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Autoimmune Diseases

Nutritional Supplements to Improve Autoimmune Health

  • Protein
  • Inflammation
  • Free-Radical Damage
  • Immune System
  • GI Tract
  • Stress
  • Liver Health

The autoimmune system needs a good nutritional foundation (over a long period of time) to alleviate or reverse lifestyle autoimmune dysfunction and assist with combating fully developed autoimmune diseases. The fundamental causal basis for autoimmune system boosting was shown in an early study designed to measure the serum concentrations of vitamin E, beta-carotene, and vitamin A in patients prior to developing rheumatoid arthritis or systemic lupus erythematosus. Two to 15 years after the volunteer patients had originally donated their blood to the serum bank (1974), the serum samples were assayed for vitamin E, beta-carotene, and vitamin A. Those patients who developed rheumatoid arthritis or lupus showed lower serum concentrations of vitamin E, beta-carotene, and vitamin A in 1974. Those with the lowest serum level of beta-carotene in 1974 were the most likely to develop rheumatoid arthritis later in life (Comstock 1997). This indicates the long-term importance of maintaining adequate vitamin status for the prevention of autoimmune diseases.

Slowing the Damage to Healthy Protein

Carnosine, a dipeptide amino acid found naturally in the body, helps slow the formation of glycated protein end products. Recall that glycated protein may be unrecognizable to the immune system, thereby triggering an autoimmune attack. Since the normal removal of damaged protein declines with aging, slowing the development of protein crosslinking (glycation) may help to reduce an autoimmune reaction. In addition to its antiglycation effects, carnosine has been found to modulate immune system neutrophils, thus suppressing a response (Tan 1998).

Reducing Inflammation

A study found that fish oil containing vitamin E delayed the onset of autoimmune diseases in autoimmune-prone mice (Venkatraman 1994). Another study on the effects of vitamin E deficiency found that dietary components that provide antioxidant effects may contribute to the treatment of inflammatory/autoimmune diseases (Amarakoon 1995).

Supplementation with omega-3 essential fatty acids (EFAs) from fish, flaxseed, or perilla oils--along with borage oil, evening primrose oil, or black currant seed oil, which contain the essential omega-6 fatty acid gamma-linolenic acid (GLA)--can alleviate many symptoms of autoimmune disease through their anti-inflammatory activity. Docosahexaenoic acid (DHA) extracted from fish oil may be as effective as some prescription medications in reducing inflammation.

Dehydroepiandrosterone (DHEA) is a pro-steroidal hormone that decreases with age. Decreases in DHEA levels have been linked to a number of chronic and degenerative diseases including cancer, coronary artery disease, depression, stress disorders, and neurological functioning (Straub 1998). As a result of aging, immunity may become compromised due to dysregulation of cellular hormones (cytokines and growth factors) that govern immune response. Too much or too little of various cytokines produces disease states or compromised responses to various challenges.

In aging animals, the addition of DHEA has normalized deranged cytokine levels, including the primary inflammatory factor interleukin-6 (IL-6) (Araghi-Niknam 1997). In the aged test animals, serum IL-6 was elevated nine-fold from normal. After administration of DHEA or dehydroepiandro-sterone-sulfate (DHEA-S), IL-6 dropped to within 15% of youthful levels. In the same studies, it was shown that antibodies directed toward oneself rose five-fold with aging, but fell by over 50% after 2 weeks on DHEA-S (Spencer 1996).

In a study of ten women with the autoimmune disease Sjogren's syndrome, all were shown to have decreased serum concentrations of DHEA-S and an increased cortisol/DHEA-S ratio compared with healthy controls (Valtysdottir 2001).

Rheumatoid arthritis is an autoimmune disorder in which the body attacks its own tissues as though they were foreign invaders. Boswellia may also offer relief to autoimmune-related rheumatoid arthritis patients. Boswellia can help reduce immune cells that encourage inflammation, while increasing the number of immune cells that inhibit inflammation (Chevrier 2005). Studies indicate that boswellia’s ability to modulate the immune system and inhibit inflammatory activity may help improve the symptoms of rheumatoid arthritis and other autoimmune conditions (Ammon 2006).

