wife. Thanks for helping me Dr Akhere contact him on email: AKHERETEMPLE@gmail.com
    or
    call/whatsapp:+2349057261346










    i am ERIC BRUNT by name. Greetings to every one that is reading this testimony. I have been rejected by my wife after three(3) years of marriage just because another Man had a spell on her and she left me and the kid to suffer. one day when i was reading through the web, i saw a post on how this spell caster on this address AKHERETEMPLE@gmail.com have help a woman to get back her husband and i gave him a reply to his address and he told me that a man had a spell on my wife and he told me that he will help me and after 3 days that i will have my wife back. i believed him and today i am glad to let you all know that this spell caster have the power to bring lovers back. because i am now happy with my wife. Thanks for helping me Dr Akhere contact him on email: AKHERETEMPLE@gmail.com
    or
    call/whatsapp:+2349057261346


    ReplyDelete
  42. 5 years ago I had warts, I was treated with some liquid applied to the warts they continued to grow and spread... The next 2 doctors did laser surgery to remove them. 1 year after the surgery, they grew back close to where the 1st ones were' so I was finally told it was hpv. I have had it for very long time, I contract it from my cheated boyfriend and I found out he was also infected and I end up the relationship between us. the warts was so embarrasses because it started spreading all over I have be dealing with this things for very long time the last treatment I take was About 2 years ago I applied natural treatment from Dr onokun herbal cure, a week after applying the treatment all the warts was gone. it's now 2 years and some months I don't have single wart or any symptoms of hpv. wow"" it's great, Dr onokun has finally cured me. Anyone living with hpv contact Dr onokun for natural treatment.
    His email address: dronokunherbalcure@gmail.com  

    ReplyDelete
  43. I have used Dr Aziba herbal Medicine cure remedy for 2 WEEKS now. So far, it has cured my HERPES, eliminated my COLD SORE, improved energy and metabolism, in the morning I feel recharged and I no longer feel sleepy after a meal. As for the scent, it does smell like motor oil but I chase it down with 100% Herbal medicine from Dr Aziba. twice a day AFTER a meal. I also experienced vivid dreams for about 5 days now it’s diminishing to during the first 2 or 3 hours of sleep . contact Dr Aziba: EMAIL: priestazibasolutioncenter@gmail.com or whatsapp +2348100368288 and He also have herbs medicine to cure some popular diseases....


    ReplyDelete
  44. I Want To Appreciate Dr.OYAGU for hs great deeds, I Was Diagnosed With type 2 Herpes Virus Last year,And Was Look For Solution To Be Cured Luckily I Saw Testimonies On How Dr.OYAGU Cure Herpes Virus I Decided To Contact Dr.OYAGU I Contacted Him He Prepared A Herbal Medicine Portion And Sent It To Me,I Started The Herbal Medicine For My Health.He Gave Me Step By Step Instructions On How To Apply It, When I Applied It As Instructed, I Was Cured Of This Deadly Herpes Within 2 weeks, I Am Now Herpes Negative.My Brother And Sister I No That There Are So Many People That Have There Same Herpes Virus Please contact Dr OYAGU To Help You Too,And Help Me To Thank Dr.OYAGU For Cure Me, I’m Cured By Dr. OYAGU Herbal Medicine,His Contact Email:oyaguspellcaster@gmail.com

    Or Cell Whatsapp Number +2348101755322 thank you .....

    ReplyDelete
  45. I Want To Appreciate Dr.OYAGU for hs great deeds, I Was Diagnosed With type 2 Herpes Virus Last year,And Was Look For Solution To Be Cured Luckily I Saw Testimonies On How Dr.OYAGU Cure Herpes Virus I Decided To Contact Dr.OYAGU I Contacted Him He Prepared A Herbal Medicine Portion And Sent It To Me,I Started The Herbal Medicine For My Health.He Gave Me Step By Step Instructions On How To Apply It, When I Applied It As Instructed, I Was Cured Of This Deadly Herpes Within 2 weeks, I Am Now Herpes Negative.My Brother And Sister I No That There Are So Many People That Have There Same Herpes Virus Please contact Dr OYAGU To Help You Too,And Help Me To Thank Dr.OYAGU For Cure Me, I’m Cured By Dr. OYAGU Herbal Medicine,His Contact Email:oyaguspellcaster@gmail.com

    Or Cell Whatsapp Number +2348101755322 thank you .....

