Natural anti-inflammatory agents for pain relief

Joseph C Maroon, Jeffrey W Bost, Adara Maroon, Joseph C Maroon, Jeffrey W Bost, Adara Maroon

Abstract

The use of both over-the-counter and prescription nonsteroidal medications is frequently recommended in a typical neurosurgical practice. But persistent long-term use safety concerns must be considered when prescribing these medications for chronic and degenerative pain conditions. This article is a literature review of the biochemical pathways of inflammatory pain, the potentially serious side effects of nonsteroidal drugs and commonly used and clinically studied natural alternative anti-inflammatory supplements. Although nonsteroidal medications can be effective, herbs and dietary supplements may offer a safer, and often an effective, alternative treatment for pain relief, especially for long-term use.

Keywords: Alternative treatments; inflammation; natural anti-inflammatories; pain.

Figures

Figure 1
Figure 1
Schematic showing that when a cell membrane is injured the arachidonic acid pathway is activated to initiate the local inflammatory response through the production of prostaglandins, thromboxanes, and leukotrienes. Their activation requires the enzymes COX and LOX. The NSAIDs can block COX action and thereby prevent the formation of the COX-derived inflammatory mediators. 5-HPETE = 5-hydroperoxyeicosatetraenoic acid; LTC4 = leukotriene C4; PGE2 = prostaglandin E2; PGF2 = prostaglandin F2; PGI2 = prostacyclin; TXA2 = thromboxane.
Figure 2
Figure 2
Schematic showing another inflammatory pathway that is activated by tissue injury. This is the NF-kB activation, in which once the protein is free as a result of tissue injury, it can enter the cell nucleus and activate the DNA to enhance the inflammatory response further by the production of additional cytokines, chemokines, and adhesion molecules (IKKB = IkB kinase)

