Acupuncture, Herbs and Foods for Diabetes

by John & Barbara Connor, M.Ac., L.Ac.

Barbara and I would like to share with you today studies on some of the natural ways you can maintain healthy blood sugar levels. These include studies on foods that are beneficial as well as harmful for type 2 diabetes, as well as studies on specific herbs and nutrients for diabetes and studies showing how acupuncture can be beneficial in treating diabetes. We hope you find this article helpful.

Table of Contents

  • Introduction
  • Foods to Eat that are Beneficial in Reducing the Risk of Type 2 Diabetes
  • Food to Avoid in Order to Reduce the Risk of Type 2 Diabetes
  • Studies Relating to Dietary Considerations in Insulin Resistance and Diabetes
  • Beneficial Herbs, Nutrients and Foods for Insulin Resistance and Diabetes
  • Studies on Beneficial Herbs, Nutrients and Foods for Insulin Resistance and Diabetes
  • Studies on the Beneficial Effects of Acupuncture on Diabetes
  • Blood Markers in Insulin Resistance and Diabetes

Introduction

In order to ensure normal body function, the human body is dependent on a tight control of its blood glucose levels. The pancreas plays a key role in this by secreting the blood sugar-lowering hormone insulin and its opponent glucagon. Disturbances in the interplay of the hormones and peptides involved may lead to metabolic disorders such as type 2 diabetes mellitus (T2DM). (Roder et al 2016)

Insulin resistance is a primary defect that is a characteristic feature of type 2 diabetes. The state of insulin resistance leads to increased insulin secretion by pancreatic β-cells and compensatory hyperinsulinemia. As long as compensatory hyperinsulinemia is sufficient to overcome the insulin resistance, fasting glycemia and glucose tolerance remain relatively normal. In patients predestined to progress to type 2 diabetes, β-cell compensation efficiency declines and relative insulin insufficiency develops, leading to impaired glucose tolerance and, eventually, type 2 diabetes. Consequently, type 2 diabetes results from the progressive failure of pancreatic β-cells in a setting of chronic insulin resistance. (Park et al 2013)

Reactive oxygen species (ROS) play an important role in insulin resistance and pancreatic β-cell dysfunction, a highly prevalent condition implicated in the development of type 2 diabetes. Under a diabetic condition, chronic hyperglycemia may induce large amounts of ROS that are responsible for the progressive dysfunction of β-cells, worsening insulin resistance and further promoting relative insulin deficiency ROS. β-Cells, in particular, are particularly sensitive to ROS because they are low in free-radical quenching (antioxidant) enzymes such as catalase, glutathione peroxidase, and superoxide dismutase. (Park et al 2013)

Prior studies have exhibited that the prevalence of obesity and T2DM in people with coronary heart disease (CHD) exceeds that of the general population. Different factors have been involved in the progression of T2DM and CHD such as little glycemic control and dyslipidemia. In addition, low-grade inflammation resulting from free radicals and reactive oxygen species (ROS) may help to the expansion of metabolic complexity in diabetic vascular disease. (Raygan et al 2016)

There is no argument that improving mean level of glycemic control, assessed by glycated hemoglobin (HbA1c), reduces the risk of microvascular complications and cardiovascular disease (CVD) events in patients with T2D. Chronic sustained hyperglycemia has been shown to exert deleterious effects on the β cells and the vascular endothelium. (Huang et al 2017)

Diabetes mellitus (DM) is associated with a wide range of microvascular complications including diabetic retinopathy (DR). One of the main risk factors associated with development of DR is poorly controlled blood sugar as assessed by glycated hemoglobin levels (HbA1c)—the higher the HbA1c, the greater the risk of developing retinopathy. (Pusparahah et al 2016)

Studies have found that peripheral neuropathy (which includes any disorder of the peripheral nervous system, including polyneuropathy, polyradiculopathies, and mononeuropathy) occurs in up to half of the population with diabetes. (Dy et al 2017 )

Progression of diabetes, and especially poor glycemic control, leads to numerous potentially life threatening complications. Almost half of the adults with chronic kidney disease are derived from diabetic population. Likewise, 9.8% of diabetics have experienced heart attack, 9.1% suffer from coronary artery disease (CAD), 7.9% have congestive heart failure, 6.6% have stroke while more than a quarter of them 27.8% suffer from chronic kidney disease, almost a quarter 22.9% have foot problems and last but not least 18.9% have eye damage. (Trikkalinou et al 2017)

Preexisting diabetes in cancer patients at the time of diagnosis was associated with a hazard ratio of 1.41 for the risk of all-cause mortality compared with individuals without diabetes when pooled across 23 studies of various types of cancer. While the association of diabetes and site-specific mortality risk reached statistical significance only for cancers of the endometrium, breast, and colorectum, diabetes appeared to be associated with some additional mortality risk for all types of cancer. (Barone et al 2011)

Foods to Eat that are Beneficial in Reducing the Risk of Type 2 Diabetes:

  • Beans/legumes
  • Dairy
  • Dairy products
  • Dietary fiber
  • Dried fruits
  • Fish
  • Fruits
  • Low glycemic index foods
  • Low glycemic load dietary pattern combined with a traditional Mediterranean diet
  • Nuts
  • Plant protein (decreases the risk of type 2 diabetes in females)
  • Polyunsaturated fats
  • Seafood omega-3s
  • Seeds
  • Soy
  • Vegetables
  • Whole grains
  • Yogurt

Foods to Avoid in Order to Reduce the Risk of Type 2 Diabetes

  • High glycemic index and high glycemic load foods
  • Nonnutritive sweeteners
  • Processed meats
  • Red meat and processed meat
  • Sugar-sweetened beverages
  • Total protein and animal protein
  • Trans-fats
  • Unprocessed red meats

Studies Relating to Dietary Considerations in Insulin Resistance and Diabetes

The results of this meta-analysis show that total protein and animal protein could increase the risk of type 2 diabetes mellitus (T2DM) in both males and females, and plant protein decreases the risk of T2DM in females. The association between high-protein food types and T2DM are also different. Red meat and processed meat are risk factors of T2DM, and soy, dairy and dairy products are the protective factors of T2DM. Egg and fish intake are not associated with a decreased risk of T2DM. This research indicates the type of dietary protein and food sources of protein that should be considered for the prevention of diabetes. (Tian et al 2017)

