Natural Products Insider

SEP-OCT 2017

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124 INSIDER September/October 2017 SupplySide West Infl ammation is a normal part of the body's response to harmful stimuli such as tissue damage, infection or exposure to toxins. Infl ammation is mediated by the immune system, and serves three immediate needs for self-preservation: to contain and repair damaged or infected tissues; to attract immune cells to local sites through infl ammatory mediators, such as cytokines; and to orchestrate a healing response. Without infl ammation, humans could not survive. But the cardinal signs of infl ammation—redness, heat, pain and swelling—especially if chronic, are often indicative of underlying disease. The Gut as Source of Infl ammation Infl ammation originating in the gut may play an underlying role in many systemic infl ammatory conditions, and dysbiosis of the gut microbiota is emerging as an important mediator of immune and infl ammatory status throughout the body. Gut microbiota are well known to help maintain tight junctions between gut epithelial cells. It should therefore come as no surprise that dysbiosis and associated increases in intestinal permeability are recognized features of rheumatoid arthritis, Alzheimer's disease, asthma, autism spectrum disorders and other systemic ills—both infl ammatory and otherwise. Intestinal barrier integrity is a prerequisite for homeostasis of mucosal function. Disruption of epithelial barrier integrity is likely one of the major etiological factors associated with several gastrointestinal (GI) diseases, including infection by pathogens, obesity and diabetes, necrotizing enterocolitis, irritable bowel syndrome (IBS) and infl ammatory bowel disease. 1 Modulating Systemic Infl ammation Via the Gut Many of the effective therapies for managing infl ammation naturally (e.g., curcumin, omega-3 fatty acids and probiotics) are seen through the lens of their activity on the gut. Consider two examples: Curcumin: Poor bioavailability of curcumin has spurred companies to enhance bioavailability through a variety of means. But turmeric has been fi ghting infl ammation longer than there have been phytosomes and nanoparticles. Could curcumin be modulating systemic infl ammation from within the gut, prior to absorption? Some researchers hypothesized that curcumin attenuates Western diet-induced chronic infl ammation and associated metabolic diseases by modulating the function of intestinal epithelial cells and the intestinal barrier function. By reducing intestinal barrier dysfunction, up-regulating the expression of occludin in the intestinal mucosa, and reducing the levels of tumor necrosis factor-alpha (TNFα) and lipopolysaccharides, curcumin could effectively modulate chronic infl ammatory diseases despite poor bioavailability. 2,3,4 Omega-3 Fatty Acids: Fish oil and its constituent fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are well-known modulators of infl ammation. Much has been written on the anti-infl ammatory and pro-resolution mechanisms of action of these fatty acids, and fi sh oil has been clinically effective in managing infl ammatory diseases, including intestinal conditions such as ulcerative colitis (UC). But do long-chain polyunsaturated fatty acids (PUFAs) exert their systemic effects by interacting with the intestinal epithelium directly? Zonulin is a protein that modulates the permeability of tight junctions between intestinal epithelial cells. Activation of zonulin leads to increased intestinal permeability to macromolecules. One group of researchers recently investigated whether the gut microbiota and diet differ according to serum zonulin concentration in overweight pregnant women. 5 They found that dietary quantitative intakes of omega-3 PUFAs, as well as fi ber and a range of vitamins and minerals, were higher in women in the low zonulin group than those in the high zonulin group. The richness and composition of the gut microbiota was also inversely associated with zonulin. These observations led researchers to conclude that modifi cation of the gut microbiota (e.g., with probiotics) and improvement of the diet (e.g., by increasing omega-3s) may benefi cially affect intestinal permeability by down- regulating zonulin, leading to improved metabolic health overall. While diverse clinical trials in humans continue to demonstrate effi cacy of natural medicines in infl ammation and in the health of the gut, further research is warranted to validate the connections between gut mucosal and microbial health and the modulation of systemic infl ammation. Jeremy Appleton, ND, is a licensed naturopathic physician, educator, and supplement industry executive. He is the author of numerous articles on natural medicine. Dr. Appleton currently works as v ice president of scientifi c and regulatory affairs for SFI-USA (sfi, which manufactures supplements for health care professionals under the Klaire Labs brand. Modulating Systemic Inflammation Via the Gut by Jeremy Appleton Learn more about how infl ammation works in the body from Jeremy Appleton during the "Addressing Infl ammation Naturally … and Legally" Workshop, underwritten by National Enzyme Co., on Friday, Sept. 29 at 8:30 a.m. at SupplySide West in Las Vegas. Scan Here Addressing Infl ammation at SupplySide West For a list of references, email

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