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2005 Inflammation

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Information about 2005 Inflammation
Education

Published on March 4, 2008

Author: Haggrid

Source: authorstream.com

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Agenda:  Agenda Inflammation: Definition and significance Is the presence of a “leaky gut” a major contributor to inflammation Dietary strategies to reduce inflammation NSAIDs: Actions and side effects Highlight on natural anti-inflammatories Celadrin, MicroLactin, Proteolytic Enzymes Quick recap For my slides, go to www.doctormurray.com What is Inflammation?:  What is Inflammation? Classic definition, presence of the following five factors: Redness (rubor) Heat (calor) Swelling (tumor) Pain (dolor) Dysfunction For my slides, go to www.doctormurray.com “Silent Inflammation”:  “Silent Inflammation” A complex scenario that is an underlying factor in many chronic degenerative diseases. Mediated by: Oxidants, pro-oxidants, and antioxidants Vascular lining Eicosanoids Prostaglandins, thromboxanes, leukotrienes, etc. Immune system Slide4:  Inflammation Cancer Arthritis Atherosclerosis Alzheimer’s Colitis Psoriasis Infection Diabetes Chronic inflammation plays a role in many disease conditions Eczema For my slides, go to www.doctormurray.com C-Reactive Protein :  C-Reactive Protein C-reactive protein is produced by the liver during an inflammatory response. Those with CRP levels above 3.0 mg/L have a risk of heart attack or stroke three to eight times higher than the risk of those with a reading of less than 0.5 mg/L. High CRP is found in those with the most severe forms of macular degeneration Those persons with high CRP have triple the risk of developing colon cancer Those persons with high CRP have 4 times the risk of developing Type-2 diabetes Less than 0.5 mg/L – ideal 0.5 to 1.0 - safe 1.0 mg/L to 3.0 mg/L – danger >3.0 - Extreme danger Natural Approach to Inflammation FOCUS ON PHYSIOLOGY:  Natural Approach to Inflammation FOCUS ON PHYSIOLOGY Identify underlying factors Lifestyle factors Dietary factors Supplementation strategies For my slides, go to www.doctormurray.com Examples of underlying factors that contribute to “silent inflammation”:  Examples of underlying factors that contribute to “silent inflammation” Increased toxin exposure Food allergies Presence of a “leaky gut” Chronic infections Genetic predisposition Insulin resistance Slide8:  Leaky gut syndrome can result in : “Leaky Gut” Food hypersensitivities Chemical sensitivity Fatigue / lethargy Sleep disturbances Hyperactivity / Irritability Inattentiveness / poor concentration Memory problems Mood swings Muscle or joint pain Cancer Psoriasis Liver disease Causes of increased intestinal permeability (“leaky gut”):  Causes of increased intestinal permeability (“leaky gut”) Food allergies or intolerances direct irritation of the intestinal cells immune system damage leading to overgrowth of harmful microbes Antibiotics kills the layer of friendly bacteria in the mucus layer covering the intestinal cells promotes the growth of antibiotic resistant bacteria, fungi and protozoa Causes of increased intestinal permeability (“leaky gut”) cont.:  Causes of increased intestinal permeability (“leaky gut”) cont. High sugar intake Overeating Altered fats (trans fatty acids, lipid peroxides) Excess alcohol Causes of increased intestinal permeability (“leaky gut”) cont.:  Causes of increased intestinal permeability (“leaky gut”) cont. Nutritional deficiencies. Poor digestion and absorption. Overgrowth of harmful microbes in the small and large intestine. What makes RevitalX so effective in healing the Leaky Gut?:  What makes RevitalX so effective in healing the Leaky Gut? Extremely