Abstract
Natural medicines are an attractive option for patients diagnosed with common and debilitating musculoskeletal diseases such as Osteoarthritis (OA) or Rheumatoid Arthritis (RA). The high rate of self-medication with natural products is due to (1) lack of an available cure and (2) serious adverse events associated with chronic use of pharmaceutical medications in particular non-steroidal anti-inflammatory drugs (NSAIDs) and high dose paracetamol. Pharmaceuticals to treat pain may disrupt gastrointestinal (GIT) barrier integrity inducing GIT inflammation and a state of and hyper-permeability. Probiotics and prebiotics may comprise plausible therapeutic options that can restore GIT barrier functionality and down regulate pro-inflammatory mediators by modulating the activity of, for example, Clostridia species known to induce pro-inflammatory mediators. The effect may comprise the rescue of gut barrier physiological function. A postulated requirement has been the abrogation of free radical formation by numerous natural antioxidant molecules in order to improve musculoskeletal health outcomes, this notion in our view, is in error. The production of reactive oxygen species (ROS) in different anatomical environments including the GIT by the epithelial lining and the commensal microbe cohort is a regulated process, leading to the formation of hydrogen peroxide which is now well recognized as an essential second messenger required for normal cellular homeostasis and physiological function. The GIT commensal profile that tolerates the host does so by regulating pro-inflammatory and anti-inflammatory GIT mucosal actions through the activity of ROS signaling thereby controlling the activity of pathogenic bacterial species.
Highlights
Patients diagnosed with musculoskeletal diseases are reported to have a predisposition to Gastrointestinal Tract (GIT) disturbances that includes dyspepsia, nausea, abdominal bloating and irregular bowel habits [1,2]
They include the family of Toll-like receptors (TLRs) and nucleotide-binding oligomerization domain (NOD1 and NOD2) proteins that allow the host to differentiate the commensal from the pathogenic bacteria [15,43]
The probiotic group did demonstrate an improvement in GIT symptoms within the 12-week period
Summary
Patients diagnosed with musculoskeletal diseases are reported to have a predisposition to GIT disturbances that includes dyspepsia, nausea, abdominal bloating and irregular bowel habits [1,2]. Evolution has naturally endowed the human species with immune/inflammatory regulatory mechanisms activated by the interactions with both the external and internal microbial environments These serve to fine-tune both Th1 and Th2 antigen-driven effector responses [38]. The enterocytes and dendritic cells express two major host pattern recognition receptor (PRR) proteins that are crucial for communicating immune cell activation in response to specific microbial antigens. They include the family of Toll-like receptors (TLRs) and nucleotide-binding oligomerization domain (NOD1 and NOD2) proteins that allow the host to differentiate the commensal from the pathogenic bacteria [15,43]. It was reported that by inducing or expanding regulatory B cells with helminths that this may open novel avenues for the treatment of inflammatory diseases, such as allergic asthma [51]
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