A release from the university notes that the research team has some of the first evidence of how the cheap, over-the-counter antacid can encourage our spleen to promote instead an anti-inflammatory environment that could be therapeutic in the face of inflammatory disease. The scientists have shown that when rats or healthy people drink a solution of baking soda, 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 tell the fist-sized organ that there’s no need to mount a protective immune response.

The release quotes Dr. Paul O’Connor, renal physiologist in the MCG Department of Physiology at Augusta University and the study’s corresponding author as saying, “It’s most likely a hamburger not a bacterial infection,” is basically the message.

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 cells 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.

Drinking baking soda, the MCG scientists think, tells the spleen – which is part of the immune system, acts like a big blood filter and is where some white blood cells, like macrophages, are stored – to go easy on the immune response. “Certainly drinking bicarbonate affects the spleen and we think it’s through the mesothelial cells,” O’Connor says.

The conversation, which occurs with the help of the chemical messenger acetylcholine, appears to promote a landscape that shifts against inflammation, they report.

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 reduce it, called M2. Macrophages, perhaps best known for their ability to consume garbage in the body like debris from injured or dead cells, are early arrivers to a call for an immune response.

In the case of the lab animals, the problems were hypertension and chronic kidney disease, problems which got O’Connor’s lab thinking about baking soda.

One of the many functions of the kidneys is balancing important compounds like acid, potassium and sodium. With kidney disease, there is impaired kidney function and one of the resulting problems can be that the blood becomes too acidic, O’Connor says. Significant consequences can include increased risk of cardiovascular disease and osteoporosis.

“It sets the whole system up to fail basically,” O’Connor says. 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 patients.

“We started thinking, how does baking soda slow progression of kidney disease?” O’Connor says.

That’s when the anti-inflammatory impact began to unfold as they saw reduced numbers of M1s and increased M2s in their kidney disease model after consuming the common compound.

When they looked at a rat model without actual kidney damage, they saw the same response. So the basic scientists worked with the investigators at MCG’s Georgia Prevention Institute to bring in healthy medical students who drank baking soda in a bottle of water and also had a similar response.

“The shift from inflammatory to an anti-inflammatory profile is happening everywhere,” O’Connor says. “We saw it in the kidneys, we saw it in the spleen, now we see it in the peripheral blood.”

The shifting landscape, he says, is 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 scientists 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 O’Connor is quick to clarify.

“We think the cholinergic (acetylcholine) signals that we know 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,” O’Connor says.

In fact, when they cut the vagal nerve, 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, it did not impact the mesothelial cells’ neuron-like behavior.

The affect, it appears, was more local because just touching the spleen did have an effect.

When they removed or even just moved the spleen, it broke the fragile mesothelial connections and the anti-inflammatory response was lost, O’Connor says. In fact, when they only slightly moved the spleen as might occur in surgery, the previously smooth covering of mesothelial cells became lumpier and changed colors.

“We think this helps explain the cholinergic (acetylcholine) anti-inflammatory response that people have been studying for a long time,” O’Connor says.

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. While there is no known direct connection between the vagal nerve and the spleen – and O’Connor and his team looked again for one – the treatment also attenuates inflammation and disease severity in rheumatoid arthritis, researchers at the Feinstein Institute for Medical Research reported in 2016 in the journal Proceedings of the National Academy of Sciences.

O’Connor hopes drinking baking soda can one day produce similar results for people with autoimmune disease.

“You are not really turning anything off or on, you are just pushing it toward one side by giving an anti-inflammatory stimulus,” he says, in this case, away from harmful inflammation. “It’s potentially a really safe way to treat inflammatory disease.”

The spleen also got bigger with consuming baking soda, the scientists think because of the anti-inflammatory stimulus it produces. Infection also can increase spleen size and physicians often palpate the spleen when concerned about a big infection.

Other cells besides neurons are known to use the chemical communicator acetylcholine. Baking soda also interact with acidic ingredients like buttermilk and cocoa in cakes and other baked goods to help the batter expand and, along with heat from the oven, to rise. It can also help raise the pH in pools, is found in antacids and can help clean your teeth and tub.

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The research was funded by the National Institutes of Health.

Arthritis can attack joints in almost any part of the body. Some types of arthritis cause changes you can see and feel—swelling, warmth, and redness in your joints. In some kinds of arthritis, the pain and swelling last only a short time, but are very uncomfortable. Other types of arthritis might be less painful, but still slowly cause damage to your joints. Here, from the experts at the National Institute on Aging, is what you need to know about an all-too-common condition:

Types of Arthritis

Arthritis is one of the most common diseases in the United States. Older people most often have osteoarthritis, rheumatoid arthritis, or gout.

