12e. Immune Health - Chronic Inflammation Flashcards

1
Q

What is the role of inflammation?

A

Localise
Eliminate
Heal affected area

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2
Q

What does inflammation involve?

A

Vasodilation
Increased tissue permeability
Blood clotting
Fluid accumulation
Recruitment of immune cells

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3
Q

What are the cardinal signs of inflammation?

A

Redness
Heat
Oedema
Pain
Loss of function

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4
Q

Why do we see the signs of inflammation?

A

As a signal to protect the affected area
Rest
Repair

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5
Q

What qualities should inflammation have?

A

Targeted
Time-limited
Proportionate

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6
Q

If inflammation isn’t targeted, time-limited or proportionate, what can happen?

A

Could target self tissue - AI
Could target non-harmful antigens - allergy
Not time-limited - chronic inflammation

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7
Q

Signs and symptoms of inflammation

A

Pain
Swelling
Aches
Joint stiffness
Redness
Heat

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8
Q

Examples of conditions with an inflammatory element

A

Depression
AZD
MS

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9
Q

What GP tests can be done to test for inflammation?

A

CRP
ESR
WBC
Fibrinogen
Low vit D
Ultrasound
MRI

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10
Q

What functional tests can be done to test for inflammation?

A

hsCRP
O6:O3 ratio
SNPs - FADS1/2, IL-6, TNF-a, HLA, VDR

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11
Q

Examples of inflammatory mediators

A

Cytokines
Histamine
Kinins
NF-kB

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12
Q

Examples of cytokines that upregulate inflammation

A

TNF-a
Il-1
IL-6

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13
Q

What role has histamine in inflammation?

A

Promotes vasodilation
Promotes vascular permeability

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14
Q

What role has kinins in inflammation?

A

Increases vasodilation
Increases permeability
Sends pain signals

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15
Q

What role has NF-kB in inflammation?

A

Activates gene transcription

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16
Q

What is NF-kB activated by?

A

Cytokines
LPS
Homocysteine
Heavy metals

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17
Q

Which conditions has NF-kB dysregulation been linked to?

A

Cancer
AI
Inflammatory disorders - RA, IBD

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18
Q

What are eicosanoids?

A

Locally acting hormone-like messengers

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19
Q

What are eicosanoids made from?

A

Oxidation of O3 and 6 fats in cell membranes

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20
Q

Examples of eicosanoids

A

Prostaglandins
Thromboxanes
Leukotrienes
Lipoxins

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21
Q

What does prostaglandin E2 do?

A

Increases vasodilation
Increases platelet aggregation
Increases histamine
Increases kinins

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22
Q

What is prostaglandin E2 made from?

A

Arachidonic acid

23
Q

What is inflammation resolution?

A

Co-ordinated response to prevent secondary tissue damage

24
Q

What does the inflammation resolution involve?

A

Production of receptor antagonist to pro-inflammatory mediators
T-reg cells produce IL-10 and TGF-b (inhibits Th1/2 activity)
Production of less inflammatory PGE-1, PGE-2, resolvins, protectins
Increase of lipoxins that downregulates NF-kB

25
What can impede inflammation resolution?
High inflammatory load to start off with Inadequate inflammatory response Inadequate resolution response Ongoing damage Inadequate recovery/repair
26
Causes/risk factors for chronic inflammation
Western diet SNPs - FADS1/2, TNF Obesity Chronic stress Poor sleep quality Excess exercise with inadequate recovery Oxidative stress High toxic load Metabolic endotoxaemia Sex hormone imbalance Persistent/latent infection
27
Why does a Western diet increase risk of chronic inflammation?
High refined sugar - increases free radicals High O6:O3 ratio - increases PG2 Trans fats PAMPs of dead bacteria in poor quality processed foods
28
Why does chronic stress increase risk of chronic inflammation?
Increases glucocorticoid receptor resistance Cortisol resistance can increase inflammation
29
Why can poor sleep quality increase chronic inflammation?
Increases CRP, IL-6, TNF (especially in women)
30
Why does metabolic endotoxaemia increase the risk of chronic inflammation?
Raises LPS in the blood Interacts with toll-like receptors
31
Why can a sex hormone imbalance increase the risk of chronic inflammation?
Oestrogen is anti-inflammatory In excess can be inflammatory Low testosterone promotes inflammation in men
32
How is chronic inflammation managed allopathically?
NSAIDs Corticosteroids DMARDS
33
What action do NSAIDs have on inflammation?
Inhibit COX1 and 2 Reduce prostaglandin synthesis
34
What are the side effects of taking NSAIDs?
GI bleeding Peptic ulceration CVD
35
What action do corticosteroids have on inflammation?
Inhibit NF-kB Inhibit LOX/COX
36
What are the side effects of taking corticosteroids?
Weight gain Diabetes Hypertension Osteoporosis
37
What are the side effects of taking DMARDS?
Increased risk of infection Throat ulcers
38
What is the natural approach to chronic inflammation?
Address causes/risk factors Blood glucose balancing Gut health - high fibre, low allergen, dysbiosis Reduce oxidative stress - high AO diet/supps Reduce stress Optimise immune function Support methylation
39
Which nutrients are useful for supporting chronic inflammation?
Turmeric Curcumin Ginger Boswellia EFAs Vit D Quercetin Reishi Probiotics
40
How does turmeric support chronic inflammation?
Anti-inflammatory Blocks NF-kB activation
41
Dosage of turmeric to support chronic inflammation
500-2000mg/day
42
How does curcumin support chronic inflammation?
AO Anti-inflammatory Reduces joint inflammation
43
Dosage of curcumin to support chronic inflammation
Up to 1000mg/day
44
How does ginger support chronic inflammation?
Anti-inflammatory Reduces joint pain
45
Dosage of ginger to support chronic inflammation
500-1000mg/day
46
How does boswellia support chronic inflammation?
Inhibits LOX Reduces pain Improves knee joint function
47
Dosage of boswellia to support chronic inflammation
250-500mg/day
48
How does vit D support chronic inflammation
Improves T-reg function Anti-inflammatory
49
Dosage of vit D to support chronic inflammation
2000-10,000iu/day
50
How does quercetin support chronic inflammation?
Inhibits LOX/COX
51
Dosage of quercetin to support chronic inflammation
250-1500mg/day
52
How does reishi support chronic inflammation?
Triterpenes are anti-inflammatory
53
Dosage of reishi to support chronic inflammation
3-9g/day