When reducing inflammation does not work

While the switch from an inflammatory to a non-inflammatory state has been shown to occur in healthy individuals, it may not occur in individuals with a chronic inflammatory condition or dysbiosis. The pathways involved with the synthesis of SPMs from omega-3 fatty acids are impaired. In these individuals, a focus on reducing inflammation rather than resolving inflammation may be ineffective.

Barden et al. (2019) observed that individuals with metabolic syndrome and obesity demonstrated dysregulated inflammatory pathways, preventing them from making adequate SPMs required to resolve inflammation. This was remedied with weight loss and improving insulin sensitivity.

Green space

Immersion in nature is associated with a more favourable inflammatory profile. Serum levels of interleukin-8 (IL-8) and TNF-α were significantly decreased after 2 hours of exposure to a forest environment in stressed Young adults compared to placebo. This is hypothesised to be due in part to exposure to anti-inflammatory terpenes released from trees which block the  nflammatory cascade.

Sauna

An inverse, dose–response relationship has been found between regular use of sauna and reduced levels of CRP. Acute exposure to heat increases IL-6, triggering the release of interleukin-10 (IL-10), inhibiting several pro-inflammatory cytokines.

Connection

Relationships that are characterised by connection and support are associated with lower levels of systemic inflammation compared to individuals who experience unsupportive or hostile relationships. Higher levels of IL-6 & TNF-a were observed in couples experiencing sustained marital conflict.

Movement & stretching

Both exercise and stretching have been shown to assist with the resolution of acute inflammation by enhancing the production of SPMs and promoting macrophage phagocytosis in vivo.

Diet

Dietary patterns that emphasise a whole food diet such as the Mediterranean diet are associated with lower levels of inflammatory cytokines, CRP and TNF-α. Key components include; seasonal fruits and vegetables, herbs & spices, anti-inflammatory fats such as extra virgin olive oil as well as omega-3 rich fish.

Supplementation

Targeting both reducing inflammation and resolving inflammation would appear most efficacious When managing chronic inflammatory conditions. In na open-label pilot study, involving 29 individuals with inflammation-associated discomfort, consumption of a combined SPM-enriched marine oil and curcumin supplement taken daily for 60 days resulted in a significant reduction in pain.

    Working with patients to identify triggers for both acute and chronic inflammation, and addressing the root cause of inflammation is key to reducing inflammation. For those patients already in a state of chronic inflammation, enhancing SPM levels both endogenously and exogenously supports the reduction in ongoing inflammation and is supported by dietary and lifestyle changes, Where needed. Supporting patients through the supplementation of SPMs can accelerate this process and should be considered a first-line treatment for chronic inflammation.

Reference

Barden A, Shinde S, Tsai IJ, Croft KD, Beilin LJ, Puddey IB, Mori TA. Effect of weight loss on neutrophil resolvins in the metabol[1]ic syndrome. Prostaglandins Leukot Essent Fatty Acids. 2019 Sep; 148:25-29. doi: 10.1016/j.plefa. 2019.07.001. Epub 2019 Jul 3. PMID: 31492430.