Only 8 identified dietary factors had probable or convincing evidence for causal effects on diabetes, including protective effects of nuts/seeds, whole grains, yogurt, and dietary fiber, and harms of unprocessed red meats, processed meats, sugar-sweetened beverages (SSBs), and glycemic load. SSBs and glycemic load were most frequently studied. Processed meats had the strongest estimated effect, with 1.51 relative risk (RR) per daily serving; other foods had more modest effects, such as 0.82 and 0.88 RR per daily serving of yogurt and whole grains, respectively. SSBs had a small but statistically significant etiologic effect on body weight, with smaller effects in normal weight (per daily serving, 0.10 kg/m2 increase in BMI) vs. overweight or obese (0.23 kg/m2) individuals. (Mischa et al 2017)

Undoubtedly, the specific composition of nuts and dried fruits means that they can be used to efficiently counteract metabolic diseases such as type 2 diabetes. Their unique profile of macronutrients, micronutrients and other bioactive compounds may explain the beneficial effects observed in clinical and epidemiological studies. However, the exact mechanisms by which they modulate glucose and insulin metabolism and influence T2D have yet to be fully discovered. (Hernandez-Alonso et al 2017)

Restricted carbohydrate (RC) diet (43-49% carbohydrate and 36-40% fats) diet in overweight T2D with  coronary heart disease (CHD) had beneficial effects on fasting plasma glucose (FPG), hs-CRP,  total antioxidant capacity (TAC), and glutathione (GSH) values. This study demonstrated that compared with a high-carbohydrate diet, adherence to a RC diet for 8 weeks decreased serum hs-CRP and increased plasma TAC and GSH concentrations. (Raygan et al 2016)

Consumption of most carbohydrates increases blood glucose and blood insulin, but to varying extents, depending on carbohydrate type and processing, amount consumed, and presence of other nutrients. These variations are captured by the glycemic index (GI), which ranks carbohydrate foods according to their ability to raise blood glucose levels. High GI foods, like white bread, are rapidly digested and cause a rapid peak in blood glucose. Low GI foods like pulses and pasta, are digested more slowly, prompting a more gradual rise in blood glucose. Glycemic load (GL), the product of a food’s GI and its available carbohydrate content, was introduced to incorporate the effect of the total amount of carbohydrate consumed: it is a measure of total glycemic effect, and is hence an indicator of the insulin demand of the diet. (Sieri et al 2017)

High glycemic index was associated with increased risk of colon and bladder cancer. High glycemic load was associated with: increased risk of colon cancer; increased risk of diabetes-related cancers; and decreased risk of rectal cancer. (Sieri et al 2017)

Glycemic load measures carbohydrate absorption in relation to insulin demand — in other words, it measures how quickly a food’s carbohydrates are turned into sugars by the body (glycemic index) in relation to the amount of carbohydrates per serving of that food. Some examples of foods with a high glycemic load are white breads, white rice, brown rice pasta, white rice cakes, popcorn and rice milk.

The results of one study showed that a high adherence to the Mediterranean diet was inversely associated with T2DM risk (OR = 0.88, CI: 0.77–0.99, p trend = 0.021) while combining it with low glycemic load (GL) the association became stronger (OR = 0.82, CI: 0.71–0.95). These results suggest that a low GL combined with a traditional Mediterranean diet conveys 18% protection against the occurrence of T2DM suggesting that even within an overall healthy diet there may be benefits of lowering the dietary GL. (Augustin et al 2015)

The results of this study suggest that for patients with diabetes low-glycemic index diets achieve a more beneficial effect on glycemic control than that of high-glycemic index foods diets. (Wang et al 2015)

Dairy products, legumes, and fruits were found to have a low-glycemic index. Breads, breakfast cereals, and rice, including whole grain, were available in both high and low GI versions. (Atkinson et al 2008)

This meta-analysis provides high-level evidence that diets with a high GI, high GL, or both, independently of known confounders, including fiber intake, increase the risk of chronic lifestyle-related diseases. The effect was modest overall (GI RR = 1.14; GL RR = 1.09) but more pronounced for type 2 diabetes (GI RR = 1.40; GL RR = 1.27), heart disease (GI RR = 1.25), and gallbladder disease (GI RR = 1.26; GL RR = 1.41). Overall, the GI had a more powerful effect than did the GL (the product of carbohydrate and GI), with more positive associations between GI and chronic disease risk, and associations of greater magnitude, which suggests that, irrespective of the level of carbohydrate intake, the GI of contributing carbohydrate foods is important. (Barclay et al 2008)

The results of this study also extend previous meta-analyses that showed higher risks of type 2 diabetes and hypertension with regular consumption of nonnutritive sweeteners, such as aspartame, sucralose and stevioside. (Azad et al 2017)

Beneficial Herbs, Nutrients and Foods for Insulin Resistance and Diabetes

  • Bitter gourd
  • Curcumin
  • Fenugreek
  • Fenugreek and onion
  • Flavonoids
  • Galega officinalis
  • Ginseng
  • Gymnena sylvestre
  • Jade Spring Pills
  • Mucuna pruriens
  • Mulberry leaf, fenugreek seed and American ginseng
  • Olive oil
  • Pterocarpus marsupiam
  • Salacia reticulata
  • Vitamin D

Studies on Beneficial Herbs, Nutrients and Foods for Insulin Resistance and Diabetes

Bitter gourd (Momordica charantia) increases insulin secretion of the pancreas, decreases intestinal glucose uptake, and increases uptake and utilization of glucose in peripheral tissues. Although human studies with type 2 diabetics are weak in their design and/or results, some of the studies do indicate anti-diabetic effects in patients and safety for bitter gourd treatment in humans. (Habicht et al 2014)

Bitter gourd (Momordica charantia) – Although evidence suggests possible beneficial effects of extracts of bitter melon and its active compounds in the prevention and control of diabetes, future clinical studies are needed to confirm this. (Ota & Ulrih 2017)

Curcumin has shown the confident results to be effective for the treatment of impaired glucose tolerance. Fenugreek and flaxseed may also be effective, but due to low quality of these studies the results must be interpreted with caution. (Demmers et al 2017)

Fenugreek  Although results from clinical trials support beneficial effects of fenugreek seeds on glycemic control in persons with diabetes, trials with better methodology quality and well characterized preparation of sufficient dose are needed to provide more conclusive evidence. With its hypoglycemic and antidyslipidemic effects, fenugreek represents an attractive new candidate for treatment of type 2 diabetes, obesity, and dyslipidemia, the key components of metabolic syndrome. (Ota & Ulrih 2017)