References

    1. Acebo E, Raton JA, Sautua S, Eizaguirre X, Trébol I, Pérez JL. Allergic contact dermatitis from Boswellia serrata extract in a naturopathic cream. Am J Contact Dermat. 2004;51:91–2.
    1. Aguilar JL, Rojas P, Marcelo A, Plaza A, Bauer R, Reininger E, et al. Anti-inflammatory activity of two different extracts of Uncaria tomentosa (Rubiaceae) J Ethnopharmacol. 2002;81:271–6.
    1. Almekinders LC, Gilbert JA. Healing of experimental muscle strains and the effects of nonsteroidal anti-inflammatory medication. Am J Sports Med. 1986;14:303–8.
    1. Almekinders LC. Anti-inflammatory treatment of muscular injuries in sport. An update of recent studies. Sports Med. 1999;28:383–8.
    1. Andersohn F, Suissa S, Garbe E. Use of first- and second-generation cyclooxygenase-2-selective nonsteroidal antiinflammatory drugs and risk of acute myocardial infarction. Circulation. 2006;113:1950–7.
    1. Boswellia serrata. Altern Med Rev. 1998;3:306–7.
    1. Araujo CC, Leon LL. Biological activities of Curcuma longa L. Mem Inst Osawaldo Cruz. 2001;96:723–8.
    1. Badria FA, El-Farahaty T, Shabana AA, Hawas SA, El-Batoty MF. Boswellia-curcumin preparation for treating knee osteoarthritis: A clinical evaluation. Alt Complement Ther. 2002;8:341–8.
    1. Banerjee M, Tripathi LM, Srivastava VM, Puri A, Shukla R. Modulation of inflammatory mediators by ibuprofen and curcumin treatment during chronic inflammation in rat. Immunopharmacol Immunotoxicol. 2003;25:213–24.
    1. Banno N, Akihisa T, Yasukawa K, Tokuda H, Tabata K, Nakamura Y, et al. Anti-inflammatory activities of the triterpene acids from the resin of Boswellia carteri. J Ethnopharmacol. 2006;107:249–53.
    1. Bengmark S. Curcumin, an atoxic antioxidant and natural NFk B, cyclooxygenase-2, lipooxygenase, and inducible nitric oxide synthase inhibitor: A shield against acute and chronic diseases. JPEN J Parenter Enteral Nutr. 2006;30:45–51.
    1. Bernstein JE, Bickers DR, Dahl MV, Roshal JY. Treatment of chronic postherpetic neuralgia with topical capsaicin. A preliminary study. J Am Acad Dermatol. 1987;17:93–8.
    1. Burton TM. Monsanto arthritis-pain drug, Celebrex, surpasses Viagra’s early sales success. The Wall Street Journal B: New York. 1999
    1. Calder PC. N-3 Polyunsaturated fatty acids, inflammation, and inflammatory diseases. Am J Clin Nutr. 2006;83:1505S–19.
    1. Caterina MJ, Julius D. The vanilloid receptor: A molecular gateway to the pain pathway. Annu Rev Neurosci. 2001;24:487–517.
    1. Caterina MJ, Leffler A, Malmberg AB, Martin WJ, Trafton J, Petersen-Zeitz KR, et al. Impaired nociception and pain sensation in mice lacking the capsaicin receptor. Science. 2000;288:306–13.
    1. Cho KJ, Yun CH, Yoon DY, Cho YS, Rimbach G, Packer L. Effects of bioflavonoids extracted from the bark of Pinus maritime on proinflammatory cytokine interleukin-1 production in lipopoysaccharide-stimulated RAW 264.7. Toxicol Appl Pharmacol. 2000;168:64–71.
    1. Chrubasik S, Eisenberg E, Balan E, Weinberger T, Luzzati R, Conradt C. Treatment of low back pain exacerbations with willow bark extract: A randomized double blind study. Am J Med. 2000;9:9–14.
    1. Chrubasik S, Künzel O, Model A, Conradt C, Black A. Treatment of low back pain with a herbal or synthetic anti-rheumatic: A randomized controlled study. Willow bark extract for low back pain. Rheumatology. 2001;40:1388–93.
    1. Chung JM, Lee KH, Hori Y, Willis WD. Effects of capsaicin applied to a peripheral nerve on the responses of primate spinothalamic tract cells. Brain Res. 1985;329:27–38.
