THE IMMUNE SYSTEM: THE FIRST STOP FOR FUNCTIONAL MEDICINE
The more we learn about immunology, the more we realize that practically all the patterns seen commonly in a functional medicine practice have a fundamentally immunological basis.
Sam Yanuck, DC, FACFN , FIAMA+, is a renowned Functional Medicine instructor and practitioner, with a focus in immunology, and is an advocate for prioritizing immune system balance as a crucial first step for many of patients. He states “the more you learn about immunology, the more you realize how many of the patterns you see in your patients have a fundamental immunological basis. It’s essential that you have a systematic plan to address the immunological basis for these patterns and the right tools to implement the plan.”
The immune system plays a central role in protecting and maintaining homeostasis in the body by distinguishing between self (your cells) and non-self (pathogens, bacteria, viruses, etc.). The robustness of this process depends on appropriate activation of T helper cell types, as well as balanced cytokine expression.
The relevance of the immune system goes far beyond natural defenses. Immunology is at the root of many common clinical objectives, including:
- Tolerance of self-tissue
- Digestive health
- Cytokine balance
- Brain function, mood and cognition
- Joint function
- Glucose homeostasis
- Sinus and respiratory health
- Cardiovascular function
It is important to have a plan in place to address the immunological basis of your patients’ concerns and the right tools available to implement the plan.
SELF-TISSUE RESPONSE: A THREE-STEP APPROACH
Each step described below supports a key aspect of the immune system and cumulatively helps promote a balanced immune response:
STEP 1. PROMOTE T-HELPER CELL BALANCE
T-helper cells are a class of lymphocyte that help the immune system respond appropriately to different types of threats faced by the body. They begin as naive T-cells and become, when activated, unique T-helper cell types. Which type they become depends on cytokines and other factors in their micro-environment at the time of their activation.
Here is a list of different T-helper cells and their role in maintaining immune system balance:
- Th1 cells: Support cell-mediated immune defenses
- Th2 cells: Help activate eosinophils and mast cells
- Treg cells: Modulate the effects of other T cells
- Th17 cells: Respond to the extracellular microbial environment
A balanced profile of T-helper cells is crucial for immune defenses and tissue homeostasis. Unfortunately, many factors commonly seen in patient cases, such as stress, diet, environment, glucose metabolism, and age, can drive an imbalance in T-helper cell types. Often, this occurs as an increase in the number and activity of Th2 cells (Th2 response) and a decrease in the number and activity of Th1 cells (Th1 response). In turn, this imbalance leads to the expansion of Th17 cells, which, through a cascade of effects, can make the patient more susceptible to developing an immune response directed at self-tissue.
Supporting and maintaining a balance of less Th2 cells and more Th1 cells, will help to moderate Th17 responses to help maintain immune homoeostasis in tissues.
STEP 2. MODULATE CYTOKINE ACTIVATION
This step supports immune system balance by modulating the activity of NFkB, a major driver of cytokine expression. This step also supports a healthy T-cell repertoire and tissue health. But first, it is crucial to first support a balanced T-helper cell profile (Step 1).
Cytokines are messenger molecules that orchestrate immune system function. NFkB is a protein complex that induces gene expression of a mixture of cytokines that initiate immune activation, which can increase self-tissue response. Persistent NFkB can decrease Th1 response, while other factors can increase Th2 response. Decreased Th1 response and increased Th2 response can increase Th17 response, which can contribute to development of a self-tissue response.
The patient factors mentioned in Step 1 can drive cytokine and NFkB activation, which in turn can influence cytokine activation in the brain, and self-tissue response throughout the body. Cytokine activation also decreases Th1 response, which we learned in Step 1 will increase Th2 response and therefore drive Th17, which impacts self-tissue response.
STEP 3. PERSONALIZE YOUR PLAN OF CARE
Functional medicine is personalized medicine, which means tailoring your plan of care with ingredients and formulas to address unique circumstances of your patient’s case.
Remember, the interconnectedness of elements in the immune system is often bidirectional. In some patients, progress depends upon addressing factors you would normally think of as downstream from the mechanisms discussed in steps 1 and 2.
For instance, G.I., sinus, lung, or bladder mucosal function, or mast cell activation can affect T cell polarization or cytokine activation. Therefore, modulating mast cell activation or supporting GI mucosal health can also contribute to a healthy T-helper cell profile.
BRINGING IT ALL TOGETHER
The immune system must distinguish between self and non-self to protect and maintain homeostasis in the body. To help your patients experiencing self-tissue response, you must understand how to balance T-helper cells (Step 1) and modulate cytokine (NFkB) activation (Step 2). Keep in mind each patient is different, so personalization will be essential in supporting immune system balance and homeostasis (Step 3).
Want to learn more about the products that can support self-tissue response in your patients every step of the way? Be sure to check out the complete protocol and guide, exclusive to Pure Encapsulations and developed by leading functional immunology expert Sam Yanuck. Check it out here.‡
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+Dr. Samuel Yanuck is a retained advisor for Pure Encapsulations®.