Etanercept VS Nobiletin in TED
This article describes a pilot study showing benefits using etranercept for TED and it describes a similar naturally occurring plant chemical, nobiletin.
The prescription drug etanercept (Enbrel) and similar compounds such as infliximab and adalimumab have been used in the treatment of several different autoimmune disorders, including Crohn's disease, rheumatoid arthritis and psoriasis. These medications, which are injected and suppress the immune system, causing risk for infection, work by inhibiting the action of the immune system chemical cytokine known as tumor necrosis factor alpha (TNF-alpha), a compound that promotes inflammation. In this article I describe a citrus bioflavinoid known as nobiletin that is also known to inhibit TNF-alpha. It is found in Arthromax, a natural supplement used to reduce inflammation in patients with arthritis.
In a pilot study conducted in 2005, etanercept was used for ten patients with thyroid eye disease (TED or Graves' ophthalmopathy). The study concluded that treatment with etanercept decreased eyelid and conjunctival inflammation but not proptosis. The study, "The effect of etanercept on Graves' ophthalmopathy: a pilot study," was published in Eye 2005; l19: 1286-1289 by D Paridaens, WA van den Bosch, TL van der Loos, EP Krennig, and PM van Hagen.
The patients in this study were treated with 25 mg of etanercept given subcutaneously twice weekly for 12 weeks. Patients were evaluated using the Clinical Activity Score and Ophthalmopathy Index for soft-tissue involvement of the eyes, proptosis, involvement of the extraocular muscles, corneal involvement and sight loss. Proptosis was measured by exophthalmometry. At twelve weeks the Clinical Activity Score decreased or improved by 60 percent and the Ophthalmopathy Index improved by 24 percent. The most significant improved occurred in eyelid and conjunctival inflammation, redness, and swelling. Six of the patients had diplopia or double vision at the start of the study, and in three of these patients improvement of diplopia was noted. Visual acuity did not change in any of the patients although all patients reported some subjective improvements. The injections were well tolerated and no adverse effects were seen in an 18-month follow-up period.
I became familiar with nobiletin when I began using it as a treatment for acute osteoarthritis of the cervical spine and degenerative disk disease. Within a week I noticed improvement although the compound I use, Arthromax manufactured by the Life Extension Foundation, contains several other substances. Arthromax contains 300 mg nobiletin citrus bioflavinoid complex with palm fruit extract for additional antioxidant protection; 75 mg of the boswelia extract 5-loxin, which inhibits the 5-lipooxygenase enzyme, thereby reducing levels of joint-damaging leukotriene B-4; 1000 mg glucosamine sulfate; 1000 mg N-acetyl-D-glucosamine, and 1000 mg methylsulfonylmethane (MSM).
According to the Life Extension Foundation, nobiletin is a citrus bioflavinoid or plant chemical that has demonstrated potent effects in suppressing destructive cytokines such as TNF-alpha and also the cytokine interleukin-1 beta. In addition, nobiletin has demonstrated natural prostglandin E2 inhibiting properties. Prostaglandins are a primary culprit in acute phase joint injury and discomfort. Before using Arthromax, I tried compounds containing glucosamine, chrondoitin, and MSM and also a product containing glucosamine alone, but I didn't experience freedom from pain until starting Arthromax in January 2006.
About a decade ago, while researching TED, a friend and I ran across several European studies showing that plant bioflavinoids were being used effectively to reduce inflammation in TED and other autoimmune conditions. While we were unable to find the exact compounds used, a citrus bioflavinoid such as nobiletin that has the ability to inhibit TNF-alpha is certainly a promising candidate. Unfortunately, while pharmaceutical manufacturers continue to pursue finding new uses for their newest drugs particularly expensive medications such as etanercept, research geared toward natural phytochemicals isn't as lucrative.
A search for nobiletin at Pub Med, the Library of Medicine's search engine for published medical articles, showed 82 citations for this compound, with reports showing nobiletin is a safe and effective anti-inflammatory agent.
