Is it possible that the massive rise in diagnoses of gluten insensitivity and Celiac disease is in some way linked to the medications people are taking? A new study published online in the journal Mayo Clinic Proceedings seems to suggest so, having found that the popular blood pressure drug Benicar (olmesartan) often causes patients to develop symptoms of Celiac disease that later subside when the medication is ceased.
Dr. Joseph A. Murray, M.D., and his colleagues at the Mayo Clinic in Rochester, Minn., first made the observation after noting that 22 of the patients admitted to the center over a three-year period had symptoms of Celiac disease, but did not test positive for the condition in blood tests. Upon further investigation, the team determined that olmesartan was the likely culprit.
When the patients with Celiac symptoms stopped taking olmesartan, their symptoms largely disappeared, which suggests that the drug and potentially others in its class may be responsible for triggering allergic and gastrointestinal reactions. In fact, a followup investigation revealed that patients who took olmesartan sustained very serious intestinal damage as a result of the drug, and that this damage began to heal when they stopped taking it.
“There is no question that the report from the Mayo Clinic documenting that olmesartan has severe gastrointestinal adverse effects is of concern,” said Dr. Franz Messerli, M.D., director of the hypertension program at St. Luke’s – Roosevelt Hospital in New York City. “Olmesartan sales have exceeded $500 million a year in the U.S. alone and the drug, as with all ARBs (angiotensin receptor blockers), stands out because of its paucity of side effects.”
Dr. Murray, author of the study, had actually reported these and other serious side effects associated with ARBs to the U.S. Food and Drug Administration (FDA) back in 2009. But the agency ignored the evidence and unilaterally decreed that the evidence was not definitive enough to verify a “statistically significant’ association between Celiac diseasesymptoms and ARBs.
But the evidence speaks for itself, as experts suspect that ARBs inhibit transforming growth factor-beta (TGF-beta), an intestinal cytokine responsible for intestinal equilibrium, also known as homeostasis. By blocking TGF-beta, ARBs prevent the human gut from properly adapting to changing levels and ratios of various bacteria, both good and bad, which upsets digestion and leads to intestinal damage.
“The gut has to learn to tolerate a lot of different bacteria and TGF-beta is an important chemical messenger for that tolerance,” said Dr. Murray to MedPage Today, noting that when patients stopped taking olmesartan, their TGF-beta levels appeared to normalize.
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