imunitet iz ugla komplementarne medicine

IMUNITET IZ UGLAKOMPLEMENTARNE MEDICINE

MR SCI MED DR DANIJELA DRAŠKOVIĆ RADOJKOVIĆ

SPEC INTERNE MEDICINE-ENDOKRINOLOG

SPECIJALISTIČKA ORDINACIJA NAYA MEDIC

BEOGRAD

HRONIČNE BOLESTI-SAVREMENA ETIOLOGIJA

PSIHONEUROENDOKRINOIMUNOLOGIJA-PNEI

DEFINICIJA OKSIDATIVNOG STRESA

• NERAVNOTEZA U CELIJSKIM OKSIDATIVNO-REDUKTIVNIMREAKCIJAMA U SMERU OKSIDACIJE TJ. KAO POREMEĆAJRAVNOTEŽE PROOKSIDANATA ( ROS, ENGL. REACTIVE OXYGEN SPECIES), I ANTIOKSIDANATA (VITAMINI I ANTIOKSIDACIJSKI ENZIMI) U KORIST PROOKSIDANATA.

• SMANJENA ANTIOKSIDATIVNA ZAŠTITA ILI JE STVARANJERADIKALA POJAČANO.

2021/4/23

– In metabolicprocesses

– In energy-supplying respiratory activity

– Inflammatory processesor diseases

– Increased physical stress

Endogenous factors Exogenous factors

Smoking –

Environmental pollutants –(e.g. car exhaust, smog,…

ozone, fine dust particles)….

Use of pharmaceuticals –

UV radiation –(intensive sun exposure)…

Excessive formation of free radicals

Origin of free radicals

TEŠKI METALI, KAO FAKTOR NASTANKA BOLESTI

ANTIOKSIDANSI

• ANTIOKSIDANSI NASTAJU U CELIJAMA ILI SE U ORGANIZAM NAJČEŠĆE UNOSE HRANOM ILI U OBLIKU VITAMINSKIH I SLIČNIH SUPLEMENATA, A DELUJU NA NEKOLIKO NAČINA: ONEMOGUĆAVAJU STVARANJE NOVIH SLOBODNIH RADIKALA U ORGANIZMU, ILI UNIŠTAVAJU U ORGANIZMU STVORENE RADIKALE (ENGL. SCAVENGERS – “ČISTAČI”), ILI POPRAVLJAJU OŠTEĆENJA U CELIJAMA NASTALA DELOVANJEM RADIKALA.

• MOGU BITI ENZIMSKI I NEENZIMSKI

ENZIMSKI ANTIOKSIDANSI

• U "PRVU LINIJU ODBRANE" ENZIMSKOG ZAŠTITNOG SASTAVA UBRAJA SE ENZIM SOD (SUPEROKSID DISMUTAZA). ON KATALIZUJE DISMUTACIJU SUPEROKSIDNOG RADIKALA NA MOLEKUL KISEONIKA (OKSIDACIJA) I H2O2 (REDUKCIJA). AKTIVNOST SOD JE REGULISANA OBIMOM NJENE BIOSINTEZE KOJA JE OSETLJIVA NA OBIM TKIVNE OKSIGENACIJE.CAT (KATALAZA) JE ENZIM KOJI BRZO REDUKUJE H2O2 DO H2O. NALAZI SE U CITOSOLU CELIJE (PEROKSIZOMI), A POSEBNO JE AKTIVAN U HEPATOCITIMA I ERITROCITIMA.

• GPX (GLUTATION PEROKSIDAZA) KATALIZIRA REDUKCIJU H2O2 I ORGANSKIH HIDROPEROKSIDA. PRISUTNA JE U CITOZOLU CELIJE KAO I U MITOHONDRIJIMA (DO 40% UKUPNE ENZIMSKE AKTIVNOSTI), TE UZ KATALAZU ZNAČAJNO DOPRINOSI UKLANJANJU H2O2.

NEENZIMSKI ANTIOKSIDANSI

• -Α-TOKOFEROL (VITAMIN E) ŠTITI STRUKTURE CELIJSKE MEMBRANE OD LIPIDNE PEROKSIDACIJE, PREKIDA KASKADU KOJOM NASTAJU U NAČELU TOKSIČNIJIRADIKALI.

• SMEŠTEN JE U MEMBRANAMA I LIPOPROTEINIMA, GDE MOŽE PREKINUTI LANČANU REAKCIJU OKSIDACIJE LDL-HOLESTEROLA, PODSTAKNUTU SLOBODNIM RADIKALIMA, SMANJITI ADHEZIJU I AGREGACIJU TROMBOCITA.

