Immunity and Inflammation in Health and Disease

Emerging Roles of Nutraceuticals and Functional Foods in Immune Support

Shampa Chatterjee, Wolfgang Jungraithmayr, Debasis Bagchi, Shampa Chatterjee, Wolfgang Jungraithmayr, Debasis Bagchi

• Publisher: Academic Press
• Year: 2017
• Print ISBN:
  9780128054178
• eBook ISBN:
  9780128054024
• Topic: Medicine
• Subtopic: Nutrition, Dietics & Bariatrics

Immunity and Inflammation in Health and Disease: Emerging Roles of Nutraceuticals and Functional Foods in Immune Support provides a comprehensive description of the various pathways by which the vertebrate immune system works, the signals that trigger immune response and how fnew and novel nutraceuticals and functional foods, can be used to contain inflammation and also to boost immunity and immune health. Inflammation is a tool to fight pathogens and the vertebrate immune system has a very complex network of cells to achieve this. However inflammation that goes awry is also the leding cause of several diseases ranging from cardiovascular diseases to diabetes. This book covers the entire gamut from the various cellular players in the inflammation-immune response to its ramifications in terms of protection against pathogens as well as in onset of metabolic, aging and auto-immune related diseases. Finally, the balancing role of dietary nutrients between host defence and immune support is also showcased. The first three scetions explain the various components of the immune system and their modes of activation. The fourth section deals with the ramifications of a robust and execessive inflammatory response. The fifth section is focused on the association between nutrition and immunity and how deficiencies in certain nutrients may affect immunocompetence. The sixth section chapters represent a vision of paradigm shifts within the field and discusses possible future directions. This bool will be a valuable reference for researchers studying immune health either in academia, or in the nutraceutical or functional food industries. Product developers in nutraceutical, supplement, functional food, and health food companies will also appreciate the information presented here. - Conceptualizes the key features in natural products which can boost immune function and immune health - Explains the intricate mechanistic aspects and balance behind immune health - Presents the pathophysiology of several diseases associated with immune system disruption

Section V

Nutraceuticals in Boosting Immune Support and as Therapeutics for Inflammatory Diseases

Outline

Chapter 19 Anti-inflammatory and Anti-microbial Properties of Achillea millefolium in Acne Treatment

Chapter 20 Lactobacillus Gasseri Potentiates Immune Response Against Influenza Virus Infection

Chapter 21 Micronutrients in Skin Immunity and Associated Diseases

Chapter 22 Mycobiome and Gut Inflammation: Implications in Gut Disease

Chapter 23 Flavonoids in Treating Psoriasis

Chapter 24 Probiotics and Anti-inflammatory Processes in HIV Infection: From Benchside Research to Bedside

Chapter 25 Chronic Inflammation in Asthma: Antimalarial Drug Artesunate as a Therapeutic Agent

Chapter 26 Nutrition as a Tool to Reverse Immunosenescence?

Chapter 19

Anti-inflammatory and Anti-microbial Properties of Achillea millefolium in Acne Treatment

Rahul Shah and Bela Peethambaran, University of Sciences, Philadelphia, PA, United States

Abstract

Inflammatory events occur very early in the development of acne lesions. Inflammation also plays a role in the late stages of acne vulgaris infection. Hence drugs used in the treatment of acne should also have anti-inflammatory properties as inflammation exists throughout the life cycle of acne lesions. This chapter gives an account of the current knowledge on the phytochemistry and pharmacological aspects of anti-acne compounds in yarrow (Achillea millefolium), which were also tested to be anti-inflammatory. Different parts of this plant have been in used in traditional medicine as astringent, stimulant and mild aromatic, for treating cold and influenza and as antiphlogistic. Alkaloids such as azulene extracted from flowers and leaves of yarrow have been reported to have anti-inflammatory and analgesic activity. A research study in our laboratory has established a novel alkamide isolated from the leaves and stems of Achillea “Moonshine” that are anti-microbial to acne causing bacteria Propionibacterium acnes. This compound was isolated from petroleum ether extracts of A. “Moonshine” leaves and stems, using high performance chromatography and bioactivity guided thin layer chromatography. The potent anti-acne alkamide demonstrated the ability to reduce inflammation, scavenge free radicals and reduce tyrosinase activity to remove residual pigmentation caused after acne treatment.

Keywords

Achillea millefolium; alkamide; anti-acne; anti-inflammatory; Acne vulgaris; A.“Moonshine”; yarrow

19.1 Introduction

Acne vulgaris affects 80% of adolescents and at times persists well into adulthood, resulting in scarring and hyperpigmentation. Acne develops in the sebaceous follicles on the cheeks, forehead, chin, and on the back. It is caused due to a combination of increased sebum production and abnormal hyperproliferation of keratinocytes. Inflammation is an important part of acne development as it is seen to develop during and even before the comedogenesis, which is the process of accumulation of sebum, enlargement of follicles, and build-up of keratinous material.

