As we all learnt in this class inflammation is one of fundamental protection mechanisms in human biology. This is how we protect ourselves from foreign invaders as well as abnormal cell inside of our body. But gone awry inflammation that spreads beyond the primary locus or fails to subside poses serious chronic and acute health risks for millions of people.
Each year about 60 million Americans sustain injuries. Trauma accounts for more than 12% of all medical spending in America. After the first 24 hours following the injury the primary cause of death is Multiple Organ Failure (MOF). It presents as an excessive inflammatory response directed towards patient’s own tissues. It is closely related to Systemic Inflammatory Response Syndrome (SIRS) and Sepsis. Sepsis alone accounts for up to 215,000 American’s lifes every year, according to the National Institute of General Medical Sciences. We referred to SIRS in Immu 7630 course as cytokine storm.
Growing evidence suggests that genetic factors drive key aspects of an individual’s inflammatory outcome. Scientists studying inflammation are trying to identify the genes that drive inflammation as well as biomarkers from throughout the course of inflammation. Genomic studies, in addition to their proteomic and metabolomic cousins, aim to resolve an age-old mystery: namely, why some patients recover readily from inflammation while others suffer and die from it. Ideally, new gene based discoveries will provide diagnostic biomarkers to predict who among these patients will react poorly to inflammation and why. If doctors could reliably predict this outcome in advance, they might tailor antibiotics and other treatment options to a patient’s own inflammatory system, potentially saving lives.
Among the numerous programs moving inflammation research forward is an effort funded by a National Institute of General Medical Sciences “glue grant,” so named because it “glues together” multidisciplinary efforts to tackle biomedical questions beyond the means of any one research group. This program, called Inflammation and the Host Response to Injury, strives to determine why patients can have dramatically different outcomes after traumatic injuries and burns.
UCD and Denver Health Medical Center are part of this multicenter research study.
In order to find immuno-inflammatory biomarkers for developing MOF Glue Grant is using genomic and proteomic analyses:
mRNA Isolation for Protein Coding
The Glue Grant investigators nationwide are isolating messenger RNA (mRNA) from blood and other available tissues. Isolation of the mRNA molecule is key to finding expressed genes in the vast expanse of the human genome. Since mRNA is very unstable outside of a cell, we are using a special enzyme called reverse transcriptase to convert it to complementary DNA (cDNA) which is a much more stable compound than mRNA and is presumed to represent the sequences of the genes being expressed. Sequences contained in the cDNA are used to generate expressed sequence tags (ESTs) that code for the protein in question or represent non-translated regions. ESTs are powerful tools for gene mapping and gene discovery. In the search for known genes, they greatly reduce the time needed to locate a gene. ESTs provide sequences that can be generated rapidly and inexpensively, in that only one sequencing experiment is needed per each cDNA generated and ESTs do not have to be confirmed for sequencing errors.
Only a fraction of genes are turned on, and it is the subset that is "expressed" that confers the unique properties to each cell type. Gene expression is the term used to describe the transcription of the information contained within the DNA into mRNA molecules that are then translated into the proteins that perform most of the critical functions of cells. Gene expression is a highly complex and tightly regulated process that allows a cell to respond dynamically both to environmental stimuli and its own changing needs. This mechanism acts as both an "on/off" switch to control which genes are expressed in a cell as well as a "volume control" that increases or decreases the level of expression of particular genes as necessary.
Microarray technology is applied to the samples to collect gene expression data. This technology works through the ability of a given mRNA molecule to bind specifically to, or hybridize to, the DNA template from which it originated. By using an array that contains many DNA samples, we can determine - in a single experiment - the expression levels of thousands of genes within a cell by measuring the amount of mRNA bound to each site on the array. The amount of mRNA bound to the spots on the microarray is precisely measured, thus generating a profile of gene expression in the cell. Microarray expression analysis are performed on the samples to determine the level, or volume, at which a certain gene is expressed. The arrays used in this analysis are called expression chips or "Gene Chips". We use the expression chips to detect expression patterns, that is, whether or not a particular gene is being expressed more or less under certain circumstances, and to examine changes in gene expression over a given period of time.
Detection and Analyses of SNPs
A single nucleotide polymorphism (SNP) is a small genetic alteration that can occur in a patient's DNA sequence. An SNP variation occurs when a single nucleotide (adenine, cytosine, thymine, or guanine) is replaced by one of the other three nucleotides. Each patient's genetic material contains a unique genetic pattern that is composed of several different genetic variations, including SNPs. It is believed that SNPs can serve both as a biological marker for pinpointing a disease or condition and may be directly associated with or causative of a certain disease or condition.