Lessening Free-Radical Damage

Antioxidants are a broad group of compounds that destroy or neutralize free radicals in the body; thus, they protect against oxidative damage to cells caused by normal aging or daily exposure to pollutants and toxic substances. Antioxidants are found naturally in healthy food, especially fruits and vegetables. The most effective antioxidants include vitamin C, vitamin E, green tea extract, beta-carotene, grape seed-skin extract, coenzyme Q10 (CoQ10), and selenium.

  • Vitamin C may be the most important water-soluble antioxidant, having the ability to scavenge both reactive oxygen and nitrogen radicals. In controlled studies, vitamin C has demonstrated antiatherogenic, anticarcinogenic, antihistaminic, and immunomodulatory benefits.
  • Vitamin E is a fat-soluble, essential nutrient for humans. Increased risk for coronary artery disease, Alzheimer's disease, and cancer has been associated with vitamin E deficiency.
  • Green tea belongs to the flavonoid family. Green tea catechins are potent free radical scavengers that have demonstrated anticarcinogenic, anti-inflammatory, antiatherogenic, and antimicrobial activity.
  • Beta-carotene is a dietary precursor to vitamin A. Beta-carotene has demonstrated immunomodulatory effects in male non-smokers and increased lymphocyte counts in healthy male smokers. Beta-carotene's antioxidant activity may prevent oxidative damage to DNA and inhibit lipid peroxidation.
  • Grapeseed-skin proanthocyanadins have demonstrated several antioxidant activities, including inhibiting the oxidation of damaging LDL cholesterol. Other research has shown tumor-protective, cardio-protective, and liver-protective benefits.
  • CoQ10 has shown antioxidant activity within the mitochondria and cellular membrane. CoQ10 levels decline with aging and are strongly related to increased cardiovascular disease, especially congestive heart failure. Supplemental CoQ10 has shown usefulness in treating periodontal disease and boosting energy levels.
  • Selenium is a trace mineral that is essential for healthy immune function. Selenium provides protection to immune cells from stress-induced oxidative damage and neutralizes the effects of some toxic metals. Low dietary intake of selenium is associated with cardiovascular disease and certain cancers.

Modulating the Immune System

The immune system functions because of adequate amounts of circulating antibodies. Antibodies are proteins with a unique concave region (combining site) in which they can combine with foreign proteins (antigens). Antigens are most often surface molecules found on the membrane of invading or diseased cells. After the antigen and antibody combine, the new complex produces a number of changes that inactivate or kill the invading cell. This function is known as humoral or antibody-mediated immunity. Lymphocytes are the most numerous cells of the immune system and are responsible for antibody production. B-cells are lymphocytes that produce humoral immunity.

T-cells are lymphocytes formed in the thymus shortly before and after birth. When T-cells come into contact with foreign antigens, the antigen binds to protein on the surface of the T-cell, making it sensitized. Sensitized T-cells destroy invading pathogens by releasing a specific and toxic poison to the cells of bound antigens. T-cells can also indirectly destroy toxic invaders by releasing a substance that attracts macrophages to the area that will ingest and destroy (phagocytose) the pathogen. This function is known as cell-mediated immunity. T-cells regulate natural killer cell activity and the body's inflammatory response to disease.

In a healthy body, circulating antibodies attack and destroy pathogenic invaders by means of humoral or cell-mediated immunity. In autoimmune disease, circulating antibodies seek, attack, and destroy self-antigens found in healthy tissue (see Table 1 for examples).

 

Table 1: Autoimmune Classification
Disease Antibody Action on
Myasthenia gravis Acetylcholine receptors
Graves' disease Thyroid-stimulating hormone receptor
Thyroiditis Thyroid
Insulin-resistant diabetes Insulin receptor
Asthma Beta-2 adrenergic receptors
Juvenile insulin-dependent diabetes Pancreatic islet cells
Pernicious anemia Gastric parietal cells
Addison's disease Adrenal cells
Idiopathic hypoparathyroidism Parathyroid cells
Spontaneous infertility Sperm
Premature ovarian failure Interstitial cells, corpus luteum cells
Pemphigus Intercellular substance of skin
Primary biliary cirrhosis Mitochondria
Autoimmune hemolytic anemia Erythrocytes
Idiopathic thrombocytopenic purpura Platelets
Idiopathic neutropenia Neutrophils
Vitiligo Melanocytes
Osteosclerosis and Meniere's disease Type-II collagen
Chronic active hepatitis Nuclei of hepatocytes
Goodpasture's syndrome Basement membranes
Rheumatoid arthritis Gamma globulin, virus-related antigens
Sjogren's syndrome Nuclei and centromeres
Systemic lupus erythematosus Nuclei, DNA, RNA, erythrocytes, etc.
Scleroderma Nuclei and centromeres
Polymyositis Nuclei, RNA

