insights

Research continues into emerging therapeutic approaches that provide clinical opportunities for a range of chronic conditions. The 2021 Annual International Conference (AIC), Advancements in Clinical Research and Innovative Practices in Functional Medicine, explores new and trending topics in medicine that have the greatest potential for improving patient health outcomes. A small sample of the novel research and clinical applications that will be discussed is highlighted below.

Polyvagal Theory and Trauma-Related Dysfunction

The vagus nerve is a core component of the parasympathetic nervous system, responsible for visceral sensation, stimulating the muscles along the digestive tract, and decreasing heart rate. The vagus nerve has been identified as a key modulator of the body’s response to various stressors, such as chronic stress, fear, and trauma. Polyvagal theory seeks to understand the role of this nerve in regulating the psychoemotional and physiological responses that may influence disease pathology.¹ In his plenary presentation, Vagal Pathways: Portals to Compassions, researcher Stephen Porges, PhD, will discuss connections in the brain between the nerves that control the heart and the face and how they may provide the structure for a “social engagement system” that links sociality with autonomic regulation. Host physiological state thus facilitates either feelings of connectedness and intimacy or of defense such as the fight or flight response, hypervigilance, dissociation, collapse, and even syncope. These insights are informing new treatment strategies for trauma-related morbidities and leading to advances in brain-body medicine.

Exposome-Metabolome Interactions Throughout the Lifespan

Early childhood exposures, especially to environmental chemicals, shape a spectrum of sensitivity that is carried on through adulthood. Chemical and toxin burden on cell function has been shown to alter mitochondrial DNA, which may lead to genetic and epigenetic risk factors for a range of chronic conditions.² New approaches in metabolomics, exposomics, and environmental toxicology testing have indicated that many complex chronic disorders like primary mitochondrial dysfunctions, autism spectrum disorder (ASD), and chronic fatigue syndrome have a unique metabolic signature that can be used in early diagnosis and intervention. Measuring blood toxin level and consequential metabolic changes will be discussed in case study analyses of children with ASD and adults with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Robert Naviaux, MD, PhD, will elaborate on this concept during his presentation: Exposome-Metabolome Interactions in Chronic Childhood and Adult Disorders.

Therapeutic Use of Isothiocyanates for Mitigating Cytotoxicity

The isothiocyanate sulforaphane, a phytochemical found in broccoli and other cruciferous vegetables, has demonstrated anti-inflammatory, anti-oxidative, and detoxification properties. Further research shows its potential to influence the immune system response to viral and bacterial infections, and as an immune system modulator, it may downregulate inflammatory pathways in autoimmune and neurodegenerative diseases.³ Sulforaphane is also present in the leaves and seeds of the tropical drumstick tree, Moringa oleifera, which may preserve human neuronal cells.⁴ Clinical findings over the last quarter-decade with isothiocyanates and their glucosinolate precursors from both broccoli and moringa will be discussed in Jed Fahey, PhD’s, talk: Phytochemicals That Enhance Healthspan: The Therapeutic Uses of Isothiocyanates Found in Crucifers and Moringa oleifera.

Personalized Medicine for Improving Cognitive Outcomes

In a recent proof-of-concept trial, the functional medicine approach was applied to patients experiencing early-onset dementia and cognitive decline to test the efficacy of personalized interventions in improving cognition or preventing further decline as compared to drug therapy candidates. In their panel presentation, Precision Medicine for Cognitive Decline: Successful Proof-of-Concept Trial, clinicians Dale Bredesen, MD, Kat Toups, MD, Deborah Gibson, MD, and Ann Hathaway, MD, will present their findings and offer insights into designing effective treatment protocols.

Exploring innovative therapeutics to treat patients and accelerating the clinical application of research into practice are foundational values of the functional medicine approach. Join IFM for AIC 2021 and see expert clinicians discuss the latest research findings and offer strategies for improving health and resilience across diverse patient populations.

References

1. Kolacz J, Kovacic KK, Porges SW. Traumatic stress and the autonomic brain-gut connection in development: polyvagal theory as an integrative framework for psychosocial and gastrointestinal pathology. Dev Psychobiol. 2019;61(5):796-809. doi:1002/dev.21852
2. Zolkipli-Cunningham Z, Falk MJ. Clinical effects of chemical exposures on mitochondrial function. Toxicology. 2017;391:90-99. doi:1016/j.tox.2017.07.009
3. Mahn A, Castillo A. Potential of sulforaphane as a natural immune system enhancer: a review. Molecules. 2021;26(3):752. doi:3390/molecules26030752
4. Jaafaru MS, Nordin N, Shaari K, Rosli R, Abdull Razis AF. Isothiocyanate from Moringa oleifera seeds mitigates hydrogen peroxide-induced cytotoxicity and preserved morphological features of human neuronal cells. PLoS One. 2018;13(5):e0196403. doi:1371/journal.pone.0196403