iThei mdcdaelcinfd o c elllllrllll ThthTht sblkidekiThcTheb“The best and most efficient pharmacy is
within your own system.”
—Robert C. Peale12: Alkaline Phosphatase
In the previous chapter, we learned the commensal bacteria in our bodies
create toxins and may be implicated in autoimmunity. Alkaline phospha-
tase deficiency is another piece of the puzzle that results in autoimmunity.
What Is Endotoxin?
Also known as lipopolysaccharide (LPS), endotoxin is a component of
the cell walls of gram-negative bacteria. Gram-negative bacteria are pres-
ent in varied amounts in the intestines of animals and humans, with
variability between 7 and 50 percent of the total bacterial species.^5 These
bacteria can either be pathogenic and cause serious illnesses, or they may
live in balance with our normal flora and be considered “opportunistic.”
Opportunistic bacteria behave well when surrounded by gram-positive
beneficial bacteria, but they may misbehave when not enough gram-pos-
itive bacteria exist to keep them in line.
Endotoxin from gram-negative bacteria can promote inflammation
through the stimulation of Th1 pro-inflammatory cytokines (TNFa) in
the intestine as well as in the rest of the body, especially in those with in-
testinal permeability. LPS in the circulation can cause inflammation and
even septic shock if present in large amounts.
Pro-inflammatory cytokines are seen with many autoimmune condi-
tions, including Hashimoto’s, type 1 diabetes, inflammatory bowel dis-
ease, and celiac disease. Endotoxin is thus being considered a promoter
of autoimmune conditions.
Alkaline Phosphatase
Alkaline phosphatase (AP) is an enzyme found in our bodies that works
to take away phosphate groups from a variety of molecules. One of the
roles of AP is to detoxify LPS from gram-negative bacteria. AP removes
phosphorous from the cell wall of the bacteria and thus detoxifies the
endotoxin. AP enzymes are anti-inflammatory and have evolved to help
us tolerate our resident microbes by making us less reactive to them.