Osteoarthritis (OA) is the most common type of arthritis in older people. OA starts when tissue, called cartilage, that pads bones in a joint begins to wear away. When the cartilage has worn away, your bones rub against each other. OA most often happens in your hands, neck, lower back, or the large weight-bearing joints of your body, such as knees and hips.

OA symptoms range from stiffness and mild pain that comes and goes to pain that doesn’t stop, even when you are resting or sleeping. Sometimes OA causes your joints to feel stiff after you haven’t moved them for a while, like after riding in the car. The stiffness goes away when you move the joint. Over time, OA can make it hard to move your joints. It can cause a disability if your back, knees, or hips are affected.

Why do you get OA? Growing older is what most often puts you at risk for OA, possibly because your joints and the cartilage around them become less able to recover from stress and damage. Also, OA in the hands may run in families. Or, OA in the knees can be linked with being overweight. Injuries or overuse may cause OA in joints such as knees, hips, or hands.

Rheumatoid arthritis (RA) is an autoimmune disease, a type of illness that makes your body attack itself. RA causes pain, swelling, and stiffness that lasts for hours. RA can happen in many different joints at the same time. People with RA often feel tired or run a fever. RA is more common in women than men.

RA can damage almost any joint. It often happens in the same joint on both sides of your body. RA can also cause problems with your heart, muscles, blood vessels, nervous system, and eyes.

Gout is one of the most painful kinds of arthritis. It most often happens in the big toe, but other joints can also be affected. Swelling may cause the skin to pull tightly around the joint and make the area red or purple and very tender.

Eating foods rich in purines like liver, dried beans, peas, anchovies, or gravy can lead to a gout attack in people with the disease. Using alcohol, being overweight, and taking certain medications may make gout worse. In older people, some blood pressure medicines can also increase the chance of a gout attack. To decide if you have gout, your doctor might do blood tests and x-rays.

Warning Signs

You might have some type of arthritis if you have:

Ongoing joint pain

Joint swelling

Joint stiffness

Tenderness or pain when touching a joint

Problems using or moving a joint normally

Warmth and redness in a joint

If any one of these symptoms lasts more than two weeks, see your regular doctor or one who specializes in treating arthritis, called a rheumatologist. If you have a fever, feel physically ill, suddenly have a swollen joint, or have problems using your joint, see your doctor right away.

Treating Arthritis

Getting enough rest, doing the right exercise, eating a healthy, well-balanced diet, and learning the right way to use and protect your joints are keys to living with any kind of arthritis. The right shoes and a cane can help with pain in the feet, knees, and hips when walking. But make sure the cane is fitted by a professional. Don’t borrow one from a friend or neighbor. There are also gadgets to help you open jars and bottles or to turn the doorknobs in your house.

Some medicines can help with pain and swelling. Acetaminophen might ease arthritis pain. Some people find NSAIDs (nonsteroidal anti-inflammatory drugs), like ibuprofen, naproxen, and ketoprofen, helpful. Some NSAIDs are sold without a prescription, while others must be prescribed by a doctor. Be very careful about possible side effects of some NSAIDs, whether sold with or without a prescription. Read the warnings on the package or insert that comes with the drug. Talk to your doctor about if and how you should use acetaminophen or NSAIDs for your arthritis pain. The U.S. Food and Drug Administration has more information about drugs such as those mentioned here.

Osteoarthritis (OA). Medicines can help you control the pain. Rest and exercise may make it easier to move your joints. Keeping your weight down is a good idea. If pain from OA is very bad, there are shots your doctor can give you.

Rheumatoid arthritis (RA). Treatment can help the pain and swelling. This might slow down or stop joint damage. You may feel better and find it easier to move around. Your doctor might also suggest anti-rheumatic drugs called DMARDs (disease-modifying antirheumatic drugs). These can slow damage from the disease. Other medicines known as corticosteroids (like prednisone) can ease swelling. These are strong medicine and should only be taken with a doctor’s prescription. Another kind of drug, called a biologic response modifier, blocks the damage done by the immune system. These may help people with mild-to-moderate RA when other treatments have not worked.