Proteomic Analyses
Cytokine mediators, leukocyte phenotypes, and cell signaling intermediates (e.g., protein kinases, NF-ê B family) will be analyzed from blood and plasma of trauma patients. Of particular interest are investigations of changes in pro-inflammatory and anti-inflammatory cytokines in isolated populations of cells from these patients. There are several cytokines of interest that include TNF, IL-1, IL-6, IL-8, IL-10, IL-12, IL-18, IL-1ra, p55, and p75.
Glue Grant study is still underway and the final results are yet to be analyzed…
For more information please visit www.gluegrant.org or search PubMed for “Inflammation and the host response to injury: a Large-Scale Collaborative Project”.
10 December 2009
09 December 2009
More news on my new favorite spice, tumeric! In a recent report researchers at the Univ. of Michigan found that the active ingredient in tumeric, curcumin, when applied to breast cancer cells in culture, was able to repress the growth of cancer stem cells, while not affecting the growth on non-stem cells. The same activity was seen with the active ingredient from black pepper, piperinem and was greatest when the two compounds were used together. Is this anti-stem cell activity a component in the anti-inflammatory mechanism used by curcumin, or perhaps an entirely separate effect?
This stem-cell specific growth inhibition may provide a better approach to limiting the growth of tumor cells in situ. Current treatments, such as standard chemotherapy or radiation, are thought to indiscriminately inhibit the growth of all cancer cells. But research has shown that many cancers are the result of cancerous stem cells driving the growth of tumors. And treatments that can specifically target these stem cells may provide better eradication than current treatments which are thought to often miss total irradication of the cancer stem cells.
Of note, the concentration of curcumin applied in culture is far greater (some 20 fold greater) than what could be obtained in the diet - supplementation would be required. Also, the study was an in vitro cell culture study, with all of the limitations inherent to cell culture models. But, the authors report that they hope to conduct Phase I safety trials as soon as next year.
1. Madhuri Kakarala, Dean E. Brenner, Hasan Korkaya, Connie Cheng, Karim Tazi, Christophe Ginestier, Suling Liu, Gabriela Dontu and Max S. Wicha. (2009) Targeting breast stem cells with the cancer preventive compounds curcumin and piperine. Breast Cancer Research and Treatment, Vol 66(3), p123-133
This stem-cell specific growth inhibition may provide a better approach to limiting the growth of tumor cells in situ. Current treatments, such as standard chemotherapy or radiation, are thought to indiscriminately inhibit the growth of all cancer cells. But research has shown that many cancers are the result of cancerous stem cells driving the growth of tumors. And treatments that can specifically target these stem cells may provide better eradication than current treatments which are thought to often miss total irradication of the cancer stem cells.
Of note, the concentration of curcumin applied in culture is far greater (some 20 fold greater) than what could be obtained in the diet - supplementation would be required. Also, the study was an in vitro cell culture study, with all of the limitations inherent to cell culture models. But, the authors report that they hope to conduct Phase I safety trials as soon as next year.
1. Madhuri Kakarala, Dean E. Brenner, Hasan Korkaya, Connie Cheng, Karim Tazi, Christophe Ginestier, Suling Liu, Gabriela Dontu and Max S. Wicha. (2009) Targeting breast stem cells with the cancer preventive compounds curcumin and piperine. Breast Cancer Research and Treatment, Vol 66(3), p123-133
08 December 2009
Hygiene Hypothesis goes in utero!
07 December 2009
Placebo Effect
I thought the conversation about the saccharine water and the placebo effect in mice was very interesting. I was wondering if any studies have been done that can show that behavior can also negatively impact the immune system.
It seems that when pregnant women get sick from a certain type of food during pregnancy, they tend to feel nauseous or get ill from that food later on after the pregnancy. I've heard similar stories with people that get food poisoning. I wonder if this has to do with the body thinking that it will get sick from that same food because it has in the past. I would think that this would be a "reverse" placebo-effect in the sense that something that causes problems once in the body will be associated in the mind as always being a problem causer.
