Trevor Marshall

Trevor G. Marshall, PhD (b. 1948, Adelaide, South Australia), is a biomedical researcher. Over the last few years, he has developed a medical treatment, called the 'Marshall Protocol', which uses low-dose antibiotics, an angiotensin II receptor antagonist (being used as a VDR agonist^[1], and avoidance of Vitamin D, to treat a class of chronic diseases, which he argues are caused by L-form or cell wall deficient bacteria. His protocol is being used by physicians worldwide to treat a variety of chronic diseases. Waterhouse reported these include include Sarcoidosis, Fibromyalgia, and rheumatoid arthritis.^[2]

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Background and early work in medicine

Trevor Marshall received his PhD in Electrical Engineering from the University of Western Australia in 1984 ^[3]. He also possesses an undergraduate and a masters (1978) degree in Electrical Engineering.^[4]

After a year as a tutor in Papua New Guinea, Marshall joined the staff of the Western Australian Institute of Technology (now Curtin University) in 1975. After gaining his Masters by thesis in 1978, Marshall moved to the University of Western Australia, where he commenced his PhD thesis research. During that time, he studied patients suffering from diabetes and infertility at the Charles Gairdner Hospital.

His research involved the description of a novel way of using pulsatile LHRH for treating cryptorchidism, along with both male and female infertility.^[5][6]

In 1982, Marshall moved to California. He continued his PhD thesis research while a Visiting Scientist in the Department of Surgery at the Hospital for Sick Children in Toronto, which at the time was a leader in pediatric diabetes research. This partnership led to his thesis Modelling and simulation in diabetes care and a paper on insulin infuser technologies.^[7]

Interest in sarcoidosis

Marshall developed sarcoidosis in the seventies and pursued a degree in biomedicine in order to further understand the processes of the disease. Sarcoidosis is a systemic granulomatous disease, which restricts lung functionality, negatively impacts lymph nodes and other organs, and usually becomes end-stage within one or two decades of diagnosis.^[8][9] At this point, sarcoidosis was considered to be a member of a class of diseases with an unclear origin and no curative treatment option.^[10]

Some consider sarcoidosis to be an autoimmune disease. Frequently it is treated with immunosuppressive drugs, including the corticosteroid prednisone.^[11] However, a 2001 study funded by the NIH shows that these steroids will not cure the illness and are only capable of bringing about periods of relative remission.^[8]

Vitamin D and sarcoidosis

As early as 1974, while teaching in Papua New Guinea, Marshall began to sense that there was a connection between his exposure to light and flare-ups of his sarcoidosis symptoms. In the decades that followed, he concluded that the vitamin D synthesis caused by incident radiation was playing a crucial role in driving his illness.

In 1999, Marshall developed an interest in a class of drugs known as Angiotensin Receptor Blockers (ARBs), specifically the class of Angiotensin II receptor antagonists, after learning that patients with sarcoidosis who are administered these drugs often develop a neurological reaction. He started a sabbatical in early 2001 in order to further investigate this reaction.

Marshall concluded that ARBs produce unexpected symptoms in sarcoidosis patients by directly affecting the immune system. Later, in 2006, Marshall would use mathematical modeling and molecular genomics to show exactly how ARBs are able to modulate the nuclear receptors of the immune system. Particularly important are his models, which show that the vitamin D receptor (VDR) must be activated in order for the body to mount a correct innate immunity response.^[12]

Marshall did further studies in molecular modeling in order to understand the precise effect of vitamin D metabolites on the VDR. He discovered that 25-hydroxy vitamin D, which has the actions of a steroid, binds and inactivates the receptor, shutting down the body’s first line of defense against intra-cellular infection.

