May 7, 2018Quiz
Can a daily dose of baking soda help reduce the destructive inflammation of autoimmune diseases like rheumatoid arthritis?
According to a report in the Journal of Immunology, scientists at the Medical College of Georgia at Augusta University, have some of the first evidence of how an inexpensive, over-the-counter antacid can encourage our spleen to promote an anti-inflammatory environment that could be therapeutic. The authors demonstrated that when rats or healthy people drink a solution of baking 1) ___, or sodium bicarbonate, it becomes a trigger for the stomach to make more acid to digest the next meal and for little-studied mesothelial cells sitting on the spleen to mount a protective immune response. The mesothelium is a membrane composed of simple squamous epithelium that forms the lining of several body cavities: the pleura (thoracic cavity), peritoneum (abdominal 2) ___ including the mesentery), mediastinum and pericardium (heart sac). Mesothelial tissue also surrounds the male internal reproductive organs (the tunica vaginalis testis) and covers the internal reproductive organs of women (the tunica serosa uteri). The mesothelium derives from the embryonic mesoderm cell layer, that lines the coelom (body cavity) in the embryo. It develops into the layer of cells that covers and protects most of the internal organs of the 3) ___. The mesothelium forms a monolayer of flattened squamous-like epithelial cells resting on a thin basement membrane supported by dense irregular connective 4) ___. Cuboidal mesothelial cells may be found at areas of injury, the milky spots of the omentum, and the peritoneal side of the diaphragm overlaying the lymphatic lacunae. The luminal surface is covered with microvilli. The proteins and serosal fluid trapped by the microvilli provide a slippery surface for internal organs to slide past one another. The mesothelium is composed of an extensive monolayer of specialized cells (mesothelial cells) that line the body's serous cavities and internal organs. The main purpose of these cells is to produce a lubricating 5) ___ that is released between layers, providing a slippery, non-adhesive, and protective surface to facilitate intracoelomic movement. The mesothelium is also implicated in the transport and movement of fluid and particulate matter across the serosal cavities, leukocyte migration in response to inflammatory mediators, synthesis of pro-inflammatory cytokines, growth factors, and extracellular matrix proteins to aid in serosal repair, and the release of factors to promote the disposition and clearance of fibrin (such as plasminogen). 6) ___ cells are capable of phagocytosis and are antigen presenting cells. Furthermore, the secretion of glycosaminoglycans and lubricants may protect the body against infection and tumor dissemination. Mesothelial cells line body cavities, like the one that contains our digestive tract, and they also cover the exterior of our organs to quite literally keep them from rubbing together. About a decade ago, it was found that these 7) ___ also provide another level of protection. They have little fingers, called microvilli, that sense the environment, and warn the organs they cover that there is an invader and an immune response is needed.
According to the authors, drinking baking soda, tells the spleen, which is part of the immune system to attenuate the immune response. The authors proposed that this communication, which occurs with the help of acetylcholine, appears to promote an environment that shifts against inflammation. In the spleen, as well as the blood and kidneys, they found after drinking water with baking soda for two weeks, the population of immune cells called macrophages, shifted from primarily those that promote inflammation, called M1, to those that 8) ___ it, called M2. In the case of the lab animals, the problems were hypertension and chronic kidney disease, problems. One of the many functions of the kidneys is balancing important compounds like acid, potassium and sodium. According to the authors, with kidney disease, there is impaired kidney function and one of the resulting problems can be that the blood becomes too acidic resulting in an increased risk of cardiovascular disease and osteoporosis. Clinical trials have shown that a daily dose of baking soda can not only reduce acidity but actually slow progression of the kidney disease, and it's now a therapy offered to 9) ___. "
In terms of the mechanism of action, the authors hypothesized that the effects are likely due to increased conversion of some of the proinflammatory cells to anti-inflammatory ones coupled with actual production of more anti-inflammatory macrophages. The authors also saw a shift in other immune cell types, like more regulatory T cells, which generally drive down the immune response and help keep the immune system from attacking our own tissues. That anti-inflammatory shift was sustained for at least four hours in humans and three days in rats. The shift ties back to the mesothelial cells and their conversations with our spleen with the help of acetylcholine. Part of the new information about mesothelial cells is that they are neuron-like, but not neurons. According to the authors, the cholinergic (acetylcholine) signals that mediate this anti-inflammatory response aren't coming directly from the vagal nerve innervating the spleen, but from the mesothelial cells that form these connections to the spleen. The reason they say this is that when the vagal nerve was cut, it did not impact the mesothelial cells' neuron-like behavior. The vagal nerve is a big cranial nerve that starts in the brain and reaches into the heart, lungs and gut to help control things like a constant heart rate and food digestion. The affect, it appears, was more local because just touching the spleen did have an effect. In fact, when the authors only slightly moved the 10) ___as might occur in surgery, the previously smooth covering of mesothelial cells became lumpier and changed colors. Studies are currently underway at other institutions that, much like vagal nerve stimulation for seizures, electrically stimulate the vagal nerve to tamp down the immune response in people with rheumatoid arthritis.
The research was funded by the National Institutes of Health. Sources: Medical College of Georgia at Augusta University: Oral NaHCO3Activates a Splenic Anti-Inflammatory Pathway: Evidence That Cholinergic Signals Are Transmitted via Mesothelial Cells. The Journal of Immunology, 2018; ji1701605 DOI: 10.4049/jimmunol.1701605; nih.gov; ScienceDaily; Wikipedia
ANSWERS: 1) soda; 2) cavity; 3) body; 4) tissue; 5) fluid; 6) Mesothelial; 7) cells; 8) reduce; 9) patients; 10) spleen