Gout. The most common treatment for an acute attack of gout is NSAIDs or corticosteroids. They can bring down the swelling, so you may start to feel better within a few hours after treatment. The pain usually goes away within a few days. If you have had an attack of gout, talk to your doctor to learn why you had the attack and how to prevent future attacks. If you have had several attacks, your doctor might prescribe medicines to prevent future ones.

Exercise Can Help

Along with taking the right medicine and properly resting your joints, exercise might help with arthritis symptoms. Daily exercise, such as walking or swimming, helps keep joints moving, lessens pain, and makes muscles around the joints stronger.

Three types of exercise are best if you have arthritis:

Range-of-motion exercises, like dancing, might relieve stiffness, keep you flexible, and help you keep moving your joints.

Strengthening exercises, such as weight training, will keep or add to muscle strength. Strong muscles support and protect your joints.

Aerobic or endurance exercises, like bicycle riding, make your heart and arteries healthier, help prevent weight gain, and also may lessen swelling in some joints.

The National Institute on Aging (NIA) has created the Go4Life® campaign to help you start and stick with a safe exercise program. You can learn all about it by going to www.nia.nih.gov/Go4Life. There you’ll find exercises, tip sheets, personal success stories, and more! You can even keep track of progress in your exercise program. You can also order Go4Life® materials in English and Spanish by calling the NIA at 1-800-222-2225 (toll-free).

Other Things To Do

Along with exercise and weight control, there are other ways to ease the pain around joints. You might find comfort by using a heating pad or a cold pack, soaking in a warm bath, or swimming in a heated pool.

Your doctor may suggest surgery when damage to your joints becomes disabling or when other treatments do not help with pain. Surgeons can repair or replace some joints with artificial (man-made) ones.

For more information on health issues from the National Institute on Aging, click here.

The release quotes Susan J. Bartlett, Ph.D., an adjunct associate professor of medicine at Johns Hopkins and associate professor at McGill University, as saying, “There’s a real surge of interest in yoga as a complementary therapy, with 1 in 10 people in the U.S. now practicing yoga to improve their health and fitness. Yoga may be especially well suited to people with arthritis because it combines physical activity with potent stress management and relaxation techniques, and focuses on respecting limitations that can change from day to day.”

Arthritis, the leading cause of disability, affects 1 in 5 adults, most of whom are under 65 years of age. Without proper management, arthritis affects not only mobility, but also overall health and well-being, participation in valued activities, and quality of life. There is no cure for arthritis, but one important way to manage arthritis is to remain active. Yet up to 90% of people with arthritis are less active than public health guidelines suggest, perhaps due to arthritis symptoms such as pain and stiffness, but also because they are unsure of how best to remain active.

The study recruited 75 people with either knee osteoarthritis or rheumatoid arthritis. Participants were randomly assigned to either a wait list or eight weeks of twice-weekly yoga classes, plus a weekly practice session at home. Participants’ physical and mental wellbeing was assessed before and after the yoga session by researchers who did not know which group the participants had been assigned to.

Compared with the control group, those doing yoga reported a 20% improvement in pain, energy levels, mood and physical function, including their ability to complete physical tasks at work and home. Walking speed also improved to a smaller extent, though there was little difference between the groups in tests of balance and upper body strength. Improvements in those who completed yoga was still apparent nine months later.

Clifton O. Bingham III, M.D., associate professor of medicine at Johns Hopkins University School of Medicine and director of the Johns Hopkins Arthritis Center, says the idea for the study grew out of his experiences treating patients with arthritis. “It was watching what happened with my patients and the changes in their lives as a result of practicing yoga that got me interested in the first place.”

Safety was a priority in the study, the authors say. “For people with other conditions, yoga has been shown to improve pain, pain-related disability and mood,” says Bingham. “But there were no well-controlled trial of yoga that could tell us if it was safe and effective for people with arthritis, and many health professionals have concerns about how yoga might affect vulnerable joints given the emphasis on changing positions and on being flexible. Our first step was to ensure that yoga was reasonable and safe option for people with arthritis. Our instructors were experienced yoga therapists with additional training to modify poses to accommodate individual abilities.” Participants were screened by their doctors prior to joining the study, and continued to take their regular arthritis medication during the study.

The researchers have developed a checklist to make it easier for doctors to safely recommend yoga to their patients, Bingham says. People with arthritis who are considering yoga should “talk with their doctors about which specific joints are of concern, and about modifications to poses,” suggests Bingham. “Find a teacher who asks the right questions about limitations and works closely with you as an individual. Start with gentle yoga classes. Practice acceptance of where you are and what your body can do on any given day.”