It seems that when pregnant women get sick from a certain type of food during pregnancy, they tend to feel nauseous or get ill from that food later on after the pregnancy. I've heard similar stories with people that get food poisoning. I wonder if this has to do with the body thinking that it will get sick from that same food because it has in the past. I would think that this would be a "reverse" placebo-effect in the sense that something that causes problems once in the body will be associated in the mind as always being a problem causer.
Aging, DNA damage, and chronic inflammation?
Hi all,
Recently I found a research article that describes experiments that show for the first time a possible cause of the chronic inflammation that seems to be implicated in the etiology of so many chronic medical conditions. This chronic inflammation becomes more common and widespread as people age, or when they somehow sustain considerable damage to a particular tissue over time. One underlying cause of this age-associated inflammation turns out to be unrepairable DNA damage which accumulates in non-cycling cells of our bodies (either quiescent or senescent) as we age. This accumulation of DNA damage in cells as we age has been known for some time - but what this paper, by Campisi et. al. [1] at the Lawrence Berkeley National Laboratory, unexpectedly showed is that these damaged cells secrete a unique and powerful battery of inflammatory cytokines. As we age we constantly secrete more and more of these inflammatory cytokines in our tissues, which can lead to the development or exacerbation of all of the chronic inflammatory conditions which we have studied this semester
As an aside, I found this paper on the Faculty of 1000 Biology web-site (http://f1000biology.com/guardpages/evaluation/1145049//article/article.asp%253Fid%253D1145049%2526view%253D%2526style%253D). This web-site is a very cool service which provides a synopsis and critique of the most interesting current papers in biology, as judged by the "Faculty of 1000" - generaly recognized respected researchers in their fields. So, if you can afford the subcription fee, you can have the hottest papers in your research area identified and critiqued by experts and sent straight to your e-mailbox! You can also get a copy at the cool free-access Public Library of Science (PLoS) website, http://www.plosbiology.org/article/info:doi%2F10.1371%2Fjournal.pbio.0060301.
Anyways, back to the paper. In their experiments, the authors modified commercial antibody arrays to substantially improve their range and sensitivity, and then measured the proteins secreted by senescent cells in culture, as well as from tissue samples that were collected from prostate cancer patients both before and after completing a DNA-damaging form of chemotherapy. They found that different types of cells from different tissue all secrete a very similar set of proteins when they senesce in response to DNA-damaging radiation or chemotherapy. The authors propose to call this common response to DNA damage and senescence "senescence-associated secretory phenotype", or SASP. Importantly, they then showed that it occurs not only in cultured cells, but also to cells in vivo in response to exogenously introduced DNA damage (and by extension to normally produced endogenous oxidative DNA damage). The SASP develops slowly over several days and only after DNA damage of sufficient magnitude to induce senescence. The SASP featured high levels of secreted inflammatory cytokines, immune modulators, and growth factors, all of which are associated with inflammation and malignancy (IL-6, IL-8, GRO-α, MCP-1, GM-CSF...).
Note: For those interested, the primary authors followed up this seminal line of experiments with further work clarify some of the molecular interactions involved in this inflammatory phenotype of aging and/or damaged cells, finding connections with the well characterized dna repair/maintenance genes ATM, NBS1 and CHK2, but not the cell-cycle arrest enforcers p53 and pRb... [2]
- Brian P
1. Jean-Philippe Coppé, Christopher K. Patil, Francis Rodier, Yu Sun, Denise P. Muñoz, Joshua Goldstein, Peter S. Nelson, Pierre-Yves Desprez, Judith Campisi (2007) Senescence-Associated Secretory Phenotypes Reveal Cell-Nonautonomous Functions of Oncogenic RAS and the p53 Tumor Suppressor, PloS Biology, www.plosbiology.org
2. Francis Rodier1,2, Jean-Philippe Coppé1, Christopher K. Patil1, Wieteke A. M. Hoeijmakers1,4, Denise P. Muñoz2, Saba R. Raza1,5, Adam Freund1,3, Eric Campeau1,6, Albert R. Davalos1 & Judith Campisi1,2 (2009) Persistent DNA damage signalling triggers senescence-associated inflammatory cytokine secretion, Nature Cell Biology 11, 973 - 979.
