Palmitoylethanolamide: A Nutritional Approach to Keep Neuroinflammation within Physiological Boundaries-A Systematic Review

Int J Mol Sci. 2020 Dec 15;21(24):9526. doi: 10.3390/ijms21249526.

Abstract

Neuroinflammation is a physiological response aimed at maintaining the homodynamic balance and providing the body with the fundamental resource of adaptation to endogenous and exogenous stimuli. Although the response is initiated with protective purposes, the effect may be detrimental when not regulated. The physiological control of neuroinflammation is mainly achieved via regulatory mechanisms performed by particular cells of the immune system intimately associated with or within the nervous system and named "non-neuronal cells." In particular, mast cells (within the central nervous system and in the periphery) and microglia (at spinal and supraspinal level) are involved in this control, through a close functional relationship between them and neurons (either centrally, spinal, or peripherally located). Accordingly, neuroinflammation becomes a worsening factor in many disorders whenever the non-neuronal cell supervision is inadequate. It has been shown that the regulation of non-neuronal cells-and therefore the control of neuroinflammation-depends on the local "on demand" synthesis of the endogenous lipid amide Palmitoylethanolamide and related endocannabinoids. When the balance between synthesis and degradation of this bioactive lipid mediator is disrupted in favor of reduced synthesis and/or increased degradation, the behavior of non-neuronal cells may not be appropriately regulated and neuroinflammation exceeds the physiological boundaries. In these conditions, it has been demonstrated that the increase of endogenous Palmitoylethanolamide-either by decreasing its degradation or exogenous administration-is able to keep neuroinflammation within its physiological limits. In this review the large number of studies on the benefits derived from oral administration of micronized and highly bioavailable forms of Palmitoylethanolamide is discussed, with special reference to neuroinflammatory disorders.

Keywords: dietary food; endocannabinoid system; mast cells; neuroinflammation; nutrient; palmitoylethanolamide.

Publication types

  • Systematic Review

MeSH terms

  • Alzheimer Disease / diet therapy
  • Alzheimer Disease / drug therapy
  • Alzheimer Disease / metabolism
  • Amides / administration & dosage*
  • Amides / metabolism*
  • Amyotrophic Lateral Sclerosis / diet therapy
  • Amyotrophic Lateral Sclerosis / drug therapy
  • Amyotrophic Lateral Sclerosis / metabolism
  • Animals
  • Autism Spectrum Disorder / diet therapy
  • Autism Spectrum Disorder / drug therapy
  • Autism Spectrum Disorder / metabolism
  • Endocannabinoids / metabolism
  • Ethanolamines / administration & dosage*
  • Ethanolamines / metabolism*
  • Humans
  • Inflammation / diet therapy*
  • Inflammation / drug therapy
  • Inflammation / metabolism
  • Metabolic Networks and Pathways
  • Multiple Sclerosis / diet therapy
  • Multiple Sclerosis / drug therapy
  • Multiple Sclerosis / metabolism
  • Nervous System Diseases / diet therapy
  • Nervous System Diseases / drug therapy*
  • Nervous System Diseases / metabolism
  • Neurodegenerative Diseases / diet therapy
  • Neurodegenerative Diseases / drug therapy*
  • Neurodegenerative Diseases / metabolism
  • Pain / diet therapy
  • Pain / drug therapy
  • Palmitic Acids / administration & dosage*
  • Palmitic Acids / metabolism*
  • Parkinson Disease / drug therapy
  • Parkinson Disease / metabolism

Substances

  • Amides
  • Endocannabinoids
  • Ethanolamines
  • Palmitic Acids
  • palmidrol