Poster - Multiple reports of symptom exacerbation on immunostimulatory treatment for autoimmune disease

Type: Poster presentation
Presented by: Paul Albert
Conference: Human Microbiome Research Conference
Location: Washington University, St. Louis
Date: August 31 - September 1, 2010
Additional Content: PDF of poster

Over the past seven years, we have been observing patients with autoimmune diagnoses use the VDR-agonist olmesartan to stimulate components of the innate immune response. Nearly all of the hundreds of patient reported outcomes describe an initial increase in symptoms specific to their autoimmune diagnoses. Additionally, patients consistently report fluctuations in objective markers of inflammation such as CRP, ACE, BUN, creatinine, and markers of liver function. After months of dealing with these fluctuations in disease state, symptomatic improvements begin to be reported, in some cases with objective markers indicating disease stabilization or remission. These symptomatic flares cannot easily be attributed to adverse events from olmesartan, as the drug is well known and unremarkable. Additionally, when healthy individuals have been administered the same medications, they suffer no similar symptoms. The most viable hypothesis for these symptomatic flares is that, by activating the innate immune system, olmesartan allows the body to mount an efective attack against pathogenic components of the microbiota. For a century, researchers have noted that death of acute and persistent pathogens is accompanied by a surge in inflammation, endotoxin, and cytokine release. Known as Jarisch-Herxheimer, or immunopathology, this phenomenon has been demonstrated in numerous diseases. Olmesartan seems to be generating immunopathology. These preliminary results also indicate immunopathology may be a necessary part of reducing the metagenomic load in patients with autoimmune diagnoses.