functional medicine and nutritional genomics - American Association ...
functional medicine and nutritional genomics - American Association ...
functional medicine and nutritional genomics - American Association ...
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AAPI’S NUTRITION GUIDE TO OPTIMAL HEALTH: USING PRINCIPLES OF FUNCTIONAL MEDICINE AND NUTRITIONAL GENOMICS<br />
Two primary arms of the immune system are the<br />
cytotoxic (Th-1) <strong>and</strong> humoral (Th-2) arms, where<br />
‚Th‛ denotes thymus, an organ thought to contribute to<br />
educating the Tcells.<br />
The cytotoxic arm is involved in cell-to-cell defenses,<br />
where the immune cell acts directly against the<br />
pathogen. The humoral immune response is antibody<br />
mediated.<br />
The immune system is modulated in part by the<br />
endocrine system.(23) The balance of the cellular<br />
<strong>and</strong> humoral arms of the immune system is regulated<br />
in part by the hormonal environment with testosterone,<br />
DHT, DHEA <strong>and</strong> DHEA-S favoring a shift toward<br />
cellular (Th1 immunity) <strong>and</strong> glucocorticoids, estrogens,<br />
<strong>and</strong> catecholamines favoring a shift toward the<br />
humoral, or antibody producing, (Th2) arm of the<br />
immune system.<br />
Gut Biome <strong>and</strong> the Immune System<br />
70-80% of the immune system cells are located<br />
around the gastrointestinal tract. There is evidence that<br />
the gut flora act to educate the immune system in<br />
self-recognition during the early years of life, as the<br />
gut environment changes in relationship to the foods<br />
that are eaten.(20) The balance of organisms in the<br />
gut therefore influence the immune activity within the<br />
gut, setting the stage for health or disease.<br />
The gut biome is very responsive to changes in diet,<br />
hormones, <strong>and</strong> stress <strong>and</strong> can shift in its balance of<br />
flora, the implications of which are not well<br />
understood.(22) This is an emerging science <strong>and</strong> is<br />
only included here to bring an awareness to the reader<br />
that there is a sophisticated <strong>and</strong> complex relationship<br />
between the organisms living within the gut, the human<br />
immune response, <strong>and</strong> the health of the human<br />
organism.(21)<br />
Evolution of sensitivity<br />
Food Sensitivity as an Immune Phenomena<br />
Consider that the development of food sensitivity is an<br />
evolutionary process; it is not likely a sudden or<br />
isolated event. The development of food sensitivity<br />
involves the exposure of the immune cells to food<br />
antigens, which requires the breakdown of multiple<br />
76<br />
2012<br />
steps in human anatomy <strong>and</strong> physiology. You learned<br />
about these steps in isolation in the preceding<br />
paragraphs. Now we will tie these concepts together to<br />
help you underst<strong>and</strong> how the process might develop.<br />
In order for food sensitivity to develop, the immune<br />
system must be exposed to food antigen. Food antigen<br />
is essentially poorly digested food. When optimal<br />
digestion has occurred, food has been broken down<br />
into its basic macronutrient components as it passes<br />
through the digestive tract. Furthermore, in order for<br />
the immune system to ‚see‛ a food antigen requires<br />
the gut barrier to be permeable to the contents of the<br />
digestive tract, a concept referred to as intestinal<br />
hyper-permeability. Poor digestion alone may not lead<br />
to the development of significant food sensitivity if<br />
there is adequate integrity of the enterocyte lining. In<br />
contrast, ensuring optimal digestion beginning with the<br />
choice of foods <strong>and</strong> how they are eaten may play a<br />
role in preventing or minimizing the development of<br />
food sensitivity if the patient has a problem with the<br />
barrier of the enterocyte layer, or a ‚leaky gut.‛<br />
The bacterial environment within the gut could be a<br />
starting point for the establishment of food sensitivity<br />
as well. Gut floral imbalances <strong>and</strong> overgrowth (termed<br />
dysbiosis) can lead to a pro-inflammatory environment<br />
within the gut. This inflammatory state may increase<br />
the degree of intestinal permeability, setting the stage<br />
for prolonged exposure of the immune cells to the<br />
intestinal contents.<br />
Dysbiosis<br />
The human microbiota is undergoing intensive study.<br />
The Human Microbiota Project which began in 2007<br />
as an extension of the Human Genome Project is<br />
intended to underst<strong>and</strong> the role of human microbial<br />
communities in human health.(28) The gut biome<br />
alone contains up to 100 trillion organisms of<br />
approximately 500 to 1000 species. The term<br />
dysbiosis refers to an abnormal, or imbalanced, growth<br />
of organisms in the digestive tract that may lead to<br />
such issues as poor digestion, malabsorption, intestinal<br />
hyper-permeability, inflammation, <strong>and</strong> other problems in<br />
various systems of the body.<br />
Dysbiosis may be caused by the growth of a specific<br />
pathogen or the overgrowth or absence of a<br />
commensal organism. These organisms likely play a