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Clinical Evidence ofImmune System DysregulationCaused byIntracellular InfectionMeg Mangin, RNImmunology SummitSeptember 30, 2014
Rickettsia-like Organisms in aPulmonary Giant Cell Granuloma0.5–1-µm 1000Violet May-Grünwald-Giemsa-stained round cellsNilsson K et al. J Infect Dis. 2002;185:1128-1138
Undulatingvariably stainingtubules0.7 umovoid bodyInfected VitreousLymphocyteWirostko et al.Uranyl acetate-leadcitrate stain (x34,722)
Lida Holmes Mattman, Ph.D.(1912-2008)
HerxheimerReaction
1,25(OH)2DCalcitriolAMPs
Intracellular bacteriaCytokinesLipopolysaccharide tra-renalTissues:monocytesmacrophagesbone rostatesynovialuterineplacenta 1,25(OH)2D 25(OH)D
TG Marshall slide
OlmesartanAgonizes VDR CYP24A1 CYP3a4 CYP27B1 ElevatedCalcitriol ElevatedCalcitriolAntimicrobial peptidesare transcribed
Recovery from SarcoidosisOct 2009
85% of subjects had elevated calcitriol without hypercalcemia.Blaney et al.
Timeline of Symptom Improvement in a Varied CohortCapt. Tom Perez MPH
20191819 Symptoms Reduced to 7 over 3 9Nov-086
Antinuclear Antibodies in a 58yo Femalewith Rheumatoid ArthritisProal et al. Immunostimulation in the era of the metagenome
BASDAI, ESR, and CRP in a 50yo Malewith Ankylosing SpondylitisProal et al. Immunostimulation in the era of the metagenome
Olmesartanimproved100% oflaboratorymarkers
Olmesartan
Research Needed In vitro study of olmesartan VDR agonist hypothesis. Calcitriol range of a healthy population. Calcitriol levels in autoimmune patients. Effect of higher dose olmesartan on elevated calcitriollevel. Long-term clinical trial of high-dose olmesartan & lowdose antibiotics.
“It is becoming increasingly clear thatmicrobes slow down immune reactivity bydysregulating the VDR, ultimately to increasetheir chance of survival.”“Immune modulatory therapiesthat enhance VDR expressionand activity should, therefore,be considered in the clinicalsetting.”Dr. Marina Rode von EssenSenior ResearchCopenhagen University Hospital
8 9 9 0 0 1 1 19 Symptoms Reduced to 7 over 3 Years . Antinuclear Antibodies in a 58yo Female with Rheumatoid Arthritis Proal et al. Immunostimulation in the era of the metagenome . BASDAI, ESR, and CRP in a 50yo Male with Ankylosing Spondylitis Proal et al. Immunostimulation in the era of the metagenome . Olmesartan