    ReplyDelete
  46. I Want To Appreciate Dr.OYAGU for hs great deeds, I Was Diagnosed With type 2 Herpes Virus Last year,And Was Look For Solution To Be Cured Luckily I Saw Testimonies On How Dr.OYAGU Cure Herpes Virus I Decided To Contact Dr.OYAGU I Contacted Him He Prepared A Herbal Medicine Portion And Sent It To Me,I Started The Herbal Medicine For My Health.He Gave Me Step By Step Instructions On How To Apply It, When I Applied It As Instructed, I Was Cured Of This Deadly Herpes Within 2 weeks, I Am Now Herpes Negative.My Brother And Sister I No That There Are So Many People That Have There Same Herpes Virus Please contact Dr OYAGU To Help You Too,And Help Me To Thank Dr.OYAGU For Cure Me, I’m Cured By Dr. OYAGU Herbal Medicine,His Contact Email:oyaguspellcaster@gmail.com

    Or Cell Whatsapp Number +2348101755322 thank you .....

    ReplyDelete
  47. I Want To Appreciate Dr.OYAGU for hs great deeds, I Was Diagnosed With type 2 Herpes Virus Last year,And Was Look For Solution To Be Cured Luckily I Saw Testimonies On How Dr.OYAGU Cure Herpes Virus I Decided To Contact Dr.OYAGU I Contacted Him He Prepared A Herbal Medicine Portion And Sent It To Me,I Started The Herbal Medicine For My Health.He Gave Me Step By Step Instructions On How To Apply It, When I Applied It As Instructed, I Was Cured Of This Deadly Herpes Within 2 weeks, I Am Now Herpes Negative.My Brother And Sister I No That There Are So Many People That Have There Same Herpes Virus Please contact Dr OYAGU To Help You Too,And Help Me To Thank Dr.OYAGU For Cure Me, I’m Cured By Dr. OYAGU Herbal Medicine,His Contact Email:oyaguspellcaster@gmail.com

    Or Cell Whatsapp Number +2348101755322 thank you ...

    ReplyDelete
  48. Greatest thanks to Dr Oyagu for his herbal drugs that he prepared for me and when i start using it in just 2weeks i was completely cured and that ended my HERPES SIMPLEX 1&2 DISEASE i am so happy and grateful to Dr Oyagu . after reading about him on a testimony of Jason Cash on a blogger. i knew suddenly Dr Oyagu was the right Doctor to cure my HERPES SIMPLEX 1&2 DISEASE. i discuss with Dr Oyagu and he prepared a herbal medicine for me and when it got sent to me in south korean . i used the herbal medicine and 2weeks and i went to check up again. after 15years of suffering from HERPES SIMPLEX 1&2 at last i am smiling once again. Dr Oyagu also has remedy to others disease like COLD SORES,HIV/AIDS,DIABETES.CANCER,HIGH BLOOD PRESSURE AND MANY MORE. I oblige everyone to contact this powerful herbalist Dr Oyagu and be free from your suffering. contact his WhatsApp line: +2348101755322 or his Email:Oyaguherbalhome@gmail.com

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  49. Are you suffering from herpes Contact a herbal doctor for cure to herpes  and all other virus, get your problem solved visit his email on {oliha.miraclemedicine@gmail.com}  or Whatsapp contact :+2349038382931 or Facebook page https://www.facebook.com/drolihamiraclemedicine/

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  50. I’m here to testify about what DR. ISIBOR did for me. I have been suffering from (GENITAL HERPES VIRUS) disease for the past 3 years and had constant pain and inching, especially in my private part. During the first year, I had faith in God that i would be cured someday.This disease started circulating all over my body and I have been taking treatment from my doctor, few weeks ago I came across a testimony of Rose Smith on the internet testifying about a Man called DR. ISIBOR on how he cured her from 7 years HSV 2. And she also gave the email address of this man, advise anybody to contact him for help on any kind of diseases that he would be of help, so I emailed him telling him about my (HSV 2) he told me not to worry that I was going to be cured!! Well, I never doubted him I have faith he can cure me too,, DR. ISIBOR prepared and sent me Healing Oil, Soap, roots and herbs which I took. In the first one week, I started experiencing changes all over me, after four weeks of using his Roots/ Herbs, Oil and Soap, I was totally cured. no more inching , pain on me anymore as DR. ISIBOR assured me. After some time I went to my doctor to do another test behold the result came out negative. So friends my advise is if you have such disease or know anyone who suffers from it or any other disease like HPV, HIV, ALS, CANCER etc. you can contact DR. ISIBOR for help via email} drisiborspellhome@gmail.com or call +2348107855231

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    Replies
    1. I Want To Appreciate Dr.OYAGU for hs great deeds, I Was Diagnosed With type 2 Herpes Virus Last year,And Was Looking For Solution To Be Cured Luckily I Saw Testimonies On How Dr.OYAGU Cure Herpes Virus I Decided To Contact Dr.OYAGU I Contacted Him He Prepared A Herbal Medicine Portion And Sent It To Me,I Started The Herbal Medicine For My Health.He Gave Me Step By Step Instructions On How To Apply It, When I Applied It As Instructed, I Was Cured Of This Deadly Herpes Within 2 weeks, I Am Now Herpes Negative.My Brother And Sister I No That There Are So Many People That Have There Same Herpes Virus Please contact Dr OYAGU To Help You Too,And Help Me To Thank Dr.OYAGU For Cure Me, I’m Cured By Dr. OYAGU Herbal Medicine,His Contact Email:oyaguherbalhome@gmail.com

