Arch Dermatol. 2004 Jun;140(6):723-7.
Activation of autoimmunity following use of
immunostimulatory herbal supplements.
Lee AN, Werth VP.
Section of Dermatology, University of Chicago

BACKGROUND: Evidence for the scientific basis
of purported therapeutic effects and adverse
effects of herbal supplements continues to grow.
Many herbal supplements are touted for their
immunostimulatory properties, and both in vitro
and in vivo experiments have supported this
claim. Although this explains their beneficial
effects in preventing or curtailing disease, to
our knowledge, no immunostimulatory herbal
supplements have been reported to exacerbate
disorders of immune system overactivity.

OBSERVATIONS: We describe 3 patients whose
autoimmune disease onset and/or flares correlated
with ingestion of herbal supplements with
proven immunostimulatory effects. Echinacea and
the alga Spirulina platensis are implicated in 2
patients' flares of pemphigus vulgaris, and a
supplement containing the algae Spirulina platensis
and Aphanizomenon flos-aquae was ingested by a
third patient days before both onset and a
severe flare of dermatomyositis. The third
patient showed heterozygosity for a tumor necrosis
factor alpha (TNF-alpha) promoter polymorphism
(-308A), leading to increased production of
TNF-alpha, which may have predisposed her to
developing dermatomyositis.

CONCLUSIONS: Immunostimulatory herbal supplements
may exacerbate preexisting autoimmune disease or
precipitate autoimmune disease in persons
genetically predisposed to such disorders.
Increased production of TNF-alpha may play a role,
although more research is needed to clarify the
mechanisms of such phenomena.