Latin for "set afire," inflammation is healthy when it's a natural response from the immune system to ward off injury and infection. When inflammation becomes chronic as in Rheumatoid Arthritis where there is pain, redness and swelling or in heart disease, Alzheimer's or diabetes, a normal immune system response has gone haywire and actually becomes disease perpetuator. For example, inflamed arteries are common in heart disease. Fats building up along the walls of the coronary arteries causes the body to retaliate with inflammatory chemicals that trigger blood clots causing heart attack or stroke. By the same template, obesity triggers retaliatory inflammation so that the body is no longer able to use insulin leading to type 2 diabetes; chronic brain inflammation leads to dementia and Alzheimer's; ulcerative colitis and Crohn's disease are types of inflammatory bowel disease reflective of the body's immune system mistaking healthy bacteria as a threat.
Inflammation can also be a sudden threat, appearing as cellulitis, skin infection or appendicitis while your body is fighting an infection.
The chronic nature of autoimmune disorders are understood to be based on an underlying deficiency syndrome. It is the deficiency that permits the pathology to manifest. If the vessels were full of qi and blood, and the organs working properly and full of their essences, the person would be healthy, or might, at the worst, suffer minor and short term diseases. Instead, the deficiency condition allows external pathogenic influences to enter, and permits the disease to progress, transform, and become serious because of inadequate resistance to this process by the normalizing qi. Genetic factors involved in diseases are often associated with the Chinese concept of essence deficiency (specifically, a kidney deficiency); diseases that progress with aging are also attributed to deficiencies of kidney and liver and involve the “essence” deficiency (jingxu). The potential role of viruses or other infectious agents in triggering the disease process corresponds, in part, to the failure to repel the external pathogen.
According to common TCM approaches to disease treatment, tonification of the deficiencies would be a part of the therapy throughout treatment, since the effect of other therapeutic approaches would be boosted by the presence of adequate qi, blood, and essence. For example, to vitalize circulation of blood, the qi must be adequate, according to the Chinese theory. Tonification would be especially important during any phases of remission where there would not be an immediate requirement to intensively alleviate inflammation, pain, and other acute symptoms, while it would usually be a secondary part of the treatment if the acute syndrome is present.
Any of the diseases that reach an advanced stage appear to manifest at least two imbalances defined in TCM. One is the deficiency of kidney that may be at the root of the disease but may also come about from the damage caused by the disease process or even by the drugs previously used to control the disease. This deficiency may manifest as cold or hot symptoms (depending on whether yin or yang is most severely affected), weakness of limbs, fatigue, changes in bowel and urination patterns, dryness or excess moisture. The other is development of blood stasis (which is considered a type of “excess” pattern). Blood stasis can occur directly as part of the local disease manifestation (for example: the autoimmune attack causes inflammation, which damages the capillary beds in the affected area) or as a later effect (for example, high blood sugar in diabetes over time causes circulatory disorders, with damage to both the capillary beds and the larger vessels).
Many herbs and isolated active components of herbs, when evaluated in model systems (such as cell cultures or laboratory animals), are shown to have anti-inflammatory activities or immune-regulating functions. Some Chinese herbs that are frequently used in treatment of autoimmune diseases have been analyzed for active component groups, which are then tested to demonstrate a possible mechanism of action in autoimmune disorders. We can begin the examination with the central herb for kidney tonification, a common ingredient in formulas for chronic diseases, particularly autoimmune disorders, and used in formulas for cold and for hot syndromes: rehmannia.
Rehmannia used in most kidney tonic formulas, such as Rehmannia Six Formula (Liuwei Dihuang Wan) and Rehmannia Eight Formula (Bawei Dihuang Wan), has as primary active components a class of chemical substances called iridoid glycosides. Iridoids, a type of monoterpene, have the basic structure shown here; which often has a glucose molecule attached, making it a glucoside (general term: glycoside). Iridoid glycosides are among the main active components for two ingredients of these formulas: rehmannia (dihuang) and cornus (shanzhuyu). And, for those formulas containing the yang tonic cistanche (roucongrong), there are additional iridioids that it provides.
Iridoid glycosides are also found as major components of some of the heat-clearing herbs, such as gardenia, scrophularia, picrorhiza, plantago seed, and chin-chiu (qinjiao) that are sometimes included in treatment of autoimmune disorders. For example, in a report on lupus therapy by integrated traditional and modern medicine (7), patients received Lingdan Pian, which included at least three herbs with iridoid glycosides: chin-chiu (qinjiao), rehmannia, and scrophularia; the formula also contains ching-hao, moutan, turtle shell, buffalo horn, licorice, and other herbs. In a treatment for ITP (8), the main ingredients of a formula included at least two herbs with iridoid glycosides: gardenia and raw rehmannia; the formula also contains red peony, moutan, tang-kuei, and astragalus. In the treatment of rheumatoid arthritis of the yin deficiency type described in the first report by Zhou, the formula included the iridoid-containing herbs rehmannia and chin-chiu; other formula ingredients were ho-shou-wu, campsis, and earthworm.
Recent studies revealed that geniposide, and other iridoids from gardenia fruits (see sample structure illustrations above, the glucose molecule is at the bottom right of each structure), showed pharmacological action consistent with suppressing immune inflammatory processes. For example, the compounds produced significant inhibition of IL-2 secretion, thus reducing antibody-stimulated activation of human peripheral blood T cells (9). In another study (10), it was shown that geniposide could lower serum IL-1β and TNF-α levels in rheumatoid arthritis rats, which was suggested to be related to its clinical effects of inhibiting development of rheumatoid arthritis. In another study, extract of chin-chiu (Gentiana macrophylla) was used in animal models of inflammation (11). It was noted in the abstract that:
The anti-inflammatory activity observed in Gentiana macrophylla is comparable to that observed in prednisone. These observations suggest that Gentiana macrophylla displays considerable potency in anti-inflammatory action and could be used as an anti-inflammatory agent in the control of inflammation of rheumatoid arthritis.
Chin-chiu extract tablets were used in previous Chinese clinical work in the treatment of lupus (SLE). It was claimed to be especially effective for nephropathy, arthralgia, and erythema, and contributed to improvement in blood parameters indicating immune status (12).
Keep in mind that your diet matters. The types of food consumed have a direct effect on inflammation levels in the body. Fruits, vegetables, whole grains, plant based proteins from beans and nuts, fish that are rich in omega-3 fatty acids such as salmon, tuna and sardines will help. Choosing plant oils like olive oil and foods with probiotics like low sugar yogurts also play a role. Adding spices like ginger, cinnamon, clove, black pepper and turmeric can not only liven up your foods, but ease the transition and establish a mindset for limiting saturated fats from meats, whole fat dairy products and processed foods.
Even with RA, exercise, exercise, exercise. Exercising is a habit that rewards in so many ways, emotionally, spiritually, mentally and physically. You don't have to run the NYC marathon or climb Mount Everest to be in top shape. As long as you exercise to your body's capacity, strengthening and lengthening muscles as you progress, you'll make a difference in how your immune system responds to stimuli, stress and infection.
Then, sleep it off. The more sleep deprived the body, the more inflammation persists. This may be related to metabolism, but the essential truth is that you're nothing without your sleep.
Excerpted from WebMD's slideshow "What is Inflammation" ; "Autoimmune Diseases and the Potential Role of Chinese Herbal Medicine" by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon.