PLoS Med2pe124(2005 Aug)
Welcome to the Marshall ProtocolA curative medical treatment for chronic inflammatory disease. Based on the Marshall Pathogenesis. Knowledge Base. The Knowledge Base is a place to get answers to many of the questions patients have about the Marshall Protocol and the science which supports it.
Main article: Introduction to the Marshall Pathogenesis
The Marshall PathogenesisA description for how chronic inflammatory diseases originate and develop., upon which the Marshall ProtocolA curative medical treatment for chronic inflammatory disease. Based on the Marshall Pathogenesis. is grounded, is a description for how bacteria interfere with the innate immune responseThe body's first line of defense against intracellular and other pathogens. According to the Marshall Pathogenesis the innate immune system becomes disabled as patients develop chronic disease.. These pathogens survive and reproduce by disrupting the Vitamin D Nuclear ReceptorA nuclear receptor located throughout the body that plays a key role in the innate immune response., an evolutionarily consistent mechanism for survival, which leads to the development of chronic inflammatory diseases. Because these diseases are fundamentally bacterial in nature, the conditions are referred to as the “Th1 diseasesThe chronic inflammatory diseases caused by bacterial pathogens..” The Marshall Pathogenesis is supported by an emerging array of evidence, including clinical evidence, evolutionary evidence, some in silicoExperiment technique performed on computer or via computer emulation. data, and environmental sampling studies.
Main article: Introduction to the Marshall Protocol
Related article: Introduction to the Marshall Pathogenesis
The Marshall ProtocolA curative medical treatment for chronic inflammatory disease. Based on the Marshall Pathogenesis., sometimes referred to as the MP, was developed by a team led by Trevor Marshall, PhD, as an antimicrobial treatment for chronic inflammatory diseases. Most diseases of unknown cause are chronic inflammatory diseases, and almost 100% of patients with these diseases have responded to the treatment. On this site and others, chronic inflammatory diseases are sometimes referred to as the Th1 diseasesThe chronic inflammatory diseases caused by bacterial pathogens..
At its essence, the MP involves five key elements, each of which is supported by the latest insights in molecular science. MP patients must:
Many MP patients also take varying combinations of pulsed, low doses of specific bacteriostatic antibiotics.
The objective of the MP is to safely activate a highly versatile defense, the innate immune responseThe body's first line of defense against intracellular and other pathogens. According to the Marshall Pathogenesis the innate immune system becomes disabled as patients develop chronic disease.. By strengthening the innate immune response, the MP targets the mix of microbes including bacteria, fungi, and viruses that play a role in chronic disease. As pathogens and infected human cells die, they generate inflammationThe complex biological response of vascular tissues to harmful stimuli such as pathogens or damaged cells. It is a protective attempt by the organism to remove the injurious stimuli as well as initiate the healing process for the tissue. (sometimes called a “cytokineAny of various protein molecules secreted by cells of the immune system that serve to regulate the immune system. storm”) and release endotoxins into the body, resulting in a temporary increase in patients' original symptoms. This is known as immunopathologyA temporary increase in disease symptoms experienced by Marshall Protocol patients that results from the release of cytokines and endotoxins as disease-causing bacteria are killed. (generally abbreviated to IP).
Treatment on the MP requires a number of years to complete, but the exact duration is determined by the rate of a patient's progress.
Main article: Starting the Marshall Protocol
Related article: Resources for patients
Patients intent upon beginning the Marshall ProtocolA curative medical treatment for chronic inflammatory disease. Based on the Marshall Pathogenesis. should familiarize themselves with the various resources and Knowledge Base articles available to the them including:
The MP Knowledge Base is partly based on that ongoing longitudinal study supported by the ARF and described below.
Anyone with one or more Auto-immune diagnoses, also anyone with long term medical problems which resist diagnosis, is invited to register.
It is most helpful to the progress of the research, for you then to post when applicable, your decision to postpone, suspend or discontinue use of Olmesartan medoxomil with your reason(s)
where this applies, we also request a brief summary annually to follow up your welfare, in order to make it possible for the research team to analyze outcomes over a ten year period wherever possible.
Support Team members.
Main article: Diseases
The Marshall Protocol has been implemented by physicians for a wide variety of chronic inflammatory conditions like “autoimmuneA condition or disease thought to arise from an overactive immune response of the body against substances and tissues normally present in the body” diseases, as well as various mood and behavioral disorders. Potentially, it may be useful for any other chronic disease, wherein either inflammationThe complex biological response of vascular tissues to harmful stimuli such as pathogens or damaged cells. It is a protective attempt by the organism to remove the injurious stimuli as well as initiate the healing process for the tissue. or hormone irregularity is a significant factor.
Laboratory and clinical assessments by a physician, competent in the use of the Marshall Protocol, may be useful in determining whether a patient can be successfully treated with the Marshall Protocol.
