CLINICAL RESEARCH REPORT

Background
Non-steroidal anti-infammatory drugs (NSAIDS), including aspirin, ibuprofen (Advil, Motrin), and naproxen
(Aleve), are drugs commonly used to alleviate musculoskeletal pain and infammation, including pain
associated with intense exercise and physical training. Although these drugs are efective in suppressing the
bodys infammatory processes, they can also have harmful efects on the body, especially when taken at high
doses for extended periods of time. NSAIDs can lead to liver and kidney problems, increased oxidative stress, and
gastrointestinal imbalances that can lead to exercise-induced intestinal injury in athletes.
1,2,3
This is a real
concern for high-intensity athletes. A clinical study reported that NSAID use increased the development of
hyponatremia and kidney dysfunction in well-hydrated triathlon athletes.
4
In another trial, ibuprofen did not
alter muscle soreness or damage, increased endotoxemia versus controls, and produced more infammatory
cytokines. NSAIDs, however, are not the only option to managing infammation. Use of several botanical
extracts and derivatives can help maintain the bodys normal infammatory response safely and efectively.*
Ingredients
Research indicates that the components of REBOUND can promote the bodys normal infammatory response
by helping to decrease the release of infammatory cytokines that can occur during exercise and training.* These
components include:
Bromelain (Ananas comosus)
Bromelain is a general name for a family of proteolytic (protein-digesting) enzymes that come from the
pineapple plant, Ananas comosus. Bromelains most common application is assisting the body in maintaining a
normal infammation response and responding to soft tissue injuries.* Bromelain has been shown to promote
healing from bruises and hematomas.*
5
A study on boxers observed the use of bromelain following blunt
injuries to the musculoskeletal system resulted in a clear reduction in swelling and tenderness.*
6

Administration of bromelain before a surgical procedure can promote post-surgery healing and reduce the
average number of days of swelling and tenderness.*
7,8
Boswellia (Boswellia serrata)
The medicinal properties of Boswellia serrata have been known and utilized since antiquity. Today, its potential
use in supporting the bodys normal infammatory response is being investigated and holds great promise.* The
active constituents of this botanical are its boswellic acids, specifcally pentacyclic triterpenic acids found in the
gum resin.
9
Glycosaminoglycans (GAGs) are an important component of connective tissue. NSAIDs can disrupt GAG
synthesis, potentially accelerating articular damage in arthritic conditions.
10,11,12,13
By contrast, an animal study
observed Boswellia signifcantly reduced the degradation of GAGs compared to the NSAID, ketoprofen.*
14
In
another study, 30 patients with osteoarthritis were given either 1 g Boswellia or placebo daily for eight weeks.
Those on Boswellia had increased range of motion and experienced a signifcant decrease in discomfort and
swelling compared to the placebo group (p < 0.001).*
15
1 Van Wijck K, Lenaerts K, Van Bijnen AA, et al. Aggravation of
exercise-induced intestinal injury by ibuprofen in athletes.
Med Sci Sports Exerc 2012. [Epub ahead of print]
2 McAnulty, et al. Ibuprofen use during extreme exercise: efects
on oxidative stress and PGE2. Medicine and Science in Sports
and Exercise 2007;39(7):1075-1079.
3 Nieman D, et al. Ibuprofen use, endotoxemia, infammation,
and plasma cytokines during ultramarathon competition.
Brain Behavior and Immunity 2006;20(6):578-584.
4 Wharam PC, Speedy DB, Noakes TD, et al. NSAID use increases
the risk of developing hyponatremia during an ironman
triathlon. Med Sci Sports Exerc 2006;38(4):618-622.
5 Blonstein JL. Control of swelling in boxing injuries. Practitioner
1960;185:78.
6 Masson M. Bromelain in blunt injuries of the locomotor
system. A study of observed applications in general practice.
Fortschr Med 1995;113:303-306.
7 Tassman GC, Zafran JN, Zayon GM. Evaluation of a plant
proteolytic enzyme for the control of infammation and pain. J
Dent Med 1964;19:73-77.
8 Tassman GC, Zafran JN, Zayon GM. A double-blind crossover
study of a plant proteolytic enzyme in oral surgery. J Dent Med
1965;20:51-54.