Bacteria in sarcoidosis

In 2001, Marshall read a paper by Nilsson, which reported finding genetic material from Rickettsia helvetica in the granuloma of two deceased sarcoidosis patients. This, along with other papers by Mattman and Wirostko, led him to conclude that intra-phagocytic, L-form bacteria could drive the biochemical processes observed in sarcoidosis.^[13]

In 2002, Marshall published a pathogenesis for sarcoidosis followed in 2004 by the definitive paper in Autoimmunity Reviews “Sarcoidosis Succumbs to Antibiotics.” ^[14]

Treatment takes shape

Marshall’s 2004 paper concludes that people who are sick with "autoimmune" diseases possess a correctable defect in innate immunity brought about by a dysregulation of vitamin D. According to Marshall, dysregulation of vitamin D allows slow-growing, mutated bacteria, known as L-form bacteria, to proliferate.

Marshall also concluded that a range of other chronic inflammatory diseases --which he has termed “Th1 illnesses”-- result from the same bacterial pathogenesis as sarcoidosis. Thus, in every Th1 disease, L-form bacteria directly drive the phagocytic biochemistry, causing the release of Th1 cytokines.

Marshall found that patients with Th1 illness are capable of restoring innate immunity by using the ARB Benicar to activate the VDR, while at the same time avoiding exogenous sources of vitamin D-- the kinds of vitamin D present in various foods and catalyzed by exposure to bright lights and sunlight. Along with the help of pulsed, low-dose antibiotics, the body’s own immune system is then able to destroy L-form bacteria-- causing a temporary change in a patient's immunopathology.^[15] Marshall argues that the release of cytokines and endotoxins generated by this reaction cause an increase in past or present Th1 symptoms. These concepts became the fundamental aspects of Marshall's treatment plan for Th1 illness, which his colleagues named the 'Marshall Protocol'.

Study-related web sites

In 2002, Trevor Marshall started the web site, sarcinfo.com to study the use of the Marshall Protocol as a curative treatment for sarcoidosis. As evidenced by members' reported progress, nearly all experience a powerful immunopathological reaction^[15] after taking a dose of antibiotics.

In 2004, Marshall started a larger study site, broader in scope, which addresses the demand to use the Marshall Protocol on a wider range of Th1 illnesses. Marshallprotocol.com represents one of the largest internet-based medical study-sites. Over 200 health professionals are members of the site, and discussions are moderated by a group of volunteer nurses. Members of the site, who have dozens of different medical conditions including Chronic Fatigue Syndrome, rheumatoid arthritis, juvenile diabetes, Lou Gehrig’s disease, and lupus are all experiencing strong, steady changes in immunopathology. As of July 2007, the site has over 4,500 members and 107,000 posts.

Foundation and present work

In 2004, Trevor Marshall founded the Autoimmunity Research Foundation, a California-based non-profit agency. The directors and members of the Foundation have worked to:
1. promote the Marshall Pathogenesis to doctors and patients
2. communicate with researchers in the field of autoimmunity and Th1 disease
3. run the MP's study web sites, marshallprotocol.com and sarcinfo.com
4. gain FDA approval for medications used in conjunction with the MP^[16]

Marshall is currently active on the medical-conference circuit. In March, 2006, he was invited by the Food and Drug Administration (FDA) Center for Drug Evaluation and Review to give a presentation in their "Visiting Professor" lecture series.^[17] In 2006, he co-authored a chapter about Vitamin D dysregulation.^[18]

Marshall has hosted two conferences on “Recovering from Chronic Disease,” the first in Chicago in 2005,^[19] and most recently in Los Angeles in 2006.^[20] In 2007, Marshall was appointed Adjunct Professor in the School of Biological Sciences and Biotechnology at Murdoch University.

Criticism of the Marshall Protocol

Observations that the Marshall Protocol successfully treats certain autoimmune diseases^[2] have yet to be fully validated by the medical community. Rosen and Bagwell, in their 2007 review of treatments for sarcoidosis^[21], argue that the Marshalls' 2003 paper, "Antibiotics in sarcoidosis—reflections of the first year" has "serious deficiencies" claiming that the data are not peer-reviewed and that results are not quantified.

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