©2019 Standard Process Inc. All rights reserved. LN1398 01/19

Chronic Inflammation & Pain

©2019 Standard Process Inc. All rights reserved. LN1398 01/19

Dr. Ryan Lazarus, DC, MSc, CNS

©2019 Standard Process Inc. All rights reserved. LN1398 01/19

Nutrigenomics for Inflammation & Pain

Modulation of genetic expression by the skillful use of dietary,

nutritional, and botanical interventions is clearly the leading edge of

modern nutritional practice.

Familiarity with the concepts and implementation of “nutrigenomics”

must become incorporated into the clinical skill set of chiropractic

and naturopathic physicians.

©2019 Standard Process Inc. All rights reserved. LN1398 01/19

Nutrigenomics for Inflammation & Pain

• Practitioners should focus on the nutritional and botanical inhibition of the

primary “amplifier of inflammation” known as nuclear transcription factor

kappaB (NF-kappaB).

• Groundbreaking research has discovered that SPMs are produced at the

inflamed site after the initial inflammatory response, and function as

“resolution agonists,” orchestrating resolution to facilitate the return to

homeostasis and tissue healing.

• An important key to controlling/resolving inflammation and subsequently

preventing chronic inflammatory conditions lies in SPMs and their pro-

resolving properties.

©2019 Standard Process Inc. All rights reserved. LN1398 01/19

The dorsal root ganglion

contains the cell bodies of

sensory neurons that bring

information from the periphery to

the spinal cord.

Substance P is related to the

transmission of pain information

into the central nervous system.

PGE2 is a prostaglandin that

ultimately induces fever and

suppresses T cell receptor

signaling and may play a role in

resolution of inflammation.

©2019 Standard Process Inc. All rights reserved. LN1398 01/19

©2019 Standard Process Inc. All rights reserved. LN1398 01/19

The Roots of Chronic Inflammation

Genetic susceptibility to triggers

Overabundance of inflammatory

precursors (for example, high AA or

glycating diet)

Lack of antioxidant phytochemicals

Insufficient dampening or excessive

upregulation by endogenous mediators

Malfunctioning “off switch”

• Inadequate priming of T regulatory cells

• imbalanced Th1/Th2 lymphocytes

©2019 Standard Process Inc. All rights reserved. LN1398 01/19

©2019 Standard Process Inc. All rights reserved. LN1398 01/19

Causes of Chronic Inflammation

©2019 Standard Process Inc. All rights reserved. LN1398 01/19 Discovery Medicine 2017

Comorbidities between common inflammatory diseases

©2019 Standard Process Inc. All rights reserved. LN1398 01/19

©2019 Standard Process Inc. All rights reserved. LN1398 01/19Serhan CN. Novel Lipid Mediators and Resolution Mechanisms in Acute Inflammation. The American Journal of Pathology. 2010;177(4):1576-1591. doi:10.2353/ajpath.2010.100322.

A New Clinical Paradigm of Inflammation – Two Key Phases

Resolving the Process and Balancing Immune-modulation

©2019 Standard Process Inc. All rights reserved. LN1398 01/19

©2019 Standard Process Inc. All rights reserved. LN1398 01/19

Inflammation Support Compounds

• Turmeric

• Bromelain

• Polyphenols

• Black Currant (Seed) Oil

• EGCG

• Ginger

• EFA’s

• SPM’s