Fenugreek and onion – This study documented the hypoglycemic and insulinotropic effects of dietary fenugreek and onion, which were associated with countering of metabolic abnormalities and pancreatic pathology. It may be strategic to derive maximum nutraceutical antidiabetic benefits from these functional food ingredients by consuming them together. (Pradeep & Srinivasan 2017)

Flavonoids – There is growing evidence based on in vitro and animal research that polyphenols in general, and in particular the flavonoids, a class of polyphenols, can improve glucose homeostasis and enhance insulin secretion and sensitivity. Our observations support previous experimental evidence of a possible beneficial relationship between increased flavonol intake and risk of T2D. (Jacques et al 2013) *Examples of flavonoid compounds are quercetin, EGCG and anthocyanins

Galega officinalis (Goat’s Rue, galega) – Together with its established hypoglycaemic effects, galega has a novel weight reducing action that, in normal mice, is largely independent of a reduction in food intake. (Palit et al 1999)

Ginseng modestly yet significantly improved fasting blood glucose in people with and without diabetes. (Shishtar et al 2014)

Gymnema sylvestre (gurmar) – Several studies have reported antidiabetic effects and sugar inactivation properties of gurmar. (Ota & Ulrih 2017)

Jade Spring Pills – According to a clinical evaluation reported by Fegn et al in The Journal of the Shangdong College of TCM 1994; 18(6): 376-377 the Chinese herb formula for diabetes, Jade Spring Pills, used for the control group, was reported to be effective in reducing blood sugar for 79% of the cases treated. (Fegn et al 1994)

Mucuna pruriens – The study clearly supports the traditional use of Mucuna pruriens for the treatment of diabetes and indicates that the plant could be a good source of potent antidiabetic drug. (Majekodumi et al 2011)

Mucuna pruriens – This study shows that Mucuna pruriens has an anti-hyperglycemic action and it could be a source of hypoglycemic compounds. (Bhaskar et al 2008)

Mulberry leaf, fenugreek seed and American ginseng – Botanicals have been used in traditional Chinese medicine (TCM) for thousands of years to treat T2DM, which is named “wasting-thirst” in TCM. A novel botanical formula containing standardized extracts of mulberry leaf, fenugreek seed and American ginseng at a ratio of 1:1.3:3.4 prevented the development of insulin resistance, impaired glucose tolerance and T2DM. Given the rising need for effective non-drug targeting of insulin resistance and progression to T2DM, complementary and alternative nutritional strategies without intolerable side effects could have meaningful impact on metabolic health and diabetes risks. (Kan et al 2017)

Olive oil – The present systematic review and meta-analysis provides evidence of favorable effects of olive oil on type 2 diabetes risk and parameters of glycemic control. (Schwingshackl et al 2017) PMID: 28394365

Pterocarpus marsupium – This study justifies the traditional claim and provides a rationale for the use of Pterocarpus marsupium to treat diabetes mellitus. The antidiabetic activity of Pterocarpus marsupium can be enhanced by extracting the heartwood by non conventional method of ultrasound-assisted extraction. (Devgan et al 2013)

Salacia reticulata – Clinically significant reductions of HbA1C and plasma Insulin are reported with treatment of 6 weeks to 3 months. One clinical trial reported significant reduction of weight and BMI when Salacia is used in combination with vitamin D. Salacia reticulata effectively improves insulin resistance, glucose metabolism and reduces obesity. A larger evidence base is required from well-planned studies to confirm its efficacy and safety. (Medagama AB 2015)

Vitamin D – The present study shows that oral Vitamin D supplementation of 60,000 IU/week for 8 weeks significantly improves vascular functions and reduces oxidative stress in type 2 diabetic patients with Vitamin D deficiency. (Anandabaskar et al 2017)

Studies on the Beneficial Effects of Acupuncture on Diabetes

Diabetes is categorized in Chinese Medicine into various patterns according to the signs and symptoms of each individual case.  Diabetes is usually attributed to Deficient Kidney Essence.  Chinese Medical patterns describing diabetes include:  Deficiency of Kidney Yin, Yin Deficiency with Internal Heat, Deficiency of Spleen Yin, Deficiency of both Yin and Qi, Excessive Heat in the Lung and Stomach and Hyperactivity of Stomach Fire. The following studies show the benefits of acupuncture in diabetes and related blood sugar issues.

  • Forty type 2 diabetes mellitus (T2DM) patients were recruited and randomized into either the acupuncture group or placebo control group. There was a significant reduction in random blood glucose level in the acupuncture group compared to baseline. No such significant change was observed in the placebo control group. The result of this study suggests that 30 minutes of needling at CV-12 might be useful in reducing blood glucose level in patients with type 2 diabetes mellitus. (Kumar et al 2017)
  • Here, a case of type 2 diabetes mellitus in a patient with Myasthenia gravis who underwent 105 sessions of acupuncture delivered over 6 months is reported. After acupuncture treatment, the patient’s fasting plasma glucose and hemoglobin A1c levels, as well as the score on the Hamilton Depression Rating Scale, were decreased. Furthermore, no adverse effects were observed. The findings in this clinical study are encouraging and provide evidence supporting the effectiveness of acupuncture in reducing type 2 diabetes mellitus in a patient with MG. (Kim Y 2017)
  • According to a review by Hui which appeared in the Journal of Traditional Chinese Medicine 1995; 15: 145-154 animal experiments have shown that acupuncture can activate glucose-6-phosphatase (an important enzyme in carbohydrate metabolism) and affect the hypothalamus.  Acupuncture can act on the pancreas to enhance insulin synthesis, increase the number of receptors on target cells and accelerate the utilization of glucose, resulting in the lowering of blood sugar.
  • According to a study reported by Chen et al in the Journal of Traditional Chinese Medicine 1994 14(3): 163-166 they found that by using acupuncture for diabetes nearly 2/3 of the patients receiving acupuncture showed marked improvement.  Furthermore the patients receiving acupuncture experienced a statistically significant decline in cholesterol, triglycerides and beta-lipoproteins. The drop in triglycerides was most substantial with a decline from an average value of 151 at the start to 117 one month later.
  • A study published in Diabetes Res Clin Pract 1998 Feb;39(2):115-21 on 46 patients with chronic painful peripheral neuropathy concluded that acupuncture is a safe and effective therapy for the long-term management of painful diabetic neuropathy, although its mechanism of action remains speculative.
  • Another study published in Russian in the journal Probl Endokrinol (Mosk) 1991 Jul-Aug,37(4)-20-3 on diabetic angiopathy of the lower extremities on 55 patients with insulin-dependent diabetes mellitus showed a direct noticeable clinical effect with acupuncture In 78.2% of cases, determined perhaps by improved elastotonic properties of arteries of average caliber, enhanced blood outflow and regulation of lower limb vascular peripheral resistance.