• UCESTVUJE U ODRŽAVANJU ARTERIJSKE VAZODILATACIJE INHIBICIJOM SINTEZE PROSTAGLANDINA E2 I PODSTICANJEM SINTEZE PROSTAGLANDINA I2 (PROSTACIKLINA).

• ZNAČAJ VITAMINA E U MALIGNIM BOLESTIMA UOČAVA SE KROZ PREVENTIVNI UTICAJ NA KARCINOM DOJKE KAO I U SMANJENJU UČESTALOSTI KARCINOMAPROSTATE ILI KOLONA.

•

NEENZIMSKI ANTIOKSIDANSI

• -ASKORBINSKA KISELINA (VITAMIN C) IMA VAŽNU ULOGU U UKLANJANJUSUPEROKSIDNOG I HIDROKSILNOG RADIKALA, PRI ČEMU NASTAJESEMIHIDROASKORBINSKA KISELINA.

• ANTIOKSIDATIVNO DELOVANJE: KOD BOLESNIKA S OSTEOARTRITISOM(SMANJUJE RIZIK GUBITKA HRSKAVICE USLED DELOVANJA ROS-A NA TKIVO, KOD PACIJENATA SA DIJABETESOM (SNIŽAVA VREDNOSTI SLOBODNIHRADIKALA, LDL-HOLESTEROLA I TRIGLICERIDA U PLAZMI, POZITIVNO UTIČENA RASPOLOŽIVOST GLUKOZE I NEOKSIDACIJSKI METABOLIZAM GLUKOZE).

• USPORAVA RAZVOJ ATEROSKLEROZE , A PROTEKTIVNI UTICAJ SE UOČAVA I U MALIGNIM BOLESTIMA (HORMONSKI-NEZAVISNIM KARCINOMIMAJEDNJAKA, LARINKSA, USNE ŠUPLJINE, PANKREASA, ŽELUCA, REKTUMA, DOJKE I GRLIĆA MATERICE).

+ Amino acids

+ Phytonutrients

+ Probiotics / prebiotics

Vitamins

Omega-3 fatty acids

Trace elements

Minerals

ULOGA ŽELUDAČNE KISELINE

ZNACI HIPOHLORHIDRIJE

MIKROBIOTA

SINDROM PROPUSTLJIVIH CREVA

SINDROM PROPUSTLJIVOG MOZGA

IZAZIVAČI AUTIMUNIH BOLESTI I KANCERA

• EBV, CMV, HHV 6,7,8

• SV I HZV ( HHV1,2), Adenovirus, Coxsackie, HIV, Kovid,

• Bacillus colli ( H.pylori I E colli ), BX virus ( Ca dojke), Kandida, Trihomonade ( Trihomonas vaginalis), Lamblia, Ureaplazma, Mycoplasma, Toxoplasma, Borelia

REVIEW OF EMERGING RESEARCHTHE FUNCTIONAL MEDICINE APPROACH TO COVID-19

• The Functional Medicine Approach to COVID-19: Virus-Specific Nutraceutical and Botanical Agents Evans JM1 , Luby R2 , Lukaczer D2 , Rountree R3 , Stone PM4 , Guilliams TG5 , Yanuck S6 , Messier H7 , Ramsdell K2 , Hanaway PJ8 1 The Center for Functional Medicine, Stamford CT 2 The Institute for Functional Medicine, Federal Way, WA 3 Boulder Wellcare, Boulder, CO 4 Stone Medical, Ashland, OR 5 Point Institute, Stevens Point, WI 6 The Yanuck Center for Life and Health, Chapel Hill, NC 7 Medical Intelligence Learning Lab, Inc (MILLI), San Jose, CA 8 The Institute for Functional Medicine COVID-19 Task Force, Federal Way, WA

Quercetin has been shown to have antiviral effects against both RNA (e.g.,

influenza and coronavirus) and DNA viruses (e.g., herpesvirus). Quercetin has a

pleiotropic role as an antioxidant and anti-inflammatory, modulating signaling

pathways that are associated with post-transcriptional modulators affecting post-

viral healing.