T-cells can further divide into helper lymphocytes (Th) and cytotoxic (Tc) or suppressor cells. In response to a foreign pathogen, T-cells secrete communication molecules known as lymphokines, cytokines, interleukins, and interferons. T-helper cells assist B-cells and further divide into two special lines of defense. These are Th1 and Th2. When one of these lines (Th1 or Th2) overexpresses, an opportunity for immune dysregulation occurs, resulting in either a hyperimmune response causing autoimmune disease or a hypoimmune response leading to uncontrollable infection. Sterinol, a combination of natural plant sterols and sterolins, modulates the function of T-cells by enhancing their ability to divide. They further promote interleukin-2 and gamma-interferon without enhancing Th2 helper cells that promote inflammation and produce more antibodies. Conventional drug treatment inhibits the entire immune response. Sterolins, however, modulate the immune response and are able to reverse immune abnormality at the disease site (Bouic 1996; Gupta 1980).

Alkylglycerols are derived from shark liver oil. Studies indicate that the activation of protein kinase C, an essential step in cell proliferation, can be inhibited by alkylglycerols. Although the mechanism of antiproliferative and immunomodulatory action is unknown, hormonal action of both the autocrine and paracrine systems has been suggested (Pugliese 1998). Alkylglycerols have been promoted for use in immune system stimulation. However, benefits have been reported in those suffering from asthma, lupus, rheumatoid arthritis, and other autoimmune disorders.

L-carnitine, an amino acid known to improve conditions associated with low cellular energy, has been shown to reduce the impairment of immune function caused by the consumption of dangerous fats (De Simone 1982). This beneficial action is attributed to L-carnitine's ability to lower serum lipids (fats) by enhancing the transport of beneficial fatty acids into the cell's mitochondria, where they are used to produce energy. Acetyl-L-carnitine is the form of carnitine utilized more efficiently in the mitochondria.

Mounting evidence suggests that vitamin D may be a critical missing link in virtually all autoimmune diseases, including lupus. Vitamin D is capable of modulating the activity of immune cells. Studies have identified widespread vitamin D deficiency in lupus patients (Toloza 2010; Lemire 1992). For example, one study found that 1.2% of lupus patients had adequate vitamin D levels compared to 45% of healthy controls (Damanhouri 2009). Another found that lower vitamin D levels were linked with more aggressive lupus autoimmunity (Ritterhouse 2011).

Scientists have discovered how to provide natural immunological support using immune-protective proteins found in hens’ eggs. This development promises to deliver substantial immune enhancement at a fraction of the cost of medications (Pawelec 2002), which is good news for all of us as we age—and great news for those whose immune systems are particularly vulnerable (eg, cancer or HIV/AIDS patients).

Paeonia lactiflora, or common peony, is a flowering plant native to Asia traditionally used as an immunomodulator and to treat a variety of systemic inflammatory conditions such as rheumatoid arthritis, lupus, hepatitis, and fever (He 2011). Contemporary research validates the clinical efficacy of peony in alleviating inflammatory conditions and suggests many of the plant’s medicinal properties may be attributable to an active constituent called paeoniflorin, which is concentrated in its roots (He 2011; Zhang 2011).

Paeoniflorin and related compounds from peony root appear capable of modulating several aspects of the inflammatory milieu that underlies autoimmunity (He 2011). Several animal studies showed peony root extract blunted the ability of immune cells to mount a robust inflammatory response in a model of arthritis that resembles rheumatoid arthritis in humans (Chen 2012; Lin 2012; Zhou 2012).

