Improving COVID-19 Pulmonary Inflammation with Nutrition

The intense immune reactions seen in many severe cases of COVID-19 are mediated in part by inflammasones, cellular multi-protein complexes that are the immune system’s first line of defense. Under normal circumstances, inflammasones are activated by the body to respond to and clear harmful stimuli such as pathogenic microbes. However, excessive activation of inflammasones can result in increased and prolonged cytokine release, chronic inflammation, and pulmonary and endothelial damage. Research shows that many naturally occurring phytochemicals found in foods can down-regulate inflammasome activation.

One type of inflammasome, known as NLRP3, is known to be activated by certain viruses, including coronaviruses. After exposure to a coronavirus, the NLRP3 inflammasome is activated by a complex combination of processes that create a highly pro-inflammatory environment in order to quickly neutralize an infection.

In severe cases of COVID-19 and other forms of Acute Respiratory Distress Syndrome, the inflammatory cascade does not “turn off” and return to equilibrium, resulting in a prolonged cytokine “storm” that can cause excessive cell death, tissue damage, and ultimately organ dysfunction. The cytokine “storm” can also damage alveoli in the lungs, making them unable to deliver oxygen to the blood. When a patient has respiratory distress in the presence of inflammasome dysregulation, exogenous oxygen therapy may not be an effective treatment, which has been the case in severe cases of COVID-19.

An assortment of phytochemical-rich food sources can regulate pulmonary NLRP3 inflammasome activation.

• Curcuminoids are derived from the turmeric plant and certain ginger plants. Studies have shown curcumin to be a regulator of NLRP3 inflammasome expression through multiple pathways. Absorption can be improved with the addition of black pepper.
• Resveratrol is found in the skins of red and purple grapes and reduces oxidative stress.
• The major bioactive polyphenol in Green Tea inhibits NLRP3 inflammasome activation.
• Sulforaphane inhibits activation of multiple inflammasomes, including NLRP3. It is found in cruciferous vegetables such as kale, broccoli, Brussels sprouts, cabbage, bok choy, and radishes. These should be steamed or sautéed for optimal benefit.
• Quercetin blocks NLRP3 activation. Quercetin is found in a variety of fruits, vegetables and herbs, especially in the red skin of apples and purple onions.
• The major active component of Ginseng modulates NLRP3 activation.
• Modified Citrus Pectin (MCP) is a dietary fiber derived from the inner peel of citrus fruit. It down-regulates the activation of the NLRP3 inflammasome and reduces secretion of inflammatory cytokines. MCP supplements should have the smallest particle size for best absorption.
• Potassium is transported at the initiation of inflammasome activation. Patients who follow a plant-based diet are likely to have normal potassium levels, but high-risk patients should have potassium and other electrolytes monitored to ensure proper immune function.

Many of the natural compounds that influence inflammasome activation are found in plant foods. A diet rich in fruits, vegetables, and herbs can have a powerful impact on pulmonary inflammation control, other chronic inflammatory illnesses, and overall long-term health.