low allergy potential High quality, hypoallergenic vegetable protein Enriched with glutamine and other “gut-critical” nutrients High in soluble fiber Rich in phytochemicals that reduce inflammation and promote healing Traditional Detoxification Programs:  Traditional Detoxification Programs Loss of lean body mass Auto-intoxication – increased circulation of toxins without proper nutritional support for efficient excretion What is a “healing crisis”? Many people end up more exhausted and increasingly hypersensitive A quick way to experience a leaky gut? Effective Detoxification Requires an Unbroken Chain of Events:  Effective Detoxification Requires an Unbroken Chain of Events Indications for continued use:  Indications for continued use RevitalX Food allergies Inflammatory bowel disease Irritation or ulceration of GI Psoriasis Leaky gut Candidiasis Fibromyalgia, CFS, MCS DetoxiTech Chronic exposure to environmental toxins Heavy metal toxicity Hepatitis Impaired liver function Fibromyalgia, CFS, MCS Key Lifestyle Strategies to Reduce Inflammation :  Key Lifestyle Strategies to Reduce Inflammation Don’t Smoke!!! Develop a positive mental attitude. Negative emotions cripple the immune response. Depression reduces activity of DNA repair mechanisms. Deal with stress effectively. Regular exposure to stress actually reduces cancer risk Get enough sleep each night. Follow a regular exercise program. Do not drink excessive amounts of alcohol. Laugh often!!! Key Dietary Strategies to Reduce Inflammation :  Key Dietary Strategies to Reduce Inflammation Identify and eliminate food allergies. Eat a “rainbow” assortment of fruits and vegetables. Reduce exposure to pesticides, and eat to enhance detoxification reactions and elimination Reduce the intake of meat and other animal foods. Eat the right types of fats . Eat to improve insulin sensitivity, eat a low glycemic load diet. Keep salt intake low, potassium intake high. Dietary Therapy in Rheumatoid Arthritis:  Dietary Therapy in Rheumatoid Arthritis Summary: The treatment group began by fasting for 7-10 days. Dietary intake during the fast consisted of herbal teas, garlic, vegetable broth, decoction of potatoes and parsley and the following juices: carrots, beets, and celery. After the fast the patients followed a vegetarian diet with careful food reintroduction. Long-term follow-up indicated "a substantial reduction in disease activity" in many patients. Improvements correlated with changes in gut flora. Scand J Rheumatol. 30(1):1-10, 2001; Clinical Rheumatology 13:475-82, 1994; Lancet 338:899-902, 1991 Dietary Therapy in Rheumatoid Arthritis:  Dietary Therapy in Rheumatoid Arthritis SUMMARY The dietary treatment group followed an anti-inflammatory diet (AID) providing an arachidonic acid intake of less than 90 mg/day. Patients in both groups were allocated to receive placebo or fish oil capsules (30 mg/kg body weight) for 3 months in a double-blind crossover study. In AID patients, the numbers of tender and swollen joints decreased by 14% during placebo treatment. In AID patients, fish oil led to a significant reduction in the numbers of tender (28% vs 11%) and swollen (34% vs 22%) joints (P<0.01). CONCLUSION: A diet low in arachidonic acid ameliorates clinical signs of inflammation in patients with RA and augments the beneficial effect of fish oil supplementation. Rheumatol Int. 2003 Jan;23(1):27-36. Superfoods to decrease inflammation:  Superfoods to decrease inflammation BEANS Pinto, navy, Great Northern, lima, garbanzo(chickpeas), black beans, lentils, green beans, sugar snap peas, and green peas FLAVONOID-RICH BERRIES Purple grapes, cranberries, boysenberries, raspberries, strawberries, currants, blackberries, cherries, and all other varieties of fresh, frozen, or dried berries