In a clinical study that enrolled 260 subjects with rheumatoid arthritis, peony extract plus the antifolate drug methotrexate (Trexall®) outperformed control treatment consisting of methotrexate plus sulfasalazine (Azulfidine®) (a conventional rheumatoid arthritis drug) in reducing symptom severity. The peony-methotrexate combination evidently provided faster relief and better compliance than the control treatment as well (Wang, Xing 2007). An earlier, smaller study on 61 subjects with rheumatoid arthritis revealed similar effects: peony extract plus methotrexate was more efficacious in improving markers of inflammation in subjects’ blood than methotrexate alone (Du 2005). Peony extract has shown efficacy in several other conditions involving autoimmunity and inflammation as well such as psoriatic arthritis, ankylosing spondylitis, and psoriasis (Wang 2013; Wang, Wang 2007; He 2011; Zhang 2011).

Supporting the GI Tract

Intestinal permeability is often disrupted by health conditions such as rheumatoid arthritis, Crohn's disease, pancreatic dysfunction, and food allergies. Aging, stress, medications, and alcohol consumption also alter permeability, compromising the barrier that separates food and intestinal bacteria from the rest of the body.

Poor intestinal motility and peristalsis can change beneficial bacterial flora by altering the natural flow of nutrients available to them. These same factors can add to the overgrowth of abnormal bacteria and the byproducts they produce, leading to the absorption of antigenic substances into the bloodstream. Immune-related disease is associated with antigenic substances produced by intestinal flora. To correct the problem, bacterial balance must be restored through the use of supplemental probiotics and prebiotics that feed the beneficial bacteria. Species of bifidobacteria and lactobacilli may help restore microfloral balance and stabilize intestinal permeability. Fructooligosaccharides (FOS) are simple sugars that are the preferred nutrient for lactobacilli and bifidobacteria (with the exception of the bifidum species).

Certain nutritional supplements are used by intestinal cells for growth and function. They include:

  • L-glutamine, a non-essential amino acid that increases the number of cells in the small intestine along with the number and height of villi on those cells
  • Butyric acid, a short-chain fatty acid that enhances function and integrity in the large intestine and is an anticancer agent
  • The fatty acids DHA (from fish oil) and GLA (from borage oil), which decrease inflammation and improve intestinal functioning

Reducing Stress

Stress is a major risk factor in developing disease. Even prolonged low-level stress stimulates the adrenal glands to produce cortisol, which in excess impairs immune function. Lack of proper rest and sleep, depression, and emotional disturbance contribute to immune dysfunction. In addition, there is a connection between the limbic system (i.e., the part of the brain that gives rise to emotion) and immune function. Therefore, to balance the immune system, one must balance the mind and emotions. Biofeedback, guided imagery, yoga, deep breathing, musical participation, positive affirmations, meditation, and prayer all help maintain balance (Hughes 1997; Long 2001; Kuhn 2002; Lehrer 2002; Vempati 2002).

A supplemental approach to stress reduction would be obtained from Garum armoricum extract, which contains a class of unique polypeptides that act as precursors to endorphins and other neurotransmitters. These polypeptides exert a regulatory effect on the nervous system enabling an individual to adapt to mentally and physically stressful conditions (Crocq 1978). Another antidote to stress is an amino acid found in green tea called theanine. Although theanine creates a tranquilizing effect on the brain, it appears to increase concentration and focus thought (Juneja 1999). DHEA supplementation is the most effective way of blocking the effects of excess cortisol secretion.

Improving Liver Health

The liver plays a critical role in all aspects of metabolism and health. It is important in the synthesis and secretion of albumin (a blood clotting protein), in the storage of glucose, and in the synthesis of vitamins and minerals. Because the liver has a major role in the purification and clearance of waste products, drugs, and toxins, disease states may be improved by supporting liver function. The herb milk thistle and its components silymarin and silibinin have two therapeutic mechanisms. First, they alter the structure of the outer cell membrane of the hepatocyte to prevent penetration of liver poison into the interior of the cell. Second, they stimulate the action of nucleolar polymerase A, resulting in an increase in ribosomal protein synthesis, thus stimulating the regenerative ability of the liver and the formation of new hepatocytes (Flora 1998; Luper 1998).