Main article: Working with a Marshall Protocol physician
Patients on the Marshall ProtocolA curative medical treatment for chronic inflammatory disease. Based on the Marshall Pathogenesis. (MP) must work with a licensed physician or other healthcare practitioner, such as a nurse practitioner or physician's assistant. Patients who have the most successful outcomes are proactive and prepared. They internalize the requirements for the MP and, when necessary, work to address any of their physicians' concerns about the treatment. At this point, no doctors are certified in the use of the MP.
Main article: Length of the Marshall Protocol
Related article: Spontaneous remission is a myth
The exact duration of the Marshall Protocol (MP) depends on any number of factors, including degree of illness, amount of fibrosis, subclinical inflammation, the health of the kidneys, and personal preference to remain on Olmesartan.
While someone who is very ill might expect the MP to take five or more years, there is no way to know for sure how long the treatment will take. Due to the nature of immunopathology, feelings of well-being and blood markers of disease tend to be variable in the short-term and improve over the long-term. Also owing to the nature of infection, different symptoms will improve at different rates.
So long as one is responding to olmesartan or olmesartan plus antibiotics with symptoms that wax and wane, there are still bacteria to be killed.
Note that there is no requirement that patients reach the maximum dosages for all antibiotics or do all antibiotic combinations in order to complete the Protocol. In many cases, patients can make considerable progress on olmesartan (Benicar) alone as the drug increases expression of the body's own antimicrobial peptidesBody’s naturally produced broad-spectrum antibacterials which target pathogens.. However, it is considered ideal for patients to stay on the Protocol until they no longer experience immunopathology from any antibiotic combination.
Main article: Cost of the Marshall Protocol
Related article: Insurance coverage
One of the prerequisites for starting on the Marshall Protocol (MP), a treatment that generally lasts for many years, is the money and/or insurance necessary to pay for certain basic expenses. These expenses include clinic visits, laboratory tests, medications, and special protective sunglasses. Some of these costs are fully or partially covered by insurance. Patients can check their coverage before agreeing to a visit, test or medication so that they are aware of the potential cost. In the United States, insurance coverage varies widely. Patients usually obtain full insurance coverage for the Protocol. The support given on the MP study site is free.
Main article: Statistics on the Marshall Protocol
The primary function of the Marshall Protocol (MP) study site is to learn how the MP affects and improves the health of patients with a variety of inflammatory conditions. As of February 2009, there are about 1,000 patients who post in their progress reports on the MP study site. Autoimmunity Research Foundation is currently in the process of partnering with a hospital which has the resources necessary to manage a large-scale cohort study of the MP.
Main article: Patient interviews
Several dozen patients, representing a range of inflammatory diagnoses, have shared their stories of recovery on Bacteriality.com.
The explanation for why the Marshall Protocol works can get sophisticated. To help patients understand all of the terminology being used, a glossary of scientific terms is available, as well as a list of medical abbreviations used on the Marshall Protocol Study Site.
Main article: Assessing the published literature
Related article: Grappling with uncertainty about the Marshall Protocol
Though well-grounded in molecular and clinical data, the conclusions offered by Marshall Protocol researchers are sometimes met with skepticism by clinicians and fellow researchers. Some wonder how the MP science could be valid, given the existence of any of the seemingly contradicting evidence.
Researchers who work with Autoimmunity Research FoundationNon-profit foundation dedicated to exploring a pathogenesis and therapy for chronic disease. (ARF) take no special pride in arguing that the nature of chronic disease is different than most clinicians and researchers have imagined. In fact, it makes matters more difficult: the less familiar a conclusion is, the harder it is to persuade someone of its validity.
Using statistical inferences, John P. A. Ioannidis concluded in the prestigious journal PLoS Medicine that half of published research must be wrong.1) In grappling with a confusing study or even a field of study, it's seriously worth considering how Ioannidis could be right.
Main article: Grappling with uncertainty about the Marshall Protocol
Related article: Concerns about progress on the Marshall Protocol
The Marshall PathogenesisA description for how chronic inflammatory diseases originate and develop. is an explanation for how all chronic inflammatory diseases share a single pathology. The Marshall ProtocolA curative medical treatment for chronic inflammatory disease. Based on the Marshall Pathogenesis. (MP) is a therapy designed to address that pathology.
One of the barriers in the way of widespread acceptance of the theory is that it contradicts so many commonly held assumptions about medicine:
The MP study site does not have the resources to support amateur scientists who offer up theories that build upon the work of the Autoimmunity Research FoundationNon-profit foundation dedicated to exploring a pathogenesis and therapy for chronic disease. (ARF), nor it does have the resources to explain how a study reconciles with the latest ARF research.
To do the MP, patients must ultimately make the decision for themselves and must make the decision realizing that, at least for now, one or more experts will disagree with that choice.