A review of complementary and alternative approaches to immunomodulation.
Current Western therapies for inflammatory diseases are suboptimal; increasingly, patients are turning to complementary and alternative medicine for symptom relief and improved quality of life. There is emerging evidence that many of these therapies have the ability to modulate the immune system and disrupt the proinflammatory cascade through a variety of mechanisms, including antioxidant effects, alterations in cell signaling (in particular the nuclear factor (NF)-kappaB pathway), cytokines, proinflammatory mediators, and disruption of bacterial flora. Using inflammatory bowel disease (IBD) as a model of inflammation, we explore the principal complementary and alternative medicine treatments that show promise in this regard, namely, resveratrol, green tea, curcumin, boswellia, fish oil, vitamin D, and probiotics. With each agent, we detail the mechanisms that have been described with regard to immune modulation, discuss the medical conditions for which it has been evaluated, and explore the data to date for the prevention or treatment of IBD.
Clarke
John O
JO
Division of Gastroenterology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. gmullin1@jhmi.edu
Mullin
Gerard E
GE
D000529:Complementary Therapies; D005228:Fatty Acids, Essential / Q000627:therapeutic use; D005419:Flavonoids / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007167:Immunotherapy; D007249:Inflammation / Q000628:therapy*; D015212:Inflammatory Bowel Diseases / Q000628:therapy*; D010636:Phenols / Q000627:therapeutic use; D059808:Polyphenols; D019936:Probiotics; D016896:Treatment Outcome; D014807:Vitamin D / Q000627:therapeutic use
D005228:Fatty Acids, Essential; D005419:Flavonoids; D007155:Immunologic Factors; D010636:Phenols; D059808:Polyphenols; D014807:Vitamin D