RESOLEÓMICA. LA NUTRICIÓN APLICADA A LA RESOLUCIÓN DE LA

INFLAMACIÓN

V Congreso Internacional de Medicina Funcional: Inflamación. Carlos Pérez Ramirez Barcelona 1 de Junio de 2012

Calcio en el citoplasma

AcMvación de Fosfolipasa A2

Ácido Araquidónico

Lipooxigenasa (LOX) Ciclooxigenasa (COX)

Leucotrienos Prostaglandinas

¡¡¡Inflamación!!!

TRENDS inImmunology Vol.23No.3March2002

TRENDS inImmunology Vol.23No.3March2002

SCIENCE VOL 294 30 NOVEMBER 2001

SCIENCE VOL 294 30 NOVEMBER 2001

Broughton G 2nd. The basic science of wound healing. Plast Reconstr Surg. 2006;117(7 Suppl):12S-34S.

Días tras la lesión

Broughton G 2nd. The basic science of wound healing. Plast Reconstr Surg. 2006;117(7 Suppl):12S-34S.

Días tras la lesión

Resistencia de la herida a la ruptura

Broughton G. The basic science of wound healing. Plast Reconstr Surg. 2006

En el proceso de inflamación los neutrófilos son las primeras células reclutadas.

Broughton G. The basic science of wound healing. Plast Reconstr Surg. 2006

Broughton G 2nd. The basic science of wound healing. Plast Reconstr Surg. 2006;117(7 Suppl):12S-34S.

Días tras la lesión

Broughton G 2nd. The basic science of wound healing. Plast Reconstr Surg. 2006;117(7 Suppl):12S-34S.

Días tras la lesión

Resistencia de la herida a la ruptura

Serhan CN. Novel endogenous small molecules as the checkpoint controllers in inflammation and resolution: entrée for resoleomics. Rheum Dis Clin North Am. 2004 Feb;30(1):69-95.

Lipoxinas

NATURE CLINICAL PRACTICE RHEUMATOLOGY YACOUBIAN AND SERHAN OCTOBER 2007 VOL 3 NO 10

CHEST / 118 / 5 / NOVEMBER, 2000

?

Serhan CN. Novel endogenous small molecules as the checkpoint controllers in inflammation and resolution: entrée for resoleomics. Rheum Dis Clin North Am. 2004 Feb;30(1):69-95.

ACETILAR Lipoxinas

•  ÁCIDO SALICÍLICO

– CILANTRO BIOLÓGICO

– ZANAHORIA BIOLÓGICA – ARÁNDANOS – POPULUS NIGRA – CÓRTEX SALIX – SÁLIX ALBA

(hfp://organicvalley.coop/uMlity/resources/reading_room/benefits.html)

(Serhan, 2004)

Serhan CN. Novel endogenous small molecules as the checkpoint controllers in inflammation and resolution: entrée for resoleomics. Rheum Dis Clin North Am. 2004 Feb;30(1):69-95.

Frenar la descomposición de LIPOXINAS

•  PGDH: Vit A, Vit D y omega 3

•  EOR: Tymol, carvacrol, pcymene, cilantrina, en aceite esencial, pignogenol (estimulan 15-LO)

(Kisko 2005)

Frenar la descomposición de LIPOXINAS

•  Tymol: ALBAHACA, ROMERO •  Carvacrol: TOMILLO, ORÉGANO •  P cymene: MENTA •  Cilantrina: CILANTRO •  Pignogenol: PIÑONES

Kisko G. 2005 Kohama T. 2006

Van Dyke TE. The management of inflammation in periodontal disease. J Periodontol 2008, Aug;79(8 Suppl):1601-8.

Produktion von Eicosanoiden

Van Dyke TE. The management of inflammation in periodontal disease. J Periodontol 2008, Aug;79(8 Suppl):1601-8.

