Potential role of nutraceutical compounds in inflammatory bowel disease

Abstract

Conventional therapies for inflammatory bowel diseases (IBD) involve combinations of pharmacologic agents such as aminosalicylates, azathioprine, and corticosteroids. Recently, the therapeutic scenario has been heavily increased by the introduction of agents including monoclonal antibodies targeted to specific proinflammatory cytokines, to adhesion molecules, and the induction of anti-inflammatory cytokines and T-cell activation. However, the use of these drugs is accompanied by a certain number of side effects, with some of them being quite severe, rising concerns about the safety profile. Furthermore, the cost of these emerging therapeutic strategies is significant , considering the increasing incidence and the chronic trend of IBD. Nutraceuticals is a broad term used to describe any product derived from food sources claiming extra health benefits beyond the intrinsic nutritional value found in foods. The beneficial effects of nutraceutical compounds in human health have been emerging in the last decades. Although few clinical trials have been performed in IBD patients, nutraceuticals, such as herbal products or vitamins, are generally accepted as safer alternative/supplementation to conventional therapy. In vitro and IBD-animal models studies have shown their involvement in several biological processes, including antioxidant defenses, cell proliferation, gene expression, which could account for a role in the maintenance of the mucosal barrier integrity, the control of the inflammatory pathways and the modulation of the immune response. These data suggest a wide spectrum of positive effects exerted by nutraceuticals, with a high potential for a therapeutic use in humans. In the present review, the beneficial effects of the most investigated nutraceutical compounds in the setting of human IBD are discussed.

Keywords: Crohn’s disease; Functional foods; Herbals; Inflammatory bowel disease; Nutraceuticals; Phytochemicals; Probiotics; Ulcerative colitis.

Figure 1

Macro-categories of Nutraceuticals and related most representative compounds.

Figure 2

Phytochemicals and their interactions with inflammatory pathways. IFN-γ: Interferon-gamma; IL: Interleukin; MIF: Macrophage migration inhibitory factor; NF-κB: Nuclear factor kappa-light-chain-enhancer of activated B cells; TNF-α: Tumor necrosis factor-alpha.