Blood Markers in Insulin Resistance and Diabetes

C-reactive protein – In this study, C-reactive protein (CRP), interleukin 6 (IL6), and tumor necrosis factor alpha (TNF-α) associated with type 2 diabetes mellitus (T2DM). Our findings suggested that these inflammatory markers, especially C-reactive protein, may initiate type 2 diabetes mellitus (Phosat et al 2017)

Folate status is typically reduced in diabetic patients. (Pusparajah et al 2016)

HbA1c – Type 2 diabetes mellitus (T2DM) is a risk factor for cardiovascular disease (CVD), and T2DM patients are at increased risk of morbidity and mortality from CVD. The presence of T2DM also increases the relative risk (RR) of developing CVD in women (RR = 8.5) compared to men (RR = 3.2). Major CVD risk factors that have been identified in type 2 diabetes mellitus patients include arterial stiffening, endothelial dysfunction, hyperglycemia, and elevated glycated haemoglobin (HbA1c) concentrations. (Vijayakumar et al 2017)

HbA1c – In type 2 diabetics, recently, elevated HbA1c level has also been considered as one of the leading risk factors for developing microvascular and macrovascular complications. Improvement in the elevated HbA1c level can be achieved through diet management; thus, the patients could be prevented from developing the diabetes complications. (Sami et al 2017)

HbA1c – There is no argument that improving mean level of glycemic control, assessed by glycated hemoglobin (HbA1c), reduces the risk of microvascular complications and cardiovascular disease (CVD) events in patients with type 2 diabetes. Chronic sustained hyperglycemia has been shown to exert deleterious effects on the β cells and the vascular endothelium. (Huang et al 2017)

Homocysteine – High levels of homocysteine (Hcys) have been identified as a risk factor for CVD in type 2 diabetes mellitus (T2DM) patients. High concentrations of Hcys are associated with increased low-density lipoprotein oxidation and endothelial dysfunction. High concentrations of Hcys can worsen T2DM by inducing reversible dysfunction of β-islet cells and inhibiting secretion of insulin. (Vijayakumar et al 2017)

Vitamin B12 and folic acid – Several other studies also reported a statistically significant increase in the total plasma level of homocysteine and a statistically significant decrease in the serum levels of vitamin B12 and folic acid in diabetic retinopathy. (Srivastav et al 2016)

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Acupuncture, Herbs and Nutrients for Immune Health

by John & Barbara Connor, M.Ac., L.Ac.

Soon we will be entering into cold and flu season so Barbara & I thought it would be timely to share with you today studies on the benefits of acupuncture, herbs, nutrients and foods and the effects of lifestyle in building and maintaining healthy immune function.  We hope you find this article helpful.

Table of Contents

  • Introduction
  • Studies on the Benefits of Acupuncture and Moxibustion on Immune Health
  • List of Beneficial Herbs, Nutrients and Foods for Immune Health
  • Studies on Beneficial Herbs, Nutrients and Foods for Immune Health
  • Effects of Lifestyle, Blood Markers, Etc. on Immune Function

Introduction

The human immune system and its response to any specific stimulus is extremely complex and comprises a variety of physical elements, cell types, hormones and interactive modulators. These responses are precisely coordinated to protect the body’s tissues against pathogenic agents. (Gunzer et al 2012)

Mucosal immunity, particularly in saliva, is considered the first line of defense against pathogens, because it contains numerous protective proteins. Some of these, such as salivary immunoglobulins (Igs), are involved in innate and adaptive immune responses. In addition to Igs, there are also cytokines, such as interleukin (IL)-1ß, tumor necrosis factor (TNF)-α, and IL-6, that are used to assess the response to acute stress, stimulating immune cells, and modulating local inflammation. (Caris et al 2017)

Components of the innate immune response, including neutrophils and macrophages, are the first line of defense against infections. (Solana et al 2012)

Macrophages are cells of the innate immune system that populate every organ. They display great functional plasticity and are required for maintenance of tissue homeostasis, immunity against invading pathogens, and tissue repair.  In adulthood, tissue resident macrophage subsets are replenished by monocytes that are recruited from the bone marrow. The two major subsets of monocytes are termed inflammatory and patrolling monocytes. Under steady state, patrolling monocytes crawl along the vasculature where they function as immune sentinels. (Lauterbach & Wunerlich 2017)

Respiratory and gastrointestinal tract infections are a relevant problem for young children attending day care or preschool, especially in the winter season. These conditions are facilitated by a general immaturity of the immune system and of respiratory and gastrointestinal tract functions. (Corsello et al 2017)

It is now widely recognized that the intestinal microbiota shape mucosal immunity through various mechanisms. (Edelblum et al 2017) Secretory immunoglobulin A (SIgA) is the principal regulator of adaptive defenses on the intestinal mucosal surface of humans. (Ren et al 2016)

The immune system is connected to the endocrine and neural systems via a number of pathways that integrate the functions of the hypothalamus, pituitary glands, adrenal glands, thyroid glands, gonads and autonomic nervous system. (Gonzalez-Diaz et al 2017)

A well-functioning immune system can be disrupted by multiple factors, such as inadequate nutrition, physical, psychological, and environmental stresses as well as oxidative stress. (Yu et al 2016) The immune system is extremely vulnerable to oxidant and antioxidant balance as uncontrolled free radical production can impair its function and defense mechanism. (Asiani & Ghobadi 2016)

Adequate intakes of vitamins and trace elements are required for the immune system to function efficiently. Micronutrient deficiency suppresses immune functions by affecting the innate T-cell-mediated immune response and adaptive antibody response, and leads to dysregulation of the balanced host response. This increases the susceptibility to infections, with increased morbidity and mortality. (Wintergerst et al 2007)

In Traditional Chinese Medicine immunity is connected with Wei Qi, Zheng Qi and the San Jiao (Triple Burner). Wei Qi or Defensive Qi deals with prevention and resistance, and protects the body against pathogens. It circulates outside the channels in the skin, muscles and fascia. It is controlled by the Lungs, so Lung deficiency can lead to Wei Qi deficiency. It is also controlled by the San Jiao. The fascia is the realm of the San Jiao and has to do with lymphatics. We would like to begin by sharing with you some studies on the benefits of acupuncture and moxibustion on immune health.

