12e. Immune Health - Chronic Inflammation Flashcards
What is the role of inflammation?
Localise
Eliminate
Heal affected area
What does inflammation involve?
Vasodilation
Increased tissue permeability
Blood clotting
Fluid accumulation
Recruitment of immune cells
What are the cardinal signs of inflammation?
Redness
Heat
Oedema
Pain
Loss of function
Why do we see the signs of inflammation?
As a signal to protect the affected area
Rest
Repair
What qualities should inflammation have?
Targeted
Time-limited
Proportionate
If inflammation isn’t targeted, time-limited or proportionate, what can happen?
Could target self tissue - AI
Could target non-harmful antigens - allergy
Not time-limited - chronic inflammation
Signs and symptoms of inflammation
Pain
Swelling
Aches
Joint stiffness
Redness
Heat
Examples of conditions with an inflammatory element
Depression
AZD
MS
What GP tests can be done to test for inflammation?
CRP
ESR
WBC
Fibrinogen
Low vit D
Ultrasound
MRI
What functional tests can be done to test for inflammation?
hsCRP
O6:O3 ratio
SNPs - FADS1/2, IL-6, TNF-a, HLA, VDR
Examples of inflammatory mediators
Cytokines
Histamine
Kinins
NF-kB
Examples of cytokines that upregulate inflammation
TNF-a
Il-1
IL-6
What role has histamine in inflammation?
Promotes vasodilation
Promotes vascular permeability
What role has kinins in inflammation?
Increases vasodilation
Increases permeability
Sends pain signals
What role has NF-kB in inflammation?
Activates gene transcription
What is NF-kB activated by?
Cytokines
LPS
Homocysteine
Heavy metals
Which conditions has NF-kB dysregulation been linked to?
Cancer
AI
Inflammatory disorders - RA, IBD
What are eicosanoids?
Locally acting hormone-like messengers
What are eicosanoids made from?
Oxidation of O3 and 6 fats in cell membranes
Examples of eicosanoids
Prostaglandins
Thromboxanes
Leukotrienes
Lipoxins
What does prostaglandin E2 do?
Increases vasodilation
Increases platelet aggregation
Increases histamine
Increases kinins
What is prostaglandin E2 made from?
Arachidonic acid
What is inflammation resolution?
Co-ordinated response to prevent secondary tissue damage
What does the inflammation resolution involve?
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
What can impede inflammation resolution?
High inflammatory load to start off with
Inadequate inflammatory response
Inadequate resolution response
Ongoing damage
Inadequate recovery/repair
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
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
Why does chronic stress increase risk of chronic inflammation?
Increases glucocorticoid receptor resistance
Cortisol resistance can increase inflammation
Why can poor sleep quality increase chronic inflammation?
Increases CRP, IL-6, TNF
(especially in women)
Why does metabolic endotoxaemia increase the risk of chronic inflammation?
Raises LPS in the blood
Interacts with toll-like receptors
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
How is chronic inflammation managed allopathically?
NSAIDs
Corticosteroids
DMARDS
What action do NSAIDs have on inflammation?
Inhibit COX1 and 2
Reduce prostaglandin synthesis
What are the side effects of taking NSAIDs?
GI bleeding
Peptic ulceration
CVD
What action do corticosteroids have on inflammation?
Inhibit NF-kB
Inhibit LOX/COX
What are the side effects of taking corticosteroids?
Weight gain
Diabetes
Hypertension
Osteoporosis
What are the side effects of taking DMARDS?
Increased risk of infection
Throat ulcers
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
Which nutrients are useful for supporting chronic inflammation?
Turmeric
Curcumin
Ginger
Boswellia
EFAs
Vit D
Quercetin
Reishi
Probiotics
How does turmeric support chronic inflammation?
Anti-inflammatory
Blocks NF-kB activation
Dosage of turmeric to support chronic inflammation
500-2000mg/day
How does curcumin support chronic inflammation?
AO
Anti-inflammatory
Reduces joint inflammation
Dosage of curcumin to support chronic inflammation
Up to 1000mg/day
How does ginger support chronic inflammation?
Anti-inflammatory
Reduces joint pain
Dosage of ginger to support chronic inflammation
500-1000mg/day
How does boswellia support chronic inflammation?
Inhibits LOX
Reduces pain
Improves knee joint function
Dosage of boswellia to support chronic inflammation
250-500mg/day
How does vit D support chronic inflammation
Improves T-reg function
Anti-inflammatory
Dosage of vit D to support chronic inflammation
2000-10,000iu/day
How does quercetin support chronic inflammation?
Inhibits LOX/COX
Dosage of quercetin to support chronic inflammation
250-1500mg/day
How does reishi support chronic inflammation?
Triterpenes are anti-inflammatory
Dosage of reishi to support chronic inflammation
3-9g/day