    1. Claeson P, Panthong A, Tuchinda P, Reutrakul V, Kanjanapothi D, Taylor WC, et al. Three non-phenolic diarylheptanoids with anti-inflammatory activity from Curcuma xanthorrhiza. Planta Med. 1993;59:451–4.
    1. Clemett D, Goa KL. Celecoxib: A review of its use in osteoarthritis, rheumatoid arthritis and acute pain. Drugs. 2000;59:957–80.
    1. Curtis CL, Harwood JL, Dent CM, Caterson B. Biological basis for the benefit of nutraceutical supplementation in arthritis. Drug Discov Today. 2004;9:165–72.
    1. Curtis CL, Hughes CE, Flannery CR, Little CB, Harwood JL, Caterson B. N-3 fatty acids specifically modulate catabolic factors involved in articular cartilage degradation. J Bio Chem. 2000;275:721–4.
    1. Curtis CL, Rees SG, Little CB, Flannery CR, Hughes CE, Wilson C, et al. Pathologic indicators of degradation and inflammation in human osteoarthritic cartilage are abrogated by exposure to n-3 fatty acids. Arthritis Rheum. 2002;46:1544–53.
    1. Graham DJ. COX-2 Inhibitors, Other NSAIDs, and Cardiovascular Risk: The Seduction of Common Sense. JAMA. 2006;296:1653–6.
    1. Daviglus ML, Stamler J, Orencia AJ, Dyer AR, Liu K, Greenland P, et al. Fish consumption and the 30-year risk of fatal myocardial infarction. N Engl J Med. 1997;336:1046–53.
    1. Ehrich EW, Dallob A, De Lepeleire I, Van Hecken A, Riendeau D, Yuan W, et al. Characterization of rofecoxib as a cyclooxygenase- 2 isoform inhibitor and demonstration of analgesia in the dental pain model. Clin Pharmacol Ther. 1999;65:336–47.
    1. Elmali N, Baysal O, Harma A, Esenkaya I, Mizrak B. Effects of resveratrol in inflammatory arthritis. Inflammation. 2007;30:1–6.
    1. Ernst E. Adulteration of Chinese herbal medicines with synthetic drugs: A systematic review. J Intern Med. 2002;252:107–13.
    1. Farquhar B, Kenney WL. Anti-inflammatory drugs, kidney function, and exercise. Sports Science Exchange. 1997;SSE #67 11:Article 4.
    1. Fernández-Celemín L, Pasko N, Blomart V, Thissen JP. Inhibition of muscle insulin-like growth factor I expression by tumor necrosis factor-a. Am J Physiol Endocrinol Metab. 2002;283:E1279–90.
    1. Fiebich BL, Chrubasik S. Effects of an ethanolic Salix extract on the release of selected inflammatory mediators in vitro. Phytomedicine. 2004;11:135–8.
    1. Fitzgerald GA. Coxibs and cardiovascular disease. N Engl J Med. 2004;351:1709–11.
    1. Fitzgerald M, Woolf CJ. The time course and specificity of the changes in the behavioral and dorsal horn cell responses to noxious stimuli following peripheral nerve capsaicin treatment in the rat. Neuroscience. 1982;7:2051–6.
    1. Fitzpatrick DF, Bing B, Rohdewald P. Endothelium-dependent vascular effects of Pycnogenol. J Cardiovasc Pharmacol. 1998;32:509–15.
    1. Foster S, Tyler VE. Tyler’s Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies. 4th ed. New York: The Haworth Press; 1999. pp. 97–9.
    1. Foster S. Herbs For Your Health. Loveland, CO: Interweave Press; 1996.
    1. Frantz B, Nordby EC, Bren G, Steffan N, Paya CV, Kincaid RL, et al. Calcineurin acts in synergy with PMA to inactivate I kappa B/MAD3, an inhibitor of NF-k B. Embo J. 1994;13:861–70.
    1. Funk JL, Oyarzo JN, Frye JB, Chen G, Lantz RC, Jolad SD, et al. Turmeric extracts containing curcuminoids prevent experimental rheumatoid arthritis. J Nat Prod. 2006;69:351–5.
    1. Gagnier JJ, vanTulder M, Berman B, Bombardier C. Herbal medicine for low back pain. Cochrane Database Syst Rev. 2006;19:CD004504.
    1. Gerhardt H, Seifert F, Buvari P, Vogelsang H, Repges R. Therapy of active Crohn disease with Boswellia serrata extract H 15. Z Gastroenterol. 2001;39:11–7.