Studies on the Benefits of Acupuncture and Moxibustion on Immune Health

  • Acupuncture may improve the immune system by increasing the counts of a few immune cells and relieve fatigue in cancer patients by decreasing FSS scores. Although this was a non-controlled study, it constitutes preliminary research investigating the potential effects of [Korean] Saam acupuncture in increasing the counts of several immune cells in cancer patients. (Kim et al 2014)
  • The acupuncture therapy at selective time is effective in the treatment of chronic fatigue syndrome of qi deficiency syndrome, which is especially better at relieving mental fatigue. The effect of this therapy is achieved probably by improving the immune function via the regulation of the ratios among CD3+, CD4+ and CD8+ T cells. (Ling et al 2013)
  • We confirmed that acupuncture stimulation could quantitatively as well as qualitatively regulate leukocytes and their subsets. First, the increase of CD2+, CD4+, CD8+, CD11b+, CD16+, CD19+ and CD56+ cell counts as well as the levels of IL-1β, IL-4 and IFN-γ suggested that acupuncture enhances humoral and cellular immunity, including the activities of NK cells (31–35). We observed that the levels of IFN-γ containing cells were increased 9 times in this trial, while in a previous trial on hot-spring bathing, the levels only increased 1.19 times. Based on the observations that expression levels of IFN-γ were elevated on day 11 and returned to the original level by 1 month after stimulation, one treatment of acupuncture per month might be recommended in order to enhance IFN-γ.  (Yamaguchi et al 2007)
  • Acupuncture for warming yang and benefiting qi effectively controls the symptoms of bronchial asthma at chronic persistent stage and improves immune and pulmonary functions. The efficacy is better than that of seretide. (Xie et al 2015)
  • Moxibustion and acupuncture have been shown to regulate the ratio of Th17 and Treg cells in the intestinal mucosa of Crohn’s disease patients and restore the balance between these immune cell subsets. Th17 cells play important roles in mediating inflammatory responses. Treg cells inhibit the proliferation of effector T cells and their reaction to autoantigens, thus controlling the strength of immune responses elicited by effector T cells and limiting the severity of associated tissue damage. (Zhao et al 2015)
  • Moxibustion at Guanyuan (CV 4), Shenshu (BL 23) and Zusanli (ST 36) can improve immune function of children with cerebral palsy, which is superior to pidotimod [an immunostimulant]. (Ying et al 2016)
  • This study demonstrated that electroacupuncture at the ST36 acupoint was able to regulate the production of immune cytokines (IFN-γ, IL-2 and IL-17) and the differentiation and activation of splenic T cells, which was mediated by the regulation of extracellular and intracellular Ca2+ concentrations. Our results also suggested that Ca2+ influx in spleen cells induced by electroacupuncture at the ST36 acupoint might be mediated by transient receptor potential vanilloid channels. (Chen et al 2017)
  • Electro-acupuncture at Zusanli and Guanyuan could improve clinical curative effect in patients with sepsis, which might be achieved by regulation of the immune system. (Yang et al 2016)

List of Beneficial Herbs, Nutrients and Foods for Immune Health

  • Aged garlic extract
  • American ginseng
  • Arginine
  • Arginine and Glutamine
  • Astragalus root
  • Astragalus seeds
  • Astragalus soup
  • Beta-glucan( β-glucan
  • Black cumin
  • Burdock (Arctium lappa), bur marigold (Bidens tripartite), nettle (Urtica dioica) and licorice (Glycyrrhisa glabra)
  • Cat’s claw and Echinacea
  • Cordyceps militaris
  • Coriolus versicolor
  • Curcumin
  • Echinacea
  • Echinacea, Astragalus and Glycyrrhiza
  • Elderberry (Sambucus nigra)
  • Ellagic acid
  • Epigallocatechin-3-gallate (EGCG)
  • Ganoderma lucidum
  • Ginger
  • Ginsenoside
  • Glucan and resveratrol
  • Glutamine
  • Glycyrrhizic acid
  • Honokiol and magnolol
  • Lactoferrin
  • Modified Aloe polysaccharide
  • Probiotics
  • Propolis
  • Rehmannia glutinosa polysaccharide
  • Resveratrol
  • Schisandra chinensis
  • Silybum Marianum (milk thistle)
  • Tangeretin
  • Vitamins A, B6, C, D, and E, zinc; iron; copper; selenium; magnesium
  • Vitamins A and D
  • Vitamins B(6), folate, B(12), C, E, and of selenium, zinc, copper, and iron
  • Vitamin C
  • Vitamin D
  • Whey protein
  • Zinc