9 Liu JJ, Huang B, Hooi SC. Acetyl-keto-beta-boswellic acid
inhibits cellular proliferation through a p21-dependent
pathway in colon cancer cells. Br J Pharmacol 2006
Aug;148(8):1099-1107.
10 Lee KH, Spencer MR. Studies on mechanism of action of
salicylates. V. Efect of salicylic acid on enzymes involved in
mucopolysaccharides synthesis. J Pharm Sci 1969;58:464-
468.
11 Palmoski MJ, Brandt KD. Efect of salicylate on proteoglycan
metabolism in normal canine articular cartilage in vitro.
Arthritis Rheum 1979;22:746-754.
12 Dekel S, Falconer J, Francis MJ. The efect of anti-infammatory
drugs on glycosaminoglycan sulphation in pig cartilage.
Prostaglandins Med 1980;4:133-140.
13 Brandt KD, Palmoski MJ. Efects of salicylates and other
non-steroidal anti-infammatory drugs on articular cartilage.
Am J Med 1984;77:65-69.
14 Reddy GK, Chandrakasan G, Dhar SC. Studies on the
metabolism of glycosaminoglycans under the infuence of
new herbal anti-infammatory agents. Biochem Pharmacol
1989;38:3527-3534.
Copyright Integrative Health Resources, 2012
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continued on page 2 >
15 Kimmatkar N, Thawani V, Hingorani L, Khiyani R. Efcacy and
tolerability of Boswellia serrata extract in treatment of
osteoarthritis of knee a randomized double-blind
placebo-controlled trial. Phytomedicine 2003;10:3-7.
16 Hammad FT, Al-Salam S, Lubbad L. Curcumin provides
incomplete protection of the kidney in ischemia reperfusion
injury. Physiol Res 2012. [Epub ahead of print]
17 Zhong F, Chen H, Jin Y, et al. Analysis of the gene expression
profle of curcumin-treated kidney on endotoxin-induced renal
infammation. Infammation 2012. [Epub ahead of print]
18 Goel A, Kunnumakkara AB, Aggarwal BB. Curcumin as
curecumin: from kitchen to clinic. Biochem Pharmacol
2008;75:787-809.
19 Abe Y, Hashimoto S, Horie T. Curcumin inhibition of
infammatory cytokine production by human peripheral blood
monocytes and alveolar macrophages. Pharmacol Res
1999;39:41-47.
20 Surh YJ, Chun KS, Cha HH, et al. Molecular mechanisms
underlying chemopreventive activities of anti-infammatory
phytochemicals: down-regulation of COX-2 and iNOS through
suppression of NF-kappa B activation. Mutat Res 2001;480-
481:243-268.
21 Jobin C, Bradham CA, Russo MP, et al. Curcumin blocks
cytokine-mediated NF-kappa B activation and
pro-infammatory gene expression by inhibiting inhibitory
factor I-kappa B kinase activity. J Immunol 1999;163:3474-
3483.
22 Huang MT, Lysz T, Ferraro T, et al. Inhibitory efects of curcumin
on in vitro lipoxygenase and cyclooxygenase activities in
mouse epidermis. Cancer Res 1991;51:813-819.
23 Belcaro G, Cesarone MR, Dugall M, et al. Product evaluation
registry of Meriva
, a curcumin-phosphatidylcholine complex,
for the complementary management of osteoarthritis.
Panminerva Med 2010;52:2-8.
24 Cuomo J, Appendino G, Dern S, et al. Comparative absorption of
a standardized curcuminoid mixture and its lecithin
formulation. J Nat Products 2011;74:664-669.
25 Atal CK, Sharma ML, Kaul A, Khajuria A. Immunomodulating
agents of plant origin. I: preliminary screening. J Ethnopharma-
col 1986;18:133-141.
26 Subedi BP. Plant profle: Kutki (Picrorhiza scrophulariifora).
Himalayan Bioresources 2000;4.
*These statements have not been evaluated by the Food and Drug Administration.
This product is not intended to diagnose, treat, cure, or prevent any disease.
1 Van Wijck K, Lenaerts K, Van Bijnen AA, et al. Aggravation of
exercise-induced intestinal injury by ibuprofen in athletes.
