Inflammation is a defense mechanism initiated by the immune system against outside threats such as stress, infection or toxins. When foreign invaders such as bacteria or viruses enter the body, or when a person scrapes or twist a knee, the body’s defense system kicks into high gear. The affected area will be flooded with chemicals (e.g., cytokines, B- and T-cells), blood, fluid and proteins, leading to swelling and localized heat to protect and repair damaged tissue, commencing the healing process. Once the trespassers are removed and route of invasion is sealed, the healing process halts.1 This short-term function of the inflammatory process is necessary and positive. However, long-term inflammation is another story.
Unlike acute inflammation that subsides after a brief period, chronic or systemic inflammation produces a steady, low level of inflammation within the body that may result in changes in normal cellular function as well as an abnormal healing process. Chronic or systemic inflammation is considered a long-term event because low levels of inflammation are triggered in the body even when there’s no sign of disease or injury, and sometimes the system can’t shut itself off. Ultimately, the body undergoes wear and tear, which further triggers diverse disease conditions including digestive disorders, skin problems, musculoskeletal conditions, cancer, diabetes, depression, heart disease, stroke, Alzheimer's disease and more.2
Natural Products in Managing Inflammation
Although both over-the-counter (OTC) and prescription non-steroidal anti-inflammatory drugs (NSAIDs) are frequently recommended for inflammatory conditions in a conventional medical practice, their use is often thought to be best limited to treat minor and temporary inflammation and accompanying pain caused by injuries or surgical procedures because these medications have limitations due to risk of their known side effects (e.g., gastrointestinal toxicity) with long-term use.3
The need for compounds with no or fewer severe side effects has led to interest in plant-based molecules as alternative treatments. Natural compounds, such as herbal remedies, that have been used by humankind for centuries to reduce pain and manage inflammation are gaining acceptance as modern research confirms safety and efficacy. The mechanism by which many of these natural compounds work is by acting on similar inflammatory pathways acted upon by NSAIDs [e.g. cyclooxygenase (COX) pathway]. Some of these materials are known to inhibit nuclear factor-kB (NF-kB) inflammatory pathways, in addition to the cyclooxygenase (COX) pathway.3
Natural Products are Effective and Potent
Several bioactive extracts and/or their active constituents are known to be helpful in managing a variety of inflammatory responses, as well as alleviating pain. Though there are numerous natural products detailed in the literature, following are a few of the most commonly available and well-validated for their anti-inflammatory potential.
Curcuma longa: This flowering plant belonging to the ginger family and commonly known as turmeric is native to the Indian subcontinent. Traditionally, it has been used as a potent anti-inflammatory agent. Studies have revealed curcumin, demethoxycurcumin (DMC) and bisdemethoxycurcumin (BDMC)—collectively known as “curcuminoids”—are the three major phenolic compounds in turmeric responsible for its myriad health benefits, including anti-inflammatory effects.4
Recently, in a randomized, double-blind, placebo-controlled trial, daily supplementation of curcuminoids and the natural bioavailability enhancer from black pepper piperine for eight weeks in metabolic syndrome patients resulted in significant reduction in serum concentrations of pro-inflammatory markers such as tumor-necrosis factor alpha (TNF-α), interlukin (IL)-6, transforming growth factor beta (TGF-β) and monocyte chemoattractant protein-1 (MCP-1) (P<0.001).5 Materials used in the study were Sabinsa’s Curcumin C3 Complex® and BioPerine®.
Boswellia serrata: The boswellia species are trees native to Arabian Peninsula and India that produce a gum resin called olibanum or frankincense. This resin is known to possess anti-inflammatory, anti-arthritic and analgesic properties. The anti-inflammatory properties of this gum resin are attributed to the presence of four major boswellic acids, of which acetyl-11-keto-β-boswellic acid (AKBBA) is the most potent. Boswellic acids have the unique property to block two pro-inflammatory enzymes: 5-lipoxygenase (5-LOX) and human leukocyte elastase (HLE), and thus help in managing various inflammatory conditions that are perpetuated by leukotrienes.
In a clinical trial, patients with osteoarthritis (OA) of the knee were given tablets containing a polyherbal combination of curcuminoids, boswellia serrata extract, Ginger extract and piperine (the formula was Sabinsa’s NiLitis®) twice a day for 56 days. Study results showed supplementation resulted in a significant improvement in the clinical and biochemical endpoints along with excellent tolerability, thus indicating the formulation can be used for the long-term management of OA.6
Ginger: Ginger (Zingiber officinale) is a rhizome that belongs to the family Zingiberaceae. This herb, originating in South-East Asia, is used in traditional herbal medicine for managing several inflammatory conditions. In a randomized, double-blind, placebo-controlled study, ginger extract reduced symptoms and pain-related OA compared to placebo treatment.7
These three traditional herbs confirmed by modern research to impart significant health benefits in addressing conditions common in today’s world remind us that the wisdom of the ancients offers opportunities to validate that traditional knowledge and use it to enhance human health.
Shaheen Majeed, president of Sabinsa Worldwide, has been involved in nearly everything the Sami Labs/Sabinsa Group of Companies does. He oversees Sabinsa’s contract farming program to ensure best agricultural practices and fair pay for farmers, is involved in the cGMP (current good manufacturing practice) and regulatory compliance at their factories and offices throughout the world, and oversees GRAS (generally recognized as safe) status applications.
- Anft M. “Understanding inflammation.” Available at: http://www.johnshopkinshealthreview.com/issues/spring-summer-2016/articles/understanding-inflammation. Accessed on: Oct 6, 2017.
- Arulselvan P et al. “Role of Antioxidants and Natural Products in Inflammation.” Oxid Med Cell Longev. 2016;2016:5276130.
- Maroon JC1 Bost JW, Maroon A. “Natural anti-inflammatory agents for pain relief.” Surg Neurol Int. 2010 Dec 13;1:80. DOI: 10.4103/2152-7806.73804.
- Majeed M, Majeed A (Eds). “Curcumin C3 Complex®—The most clinically studied curcumin brand in the world. Curry powder to clinical significance.” New Jersey: NutriScience Publishers, LLC; 2015.
- Panahi Y et al. “Effects of curcumin on serum cytokine concentrations in subjects with metabolic syndrome: A post-hoc analysis of a randomized controlled trial.” Biomed Pharmacother. 2016 Aug;82:578-82. DOI: 10.1016/j.biopha.2016.05.037.
- Natarajan S, Majeed M. “To assess the efficacy and safety of NILIN™ SR tablets in the management of osteoarthritis of knee.” Int J Pharm Life Sci. 2012;3(2):1413–23.
- Haghighi et al. “Comparing the Effects of Ginger (Zingiber Officinale) Extract and Ibuprofen on Patients with Osteoarthritit.” Arch Iranian Med. 2005;8(4):267–71.