The Role of an Anti-Inflammatory Cytokine in IBS & IBD (IL10)

Avoid Cigarettes

Some studies showed that smokers tend to have lower IL-10 levels (and higher levels of several inflammatory cytokines) in their blood and saliva [R, R].

Smoking is clearly associated with an increased incidence of Crohn’s disease, while its effects on ulcerative colitis are less evident — this condition seems to be more common among former smokers but less among people who currently smoke [R].

Smoking is also associated with an increased incidence and severity of stomach and colorectal cancer [R, R].

Moderate Sun Exposure

Both vitamin D and direct sun exposure seem to increase IL-10 [R, R, R].

Crohn’s disease (and the steroids used to treat it) have been linked to vitamin D deficiency and osteoporosis. If vitamin D supplements are not recommended, the best way to make sure you’re getting enough is with moderate sun exposure [R, R, R].

Moderate Exercise

Exercise and physical fitness improve the immune response and reduce rates of illness. Physical activity can increase the level of IL-10 in the blood, which contributes to the anti-inflammatory effect of exercise. Research suggests that exercise duration stimulates IL-10 activity more than exercise intensity [R, R, R].

Moderate exercise is among the best remedies for overall and gut health. Physical activity changes the composition of the gut flora by increasing beneficial species [R, R].

While exercise helps prevent IBD, people with active disease may or may not be able to adjust their physical activity, depending on their condition. It’s essential to stay physically fit and exercise regularly as a means of prevention [R, R, R].

Avoiding cigarettes, getting a moderate amount of sun exposure, and staying fit are good ways to increase IL-10 and prevent or control IBS and IBD.

People who eat a Mediterranean diet—rich in fruits, vegetables, nuts, whole grains, and olive oil; including more fish while cutting back on red meat and sweets—tend to have more circulating IL-10 [R, R].

Dietary recommendations to keep IBD in remission generally follow the Mediterranean diet [R]:

• Increased intake of fiber, especially from fruits and vegetables
• Avoiding processed vegetable oils
• Cutting back on red meat
• Reduced intake of sweets and refined carbs

The Mediterranean diet is rich in fruits, vegetables, nuts, whole grains, and olive oil. It implies a moderate intake of fish while cutting back on red meat and sweets.

Some experts recommend the Mediterranean diet as a complementary approach to digestive disorders such as IBD. The incidence of IBD is lower in the Mediterranean regions, compared with northern Europe [R, R, R].

Due to high fiber content, IBD patients may want to avoid this kind of diet during the active phases of “flares” [R].

The Mediterranean diet, which is rich in fruits, vegetables, nuts, whole grains, and olive oil and low in red meat and sugar, increases IL-10 and may help prevent gut inflammation.

N-Acetylcysteine

N-acetylcysteine (NAC) decreases the inflammatory response by reducing the levels of pro-inflammatory cytokines and increasing those with an anti-inflammatory activity. NAC helped maintain high levels of the anti-inflammatory IL-10 even a week after exercising in 29 people. It also increased this cytokine in another trial on 50 people undergoing a liver transplantation [R, R].

NAC has shown promise as a complementary approach alongside mesalamine in ulcerative colitis patients. It also had protective effects in a study of colitis in pigs [R, R, R].

Curcumin

Curcumin, a well-known anti-inflammatory compound extracted from turmeric, decreases IL-6, increases IL-10, and may enhance other parts of the immune response [R, R, R].

Multiple clinical trials have produced promising results for curcumin in IBD, and further research is currently underway [R, R, R].

Black Cumin Seed Oil

Nigella sativa, commonly known as black seed or black cumin, is a flowering plant native to South Asia. An active compound of black cumin called thymoquinone has been found to reduce airway inflammation, reduce inflammatory cytokines, and increase IL-10 in animal studies [R, R, R, R].

Notably, black cumin seed oil has also been found to decrease excessively high IL-10 in animal studies. However, even this may just be a side effect of reduced inflammation—remember that IL-10 increases to prevent the immune system from harming host tissues [R, R, R].

Some studies suggest that black cumin may also help protect the stomach and intestinal lining from damage and ulcers, mostly based on findings from animal studies [R, R, R, R].

Some anti-inflammatory supplements work by increasing IL-10 production. Some of these, which have also been found to improve IBS and IBD symptoms, include NAC, curcumin, and black cumin seed oil.

Probiotics

Probiotic supplements including different species of Lactobacillus (L. casei, L. paracasei, L. delbrueckii, L. rhamnosus, L. plantarum, L. acidophilus, and L. gasseri) and Bifidobacterium (B. animalis and B. bifidum) can change the cytokine profile towards a more anti-inflammatory one. In multiple clinical trials, they increased IL-10 levels [R, R, R, R, R].

People with IBD often have impaired gut microbiome, which may worsen their disease. In a meta-analysis, a blended probiotic containing Lactobacillus and Bifidobacterium strains increased remission rates by 1.7 times in ulcerative colitis patients [R].

These strains were beneficial in multiple different trials of ulcerative colitis patients [R, R, R, R].

Certain probiotic strains have been studied in people with Crohn’s disease, including Lactobacillus rhamnosus, Lactobacillus casei, Bifidobacterium breve, Bifidobacterium longum, and Saccharomyces boulardii. Of these, the first four showed some promise for people with active Crohn’s disease, while S. boulardii and L. rhamnosus may be helpful for keeping the disease at bay in patients in remission [R].

Certain probiotic bacteria promote the production of IL-10 and may help correct the imbalances in gut flora characteristic of IBS and IBD.