©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