Take home points: September 2015

Amentoflavone	Ginkgo biloba, St. John’s Wort	Decreases histamine release
Artekeiskeanol A	Artemisa keiskeana	May treat arthritis Decreases mast cell degranulation Decreases production of IL-13 and TNF
Curcimin	Turmeric	Decreases degranulation Decreases production of IL-4 and TNF
Ellagic acid	Strawberries, raspberries, pomegranate, walnuts	Suppresses IgE activation Decreases release of histamine, TNF, IL-6
Emodin	Rhubarb, frangula bark	Decreases IgE degranulation Decreases IgE triggered production of TNF, PGD2, LTC4 Decreases secretion of TNF and IL-6
Epigallocatechin gallate	White and green teas, apples, onions, hazelnuts	Decreases degranulation Decreases LTC4 secretion
Fisetin	Apples, onions, persimmon, strawberries, cucumber	Decreases IgE degranulation Decreased IgE triggered histamine release Decreases production of IL-1b, IL-6, IL-8 and TNF Decreased action of NF-kB, decreased mediator production
Furanocoumarin from Angelica dahurica	Angelica dahurica	Inhibits COX-2 and 5-LO, decreasing production of prostaglandins and LTC4
Genistein	Genista tinctoria	Decreases IgE degranulation Decreases histamine release Nature tyrosine kinase inhibitor
Ginkgetin	Gingko biloba	Inhibits COX-2 and 5-LO, inhibiting production of prostaglandins and leukotrienes
Gnetin H	Paeonia aneomala	Resveratrol derived polymer Decreases mast cell degranulation Effective at lower dose than reservatrol Decreases histamine secretion Decreases production of TNF, IL-4, COX-2 and PGE2
Homoisoflavonone	Cremastra appendiculata	Inhibits COX-2 and 5-LO, inhibiting production of prostaglandins and leukotrienes Decreases IgE triggered production of TNF and IL-6
Honokiol	Magnolia obovata	Suppresses allergic response and basophil activation
Hydroxytyrosol	Olive oil, olive leaves	Inhibited activation of mast cells at high concentration
Hypothemycin	Hypomyces mushrooms	Interfere with activation of CKIT and IgE receptors, inhibiting mast cell activation Decreases production of IL-4
Kaempferol	Potatoes, squash, cucumbers, peaches, Aloe versa	Decreases IgE degranulation Decreased IgE triggered histamine release Affects estrogen signaling
Luteolin	Celery, carrots, chamomile tea	Prophylactic use of luteolin suppresses activation of mast cells and T cells Decreases IgE degranulation Decreases production of mediators
Magnolol	Magnolia obovata	Suppresses allergic response and basophil activation
Morin	Osage orange, guava	Decreases mast cell degranulation Decreases IgE activation
Myricetin	Walnuts, onions, red grapes	Decreases IgE degranulation Decreased IgE triggered histamine release Decreases production of IL-6 and TNF Decreased action of NF-kB, decreased mediator production
Polydatin		Resveratrol precursor Makes small intestine mucosa less “leaky” and inhibited allergic reaction in intestines Decreases degranulation by up to 65% Decreases histamine in intestinal mucosa and serum Decreases production of IL-4
Quercetin	Red onion, sweet potato, kale	Inhibits production of histamine, prostaglandins, leukotrienes, IL-1b, IL-6, IL-8 and TNF
Resveratrol	Grapes, raspberries, blueberries, peanuts	Directly interferes with degranulation Decreases production of TNF, IL-6 and IL-8
Rottlerin	Mallotus philippensis	Decreases degranulation of airway mast cells Decreases histamine release Suppresses IgE activation
Rutin		Decreases IgE degranulation Decreased IgE triggered histamine release Decreases production of IL-1b, IL-6, IL-8 and TNF Decreased action of NF-kB, decreased mediator production
Scopoletin	Stinging nettle, Japanese belladonna, chicory, passion flower	Decreases production of TNF, IL-6, IL-8 Inhibits NF-kB, affecting mediator production
Selinidin	Angelia keiskei	Inhibits IgE degranulation Decreases production of LTC4 and TNF
Substance	Source	Function
Thunberginol A	Hydrangeae macrophylla	Decreases histamine release Decreases production of TNF and IL-4
Thunberginol B	Hydrangeae macrophylla	Decreases degranulation from IgE or other sources Decreases IgE triggered production of IL-2, IL-3, IL-4, IL-13, TNF and GM-CSF
Xanthones from purple mangosteen	Garcinia mangostana	Decreases release of histamine, PGD2, LTC4 and IL-6

Role of sex hormones in hereditary angioedema

Gastroparesis: Autonomic nervous system and vagus nerve (Part Six)

ANS controls many involuntary functions including digestion and therefore gastric emptying
The vagus nerve coordinates gastric motility
ANS dysfunction inhibits digestion and motility
GP is common in patients with ANS conditions, like POTS
Treatment of autonomic dysfunction (as in POTS) can sometimes improve GP
Damage to the vagus nerve can cause liquids to move rapidly out of the stomach while solids are retained
Surgery and high blood sugar can damage the vagus nerve
In GP patients, nerve cells are not shaped correctly
83% of GP patients have abnormalities in their stomach biopsies

Gastroparesis: Idiopathic gastroparesis (Part Seven)

35-67% of GP cases are idiopathic (IGP)
IGP affects three times more women than men, especially young and middle-aged women
IGP is more likely in young women who are overweight or obese
Moderate to severe abdominal pain was more frequent in IGP than other types
Nausea, abdominal pain, vomiting, bloating and feeling full are common in IGP
Medications that may be helpful but need investigation include sildenafil, paroxetine, cisapride, tegaserod, clonidine and buspirone