    1. Gupta I, Parihar A, Malhotra P, Gupta S, Ludtke R, Safayhi H, et al. Effects of gum resin of Boswellia serrata in patients with chronic colitis. Planta Med. 2001;67:391–5.
    1. Ghosh S, May MJ, Kopp EB. NF-k B and Rel proteins: Evolutionarily conserved mediators of immune responses. Annu Rev Immunol. 1998;16:225–60.
    1. Gilroy DW, Colville-Nash PR, Willis D, Chivers J, Paul-Clark MJ, Willoughby DA. Inducible cyclooxygenase may have anti-inflammatory properties. Nat Med. 1999;5:698–701.
    1. Grimm T, Chovanová Z, Muchová J, Sumegová K, Liptáková A, Durackova Z, et al. Inhibition of NF-kB activation and MMP-9 secretion by plasma of human volunteers after ingestion of maritime pine bark extract (Pycnogenol) J Inflamm. 2006;3:1.
    1. Grimm T, Schäfer A, Högger P. Antioxidant activity and inhibition of matrix metalloproteinasas by metabolites of maritime pine bark extract (Pycnogenol) Free Radic Biol Med. 2004;36:811–22.
    1. Gulati OP. Pycnogenol in venous disorders: A review. Eur Bull Drug Res. 1999;7:8–13.
    1. Gupta I, Gupta V, Parihar A, Gupta S, Ludtke R, Safayhi H, et al. Effects of Boswellia serrata gum resin in patients with bronchial asthma: Results of a double-blind, placebo-controlled, 6-week clinical study. Eur J Med Res. 1998;3:511–4.
    1. Haqqi TM, Anthony DD, Gupta S, Ahmad N, Lee MS, Kumar GK, et al. Prevention of collagen-induced arthritis in mice by a polyphenolic fraction from green tea. Proc Natl Acad Sci U S A. 1999;96:4524–9.
    1. Harris WS, von Schacky C. The Omega-3 Index: A new risk factor for death from coronary heart disease? Prev Med. 2004;39:212–20.
    1. Hegmann T. A tale of two coxibs. JAAPA. 2005;18:14–7.
    1. Hitti M. Timeline of pain reliever controversy, tracing the path on Cox-2, NSAID pain relievers. WebMD Medical News, 2005 Apr 7. Available from: ) [Last accessed 2010 Aug 6]
    1. Hollman PC, Feskens EJ, Katan MB. Tea flavonols in cardiovascular disease and cancer epidemiology. Proc Soc Exp Biol Med. 1999;220:198–202.
    1. Holmes-McNary M, Baldwin AS., Jr Chemopreventive properties of trans-resveratrol are associated with inhibition of activation of the IkappaB kinase. Cancer Res. 2000;60:3477–83.
    1. Holzer P. Capsaicin: Cellular targets, mechanisms of action, and selectivity for thin sensory neurons. Pharmacol Rev. 1991;43:143–201.
    1. Hostanska K, Daum G, Saller R. Cytostatic and apoptosisinducing activity of boswellic acids toward malignant cell lines in vitro. Anticancer Res. 2002;22:2853–62.
    1. Jachak SM. Cyclooxygenase inhibitory natural products: Current status. Curr Med Chem. 2006;13:659–78.
    1. Jancsó G, Kíraly E, Jancsó-Gábor A. Direct evidence for an axonal site of action of capsaicin. Naunyn Schmiedebergs Arch Pharmacol. 1980;313:91–4.
    1. Jang M, Cai L, Udeani GO, Slowing KV, Thomas CF, Beecher CW, et al. Cancer chemopreventive activity of resveratrol, a natural product derived from grapes. Science. 1997;275:218–20.
    1. Maroon JC, Bost JW, Borden MK, Lorenz KM, Ross NA. Natural antiinflammatory agents for pain relief in athletes. Neurosurg Focus. 2006;21:E11.
    1. Keplinger K, Laus G, Wurm M, Dierich MP, Teppner H. Uncaria tomentosa (Wild) DC-Enthnomedicinal use and new pharmacological, toxicological and botanical results. J Ethnopharmacol. 1999;64:23–34.
    1. Kimmatkar N, Thawani V, Hingorani L, Khiyani R. Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis on knee-a randomized double blind placebo controlled trial. Phytomedicine. 2003;10:3–7.
    1. Ko RJ. Adulterants in Asian patent medicines. N Engl J Med. 1998;339:847.