      Or Cell Whatsapp Number +2348101755322 thank you

      Delete
  51. I am here to testify how great man called Dr AGBOMINA helped me out with herbs and roots which he prepared for me in use of curing my Hepatitis B I takes his product (cure) for (14) days before I am to known I was totally cure out of it, and i promised him that i will testify my healing to the whole world about how he cured me which I am very happy I am doing now , Dr AGBOMINA also cure all kinds of diseases , HEPATITIS, A,B,C , CANCER, DIABETICS , FRIBLOD,ALL KINDS OF SPELL CAST ,and so much more , please you can get him contacted on his whatsapp or call on +2349039139161 or email dragbonherbalmedicine@gmail.com He can also cure following virus (1).Herpes (2).Cancer (3).Hepatitis (4).Hiv/aids (5).Pcos (6).Fibroid

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  52. I Want To Appreciate Dr.OYAGU for hs great deeds, I Was Diagnosed With type 2 Herpes Virus Last year,And Was Looking For Solution To Be Cured Luckily I Saw Testimonies On How Dr.OYAGU Cure Herpes Virus I Decided To Contact Dr.OYAGU I Contacted Him He Prepared A Herbal Medicine Portion And Sent It To Me,I Started The Herbal Medicine For My Health.He Gave Me Step By Step Instructions On How To Apply It, When I Applied It As Instructed, I Was Cured Of This Deadly Herpes Within 2 weeks, I Am Now Herpes Negative.My Brother And Sister I No That There Are So Many People That Have There Same Herpes Virus Please contact Dr OYAGU To Help You Too,And Help Me To Thank Dr.OYAGU For Cure Me, I’m Cured By Dr. OYAGU Herbal Medicine,His Contact Email:oyaguherbalhome@gmail.com

    Or Cell Whatsapp Number +2348101755322 thank you

    ReplyDelete
  53. I Want To Appreciate Dr.OYAGU for hs great deeds, I Was Diagnosed With type 2 Herpes Virus Last year,And Was Looking For Solution To Be Cured Luckily I Saw Testimonies On How Dr.OYAGU Cure Herpes Virus I Decided To Contact Dr.OYAGU I Contacted Him He Prepared A Herbal Medicine Portion And Sent It To Me,I Started The Herbal Medicine For My Health.He Gave Me Step By Step Instructions On How To Apply It, When I Applied It As Instructed, I Was Cured Of This Deadly Herpes Within 2 weeks, I Am Now Herpes Negative.My Brother And Sister I No That There Are So Many People That Have There Same Herpes Virus Please contact Dr OYAGU To Help You Too,And Help Me To Thank Dr.OYAGU For Cure Me, I’m Cured By Dr. OYAGU Herbal Medicine,His Contact Email:oyaguherbalhome@gmail.com

    Or Cell Whatsapp Number +2348101755322 thank you

    ReplyDelete
  54. DR SAYO HERBAL HEALER HAS THE CURE TO ALL DEADLY DISEASE/VIRUS AND ILLNESS.
    Hello everyone, i don't know the reason why some people is finding it difficult to believe that there is a cure for herpes virus, i was browsing the internet searching for help when i came across lot of testimonies shared by a lot of people on how Dr. sayo cured diabetes, cancer, hiv/aids, fibrold, hsv, pad, hpv, etc.... i was so much in need of getting his treatment so i contacted Dr. sayo and told him i have herpes since last 3 years and then Dr. sayo brought smile to my face with his herbal medicine i am happy that i am cured from herpes with herbal medicine prepared by Dr. sayo the great herbal healer, i am so much happy today that we have someone like this great healer out there, so everyone out there kindly contact this great healer on his email address: sayoherbalhealer@gmail.com or whatsapp him on: +2349012175679
    visit his website: http://sayoherbalhome.com/
    visit his FB page: https://www.facebook.com/SayoHerbalHealer
    please sir keep your good work cause there are people out there who is in need of your healing herbal medicine thank you.

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  55. เว็บตรง ไม่ผ่านเอเย่น เชื่อถือได้ ปลอดได้ ไม่มีโกงต้องที่นี่ สล็อต ตอบโจทย์ความต้องการได้ดีอย่างมากทั้งเรื่องของการเงินการเดิมพันที่หลากหลาย เพื่อเป็นการยกฐานะการให้บริการให้ดีขึ้นไป

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