Schwab and Serhan. Lipoxins and new lipid mediators in the resoluMon of inflammaMon Current Opinion in Pharmacology 2006, 6:414–420

RELACIÓN DE GRASAS

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Ȏ-6 Fatty acids

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Ǽ6 Desaturase

Elongase

Ǽ5 Desaturase

Elongase

Elongase

Ǽ6 Desaturase

Ȗ-oxidation

E series Resolvin

D series ResolvinProtectin

Leukotrien

ProstaglandinThromboxan

Lipoxin

ATLs

5-LOX

COX-1,2

12,15-LOX

Acetylated COX-2

Ȏ-3 Fatty acids

Figure 4: Synthesis of unsaturated fatty acids in mammals by Desaturase and Elongase

Figure 4Figure 4Bosman M. Chronic inflammatory diseases are stimulated by current lifestyle: how diet, stress levels and medication prevent our body from recovering. Nutrition & Metabolism 2012, 9:32

EPA-DHA por cada 100gr de pescado

Fedacko. Pathophysiology. n−3 PUFAs— From dietary supplements to medicines. Pathophysiology 14 (2007) 127– 132

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Figure 3Bosman M. Chronic inflammatory diseases are stimulated by current lifestyle: how diet, stress levels and medication prevent our body from recovering. Nutrition & Metabolism 2012, 9:32

ÁCIDO LINÓLICO

Viswanathan. Involvement of CYP 2C9 in Mediating the Proinflammatory Effects of Linoleic Acid in Vascular Endothelial Cells. J Am Coll Nutr. 2003 Dec;22(6):502-10.

The local/systemic/central resolution approach; clinical PNI of the highest level

Bosma, van Wetten, Pruimboom 2011, in press

Bosman M. Chronic inflammatory diseases are stimulated by current lifestyle: how diet, stress levels

and medication prevent our body from recovering. Nutrition & Metabolism 2012, 9:32

Charles N. Serhan. Resolving inflammation: dual anti-inflammatory and pro- resolution lipid mediators. Nat Rev Immunol. 2008 May ; 8(5): 349–361

Inhibir citoquinas proinflamatorias

Tsuji NM, Kosaka A. Oral tolerance: intesMnal homeostasis and anMgen-­‐specific regulatory T cells. Trends Immunol. 2008 Nov;29(11):532-­‐40.

Generations (~30 yrs) in the Evolution of Humanity

Generations % Total Homo habilis (1st Homo species ) 76,667 100.0 Homo erectus (modern body size) 60,000 78.2 Modern Homo sapiens (cranial size) 6,666 8.7 Agricultural Revolution (cereals) 333 0.4 Advent of Dairying (milk, cheese etc) 200 0.26 Industrial Revolution (refined sugars, 7 0.009 refined cereals, oils, canned food) Food Processing Industry (junk food) 4 0.005

Conclusión: El 95% de todas las generaciones del Homo sapiens han vivido como cazadores-­‐recolectores.

Cordain, L., Eaton, S.B. 1999. World Rev Nutr Diet 84:19 –73.

¿qué comíamos?

•  Pescados y mariscos •  Carne que se movía y no

comía cereales •  Huevos •  Frutas •  Verduras •  Frutos secos •  Algo de miel

Cordain, JANA 2002

Food Components of Typical Hunter-Gatherer Diet

•  1. Animal food energy = 55% •  a. Hunted animal = 27.5% •  b. Fished animal = 27.5% •  c. No fatty or processed

meats •  d. No dairy foods •  2. Plant food energy = 45% •  a. No cereal grains •  b. Minimally processed

fresh fruits, vegetables, seeds & nuts

•  3. No Processed Foods

(19-35 %) Protein

(22-40 %) Carbohydrate

(28-47 %) Fat

Typical Macronutrient Breakdown

Cordain L et al. Am J Clin Nutr, 2000, 71: 682-692.

Apportionment of daily energy to the five food groups in a contemporary diet based upon Paleolithic food groups

15 15 15

27,5 27,5

0

5

10

15

20

25

30

Vegetables Fruits Nuts/seeds Sea Food Lean Meats

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Cordain L et al. Am J Clin Nutr, 2000, 71: 682-692.

Refined sugars, grains, vegetable oils and dairy = 70.9% of energy in the U.S. food supply

•  Refined sugars, grains, vegetable oils and dairy represent Neolithic & Industrial era foods that were not present in traditional ancestral human diets

•  By default, their inclusion displaces minimally processed, wild plant and animal foods.

15,7 1,43,13,3

4,80,8

10,623,9

17,8

18,6Refined Sugars

Refined Vegetable Oils

Vegetables

Fruits

Grains

Nuts, Seeds Legumes

Eggs

Dairy

Meats, Fish

Miscellaneous

Gerrior S, Bente I. 2002. Nutrient Content of the U.S. Food Supply, 1909-99: A Summary Report. U.S.D.A, Center for Nutrition Policy and Promotion. Home Economics Research Report No. 55

123

Los grandes cambios

• 1. Carga glicemica• 2. Relación de Ácidos grasos• 3. Macronutrientes• 4. Micronutrientes• 5. pH• 6. Na/K y Ca/Mg• 7. Tipo y cantidad de fibra• 8. Mycotoxinas

Las 8 grandes razones

Pruimboom, L. et al. Nutrition and metabolism2010

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Figure 7Bosman M. Chronic inflammatory diseases are stimulated by current lifestyle: how diet, stress levels and medication prevent our body from recovering. Nutrition & Metabolism 2012, 9:32

Acid/Base Balance + values = acid (deplete body calcium) -values = alkaline (buffer acid load) Grains: Meats, Fish, Eggs Brown rice 12.5 Trout 10.8 Rolled oats 10.7 Turkey 9.9 Whole wheat bread8.2 Chicken 8.7 Spaghetti 7.3 Eggs 8.2 Cornflakes 6.0 Beef 7.8 White Rice 4.6 Cod 7.1 Dairy: Fruits Parmesan cheese 34.2 Raisins -21.0 Processed cheese 28.7 Black currants -6.5 Hard cheese 19.2 Bananas -5.5 Cottage Cheese 8.7 Apricots -4.8

Vegetables Legumes: Spinach -14.0 Peanuts 8.3 Celery -5.2 lentils 3.5 Carrots -4.9 Peas 1.2 Lettuce -2.5

Potential Renal Acid Loads of Foods (100 g portion)

Remer T, Manz F. Potential renal acid load of foods and its influence on urine pH. J Am Diet Assoc 1995;95:791-97

Fresh Fruits Fresh Veggies

Nuts/Seeds Fish/Seafood Lean Meats

Healthful Oils

Recommenda@ons for a Contemporary Diet Based Upon Paleolithic Food Groups

Cordain L. Am J Clin Nutr. 2005

Nutrición como medicamento

-  Ajo, cebolla, puerro -  Brocoli, coliflor -  Frutos del bosque -  Uva, cacao -  Curcumina -  Salvia -  Jengibre -  Zanahoria -  Cilantro -  Aceites esenciales -  Grasas - proteína

Terapia Ortomolecular

•  Aceite omega 3 3000 mg: 1-­‐1-­‐1

•  Aceite de hígado 4-­‐6/día analí@ca – Vit D3 40-­‐60 mcg – Vit A 4000-­‐6000 mcg •  Salix alba 1500 mgr (1-­‐1-­‐1) o Populus nigra – Fase aguda 30 gotas cada 4 horas – Fase subaguda 30/30/30

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Figure 6Bosman M. Chronic inflammatory diseases are stimulated by current lifestyle: how diet, stress levels and medication prevent our body from recovering. Nutrition & Metabolism 2012, 9:32

Gracias por su atención

carlos@regenera.cat