    1. Krivoy N, Pavlotzky E, Chrubasik S, Eisenberg E, Brook G. Effect of salicis cortex extract on human platelet aggregation. Planta Med. 2001;67:209–12.
    1. Liu F, Zhang Y, Lau BS. Pycnogenol improves learning impairment and memory deficit in senescence-accelerated mice. J Anti-aging Med. 1999;2:349–55.
    1. Liu X, Wei J, Tan F, Zhou S, Würthwein G, Rohdewald P. Pycnogenol, French maritime pine bark extract, improves endothelial function of hypertensive patients. Life Sci. 2004;74:855–62.
    1. Malmstrom K, Daniels S, Kotey P, Seidenberg BC, Desjardins PJ. Comparison of rofecoxib and celcoxib, two cyclooxygenase- 2 inhibitors, in postoperative dental pain: A randomized, placebo-and active-comparator-controlled clinical trial. Clin Ther. 1999;21:1653–63.
    1. Manna SK, Mukhopadhyay A, Aggarwal BB. Resveratrol suppresses TNF-induced activation of nuclear transcription factors NF-kappaB, activator protein-1 and apoptosis: Potential role of reactive oxygen intermediates and lipid peroxidation. J Immunol. 2000;164:6509–19.
    1. Marcus D. Willow bark extract, a useful alternative for the treatment of osteoarthritis: Comment on the editorial by Marcus and Suarez-Almazor (Reply) Arthritis Rheum. 2003;48:279–80.
    1. Marienfeld R, Neumann M, Chuvpilo S, Escher C, Kneitz B, Avots A, et al. Cyclosporin A interferes with the inducible degradation of NF-k B inhibitors, but not with the processing of p105/NF-k B1 in T cells. Eur J Immunol. 1997;27:1601–9.
    1. Maroon JC, Bost JW. Omega-3 fatty acids (fish oil) as an antiinflammatory: An alternative to nonsteroidal anti-inflammatory drugs for discogenic pain. Surg Neurol. 2006;65:326–31.
    1. Maroon JC. The Longevity Factor: How Resveratrol and Red Wine Activates Genes for a Longer and Healthier Life. New York: Simon and Schuster; 2009.
    1. McGettigan P, Henry D. Cardiovascular risk and inhibition of cyclooxygenase: A systematic review of the observational studies of selective and nonselective inhibitors of cyclooxygenase 2. JAMA. 2006;296:1633–44.
    1. Meadows M. Why drugs get pulled off the market. FDA Consumer. 2002;36:11–7.
    1. Meyer S, Kohler NG, Joly A. Cyclosporine A is a non-competitive inhibitor of proteasome activity and prevents NF-k B activation. FEBS Lett. 1997;413:354–8.
    1. Miller MJ, Ahmed S, Bobrowski P, Haqqi TM. The chondroprotective actions of a natural product are associated with the activation of IGF-1 production by human chondrocytes despite the presence of IL-1b. BMC Complement Altern Med. 2006;6:13.
    1. Mix KS, Mengshol JA, Benbow U, Vincenti MP, Sporn MB, Brinckerhoff CE, et al. A synthetic triterpenoid selectively inhibits the induction of matrix metalloproteinases 1 and 13 by inflammatory cytokines. Arthritis Rheum. 2001;44:1096–104.
    1. Moncado S, Gryglewski R, Bunting S, Vane JR. An enzyme isolated from arteries transforms prostaglandin endoperoxides to an unstable substance that inhibits platelet aggregation. Nature. 1976;263:663–5.
    1. Morrison BW, Christensen S, Yuan W, Brown J, Amlani S, Seidenberg B. Analgesic efficacy of the cyclooxygenase-2- specific inhibitor rofecoxib in post-dental surgery pain: A randomized, controlled trial. Clin Ther. 1999;21:943–53.
    1. Negri L, Lattanzi R, Giannini E, Colucci M, Margheriti F, Melchiorri P. Impaired nociception and inflammatory pain sensation in mice lacking the prokineticin receptor PKR1: Focus on interaction between PKR1 and the capsaicin receptor TRPV1 in pain behavior. J Neurosci. 2006;26:6716–27.
    1. Nelson AB, Lau BH, Ide N, Rong Y. Pycnogenol inhibits macrophage oxidative burst, lipoprotein oxidation, and hydroxyl radical-induced DNA damage. Drug Dev Ind Pharm. 1998;24:139–44.