Studies on Beneficial Herbs, Nutrients and Foods for Immune Health

  • Aged garlic extract – This study concluded that supplementing the diet with aged garlic extract resulted in enhanced immune cell function, and perhaps under less inflammatory conditions. (Percival SS 2016)
  • American ginseng – This study found that a novel protein of the roots of American ginseng had good immunoregulatory effects supporting the traditional claims and may provide a valuable therapeutic strategy to promoting immune function and metabolism. (Qi et al 2016)
  • Arginine and glutamine – The results of this animal study suggest that dietary arginine or glutamine supplementation may inhibit intestinal Enterotoxigenic Escherichia coli infection through intestinal innate immunity. (Liu et al 2017)
  • Arginine metabolism has emerged as a critical regulator of innate and adaptive immune responses. The major arginine-catabolizing enzymes involved in inflammatory immune responses are the isoforms of NOS (NOS1–3) and arginase (arginase 1 and 2). (Rodriguez et al 2017)
  • Astragalus root (Astragali Radix)– The results of this study indicate that total flavonoids of Astragalus have potential immunostimulatory and anti-inflammatory effects. (Guo et al 2016) PMID: 28852721 Flavonoids are a large group of secondary plant metabolites present in the diet. In addition to antioxidant, anti-inflammatory, cholesterol-lowering, and many other biological functions reported in the literature, flavonoids appear to inhibit cancer cell proliferation and stimulate immune function. (Burkard et al 2017)
  • Astragalus seeds – The results of this study suggest that the flavonoid component from the seeds of Astragalus complanatus (FAC) upregulate the expressions of NKG2D, NKp44, which in turn influence NK-92 cells activation. FAC may serve as an immunostimulatory of natural killer (NK) cells for tumor treatment. (Han et al 2015)
  • Astragalus soup – In a relatively short period of three months, Taiji boxing produces no noticeable effect on the improvement of immunity in elderly women. However, when they resume the exercise for another three months and longer, Taiji boxing has a noticeable advantage and the effect is the most favorable when it is combined with astragalus soup. (Song et al 2014)
  • Beta-glucan( β-glucan) – Recent studies also demonstrate that β-glucan can function as a potent adjuvant to stimulate innate and adaptive immune responses. Most β-glucans are derived from yeast, bacteria, barley or fungi. (Ning et al 2016)
  • Black cumin (Nigella sativa) and its major active ingredient, thymoquinone (TQ) – Experimental evidence suggests that N. sativa extracts and TQ can potentially be employed in the development of effective therapeutic agents towards the regulation of immune reactions implicated in various infectious and non-infectious conditions including different types of allergy, autoimmunity, and cancer. (Majdalawieh & Fayyad 2015)
  • Burdock (Arctium lappa) and bur marigold (Bidens tripartite) extracts stimulated the humoral immune response, nettle (Urtica dioica) and licorice (Glycyrrhisa glabra) extracts stimulated cellular response and nonspecific resistance, their effects being superior to those of pharmacopoeial Echinacea purpurea tincture in this animal study. (Borsuk et al 2011)
  • Cat’s claw and Echinacea – Comparison of the in vitro data with our earlier observations that cat’s claw and Echinacea were each effective in reducing B16/F10 lung tumor colony formation in C57BL/6J mice suggests macrophage activation is the primary means by which these herbs modulate the immune system. (Groom et al 2007)
  • Cordyceps militaris is safe and effective for enhancing cell-mediated immunity of healthy male adults. (Kang et al 2015)
  • Coriolus versicolor – Clinical studies support PSP, a unique peptide-containing polysaccharide and the most active biological component in Coriolus versicolor, being a potential immunotherapeutic. However, the complicated chemical and multiple pharmacological properties of PSP need to be investigated further. Both innate and acquired immunities are enhanced by PSP through activating T-cells, B-cells, NK-cells, cytotoxic T-cells, antigen-presenting cells, and tissue macrophages accompanied by releasing a variety of chemokines, cytokines, and growth factors. (Chang et al 2017)
  • Curcumin – This cell and animal study supports the potential of curcumin as a promising treatment against influenza A virus infection, whose effect may be mediated by regulating immune response to prevent injury to the lung tissue. (Han et al 2017)
  • Echinacea purpurea succus from aerial plant parts is a wide-spectrum immunomodulator, with various forms that differ greatly between each other. They can contain a number of active compounds that in specific proportions can either work synergistically or oppose one another. Hence every medication that is based on those substances should be thoroughly tested prior to being approved for use in various immune system malfunctions. (Balan et al 2016)
  • Echinacea, Rhodiola, Ginseng – In this review we try to find out if the most common herbal supplements (Echinacea, Rhodiola, Ginseng) are effective in the improvement of performance or in the modulation of the immune system. According to the results of our review, the prevalent effect is adaptogenic rather than ergogenic, with a better tolerance of the exercise induced stress, related to enhancement of the whole immune system and decrease of the oxidative damage. (Amico et al 2013)
  • Echinacea – The findings of this animal study demonstrated that Echinacea is a wide-spectrum immunomodulator that modulates both innate and adaptive immune responses. (Zhai et al 2007)
  • Echinacea, Astragalus and Glycyrrhiza – The results of this pilot human study demonstrate that Echinacea, Astragalus and Glycyrrhiza herbal tinctures stimulated immune cells as quantified by CD69 expression on CD4 and CD8 T cells. This activation took place within 24 h of ingestion, and continued for at least 7 days. In addition, these three herbs had an additive effect on CD69 expression when used in combination. (Brush et al 2006)
  • Elderberry (Sambucus nigra) – The results of this study clearly show the in vivo efficacy of elderberry in suppressing viral replication and stimulating the immune response. (Kinoshita et al 2012)
  • Ellagic acid (EA) – This study demonstrated that oral innate immunity is affected by EA found in fruits. Thus, it may play some roles in mucosal innate immunity. The potential of EA for modulating the innate immune mediators may lead to developing a new topical agent to treat and/or prevent immune-mediated oral diseases. Ellagic acid is found in various fruits such as pomegranates, blackberries, raspberries, strawberries, and walnuts. (Promsong et al 2015)
  • Epigallocatechin-3-gallate (EGCG) – The results of this animal study collectively show that EGCG consumption during aging strengthens systemic immunity by enhancing cellular immune response and simultaneously attenuating antibody response aided by an increase in adrenal DHEA production. Thus, consumption of green tea may be beneficial in alleviating some of the deleterious aspects of aging and immunosenescence in elderly. (Sharma et al 2017)
  • Ganoderma lucidum polysaccharides (GL-PS) display regulatory abilities toward the immune system, resulting in antitumor and antioxidation effects. (Zeng et al 2017)
  • Ginger extract – Macrophages play a role in the activation of the adaptive immune system by behaving as antigen presenting cells (APCs). In conditions like transplantation macrophages infiltrate the graft at an early stage and initiate an inflammatory response against the graft and also act as APCs thereby activating the T cell mediated graft rejection course. Our results indicate that ginger extract suppresses the antigen presentation function of macrophages by decreasing MHC class II molecule expression. It also decreases the costimulatory molecule expression, the second signal essential for T cell activation, and also inhibits the cytokine and chemokine production. (Tripathi et al 2008)
  • Ginsenoside (a compound isolated from panax ginseng) – Ginsenoside Rg1 has been demonstrated to promote immunological response and may enhance T-cell activities (22,23). Ginsenoside Rh2 and Rd also acted as immunomodulators in a lot of physiological and pathological processes. (Wang et al 2017)
  • Glucan and resveratrol – The results of this study showed that both glucan and resveratrol complex stimulated phagocytosis of blood leukocytes, caused increase in surface expression of CD(+) splenocytes and showed higher restoration of spleen recovery after experimentally induced leucopenia. In all these cases, strong synergetic effects were observed. When we measured the effects of these substances on expression level of NF-kappaB2, Cdc42 and Bcl-2 in breast cancer cells, upregulation of Cdc42 expression was evident only using both immunomodulators in combination. (Vetvicka et al 2007)
  • Glutamine supplementation may be able to restore immune function and reduce the immunosuppressive effects of heavy-load training. (Song et al 2015)
  • Glycyrrhizic acid (GA) (a bioactive ingredient of licorice) – Clinical and experimental studies suggest that GA possesses several useful pharmacological properties, including anti-inflammatory and immunomodulatory properties. (Han et al 2017)
  • Honokiol and magnolol – In this study, we found that herbal medicines, honokiol and magnolol, caused a significant cellular immune modulatory effect during S. aureus infection. (Choi it al 2015)
  • Lactoferrin (Lf) is a glycoprotein of the primary innate immune-defense system of mammals present in milk and other mucosal secretions. This protein of the transferrin family has broad antimicrobial properties by depriving pathogens from iron, or disrupting their plasma membranes through its highly cationic charge. Noteworthy, Lf also exhibits immunomodulatory activities performing up- and down-regulation of innate and adaptive immune cells, contributing to the homeostasis in mucosal surfaces exposed to myriad of microbial agents, such as the gastrointestinal and respiratory tracts. (Drago-Serrano et al 2017)