Recently I found a research article that describes experiments that show for the first time a possible cause of the chronic inflammation that seems to be implicated in the etiology of so many chronic medical conditions. This chronic inflammation becomes more common and widespread as people age, or when they somehow sustain considerable damage to a particular tissue over time. One underlying cause of this age-associated inflammation turns out to be unrepairable DNA damage which accumulates in non-cycling cells of our bodies (either quiescent or senescent) as we age. This accumulation of DNA damage in cells as we age has been known for some time - but what this paper, by Campisi et. al. [1] at the Lawrence Berkeley National Laboratory, unexpectedly showed is that these damaged cells secrete a unique and powerful battery of inflammatory cytokines. As we age we constantly secrete more and more of these inflammatory cytokines in our tissues, which can lead to the development or exacerbation of all of the chronic inflammatory conditions which we have studied this semester
As an aside, I found this paper on the Faculty of 1000 Biology web-site (http://f1000biology.com/guardpages/evaluation/1145049//article/article.asp%253Fid%253D1145049%2526view%253D%2526style%253D). This web-site is a very cool service which provides a synopsis and critique of the most interesting current papers in biology, as judged by the "Faculty of 1000" - generaly recognized respected researchers in their fields. So, if you can afford the subcription fee, you can have the hottest papers in your research area identified and critiqued by experts and sent straight to your e-mailbox! You can also get a copy at the cool free-access Public Library of Science (PLoS) website, http://www.plosbiology.org/article/info:doi%2F10.1371%2Fjournal.pbio.0060301.
Anyways, back to the paper. In their experiments, the authors modified commercial antibody arrays to substantially improve their range and sensitivity, and then measured the proteins secreted by senescent cells in culture, as well as from tissue samples that were collected from prostate cancer patients both before and after completing a DNA-damaging form of chemotherapy. They found that different types of cells from different tissue all secrete a very similar set of proteins when they senesce in response to DNA-damaging radiation or chemotherapy. The authors propose to call this common response to DNA damage and senescence "senescence-associated secretory phenotype", or SASP. Importantly, they then showed that it occurs not only in cultured cells, but also to cells in vivo in response to exogenously introduced DNA damage (and by extension to normally produced endogenous oxidative DNA damage). The SASP develops slowly over several days and only after DNA damage of sufficient magnitude to induce senescence. The SASP featured high levels of secreted inflammatory cytokines, immune modulators, and growth factors, all of which are associated with inflammation and malignancy (IL-6, IL-8, GRO-α, MCP-1, GM-CSF...).
Note: For those interested, the primary authors followed up this seminal line of experiments with further work clarify some of the molecular interactions involved in this inflammatory phenotype of aging and/or damaged cells, finding connections with the well characterized dna repair/maintenance genes ATM, NBS1 and CHK2, but not the cell-cycle arrest enforcers p53 and pRb... [2]
- Brian P
1. Jean-Philippe Coppé, Christopher K. Patil, Francis Rodier, Yu Sun, Denise P. Muñoz, Joshua Goldstein, Peter S. Nelson, Pierre-Yves Desprez, Judith Campisi (2007) Senescence-Associated Secretory Phenotypes Reveal Cell-Nonautonomous Functions of Oncogenic RAS and the p53 Tumor Suppressor, PloS Biology, www.plosbiology.org
2. Francis Rodier1,2, Jean-Philippe Coppé1, Christopher K. Patil1, Wieteke A. M. Hoeijmakers1,4, Denise P. Muñoz2, Saba R. Raza1,5, Adam Freund1,3, Eric Campeau1,6, Albert R. Davalos1 & Judith Campisi1,2 (2009) Persistent DNA damage signalling triggers senescence-associated inflammatory cytokine secretion, Nature Cell Biology 11, 973 - 979.
06 December 2009
Pharmacist's Letter Continued!
For those of you in the UA course, I presented info from the pharmacist's letter database on turmeric. The database is designed to show any info that is related to medications including natural supplements that allow pharmacists to convey information including interactions, safety, and effectiveness. Recall that turmeric is only possibly safe when used orally or topically in medicinal amounts and likely safe when used in amounts commonly found in food. I found similar information using the same database regarding the scientific article from last Monday where they tested several active spice-derived components and how effective they were at being anti-inflammatories. This may be a long blog so sorry in advance. I just found it really interesting. I tried to bold anything related to inflammation to bring attention to them.
