University of L'Aquila, Department of Life, Health, and Environmental Sciences, San Salvatore Hospital, L'Aquila, Italy.
Curr Pharm Des. 2020;26(22):2620-2629. doi: 10.2174/1381612826666200403122600.
Systemic inflammation is a common denominator to a variety of cardiovascular (CV) and non-CV diseases and relative risk factors, including hypertension and its control, metabolic diseases, rheumatic disorders, and those affecting the gastrointestinal tract. Besides medications, a non-pharmacological approach encompassing lifestyle changes and other complementary measures is mentioned in several updated guidelines on the management of these conditions. We performed an updated narrative review on the mechanisms behind the systemic impact of inflammation and the role of non-pharmacological, complementary measures centered on lowering systemic phlogosis for preserving or restoring a good global health. The central role of genetics in shaping the immune response is discussed in conjunction with that of the microbiome, highlighting the interdependence and mutual influences between the human genome and microbial integrity, diversity, and functions. Several plausible strategies to modulate inflammation and restore balanced crosstalk between the human genome and the microbiome are then recapitulated, including dietary measures, active lifestyle, and other potential approaches to manipulate the resident microbial community. To date, evidence from high-quality human studies is sparse to allow the unconditioned inclusion of understudied, though plausible solutions against inflammation into public health strategies for global wellness. This gap claims further focused, well-designed research targeted at unravelling the mechanisms behind future personalized medicine.
系统性炎症是多种心血管（CV）和非 CV 疾病及相关危险因素的共同特征，包括高血压及其控制、代谢疾病、风湿性疾病以及影响胃肠道的疾病。除了药物治疗外，在这些疾病的管理的多项更新指南中还提到了一种非药物方法，包括生活方式改变和其他补充措施。我们对炎症对全身的影响机制以及以降低全身炎症为中心的非药物、补充措施在维持或恢复整体健康方面的作用进行了更新的叙述性综述。遗传在塑造免疫反应中的核心作用与微生物组的作用一起进行了讨论，强调了人类基因组与微生物完整性、多样性和功能之间的相互依存和相互影响。然后，我们总结了几种可能的调节炎症和恢复人类基因组与微生物组之间平衡对话的策略，包括饮食措施、积极的生活方式以及其他可能的方法来操纵常驻微生物群落。迄今为止，由于高质量的人类研究证据不足，因此无法将研究不足但合理的抗炎解决方案不加条件地纳入全球健康的公共卫生策略中。这一差距需要进一步进行有针对性的、精心设计的研究，以揭示未来个性化医学背后的机制。
