Table 3
Summary of the main inflammatory mediators present in recovery from a sports injury with their potential nutritional modulation based on current data.
| Mediator or marker | Function | Nutritional intervention and its evidence |
| IL-1α | Stimulates the immediate immune response. | Systematic review shows a decrease with the use of curcumin as an adjuvant treatment with infliximab in Crohn’s disease (Schneider et al., 2017). Whey protein reduces its level, acting as an immunomodulator (Patel, 2015). |
| IL-1β | Promotes the arrival of macrophages and B-lymphocytes. Promotes production of IL-6 by muscle cells. | Whey protein reduces its level, acting as an immunomodulator (Patel, 2015). Curcumin associated with resveratrol neutralised IL-1 -induced type II collagen inhibition (Henrotin et al., 2013). Omega-3 decreases its levels in paddlers engaged in intense exercise (Delfan et al., 2015). Curcumin decreases its levels in in vitro studies (Karimian et al., 2017). |
| IL-2 | Secreted by Th2 T helper cells with anti-inflammatory effect that suppresses the Th1 response. | El omega 3 aumenta sus niveles después de ejercicio aeróbico único (Delfan et al., 2015). La proteína de suero de leche aumenta sus niveles (Patel, 2015). |
| IL-4 | Secreted by Th2 T helper cells with anti-inflammatory effect that suppresses the Th1 response. | Whey protein increases its levels (Patel, 2015). |
| IL-6 | Pro-inflammatory cytokine produced by macrophages, monocytes and muscle cells among others. | Meta-analysis shows that curcumin significantly decreases its levels (Derosa et al., 2016). Curcumin decreases its levels in in vitro studies (Henrotin et al., 2013). Tart cherry extract decreased its level after intermittent intense exercise (Bell et al., 2016). Omega 3 inhibits its synthesis by the endothelial cell (Capó et al., 2016). |
| IL-7 | Anti-inflammatory effect. | Participates in the maturation of T and B lymphocytes. Whey protein increases its levels (Patel, 2015). |
| IL-8 | Produced by monocytes, neutrophils, fibroblasts and epithelial cells. Factor that attracts lymphocytes and neutrophils. | Whey protein increases its levels (Patel, 2015). Curcumin decreases its levels in in vitro studies (Henrotin et al., 2013). Omega 3 inhibits its synthesis by the endothelial cell (Capó et al., 2016). |
| IL-10 | Anti-inflammatory cytokine. Inhibits pro-inflammatory cytokines of T-lymphocytes and macrophages. Fosters the shift from M1 to M2 macrophages. | Omega 3 increases its levels in paddlers engaged in intense exercise (Delfan et al., 2015). |
| TNF-α | Induces vasodilation, increased vascular permeability and infiltration of lymphocytes, neutrophils and monocytes. | Systematic review shows its reduction using curcumin (Sahebkar et al., 2016). Omega 3 decreases its synthesis after eccentric exercise (Da Boit et al., 2017; Delfan et al., 2015). Whey protein reduces its level, acting as an immunomodulator (Patel, 2015). |
| Prostaglandin E2 (PGE2) | Powerful vasodilator. | Curcumin decreases its levels in in vitro studies (Henrotin et al., 2013). |
| Leukotrienes | Pro-inflammatory mediator derived from arachidonic acid. | Omega 3 decreases their levels by competing with arachidonic acid (AA) (Capó et al., 2016). |
| Cyclooxygenase 2 (COX-2) | Enzyme that allows the synthesis of prostaglandins from arachidonic acid. | Tart cherry extract inhibits it by 38.3%, equivalent to the effect of ibuprofen or naproxen (Bell et al., 2013). Curcumin decreases its levels in in vitro studies (Henrotin et al., 2013). |
| Total creatine kinase (CK) | Muscle damage marker. | Omega 3 decreases its synthesis after eccentric exercise (Da Boit et al., 2017). |
| C-reactive protein (CRP) | Inflammatory response marker. | Meta-analysis shows its decrease with the use of curcumin (Sahebkar, 2013). |
