I am sure you have heard of the “cytokine storm” in regards to the cause of death from COVID19. It is obvious that this is a bad thing but to keep with my geeky COVID19 emails I thought I would explain this phenomena a little more and how one specific pathway may be very important in helping prevent this.
When a pathogen, in this case virus, invades the body there is an inflammatory response. The initial goal of the inflammation is to limit and eliminate the cause of the damage and initiate cellular repair. Many cells are activated and recruited to the site of injury including mast cells, monocytes, lymphocytes and other immune cells. These cells in response produce inflammatory mediators which includes cytokines among other ones. Cytokines are proteins that have a variety of jobs including regulating cell growth, immune function, inflammation and wound healing. They are a complex group that has a lot of overlap, having multiple functions that are sometimes dependent on the presence or absence of other cytokines. Specific cytokines include interleukins, interferons, tumor necrosis factor, chemokines, colony stimulating factor and growth factors. Some cytokines are pro-inflammatory and others have anti-inflammatory functions.
When the body is exposed to pathogens the process of trying to contain and eradicate them creates something called oxidative stress. When this occurs its result in the production of even more cytokines which creates more oxidative stress in the targeted cells to try to kill whatever is attacking it. It becomes a viscous circle that escalates into a “storm” of cytokines. The “storm” will begin locally and then spread throughout the body damaging tissues and organs. In the lungs it can cause severe injury resulting in acute respiratory distress syndrome (ARDS) which is why people are ending up on ventilators.
There are several pathways the body utilizes to try to protect itself from these cytokines. One of the pathways is called Nrf2. The Nrf2 pathway regulates the enzyme breakdown of the pro-inflammatory pathway and helps disrupt the cytokine/oxidative stress cycle. The Nrf2 has been shown to help enzymatically degrade the pro-inflammatory free heme often related to the oxidative stress cycle. Now, let’s bring this full circle. Recall, COVID19 causes the release of free heme (when it attacks the red blood cell) which is very inflammatory. The lungs are very sensitive to this type of inflammatory process and all of this accelerates the lung damage.
Can we help the Nrf2 pathway do it’s job? Yes!! There are a multitude of studies and actual clinical trials looking at supporting the Nrf2 pathway for a variety of conditions. Turns out this pathway can help with different medical conditions including gastritis, colitis, arthritis, pneumonia, liver damage, cardiovascular disease, neurodegenerative disease, and brain damage. This is clearly not just about COVID19!
There are trials looking at the following:
- ECGC (green tea extract) in lupus kidney inflammation and brain inflammation
- Curcumin in spinal cord injury and breast inflammation
- Sulfurophane (broccoli seed) in nasal inflammation, dermatitis, as well as hpylori infections
- Resveratrol in chronic kidney disease and ulcerative colitis
- Astaxanthin in chronic inflammatory diseases, cardiovascular disease
There are 21 supplements and medications that are being looked at officially. Many of the supplements have already had good evidence showing it favorably affected the Nrf2 pathways and are already in phase II trials!
Cue, Nrf2 Activator by Xymogen. This product has curcumin, ECGC (green tea) and Broccoli extract which are thought to support the Nrf2 pathway. I look at this product as a powerhouse of three supplements in one! You don’t need separate supplements with these ingredients in them. You can obviously pick some of the supplements listed above, too. This is not about preventing COVID19. Will you still get the production of cytokines with it – of course! All we are trying to do with any supplement is to help the body do its’ job as well as it can There will still be times it will be overpowered but it is at least an effort. I recommend many of these ingredients to patients with many different inflammatory conditions and after researching this pathway in depth I am going to be recommending the Nrf2 activator even more to see if people can tell a difference.
Keep working on your healthy lifestyle – eat right, exercise, lose weight if needed, quit smoking. All of these things are the most important changes you can be doing to help your body during this stressful time.
To your health,