Angelita B. Frando, MD
Board Certified in Family Medicine
Board Certified , Medical Acupuncture
Definition:
 complex biological response to harmful stimuli
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(pathogens, damaged cells or irritants)
Protective attempt to remove the injurious stimuli and
initiate the healing process
Important for survival
Causes wounds and infections to heal (acute)
Chronic = progressive destruction of tissue =>disease
and degenerative changes
Manifestations (Signs):
 Calor (Heat)
 Rubor (Redness)
 Tumore (Swelling)
 Dolor (Pain)
 Functio laesa (loss of function)
Causes:
 Burns
 Chemical irritants
 Frostbite
 Toxins
 Infection by pathogens
 Physical injury, blunt or penetrating
 Immune reactions due to hypersensitivity
 Ionizing radiation
 Foreign bodies (ie., splinters, dirt and debris)
 Stress
 Trauma
 Alcohol
Types: Acute & Chronic
 Names Based on body systems / organs involved: ( “-itis”)
 Appendicitis
 Arthritis
 Bursitis
 Colitis
 Cystitis
 Dermatitis
 Myositis
 Meningitis
 Tendonitis
 Tonsillitis
 Vasculitis
Acute vs Chronic
Causative agent:
 Bacteria, injured tissues
 Persistent acute
 Immediate onset
inflammation, viruses,
persistent foreign bodies,
autoimmune reactions
 Delayed Onset
 Up to many months or years
 Outcome:
 Duration: Few days
 Outcome:
 Resolution, abscess, or
chronic inflammation
 Tissue destruction, fibrosis,
necrosis
Process of Acute Inflammation:
 Injury/pathogen => cells activated to release
inflammatory mediators:
 Vasodilatation => Increased blood flow => redness and
heat
 Increased blood vessel permeability => leakage of
plasma proteins and fluid into tissues (swelling)
 Some mediators increase sensitivity to pain
 Other biochemical reactions occur (complement
system, coagulation and fibrinolysis systems, etc.)
Cell derived mediators:
 Lysosome granules
 Histamine
 Interferon (cytokines)
 IL-8 (Interleukin 8)
 Leukotriene B4
 Nitric oxide
 Prostaglandins
 TNF-alphaand IL-1
Inflammatory Markers:
 CRP (C-reactive protein)
 Increased levels associated with increased risk of heart
attacks, strokes, high blood pressure, muscle weakness
and fragility
 ESR (erythrocyte sedimentation rate)
 Homocysteine levels
 Tumor necrosis factor –alpha (TNF-@)
 Interleukin 6, 8, 18 (IL-6, IL-8, IL18)
 Blood glucose, insulin and leptin (especially for obese)
Disorders associated with Inflammation:
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Acne vulgaris
Allergies
Asthma
Atherosclerosis
Autoimmune disease
Cancer
Celiac disease
Chronic prostatitis
Degenerative arthritis,
Hypersensitivities
Interstitial cystitis
Inflammatory bowel / Digestive tract disordes (Pancreatitis, Crohn’s disease, Regional enteritis, Enteropathies, Hepatitis, etc.)
Kidney diseases (Diabetic Nephropathy, Glomerulonephritis, etc)
Myopathies
Obesity
Osteoporosis
Pelvic inflammatory disease
Reperfusion injury
Rheumatoid arthritis , Lupus, and other connective tissue disorders
Skin: Psoriasis, Dermatitis
Sarcoidosis
Transplant rejection
Vasculitis
Medications vs Inflammation
 Aspirin
 Works on prostaglandins
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Watch for gastrointestinal ulcers and bleeding
 NSAIDS
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May cause gastric/duodenal ulcers
May damage kidneys with prolonged use
 Cox-2 inhibitors
 Steroids:
 Problems with prolonged use
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Weight gain, metabolic syndrome, gastric ulcers, blunts
adrenal function, etc.
Supplements vs Inflammation
 Arthritis:
 OPC3
 Omega 3
 Glucosatrin (Boswellia with Cox-2 inhibition)
Supplements vs Inflammation
 Acne vulgaris:
 Prevaderm
 Digestive enzymes
Supplements vs Inflammation
 Asthma/ Allergies:
 OPC3
 Aloe
 ORAC
Supplements vs Inflammation
 Atherosclerosis
 OPC3
 Heart Health
 Omega 3
 Activated Vitamin B
 Resveratrol
Supplements vs Inflammation
 Autoimmune diseases:
 OPC3
 Omega 3
 Resveratrol (do not give with Coumadin or breast
cancer)
 Co-Q-10
 Vitamin B
 Multivitamins/Minerals
Supplements vs Inflammation
 Cancer
 During remissions
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Breast Cancer
 B complex
 Vitamin D3
 Calcium
 CoQ-10
 OPC3
 Multivitamins/multiminerals
Supplements vs Inflammation
 Cancer
 During remissions (not during treatment)
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Colon Cancer
 Resveratrol
 Fiber powder
 B complex
 CoQ-10
 OPC3
 Multivitamins/multiminerals
Supplements vs Inflammation
 Celiac disease
 Digestive enzymes
 Aloe
Supplements vs Inflammation
 Degenerative arthritis:
 Omega 3
 OPC3
 Glucosatrin
Supplements vs Inflammation
 Inflammatory GI/bowel disorders, etc.
 Crohn’s disease – OPC3, Digestive enzymes, Aloe
 Irritable Bowel Syndrome – OPC3, Aloe, Digestive
enzymes
 Diverticulitis – (after bowel rest and antibiotics) Aloe,
Digestive enzymes, fiber powder (for diverticulosis),
OPC3
 Pancreatitis – Digestive enzymes
 Gastric / Duodenal Ulcer – Aloe, Digestive enzymes
 Hepatitis – Digestive enzymes, Hepatocleanse
Supplements vs Inflammation
 Kidney disease due to diabetes:
 OPC3
 Interstitial cystitis
 OPC3
Supplements vs Inflammation
 Osteoporosis:
 Calcium plus
 Vitamin D3 with K2 (IF Vitamin D deficient)
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D3 levels should be optimally placed at around 40-60 nmol/l
Monitor blood levels to avoid toxicity
Supplements vs Inflammation
 OBESITY:
 Associated with chronic inflammation
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Waist circumference correlates to inflammatory response
 OPC3
 Resveratrol
 Omega 3
 Transitions
Supplements vs Inflammation
 Reperfusion Injury (Heart and Brain):
 Post- Myocardial infarction and Post-Stroke
 OPC3
 Resveratrol
 Omega 3
 Psoriasis:
 OPC3
Keep Inflammation in moderation