  • Lactoferrin has multiple functions in host defense through binding iron, binding to bacterial membranes, inhibition of tumor necrosis factor-alpha (TNF-α) and interleukin-1β (IL-1β), stimulating the activity, maturation of lymphocytes, and contributing to an anti-oxidizing mileau. (Cacho & Lawrence 2017)
  • Modified Aloe polysaccharide (MAP) – The results of this animal study consistently suggest that oral administration of modified Aloe polysaccharide (extracted from Aloe vera) markedly prevented the immune system from being weakened under chronic EFS stress conditions. Furthermore, the immune-enhancing effect of MAP was demonstrated on every component of the immune system not only on the non-specific and specific immunity, but also on cellular and humoral responses of the specific immunity. (Lee et al 2016)
  • Probiotics demonstrate immunomodulation properties on both local and systemic (some aspects of both innate and acquired immune responses) immunity. In non-athletic populations, a recent systematic review concluded that probiotic use resulted in a lower incidence of upper respiratory tract infections, reduced numbers of illness days, and fewer days of absence from day care/school/work. Despite a lower number of studies, the same benefits seem to exist in athletic populations. (Bermon et al 2017)
  • Probiotics may improve a person’s health by regulating their immune function. In this Cochrane review probiotics were better than placebo in reducing the number of participants experiencing episodes of acute upper respiratory tract infections (URTIs), the mean duration of an episode of acute URTI, antibiotic use and cold-related school absence. This indicates that probiotics may be more beneficial than placebo for preventing acute URTIs. However, the quality of the evidence was low or very low. (Hao et al 2015)
  • Propolis modulated the maturation and function of dendritic cells (DCs) and may be useful in the initial steps of the immune response, providing a novel approach to the development of DC-based strategies and for the discovery of new immunomodulators. Dendritic cells are antigen-presenting cells, essential for recognition and presentation of pathogens to T cells. (Conti et al 2016)
  • Propolis activated macrophages to stimulate interferon (IFN)-gamma production in association with the secondary activation of T-lymphocytes, resulting in a decrease in IgG and IgM production. Cytokines released from macrophages in mouse peripheral blood after Propolis administration activated helper T-cells to proliferate. In addition, activated macrophages in association with the secondary T-lymphocyte activation increased IFN-gamma production and stimulated proliferation of cytotoxic T-cells and suppressor T-cells, indicating the activation of cell-mediated immune responses. (Takagi et al 2005)
  • Rehmannia glutinosa polysaccharide (RGP) – The findings of this study provided valuable information that RGP possessed strong immunoenhancement activity. (Huang et al 2013)
  • Resveratrol – The results of this study demonstrated that resveratrol had potent immune enhancement activity in immunosuppressive mice, and one possible mechanism of action was to activate the NF-κB. (Lai et al 2016)
  • Resveratrol – By administering resveratrol to healthy humans and utilizing primary immune cells we were able to detect TNF-α enhancing properties of the agent. In parallel, we found enhanced alternative NF-κB activation. (Gualdoni et al 2014)
  • Schisandra chinensis This study done using human monocytic leukemia cells found that Schisandra chinensis may be therapeutically beneficial by promoting humoral and cell-mediated immune responses. (lin et al 2011)
  • Silybum Marianum (milk thistle) extract – This study found that Milk Thistle is immunostimulatory in vitro. It increased lymphocyte proliferation in both mitogen and mixed lymphocyte culture (MLC) assays. These effects of Milk Thistle were associated with an increase in interferon gamma, interleukin (IL)-4 and IL-10 cytokines in the MLC. This immunostimulatory effect increased in response to increasing doses of Milk Thistle. Our study has uncovered a novel effect of milk thistle on the immune system. This immunostimulatory effect may be of benefit in increasing the immunity to infectious diseases. (Wilasrusmee et al 2002)
  • Tangeretin (a major constituent of the pericarp of Citrus sp) – The results of this study suggest that oral administration of tangeretin may attenuate colitis by suppressing IL-12 and TNF-α expression and nuclear factor kappa-B activation through the inhibition of lipopolysaccharide binding on immune cells such as dendritic cells. (Eun et al 2017)
  • Vitamins A, B6, C, D, and E, zinc; iron; copper; selenium; magnesium Immune cells need energy fuel substrates (glucose, amino acids, and fatty acids) and multiple nutrients to divide and produce protective chemicals; to move, engulf, and destroy pathogens; and produce proteins (e.g., cytokines and immunoglobulins) and lipid mediators (e.g., prostaglandins, leukotrienes, and specialized pro-resolving mediators). Multiple enzyme systems are involved, with critical roles defined for zinc; iron; copper; selenium; magnesium; vitamins A, B6, C, D, and E; and others. (Nieman & Mitmesser 2017)
  • Vitamins A and D play important roles in both cell-mediated and humoral antibody response and support a Th2-mediated anti-inflammatory cytokine profile. Vitamin A deficiency impairs both innate immunity (mucosal epithelial regeneration) and adaptive immune response to infection resulting in an impaired ability to counteract extracellular pathogens. Vitamin D deficiency is correlated with a higher susceptibility to infections due to impaired localized innate immunity and defects in antigen-specific cellular immune response. (Wintergerst et al 2007)
  • Vitamins B(6), folate, B(12), C, E, and of selenium, zinc, copper, and iron – Adequate intake of vitamins B(6), folate, B(12), C, E, and of selenium, zinc, copper, and iron supports a Th1 cytokine-mediated immune response with sufficient production of proinflammatory cytokines, which maintains an effective immune response and avoids a shift to an anti-inflammatory Th2 cell-mediated immune response and an increased risk of extracellular infections. Supplementation with these micronutrients reverses the Th2 cell-mediated immune response to a proinflammatory Th1 cytokine-regulated response with enhanced innate immunity. (Wintergerst et al 2007)
  • Vitamin C (ascorbic acid) is thought to enhance immune function, but the mechanisms involved are obscure.  The results of this in vitro study provide strong experimental evidence supporting a role for ascorbic acid in T-cell maturation as well as insight into the mechanism of ascorbate-mediated enhancement of immune function. (Manning et al 2013)
  • Vitamin D – A large number of different immune cells and functions are influenced by vitamin D. These effects are mainly mediated through modulation of the expression of several genes. Optimal circulating 25-hydroxy vitamin D concentration is possibly beyond 75 nmol/l as individuals with such a vitamin D concentration demonstrated a lower incidence of upper respiratory tract illness than those with an actually recommended vitamin D concentration (of around 50 nmol/l). (Bermon et al 2017)
  • Vitamin D is crucial to activating our immune defenses. Without sufficient intake of the vitamin, the killer cells of the immune system — T cells — are not be able to react to and fight off serious infections in the body. For T cells to detect and kill foreign pathogens such as clumps of bacteria or viruses, the cells must first be ‘triggered’ into action and ‘transform’ from inactive and harmless immune cells into killer cells that are primed to seek out and destroy all traces of a foreign pathogen. It was found that the T cells rely on vitamin D in order to activate and they would remain dormant, ‘naïve’ to the possibility of threat if vitamin D is lacking in the blood. (von Essen et al 2010)
  • Whey protein – The components of whey include beta-lactoglobulin, alpha-lactalbumin, bovine serum albumin, lactoferrin, immunoglobulins (e.g. IgA), lactoperoxidase enzymes, glycomacropeptides, vitamins such as vitamin D, and minerals such as Ca2+. Whey protein supplements are considered also as a cocktail of amino acids, since they contain up to 26% of branched chain amino acids, plus L-arginine, L-lysine, L-glutamine, among others. Thus, the effects of whey protein in the immune system may represent the effect of particular amino acids per se. (Cruzat et al 2014)
  • Zinc – Many organs are affected by zinc deficiency, especially the immune system which is markedly susceptible to changes of zinc levels. Polymorphonuclear cells chemotaxis and phagocytosis are reduced during zinc deficiency, whereas zinc supplementation has the opposite effect. Moreover, before macrophages can mature into tissue resident cells, circulating monocytes must be attracted to the target tissues and adhere to endothelial cells. In vitro, this process of adhesion is augmented by zinc. In terms of the adaptive immune response, zinc deficiency causes thymic atrophy and subsequent T-cell lymphopenia as well as reduction of premature and immature B cells, and consequently antibody production is also reduced. (Gammoh & Rink 2017)
  • Zinc is an essential component of numerous proteins involved in the defense against oxidative stress. It has been shown, that depletion of Zinc may enhance DNA damage via impairments of DNA repair mechanisms. In addition, Zinc has an impact on the immune system and possesses neuroprotective properties. (Jomova & Valko 2011)

