Mechanistic Basis for the Role of Phytochemicals in Inflammation-Associated Chronic Diseases.

Brianna Cote,Fiona Bui,Fawzy Elbarbry,Deepa A Rao,Joe W Su,Karen Seo,Max Lee,Arthur Nguyen

doi:10.3390/molecules27030781

Abstract

Chronic inflammatory diseases occur in a large portion of the population and are associated with a poor diet. Key natural products found in fruits and vegetables may assist in lowering inflammation associated with chronic diseases such as obesity, diabetes, cardiovascular diseases, and cancer. This review seeks to examine the roles of several natural products, resveratrol (RES), quercetin (QUE), curcumin (CUR), piperine (PIP), epigallocatechin gallate (EGCG), and gingerol (GIN), in their ability to attenuate inflammatory markers in specific diseases states. Additionally, we will discuss findings in past and ongoing clinical trials, detail possible phytochemical–drug interactions, and provide a brief resource for researchers and healthcare professionals on natural product and supplement regulation as well as names of databases with information on efficacy, indications, and natural product–drug interactions. As diet and over-the-counter supplement use are modifiable factors and patients are interested in using complementary and alternative therapies, understanding the mechanisms by which natural products have demonstrated efficacy and the types of drugs they interact with and knowing where to find information on herbs and supplements is important for practicing healthcare providers and researchers interested in this field.

Highlights

Chronic inflammation is long-term, low-grade, asymptomatic inflammation that can occur due to various conditions such as chronic infections, low physical inactivity, obesity, poor diet, disturbed sleep patterns, isolation, and stress [1]
As CYP3A4 is the most abundant isoform and is responsible for metabolizing approximately 50% of marketed drugs, inhibition by RES could result in major drug interactions due to an increase in oral bioavailability and the accumulation of drugs that are metabolized by this isoform [154]
These include a paucity of clinical trials to establish dose; the lack of standardized design for in vivo and clinical trials to effectively compare doses with the responses observed; the low solubility and poor oral bioavailability of many of these compounds (Table 2), raising questions regarding their use in the short term, especially with the prevalent data indicating that chronic daily use may be needed to see effects; and, lastly, the potential interactions that may occur when these phytochemicals are used with conventional therapeutics in these concomitant disease states

Summary

Introduction

Chronic inflammation is long-term, low-grade, asymptomatic inflammation that can occur due to various conditions such as chronic infections, low physical inactivity, obesity, poor diet, disturbed sleep patterns, isolation, and stress [1]. If unaddressed and chronic inflammation persists, it can lead to diabetes, cancer, depression, metabolic syndrome, neurodegenerative diseases, and autoimmune diseases [1]. Sixty percent of all deaths around the world occur from conditions associated with chronic inflammatory diseases, such as obesity, diabetes, cardiovascular disorders, and cancer [2]. The impact of diet on inflammation-associated disease is well-studied [3], and poor diet is associated with chronic degenerative diseases [4]. Numerous studies depict a healthy diet as a modifiable determinant of chronic diseases, resulting in the attenuation of oxidative stress [6], a decrease in cancerspecific mortality [7], and suppression of chronic inflammation [8]

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Discussion

Conclusion