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 **Date:**  May 2010\\ **Date:**  May 2010\\
  
 +===== Abstract =====
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 +Recent research highlights the importance of VDR integrity and responsiveness on innate immune function. VDR knock out mice show both an increased frequency and severity of autoimmune disease and reduced ability to cope with bacterial infection and persistence. We have found that autoimmune disease in humans is associated with elevated levels of 1,25 OH Vitamin D indicating VDR resistance. Co-morbid conditions such as colitis, sinusitis, vasculitis and recurrent infections, reflecting intracellular or biofilm bacterial persistence, have been found by ourselves and others in autoimmune diseases. In silico modeling and clinical observation show that olmesartan medoxomil, an angiotensin receptor blocker, acts as a VDR agonist. Selected patients with significant and advanced autoimmune disease, including inflammatory arthropathy, autoimmune thyroiditis, ankylosing spondylitis, sarcoidosis,  were treated with olmesartan at dosing levels sufficient to activate the VDR along with bacteriostatic antibiotics at sub-inhibitory dose levels. During treatment, temporary exacerbation of symptoms and worsening of clinical markers were seen reflecting immune response. Physical manifestations included inflammation and swelling of joints, dermatitis, central and peripheral nervous system dysfunction, fever and fatigue. Laboratory changes included reduction in red and white blood cells, platelets; elevation in serum potassium, creatinine; and reduction in eGFR. After sufficient time of treatment, positive therapeutic responses that manifested included reversal of late-stage autoimmune conditions including carotid artery calcification, inflammatory joint disease, neuropathy, and osteoporosis. In addition normalization of clinical markers such as CRP,SED rate, kidney function were observed.  
  
 ===== Transcript ===== ===== Transcript =====
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 Sixth, low dose, pulsed bacteriostatic antibiotics, taken over a prolonged time are safe and are not associated with development of bacterial resistance or overgrowth of other pathogens such as C. difficile or candida albicans. Sixth, low dose, pulsed bacteriostatic antibiotics, taken over a prolonged time are safe and are not associated with development of bacterial resistance or overgrowth of other pathogens such as C. difficile or candida albicans.
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 Finally, persistent infection is a likely cause of some autoimmune and chronic diseases that are associated with immune imbalance. The recognized capacity of bacteria to resist lysosomal degradation, to be able to transform into cell wall deficient forms, to communicate and share information, to create persister cells and the ability to establish biofilms, all enable persistence. Any or all of these actions could then have a profound impact on immune capacity and tolerance. If so, it will explain some of the mysteries still existing in autoimmunity and open new opportunities for therapy. Finally, persistent infection is a likely cause of some autoimmune and chronic diseases that are associated with immune imbalance. The recognized capacity of bacteria to resist lysosomal degradation, to be able to transform into cell wall deficient forms, to communicate and share information, to create persister cells and the ability to establish biofilms, all enable persistence. Any or all of these actions could then have a profound impact on immune capacity and tolerance. If so, it will explain some of the mysteries still existing in autoimmunity and open new opportunities for therapy.
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 +{{tag>presentations videos Greg_Blaney_MD 2010}}
  
 ===== Notes and comments ===== ===== Notes and comments =====
  
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 ===== References ===== ===== References =====
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