    1. Abdul-Hadi O, Parvizi J, Austin MS, Viscusi E, Einhorn T. Nonsteroidal Anti-Inflammatory Drugs in Orthopaedics. J Bone Joint Surg. 2009;91:2020–7.
    1. Packer L, Rimbach G, Virgili F. Antioxidant activity and biologic properties of a procyanidin-rich extract from Pine (pinus maritima) bark, Pycnogenol. Free Radic Biol Med. 1999;27:704–24.
    1. Peng Q, Wei Z, Lau BH. Pycnogenol inhibits tumor necrosis factor-a -induced nuclear factor kappa B activation and adhesion molecule expression in human vascular endothelial cells. Cell Mol Life Sci. 2000;57:834–41.
    1. Pepping J. Omega-3 essential fatty acids. Am J Health Syst Pharm. 1999;56:719.
    1. Piscoya J, Rodriquez Z, Bustamante SA, Okuhama NN, Miller MJ, Sandoval M, et al. Efficacy and safety of freeze-dried cat’s claw in osteoarthritis of the knee: Mechanisms of action of the species Uncaria guianensis. Inflamm Res. 2001;50:442–8.
    1. Plummer SM, Holloway KA, Manson MM, Monks RJ, Kaptein A, Farrow S, et al. Inhibition of cyclo-oxygenase 2 expression in colon cells by the chemopreventive agent curcumin involves inhibition of NF-k B activation via the NIK/IKK signalling complex. Oncogene. 1999;18:6013–20.
    1. Pospisilova E, Palecek J. Post-operative pain behavior in rats is reduced after single high-concentration capsaicin application. Pain. 2006;125:233–43.
    1. Psaty BM, Furberg CD, Ray WA, Weiss NS. Potential for conflict of interest in the evaluation of suspected adverse drug reactions. JAMA. 2004;292:2622–31.
    1. Pungle P, Banavalikar M, Suthar A, Biyani M, Mengi S. Immunomodulatory activity of boswellic acids of Boswellia serrata Roxb. Indian J Exp Biol. 2003;41:1460–2.
    1. Rehman Q, Sack KE. When to try COX-2-specific inhibitors: Safer than standard NSAIDS in some situations. Postgrad Med. 1999;106:95–106.
    1. Reuben SS, Connelly NR. Postoperative analgesic effects of celecoxib or rofecoxib after spinal fusion surgery. Anesth Analg. 2000;91:1221–5.
    1. Reynolds JF, Noakes TD, Schwellnus MP, Windt A, Bowerbank P. Non-steroidal anti-inflammatory drugs fail to enhance healing of acute hamstring injuries treated with physiotherapy. S Afr Med J. 1995;85:517–22.
    1. Safayhi H, Mack T, Sabieraj J, Anazodo MI, Subramanian LR, Ammon HP. Boswellic acids: Novel, specific, nonredox inhibitors of 5-lipoxygenase. J Pharmacol Exp Ther. 1992;261:1143–6.
    1. Safayhi H, Sailer ER. Anti-inflammatory actions of pentacyclic triterpenes. Planta Medica. 1997;63:487–93.
    1. Sailer ER, Subramanian LR, Rall B, Hoernlein RF, Ammon HP, Safayhi H. Acetyl-11-keto-beta-boswellic acid (AKBA): Structure requirements for binding and 5-lipoxgenase inhibitory activity. Br J Pharmacol. 1996;117:615–8.
    1. Sandoval M, Charbonnet RM, Okuhama NN, Roberts J, Krenova Z, Trentacosti AM, et al. Cat’s claw inhibits TNF- aproduction and scavenges free radicals: Role in cytoprotection. Free Radic Biol Med. 2000;29:71–8.
    1. Sandoval-Chacón M, Thompson JH, Zhang XJ, Liu X, Mannick EE, Sadowska-Krowicka H, et al. Antiinflammatory actions of cat’s claw: The role of NF-k B. Aliment Pharmacol Ther. 1998;12:1279–89.
    1. Schmid B, Kótter I, Heide L. Pharmacokinetics of salicin after oral administration of a standardised willow bark extract. Eur J Clin Pharmacol. 2001;57:387–91.
    1. Schmid B, Lüdtke R, Selbmann HK, Kótter I, Tschirdewahn B, Schaffner W, et al. Efficacy and tolerability of a standardized willow bark extract in patients with osteoarthritis: Randomized placebo-controlled double blind clinical trial. Phytother Res. 2001;15:344–50.