CRUCIFEROUS VEGETABLES Brussel sprouts, cabbage, kale, turnips, cauliflower, collards, bok choy, mustard green, Swiss chard LOW GLUTEN WHOLE GRAINS Brown rice, barley, buckwheat, millet, amaranth, quinoa, triticale, kamut, yellow corn, wild rice, spelt, couscous CITRUS FRUITS Lemons, white, and pink grapefruit, kumquats, tangerines, limes HIGH-CAROTENE VEGETABLES Pumpkins, carrots, butternut squash, sweet potatoes, orange bell peppers Superfoods to decrease inflammation:  Superfoods to decrease inflammation SALMON Wild Alaskan salmon SOY Tofu, soymilk, soy nuts, edamame, tempeh, miso   GREEN LEAFY VEGETABLES Kale, collard, Swiss chard, mustard greens, turnip greens, bok choy, romaine lettuce LYCOPENE SOURCES Tomatoes, watermelon, pink grapefruit, Japanese persimmons, red-fleshed papaya, strawberry, guava NUTS AND SEEDS Walnuts, almonds, pistachios, macadamia nuts, pecans, hazelnuts cashews; sesame pumpkin and sunflower seeds HERBS and SPICES Turmeric (curcumin), capsicum, ginger, garlic, onions, dill, rosemary, etc. Avoid:  Avoid Trans-fatty acids (VERY BAD!) Intake of arachidonic acid (meat and dairy) High intake of omega-6 fatty acids Corn oil, cottonseed oil, grapeseed oil, peanut oil, safflower oil, sesame oil, soybean oil, sunflower oil Margarine Fried foods and high saturated fats Any product with long shelf life (crackers, pastries, chips) Trans Fatty Acids are Harmful: Detriments to Human Health:  Trans Fatty Acids are Harmful: Detriments to Human Health Lowers “good” HDL Cholesterol Raises atherogenic lipoprotein (a) Lowers volume and quality of breast milk Correlates to low birth weight in infants Interferes with gestation Negatively affects the immune system Increases level of abnormal sperm Alters cell membrane function and structure Causes alteration in adipose cell size and fatty acid composition Escalates the problem of essential fatty acid deficiency Potentiates free radical formation Causes insulin insensitivity Promote inflammation Functions of EFAs:  Functions of EFAs Membrane Functions and Integrity Regulation of Cell Processes Biosynthesis of Eicosanoids Every cell in the body uses EFAs...:  Every cell in the body uses EFAs... The body is made out of cells Cells are made out of membranes Membranes are made out of fats Good fat builds good membranes cell cell membrane cell membrane fatty acids Cell membrane consequences of fatty acid structure:  Cell membrane consequences of fatty acid structure Saturated and trans fatty acid chains pack tightly and form more rigid membranes. Unsaturated chains bend and pack in a less ordered way, with greater potential for motion, elasticity, and function. Eicosanoids:  Eicosanoids Hormone-like compounds that impact virtually every system in the body Examples: prostaglandins (series 1, 2, and 3) thromboxanes (TXs) leukotrienes (LTs) hydroxy fatty acids Eicosanoids mediate:  Eicosanoids mediate Allergic response Blood clotting and platelet aggregation Blood pressure Gastrointestinal function and secretions Heart function Inflammation, pain, and swelling Kidney function and fluid balance Nerve transmission Steroid production and hormone synthesis The Three Eicosanoid Families:  The Three Eicosanoid Families From EPA-PGE3 Anti-inflammatory Anti-aggregatory Dilate blood vessels From GLA- PGE1 Strong anti-inflammatory Dilate blood vessels Reduce blood clotting From AA-PGE2 Strong pro-inflammatory Constrict blood vessels Increase blood clotting Very beneficial potentially harmful very beneficial Effects of Eicosanoid Imbalance:  Effects of Eicosanoid Imbalance Inflammation Blood vessel constriction Increased allergic response Impaired immune response Abnormal cell function Disease: arthritis, diabetic nerve damage, heart attacks, high blood pressure, atherosclerosis, allergies, skin inflammations, and cancer Fatty Acid Metabolism:  Fatty Acid Metabolism   Inhibitors of Delta 6 Desaturase:  Inhibitors of Delta 6 Desaturase Diabetes Viral infection Atopic disease Cholesterol Stress hormones Corticosteroids Catecholamines Aging Alcohol Smoking Arachidonic acid Saturated fat Trans fatty acids Nutrient deficiency Zinc, B6, vitamin C Long Chain Omega-3 Fatty Acids: Major Health Benefits:  Long Chain Omega-3 Fatty Acids: Major Health Benefits Cancer & Cardiovascular disease Neurological diseases Depression, OCD, ADD Alzheimer’s disease Inflammatory diseases Psoriasis, eczema Inflammatory bowel disease (IBD) Rheumatoid arthritis Conner WE. Importance of n-3 fatty acids in health and disease. AJCN 2000;72:1241 What is “pharmaceutical grade?”:  What is “pharmaceutical grade?” Proposed criteria: Manufactured in a certified GMP facility approved for pharmaceutical products or by the USP. Manufactured according to pharmaceutical standards that include quality control steps to insure purity and potency. Must provide at least a 60% concentration of the most active long-chain omega-3 fatty acids (EPA and DHA). Ratio of omega-3 fatty acids to arachidonic acid must be greater than 50:1. How much do I take?:  How much do I take? For general health and prevention of cardiovascular disease: 1,000 mg of EPA/DHA daily For other indications, especially in cancer and inflammatory states: 3,000 mg EPA/DHA daily NSAIDs – New Sorts of Aspirin in Disguise:  NSAIDs – New Sorts of Aspirin in Disguise Classes Butypyrazolidines (eg.,kebuzone, mofebutazone) Acetic acid & acenamide derivatives (eg.,Arthrotec®, diclofenac) Oxicams (eg.,meloxicam, piroxicam) Propionic acid derivatives (eg.,oxaprozin, ibuprofen, naproxen) Fenamates (eg.,mefenamic acid) Cox-2 inhibitors (eg.,celecoxib, rofecoxib) Side Effects Gastric irritation and ulcers Kidney and liver damage Allergic reactions, tinnitus, easy bleeding and bruising, and various minor disturbances Inhibition of cartilage repair and promotion of osteoarthritis Slide37:  Cyclooxygenase (COX) Two isoenzymes Cyclooxygenase-1 (COX 1): constitutive - physiologic production of PG in gastric mucosa, endothelium, platelet, kidney Cyclooxygenase-2 (COX 2): inducible - induced by mitogen, cytokine, endotoxin - promotes synthesis of pro-inflammatory prostaglandins Slide38:  Cox-1 vs. Cox-2 What the drug companies wanted us to believe. Arachidonic acid COX-2 “Inducible” Bad Prostaglandins Inflammation Pain Fever Slide39:  Cox-1 vs. Cox-2 The reality. Arachidonic acid COX-2 “Inducible” Prostaglandins Pathological Physiological Inflammation Pain Fever Renal function Vascular Tissue repair Slide40:  Aspirin COX-1 Thromboxane Prostacyclin Thromboxane COX-2 inhibitors Decreased CV events Prostacyclin Increased CV events COX-2 Why do Cox-2 inhibitors increase risk for heart disease? #1. Because they adversely effect the ratio of thromboxane to prostacyclin Slide41:  Why do Cox-2 inhibitors increase risk for heart disease? #2. Because they adversely effect resolvin levels Resolvin E1 is a newly discovered physiological derivative of eicosapentaenoic acid (EPA) that inhibits both the migration of inflammatory cells to sites of inflammation and the turning on of other inflammatory cells. The synthesis of Resolvin E1 requires Cox-2. Therefore, inhibition of vascular COX-2 blocks the synthesis of Resolvin E1 in addition to blocking the beneficial PGI3 form of prostacyclin. Journal of Experimental Medicine 2005;201:713-722 Slide42:  Osteoarthritis - The most common form of arthritis 40 Million Americans suffer from OA 75% of Americans over 50 have OA Symptoms tend to be more severe in women Drug sales of NSAIDs in the US for OA exceed $6.6 billion Sales of GS and CS rank #3 in supplement sales (behind multivitamins and calcium) OVER 400,000 joint replacements each each in the U.S. due to OA Natural Products for Osteoarthritis:  Natural Products for Osteoarthritis Glucosamine sulfate Most useful, best clinical documentation, and cost effective Long-term studies now document significant clinical benefit Meta-analysis shows structural and symptomatic efficacy of glucosamine and chondroitin in knee osteoarthritis Arch Intern Med. 2003;163:1515-22 Chondroitin sulfate Clinical effectiveness documented in 9 double-blind clinical trials Controversies remain over quality control issues and mechanism of action MSM Sulfur critically important to cartilage formation, structure and integrity MSM + Glucosamine more effective than Glucosamine alone Clinical Drug Investigation, 2004;24:353-363. Natural Products for Osteoarthritis (cont.):  Natural Products for Osteoarthritis (cont.) Niacinamide Under utilized, but highly effective therapy (3,000 mg daily). Celandrin® Patented mix of cetylated, esterifed fatty acids. Fast-acting natural approach to inflammation. Excellent results with either oral or topical application. MicroLactin Highly purified mixture of milk peptides derived from hyper-immunized cows. Excellent documentation. Mixtures of proteolytic enzymes Clinically proven, old-time therapy for inflammation. What is Celadrin ® :  Celadrin® is a patented combination of special cetylated, esterifed fatty acids. Celadrin® reduces inflammation and pain quickly with no side effects. Available in cream and capsule form. Celadrin® has been shown to be effective in double-blind clinical trials published in peer-reviewed medical journals. Celadrin® has been shown to improve osteoarthritis and psoriasis; and lower CRP. Celadrin® applied topically works in just 30 minutes with significant improvement. What is Celadrin ® How does Celadrin Work?:  How does Celadrin Work? Possible mechanisms: Stabilization of phospholipid membrane pool Structural Reduces the availability of fatty acids for action by PLA-2 Reduces lipid peroxidation and induction of non-enzymatic cleaving of phospholipids Enzymatic Directly inhibits PLA-2 Indirectly inhibits PLA-1 via inhibition of cytokines Modulation of Cox-1 and Cox-2 activity Inhibition of lipoxygenase Reduces formation of isoprostanes Slide47:  World Class Clinical Trial Pedigree 32 Clinical Trials Performed to date 17 Published Clinical Trials 800+ Patients Studied (MicroLactin group only) Ohio Survey – 35 years with 8,000 case histories Indications (patient groups) studied: Rheumatoid & Osteoarthritis Cholesterol Hypertension Osteoarthritis Study - Treatment Effect:  Osteoarthritis Study - Treatment Effect MicroLactin™ has 60% greater Treatment Effect than Glucosamine Mechanism of Action:  Mechanism of Action The inflammation seen with osteoarthritis is in part neutrophil mediated. MicroLactin produces a suppression of neutrophil migration from vascular space and through vascular “tight junctions” (75%) MicroLactin™ Osteoarthritis Study revealed an increase in the absolute serum neutrophil count. Mechanism of Action:  Mechanism of Action Osteoarthritis Study – Serum Neutrophils:  Osteoarthritis Study – Serum Neutrophils Proteolytic Enzymes:  Proteolytic Enzymes Pancreatin – from hog pancreas Chymotrypsin and trypsin Papain – from unripe papaya Bromelain – from pineapple stem Fungal proteases Protease I, II, and III Serratia peptidase (Peptizyme SP™) Proteolytic Enzymes:  Proteolytic Enzymes How are they different?? Site of action and mechanisms Methods of potency and purity Activity in different pH environments Clinical documentation of effectiveness Proteolytic Enzymes:  Proteolytic Enzymes Serine Proteases Cysteine Proteases Trypsin Bromelain Chymotrypsin Papain Serratia peptidase Fungal