What is arthritis?

• Arthritis is an umbrella term encompassing more than 100 conditions affecting joints and connective tissue.
• As there are different types of arthritis, there is no uniform set of symptoms. In general, arthritis and other related conditions are characterized by pain and stiffness in and around joints. Symptoms can develop gradually or they can appear suddenly.
• Conditions are clinically diagnosed by assessing medical history, symptoms and laboratory studies.

Who is affected?

• Arthritis affects one in five adults in the United States
  • This equates to an estimated 52.5 million adults.
  • Projections estimate this figure will rise to 67 million by the year 2030.
• Two-thirds of people with arthritis are younger than age 65.
• A greater proportion of Caucasians (22%) report doctor-diagnosed arthritis than Hispanics (16%).
• However, Hispanics and African-Americans report higher rates of activity limitations and severe pain in comparison to Caucasians.

What is the impact of arthritis?

• Activity limitations are common: over 22.7 million adults experience limitations in everyday activities due to arthritis.
• Among adults with doctor-diagnosed arthritis, many report significant limitations in vital activities:
  • walking 1/4 mile – 6 million
  • stooping/ bending/ kneeling – 8 million
  • climbing stairs – 5 million
  • social activities such as church and family gatherings – 2 million
• One quarter of adults with doctor diagnosed arthritis report severe pain in the last 30 days.
• Arthritis commonly occurs with and can complicate the management of other chronic diseases
  • More than half the people with heart disease and diabetes also have arthritis.
  • People with heart disease or diabetes in conjunction with arthritis are more likely to be inactive than people with none or just one of those conditions.
  • Nearly one-third (30%) of obese Americans have arthritis; the combination of obesity and arthritis makes them 44% more likely to be inactive.

What is the cost to society?

• Total cost attributable to arthritis was estimated at $128 Billion in 2003, $81 Billion in direct medical expenses, and $47 Billion in indirect costs such as lost wages.
• Arthritis is the most common cause of disability among adults in the United States. Arthritis causes work limitations for 30% of working age people with the condition.
  • An estimated 8.8 million working Americans report work limitations.
• Arthritis negatively impacts the ability of American adults ≥45 years old to volunteer (or do unpaid work outside of their home).
  • 41% of people with arthritis (4.9 million) who volunteer reported arthritis impedes their ability to volunteer.

27% (6.8 million) of people with arthritis who do not volunteer cited arthritis as their main barrier to doing so.

The investigators, from Johns Hopkins, focused on how the immune system chooses bits of protein to turn into so-called dominant epitopes. In a typical immune-system reaction, white blood cells are programmed to fight dominant epitopes.

To further understand that process, a team led by Scheherazade Sadegh-Nasseri, Ph.D., a professor of immunology and pathology in the University’s School of Medicine, devised a mixture of proteins and chemicals that replicates the process that yields the dominant epitopes.

They found that epitopes that are linked with autoimmune diseases such as diabetes and rheumatoid arthritis bind to receptors that block enzymes from destroying the epitopes. When the epitopes reach critical mass, they achieve “dominance” and ultimately cause the inflammation characteristic of diabetes and rheumatoid arthritis.

Making this discovery about the link between epitopes and inflammation, the researchers said, could lead to new targets for treatment related to immune-system conditions.

The study was published in the journal Nature Communications.

The finding, by investigators from the University of Illinois at Chicago College of Medicine, means that there is now a new target for potential treatments of RA.

The receptor, TLR5 or toll-like receptor 5, begins the damaging process of inflammation and bone degradation that characterizes RA, the researchers said. It’s found on cells in the fluid of arthritic joints.

“TLR5 does it all,” said Shiva Shahrara, UIC associate professor of rheumatology and corresponding author on the paper. TLR5, or toll-like receptor 5, is found on myeloid, or marrow-derived, cells that migrate from the blood into affected joints.

Using a mouse model, Shahrara and her colleagues found that the receptor is much more abundant in mice with RA as compared with mice who don’t have the condition. They also discovered that the receptor works with an inflammatory molecule called TNF-alpha to aggravate RA.

Based on the mouse study, Shahara said she believes a drug that prevents TLR5 activation could slow or prevent the inflammation and bone erosion of later-stage rheumatoid arthritis in humans.

The findings were published in the Journal of Immunology.