1. Black Mustard (allyl isothiocyanate)
-Uses: the oil is used for the common cold, rheumatism and osteoarthritis; orally - used to induce vomiting, a diuretic, and an appetite stimulant; topically - pneumonia, osteoarthritis, aching feet, and as a counterirritant (something that causes inflammation in one area to lessen it in another)
-Safety: likely safe when used orally in the amounts commonly found in foods; there is insufficient reliable information available about the safety of black mustard when used orally or topically for medicinal purposes
-Effectiveness: There is insufficient reliable information about the effectiveness of black mustard
-Mechanism of action: applicable part are the seed, oil, leaf, and powder; the powder contains glucosinolate sinigrin, which produces allyl isothiocyanate when mixed with warm water that has strong antimicrobial (bacterial and fungal) properties and can act as a counterirritant when diluted; seed, oil, and powder can have powerful irritant properties that can cause pain and increase inflammation of the skin
-Interactions with Herbs & Supplements, Drug, Foods, Lab Test, and Disease or Conditions - None known
-Adverse Reactions: Large amounts orally - vomiting, stomach pain, diarrhea, cardiac failure, breathing difficulties, coma, and possibly death
-The interesting thing I found was that this drug is such a potent so when applied topically for too long (longer than 10 minutes), it can lead to severe skin irritation and even burns and the concentrations as a counterirritant is 0.5% to 5% and used 3-4 times a day
2. Garlic (diallyl disulfide)
-Uses: hypertension, hyperlipidemia, coronary heart disease, earaches, chronic fatigue syndrome, prevention of colon cancer and other cancers of the breast, lung, prostrate, and bladder, osteoarthritis, allergic rhinitis, colds, flu, TB, whooping cough, and a lot of other random things; topically - oil is used for scalp diseases and vaginitis
Safety: Likely safe when used orally and appropriately; has been used safely in clinical studies lasting up to 7 years without significant toxicity; possibly unsafe when used topically - can cause severe skin irritation; possible safe for children in appropriate oral amounts and possibly unsafe in large amounts; pregnancy - likely safe when used orally in amounts commonly found in foods; possibly unsafe - orally in medicinal amounts
-Effectiveness: possibly effective to treat atherosclerosis at 300 mg per day, some evidence associated with decreasing the risk of developing stomach cancer, and come clinical research shows that taken orally, garlic can modestly reduce blood pressure
-Mechanism of action: bulb mostly used as an antihyperlipidemic, antihypertension, antifungal, and has also been reported to have antibacterial, antihelmintic, antiviral, antispasmodic, antithrombotic, and an immunostimulant
-Based on this info and other info that I found off the database, I didn't find any clinical evidence that suggests that garlic has no evidence of having anti-inflammatory properties. If it did, this database would discuss it because it talks about everything related in clinical terms regarding supplements.
3. Ginger (zingerone)
-Uses: Orally - motion sickness, morning sickness, dyspepsia, rheumatoid arthritis, loss of appetite, osteoarthritis, migraines, headache, anorexia, cough, bronchitis, stomachache, and others; Fresh ginger - orally for malaria, rheumatism, and toothaches
-Safety: likely safe - when used orally and appropriately; has been used in clinical trials (includes trial info in the database)
-Effectiveness: can reduce severity of nausea and vomiting in pregnant patients and postoperative patients and insufficient reliable evidence to treat chemo-induced nausea and vomiting; preliminary evidence shows modest benefits in OA - extract at 170 mg a day three times daily for 3 weeks is effective in reducing pain; some preliminary evidence shows that ginger might help in decreasing joint pain in patients with RA
-Mechanism of action: pharmacological properties - antipyretic, analgesic, anti-inflammatory, sedative, antibiotic, and other properties
4. Black Pepper (piperine)
-Uses: stomach upset, bronchitis, and cancer
-Safety: Likely safe when used orally in amounts commonly found in foods; possibly safe when used orally and appropriately in medicinal amounts; black pepper oil is used topically and is nonirritating and typically well tolerated; likely safe in children, pregnancy, and lactation
-Effectiveness: Insufficient reliable information about the effectiveness of black pepper
-Mechanism of Action: a typical diet provides 360 mg of black pepper provides about 60-110 micromolar of piperine that seems to increase oral absorption of drugs and other substances
-There doesn't seem to be much clinical evidence that black pepper works as an anti-inflammatory
In conclusion, only two out of the four anti-inflammatory agents mentioned in the article seem to have any clinical evidence. It will be interesting to see if new research sheds any more light on black pepper and garlic.