peptidases Proteolytic Enzymes Effects on aspects of inflammation:  Proteolytic Enzymes Effects on aspects of inflammation (B=Bromelain, P=Papain, T/C=Trypsin & Chymotrypsin, SP=Serratia Peptidase) B P T/C SP Depletion of kininogen + - - - Inhibiting release of bradykinin - - - + Inhibiting release of histamine - - + + Promotion of fibrinolysis + + + +++ Alpha-macroglobulin binding + + ++ +++ Reduction in inflammatory cytokines + + ++ +++ Modulation of prostaglandins + - - - Blocking of adhesion molecules + + + + Proteolytic Enzymes Effects on immune complexes:  Proteolytic Enzymes Effects on immune complexes (B=Bromelain, P=Papain, T/C=Trypsin & Chymotrypsin, SP=Serratia Peptidase, IC=Immune Complex) B P T/C SP Reduction of IC + + - + Inhibition of IC-formation + + - + Reduction of C1q-binding - + + + Examples of Immune Complex/Autoimmune Diseases:  Examples of Immune Complex/Autoimmune Diseases Rheumatoid arthritis Multiple sclerosis Lupus Grave’s disease Scleroderma AIDS Slide58:  Proteolytic Enzymes Benefits to the patient with autoimmune disease: Promotes fibrinolysis Reduces inflammatory cytokines Reduces circulating immune complexes Increases antioxidant enzymes (SOD, catalase, and glutathione peroxidase) Proteolytic Enzymes Clinical study in rheumatoid arthritis:  Proteolytic Enzymes Clinical study in rheumatoid arthritis Summary: In a 6 month study, 156 patients with RA being treated with MTX and NSAIDs were randomly divided into two groups: a control group and a group assigned to receive enzymes. Significant improvements were noted in both clinical and laboratory assessments. Int J Immunotherapy 1997;13:85-91. Proteolytic Enzymes Results from a double-blind study in RA:  Proteolytic Enzymes Results from a double-blind study in RA Parameter Control Enzyme Morning stiffness (min.) 87.3 54.8 Richie index, points 20.7 15.7 Circulating immune complexes 88.1 55.6 Erythrocyte sedimentation rate 29.7 25.8 Rheumatoid factor titer 98.5 55.6 Typical dosage: 30 to 60 mg daily What natural product to use?:  What natural product to use? For silent inflammation Always build a strong foundation: High potency multiple, good greens drink, pharmaceutical grade fish oil (1,000 mg of EPA/DHA daily) 7-Day Total Nutritional Cleansing Program For osteoarthritis Begin with GS and Celadrin (oral and topical) If less than full response add MSM, then Microlactin For severe inflammatory conditions (e.g., RA, psoriasis, IBD) RevitalX Increase EPA/DHA to 3 grams daily Curcumin – 200 to 400 mg three times daily Proteolytic enzyme mixture Recap of Key Points:  Recap of Key Points Silent inflammation is an underlying factor in many chronic degenerative diseases Natural treatments for inflammation offer significant advantages Safety, effectiveness, and cost Effective strategies to reduce inflammation: Consume an anti-inflammatory diet Utilize pharmaceutical grade fish oil Use appropriate natural products Enhance endothelial function For my slides, go to www.doctormurray.com Why is the Future Bright for the Natural Product Industry?:  Why is the Future Bright for the Natural Product Industry? Growing need for real solutions Aging population Continued rise in diet related diseases Truth will prevail New and exciting products Best from nature is yet to come Effective consumer education Common Characteristics of Successful Retailers:  Common Characteristics of Successful Retailers HIGH VALUES!! Credible Passionate Educated Dedicated Positive and adaptable Effective communication Strong sense of mission 5 Keys to Life :  5 Keys to Life Make a spiritual connection Take personal responsibility Develop a positive attitude Find your passion Create a vehicle for making a difference in the lives of others

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