Effects of Lifestyle, Blood Markers, Etc. on Immune Function

  • Yoga – Regular yoga practice remarkably attenuated oxidative stress and improved antioxidant levels of the body. Moreover, yoga beneficially affected stress hormone releases as well as partially improved immune function.(Lim & Cheong 2015)
  • Intense exercise – IgA is the most abundant protein in the antibacterial mucosa and it is considered the best indicator of oral mucosal immunity. Intense exercise causes a reduction in IgA levels and increases in Interleukin-1 ß (IL-1ß), TNF-α, and IL-6 concentrations, resulting in poor performance of the immune function of the mucous membranes, increasing the incidence of upper respiratory tract infections (URTIs), and the emergence of other opportunistic diseases. (Caris et al 2017)
  • Physical activity in breast cancer patients – This review summarizes the results of international studies and the current discussion of effects of physical activity on the immune system of breast cancer patients. Increased immunological anti-cancer activity due to physical activity is probably mediated via an increase in number and cytotoxicity of monocytes and natural killer cells and cytokines. (Schmidt et al 2017)
  • Stress – Immediate immunomodulation to acute psychological stress was defined as a short-term selective up-regulation of natural killer (NK) cell-associated cytotoxic and IL-12 mediated signaling genes that correlated with increased cortisol, catecholamines and NK cells into the periphery. In parallel, we observed down-regulation of innate immune toll-like receptor genes and genes of the MyD88-dependent signaling pathway. (Breen et al 2016)
  • Stress – Over the past 20 years these authors have demonstrated both in animal models and in human studies that stress increases neuroendocrine hormones, particularly glucocorticoids and catecholamines but to some extent also prolactin, growth hormone and nerve growth factor. They have also shown that stress, through the action of these stress hormones, has detrimental effects on immune function, including reduced NK cell activity, lymphocyte populations, lymphocyte proliferation, antibody production and reactivation of latent viral infections. (Webster Marketon & Glaser 2008)
  • Elevated cortisol – These findings support previously published relationships between blunted cortisol responses and risk for problem drinking, as well as elevated cortisol and decreased immune response. (Cebqallos et al 2015)
  • Cortisol is widely recognized for its role in the stress response and for its physiologic anti-inflammatory effects. The mechanism underlying its anti-inflammatory effects may be multifaceted including transcriptional suppression of proinflammatory genes and inhibition of the functions of macrophages and neutrophils. (Dong et al 2016)
  • Chronic inflammation is frequently associated with malignant growth and is thought to promote and enhance tumor progression, although the mechanisms which regulate this relationship remain elusive. The results of this study support the hypothesis that inflammation promotes malignant cell growth by inducing immune suppression, and show that decreased accumulation of myeloid-derived suppressor cells (MDSC) is one of the mechanisms by which reducing inflammation delays tumor progression. (Bunt et al 2007)
  • Immunosuppression is a state of temporary or permanent immunity dysfunction and can make an organism more sensitive to pathogens due to damage to the immune system. (Gong et al 2015)
  • Immunosuppression – The tumor microenvironment is well known to be immunosuppressive. Tumor cells consistently release many types of immunosuppressive and proinflammatory factors, such as vascular endothelial growth factor (VEGF), TGF-β, IL-10 and IL-6, and express surface molecules such as PD-1, B7-H1 and TIM-3, which facilitate tumor immune escape and tumor growth. (Ning et al 2016)
  • LDH (lactate dehydrogenase) – It is interesting to observe that elevated LDH (a blood biomarker) is a negative prognostic biomarker not only because it is a key enzyme involved in cancer metabolism, but also because it allows neoplastic cells to suppress and evade the immune system by altering the tumor microenvironment. (Ding et al 2017)
  • Bisphenol – In an animal study perinatal exposure to bisphenol weakens protective and regulatory immune functions in the intestine and at the systemic level in adult progeny. (Malaise et al 2017)

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