    1. Seibert K, Masferrer JL. Role of inducible cyclooxygenase (COX-2) in inflammation. Receptor. 1994;4:17–23.
    1. Setty AR, Sigal LH. Herbal medications commonly used in the practice of rheumatology: Mechanisms of action, efficacy, and side effects. Semin Arthritis Rheum. 2005;34:773–84.
    1. Shao Y, Ho CT, Chin CK, Badmaev V, Ma W, Huang MT. Inhibitory activity of boswellic acids from Boswellia serrata against human leukemia HL-60 cells in culture. Planta Med. 1998;64:328–31.
    1. Sharma S, Thawani V, Hingorani L, Shrivastava M, Bhate VR, Khiyani R. Pharmacokinetic study of 11-keto beta-Boswellic acid. Phytomedicine. 2004;11:255–60.
    1. Sheng Y, Pero RW, Amiri A, Bryngelsson C. Induction of apoptosis and inhibition of proliferation in human tumor cells treated with extracts of Uncaria tomentosa. Anticancer Res. 1998;18:3363–8.
    1. Stanbury RM, Graham EM. Systemic corticosteroid therapy-side effects and their management, Br J Ophthalmol. 1998;82:704–8.
    1. Subbaramaiah K, Chung WJ, Michaluart P, Telang N, Tanabe T, Inoue H, et al. Resveratrol inhibits cyclooxygenase-2 transcription and activity in phorbol ester-treated human mammary epithelial cells. J Biol Chem. 1998;273:21875–82.
    1. Sumpio BE, Cordova AC, Berke-Schlessel DW, Qin F, Chen QH. Green tea, the “Asian paradox” and cardiovascular disease. J Am Coll Surg. 2006;202:813–25.
    1. Surh YJ, Chun KS, Cha HH, Han SS, Keum YS, Park KK, et al. Molecular mechanisms underlying chemopreventive activities of anti-inflammatory phytochemicals: Down-regulation of COX-2 and iNOS through suppression of NFkappa B activation. Mutat Res. 2001;480-481:243–68.
    1. Szallasi A, Blumberg PM. Vanilloid (Capsaicin) receptors and mechanisms. Pharmacol Rev. 1999;51:159–212.
    1. Talalay P, Talalay P. The importance of using scientific principles in the development of medicinal agents from plants. Acad Med. 2001;76:238–47.
    1. Tijburg LB, Mattern T, Foltz JD, Weisgerber UM, Katan MB. Tea flavonoids in cardiovascular diseases: A review. Crit Rev Food Sci Nutr. 1997;37:771–85.
    1. Tilley SL, Coffman TM, Koller BH. Mixed messages: Modulation of inflammation in immune responses by prostaglandins and thromboxanes. J Clin Invest. 2001;108:15–23.
    1. Vane J, Botting R. Inflammation and the mechanism of action of anti-inflammatory drugs. FASEB J. 1987;1:89–96.
    1. Vane JR. Inhibition of prostaglandin synthesis as a mechanism of action for aspirin-like drugs. Nat New Biol. 1971;231:232–5.
    1. Vane JR. The fight against rheumatism: From willow bark to COX-1 sparing drugs. J Physiol Pharmacol. 2000;51:573–86.
    1. Vankemmelbeke MN, Jones GC, Fowles C, Ilic MZ, Handley CJ, Day AJ, et al. Selective inhibition of ADAMTS-1, -4 and- 5 by catechin gallate esters. Eur J Biochem. 2003;270:2394–403.
    1. Wang C, Chung M, Lichtenstein A, Balk E, Kupelnick B, Devine D, et al. Effects of omega-3 fatty acids on cardiovascular disease. Evid Rep Technol Assess (Summ) 2004;94:1–8.
    1. Yamamoto Y, Gaynor RB. Therapeutic potential of inhibition on the NK-k B pathway in the treatment of inflammation and cancer. J Clin Invest. 2001;107:135–42.
    1. Yang CS, Wang ZY. Tea and cancer: A review. J Natl Cancer Inst. 1993;85:1038–49.
    1. Zandi E, Karin M. Bridging the gap: Composition, regulation, and physiological function of the Ik B kinase complex. Mol Cell Biol. 1999;19:4547–51.
    1. Zwillich T. Group calls for 2 arthritis drug bans, public citizen says Celebrex, Bextra share Vioxx’s problems. Available from: ) [Last accessed on 2010 Aug 62]

Source: PubMed

Sponsoren und Mitarbeiter

Krankheiten

Drogeninterventionen

3
Abonnieren