19.2 Inflammation

Inflammation is described as “the succession of changes which occurs in a living tissue when it is injured provided that the injury is not of such a degree as to at once destroy its structure and vitality” (Sanderson et al., 1871), or “the reaction to injury of the living microcirculation and related tissues” (Spector et al., 1963). However, in ancient times inflammation was recognized as a part of the healing process. Inflammation is characterized by signs such as: rubor (redness), calor (increased heat), tumor (swelling), dolor (pain), and functio laesa (loss of function). Redness and heat are due to increased blood flow to the inflamed area; swelling is a result of accumulation of fluid; pain is due to release of chemicals that stimulate nerve endings; while loss of function is a result of the combination of all the factors. Inflammation exists through the lifecyle of acne lesion and hence is an important part of the treatment of acne.

Histological and immunological evidence, derived from analysis of skin samples from patients, supports that inflammation is a fundamental process in the development of acne lesions. The analyzed skin samples had elevated levels of CD3⁺ and CD4⁺ T-cells in the perifollicular and papilliary dermis and there were increased macrophages in these papules (Jeremy et al., 2003). Studies in early lesions have shown upregulation of inflammatory mediators such as E-selection, vascular adhesion molecule-1, interleukin-1, and integrin (Jeremy et al., 2003; Layton et al., 1998). Current drugs used for treatment of acne such as retinoids are effective in treating noninflammatory lesions (Eichenfield et al., 2010) by downregulating Toll-like receptor-2 and interleukin-10 expression (Tenaud et al., 2007; Liu et al., 2005). Gene array expression studies from skin biopsies of six acne patients showed that out of 211 upregulated genes the majority were involved in matrix remodeling and inflammation (Trivedi et al., 2006).

19.3 Etiology and Pathology of Acne vulgaris

Acne vulgaris (cystic acne or simply acne) is a common human skin disease, occurring mostly during the onset of puberty. It is mainly a disorder of the pilosebaceous unit. It affects almost 40–50 million Americans and is estimated to occur in 85% of people at least some point in their lives. Analysis has also shown prevalence of acne in individuals in the beginning or during puberty (Bhambri et al., 2009). Acne occurs in areas of skin with large number of sebaceous follicles, which are found on the cheek, forehead, and back (Tanghetti, 2013). Acne is generally characterized by areas of skin with seborrhea, comedones, papules (pinheads), pustules (pimples), nodules and possibly scarring. The precise mechanism of acne is not known but is thought to involve four main pathogenic factors: follicular keratinization, increased sebum production, presence of Propionibacterium acnes, and inflammation (Bhambri et al., 2009).

Apart from the above mentioned factors, which are central to acne, genetic and hormonal changes, birth control pills, certain medication, stress, use of oily cosmetics are also some of the major factors that can cause acne by creating a favorable environment for the growth of P. acnes in the follicles.

Acne occurs due to blockage in the follicles resulting in the formation of comedones. The earliest microscopic lesion observed is the microcomedones. Microcomedones are the precursors that can develop into both noninflammatory and/or inflammatory lesions. They are characterized by follicular plugging which is caused due to follicular keratinization and reduced desquamation of keratinocytes in the pilosebaceous unit. Recently, the role of biofilm formation by P. acnes leading to formation of microcomedones has also been hypothesized. Over time, the microcomedones develop into comedones that further develop into blackheads and whiteheads. Lack of oxygen in these plugged follicles creates an anaerobic environment suitable for the growth of P. acnes. The cell wall and the biological by-products of these flourishing bacteria act as chemo-attractants and proinflammatory mediators leading to inflammation. The inflammatory cells diffuse from the follicle to the surroundings, secreting enzymes that rupture the follicular walls. These inflammatory mediators stimulate a localized immune response resulting in the formation of pustules, while a more intense inflammation is accompanied by formation of comedonal acne(Harper, 2004; Bhambri et al., 2009).

Several factors influence the development of acne. These include infection of P. acnes and Staphylococcus epidermidis, natural environmental insults that produce free radical scavenging activity, skin type, and hormonal imbalance. There are also resulting effects post-acne formation that include inflammation and scarring of tissues. P. acnes are gram-positive, anaerobic bacteria that are present in the normal skin and are found in the sebaceous follicle. The obstructed lipid rich lumen with decreased oxygen tension in the comedones makes it an ideal environment for the bacteria to flourish. These bacteria hydrolyze the sebum triglycerides producing free fatty acids. P. acnes also encourages the proliferation of other aerobic, gram-positive bacteria S. epidermidis, which reside normally on the skin. Both these bacteria are found to colonize the acne prone areas.

19.4 Management of Acne vulgaris

There has been no significant change in the treatment and management of acne vulgaris for the last twenty-five years. Topical retenoids have been the drug of choice for acne treatment, but there have been problems of skin irritation leading to decreased patient compliance. Isotretinion, approved in 1982, is to date the most effective acne medication, clearing the acne lesions in 85% of the users. However its use causes teratogenic effects and psychiatric disturbances, an...

Table of contents

• Cover image
• Title page
• Table of Contents
• Copyright
• Dedication
• List of Contributors
• Preface
• Section I: Innate and Adaptive Immune Systems: Components and Regulation
• Section II: Reactive Oxygen Species, Oxidative Stress and Immune Cell Activation
• Section III: Inflammatory Systems: Mechanistic Pathways of Stimulation and Suppression
• Section IV: Immunity and Inflammation: Common Threads of Multifactorial Diseases
• Section V: Nutraceuticals in Boosting Immune Support and as Therapeutics for Inflammatory Diseases
• Section VI: New Perspectives and Future Directions
• Appendix
• Index