1. Black Mustard (allyl isothiocyanate)
-Uses: the oil is used for the common cold, rheumatism and osteoarthritis; orally - used to induce vomiting, a diuretic, and an appetite stimulant; topically - pneumonia, osteoarthritis, aching feet, and as a counterirritant (something that causes inflammation in one area to lessen it in another)
-Safety: likely safe when used orally in the amounts commonly found in foods; there is insufficient reliable information available about the safety of black mustard when used orally or topically for medicinal purposes
-Effectiveness: There is insufficient reliable information about the effectiveness of black mustard
-Mechanism of action: applicable part are the seed, oil, leaf, and powder; the powder contains glucosinolate sinigrin, which produces allyl isothiocyanate when mixed with warm water that has strong antimicrobial (bacterial and fungal) properties and can act as a counterirritant when diluted; seed, oil, and powder can have powerful irritant properties that can cause pain and increase inflammation of the skin
-Interactions with Herbs & Supplements, Drug, Foods, Lab Test, and Disease or Conditions - None known
-Adverse Reactions: Large amounts orally - vomiting, stomach pain, diarrhea, cardiac failure, breathing difficulties, coma, and possibly death
-The interesting thing I found was that this drug is such a potent so when applied topically for too long (longer than 10 minutes), it can lead to severe skin irritation and even burns and the concentrations as a counterirritant is 0.5% to 5% and used 3-4 times a day
2. Garlic (diallyl disulfide)
-Uses: hypertension, hyperlipidemia, coronary heart disease, earaches, chronic fatigue syndrome, prevention of colon cancer and other cancers of the breast, lung, prostrate, and bladder, osteoarthritis, allergic rhinitis, colds, flu, TB, whooping cough, and a lot of other random things; topically - oil is used for scalp diseases and vaginitis
Safety: Likely safe when used orally and appropriately; has been used safely in clinical studies lasting up to 7 years without significant toxicity; possibly unsafe when used topically - can cause severe skin irritation; possible safe for children in appropriate oral amounts and possibly unsafe in large amounts; pregnancy - likely safe when used orally in amounts commonly found in foods; possibly unsafe - orally in medicinal amounts
-Effectiveness: possibly effective to treat atherosclerosis at 300 mg per day, some evidence associated with decreasing the risk of developing stomach cancer, and come clinical research shows that taken orally, garlic can modestly reduce blood pressure
-Mechanism of action: bulb mostly used as an antihyperlipidemic, antihypertension, antifungal, and has also been reported to have antibacterial, antihelmintic, antiviral, antispasmodic, antithrombotic, and an immunostimulant
-Based on this info and other info that I found off the database, I didn't find any clinical evidence that suggests that garlic has no evidence of having anti-inflammatory properties. If it did, this database would discuss it because it talks about everything related in clinical terms regarding supplements.
3. Ginger (zingerone)
-Uses: Orally - motion sickness, morning sickness, dyspepsia, rheumatoid arthritis, loss of appetite, osteoarthritis, migraines, headache, anorexia, cough, bronchitis, stomachache, and others; Fresh ginger - orally for malaria, rheumatism, and toothaches
-Safety: likely safe - when used orally and appropriately; has been used in clinical trials (includes trial info in the database)
-Effectiveness: can reduce severity of nausea and vomiting in pregnant patients and postoperative patients and insufficient reliable evidence to treat chemo-induced nausea and vomiting; preliminary evidence shows modest benefits in OA - extract at 170 mg a day three times daily for 3 weeks is effective in reducing pain; some preliminary evidence shows that ginger might help in decreasing joint pain in patients with RA
-Mechanism of action: pharmacological properties - antipyretic, analgesic, anti-inflammatory, sedative, antibiotic, and other properties
4. Black Pepper (piperine)
-Uses: stomach upset, bronchitis, and cancer
-Safety: Likely safe when used orally in amounts commonly found in foods; possibly safe when used orally and appropriately in medicinal amounts; black pepper oil is used topically and is nonirritating and typically well tolerated; likely safe in children, pregnancy, and lactation
-Effectiveness: Insufficient reliable information about the effectiveness of black pepper
-Mechanism of Action: a typical diet provides 360 mg of black pepper provides about 60-110 micromolar of piperine that seems to increase oral absorption of drugs and other substances
-There doesn't seem to be much clinical evidence that black pepper works as an anti-inflammatory
In conclusion, only two out of the four anti-inflammatory agents mentioned in the article seem to have any clinical evidence. It will be interesting to see if new research sheds any more light on black pepper and garlic.
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