Intervention Quercetin

Suggested dose Regular: 1 gm po bid; phytosome: 500 mg, bid

Mechanism(s) of action against non-COVID-19 viruses

•Promote viral eradication or inactivation:9Inhibition

of viral replication•Favorably modulate viral-induced pathological cellular processes:Modulation of NLRP3 inflammasome activation

5

•Mechanistically promote resolution of collateral damage and restoration of function:Modulation of mast cell stabilization (anti-fibrotic)

Outcomes data supporting their mitigating effects on illness from other viral strains

Reduction of symptoms

Strength of evidence Moderate

Risk of harm16

Mimimal

Curcumin has been shown to modulate the NLRP3 inflammasome, and a preprint

suggests that curcumin can target the SARS-CoV-2 main protease to reduce viral

replication

Intervention Curcumin

Suggested dose 500–1,000 mg po bid (of absorption-enhanced curcumin)


•Favorably modulate viral-induced pathological cellular processes:Modulation of NLRP3 inflammasome activation

5


No data available

Strength of evidence Conditional

Risk of harm22-

Mimimal

Green tea, in addition to modulating the NLRP3 inflammasome and, based on a

preprint, potentially targeting the SARS-CoV-2 main protease (Mpro) to reduce

viral replication, has also been shown to prevent influenza in healthcare workers.

Intervention Epigallocatechin gallate (EGCG)

Suggested dose 4 cups daily or 225 mg po qd


•Favorably modulate viral-induced pathological cellular processes:Modulation of NLRP3 inflammasome activation

5


No data available

Strength of evidence Conditional

Risk of harm30-3

Significant (rare)—Hepatotoxicity

N-Acetylcysteine promotes glutathione production, which has been shown to be

protective in rodents infected with influenza. In a little-noticed six-month

controlled clinical study enrolling 262 primarily elderly subjects, those receiving

600 mg NAC twice daily, as opposed to those receiving placebo, experienced

significantly fewer influenza-like episodes and days of bed confinement.3

Intervention N-Acetylcysteine (NAC)

Suggested dose 600-900 mg po bid


•Favorably modulate cellular defense and repair mechanisms:Repletion of glutathione and cysteine


Reduce progression from colonization to illnessReduce the severity and duration of acute symptoms

Strength of evidence Limited

Risk of harm Mimimal

VITAMIN D

• Activated vitamin D,1,25(OH) D, a steroid hormone, is an immune system modulator that reduces the

expression of inflammatory cytokines and increases macrophage function. Vitamin D also stimulates the

expression of potent antimicrobial peptides (AMPs), which exist in neutrophils, monocytes, natural killer

cells, and epithelial cells of the respiratory tract. Vitamin D increases anti-pathogen peptides through

defensins and has a dual effect due to suppressing superinfection. Evidence suggests vitamin D

supplementation may prevent upper respiratory infections. However, there is some controversy as to

whether it should be used and the laboratory value that should be achieved. Research suggests that

concerns about vitamin D (increased IL-1beta in cell culture) are not seen clinically. The guidance we

suggest is that a laboratory range of >50 and < 80ng/mL serum 25-hydroxy vitamin D may help to

mitigate morbidity from COVID-19 infection.

Vitamin C contributes to immune defense by supporting various cellular functions of both the innate and

adaptive immune system. Vitamin C accumulates in phagocytic cells, such as neutrophils, and can enhance

chemotaxis, phagocytosis, generation of reactive oxygen species, and ultimately microbial killing.

Supplementation with vitamin C appears to be able to both prevent and treat respiratory and systemic

infections. Vitamin C has been used in hospital ICUs to treat COVID-19.

Intervention Vitamin C

Suggested dose 1–3 grams po qd


Favorably modulate cellular defense and repair mechanismsFavorably modulate viral-induced pathological cellular processes


No data available

Strength of evidence Strong

Risk of harm12

Mimimal

PREPORUKE ZA ODRŽAVANJE FUNKCIONALNOGSTANJA ORGANIZMA

• 1. Suplementacija vitamina I minerala ( antioksidantna terapija, enzimska I neenzimska)

• 2. Detoksikacija teških metala

• 3. Oslobađanje funkcionalno povišenih vrednosti h.pylori I kandide I optimalizacija količine HCLa

• 4. Probiotici I prebiotici

• 5. Suplementacija Vit D u odgovarajućim dozama

• 6. Ishrana bogata voćem I povrćem

• 7. Fizička aktivnost , odmor, zagrevanje ( održavanje optimalne telesne temperature)

• 8. Mentalno/emotivni balans

• 9. Imunomodulacija

PREPORUKE LEČENJA PACIJENATA U COVID STANJU I NAKON PRELEŽALE KORONE

• -Visoke doze Vit C intravenski, ali u obliku Na ascorbate( 1g/kg tt) ili oralno na svakih 6 sati po 2g

• - Biobran 1g dnevno

• - Visoke doze vit D ( 10 000 ij)

• - Curcumin plus , kombinacija Curcumina I Gingerola, kao antinflamatornih supstanci

• - Spironolakton, ROS protect, Organic silica, HCL balans

• Natto NKCP I 3 HOT, zbog opasnosti od DIKa, povećanog D dimera I aglutinacije eritrocita

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