Med Sci Sports Exerc 2012. [Epub ahead of print]
2 McAnulty, et al. Ibuprofen use during extreme exercise: efects
on oxidative stress and PGE2. Medicine and Science in Sports
and Exercise 2007;39(7):1075-1079.
3 Nieman D, et al. Ibuprofen use, endotoxemia, infammation,
and plasma cytokines during ultramarathon competition.
Brain Behavior and Immunity 2006;20(6):578-584.
4 Wharam PC, Speedy DB, Noakes TD, et al. NSAID use increases
the risk of developing hyponatremia during an ironman
triathlon. Med Sci Sports Exerc 2006;38(4):618-622.
5 Blonstein JL. Control of swelling in boxing injuries. Practitioner
1960;185:78.
6 Masson M. Bromelain in blunt injuries of the locomotor
system. A study of observed applications in general practice.
Fortschr Med 1995;113:303-306.
7 Tassman GC, Zafran JN, Zayon GM. Evaluation of a plant
proteolytic enzyme for the control of infammation and pain. J
Dent Med 1964;19:73-77.
8 Tassman GC, Zafran JN, Zayon GM. A double-blind crossover
study of a plant proteolytic enzyme in oral surgery. J Dent Med
1965;20:51-54.
9 Liu JJ, Huang B, Hooi SC. Acetyl-keto-beta-boswellic acid
inhibits cellular proliferation through a p21-dependent
pathway in colon cancer cells. Br J Pharmacol 2006
Aug;148(8):1099-1107.
10 Lee KH, Spencer MR. Studies on mechanism of action of
salicylates. V. Efect of salicylic acid on enzymes involved in
mucopolysaccharides synthesis. J Pharm Sci 1969;58:464-
468.
11 Palmoski MJ, Brandt KD. Efect of salicylate on proteoglycan
metabolism in normal canine articular cartilage in vitro.
Arthritis Rheum 1979;22:746-754.
12 Dekel S, Falconer J, Francis MJ. The efect of anti-infammatory
drugs on glycosaminoglycan sulphation in pig cartilage.
Prostaglandins Med 1980;4:133-140.
13 Brandt KD, Palmoski MJ. Efects of salicylates and other
non-steroidal anti-infammatory drugs on articular cartilage.
Am J Med 1984;77:65-69.
14 Reddy GK, Chandrakasan G, Dhar SC. Studies on the
metabolism of glycosaminoglycans under the infuence of
new herbal anti-infammatory agents. Biochem Pharmacol
1989;38:3527-3534.
CLINICAL RESEARCH REPORT
www.thorneperformance.com
Curcumin (Curcuma longa) phytosome
Curcumin is the key constituent of the herb Curcuma longa, also known as the spice, turmeric. Curcumin is also
reported to have kidney-protective efects in laboratory and human studies.*
16,17
Curcumin supports a normal
infammatory response by down-regulating the activity of cyclooxygenase-2 (COX-2), lipoxygenase, and
inducible nitric oxide synthase (iNOS) enzymes; by inhibiting the production of the infammatory cytokines tumor
necrosis factor-alpha (TNF-), interleukin (IL) -1, -2, -6, -8, and -12, monocyte chemo-attractant protein (MCP),
and migration inhibitory protein; and down-regulating mitogen-activated and Janus kinases.*
18,19
Curcumins
mechanism of action is likely accomplished via its suppression of nuclear factor-kappaB (NF-kB) activation, which
subsequently down-regulates COX-2 and iNOS expression, thus promoting normal infammatory processes.*
20,21

In an animal model, curcumin also inhibited arachidonic acid metabolism and markers of infammation in mouse
skin epidermis via down-regulation of the cyclooxygenase and lipoxygenase pathways.*
22
In a study using Meriva, a proprietary form of curcumin complexed with phosphatidylcholine, 50 patients with
osteoarthritis were given 200 mg of Meriva or placebo daily. After three months it was observed that the Meriva
group had improved walking performance and signifcantly lower C-reactive protein markers.*
23
Because
curcumin is not readily absorbed from the GI tract, the curcumin phytosome (curcumin complexed with
phosphatidylcholine) was formulated to improve bioavailability and increase the clinical utility of curcumin.*
Clinical studies report that the bioavailability of curcuminoids is approximately 23 times greater when using the
curcumin phytosome compared to standard curcumin.*
24
Picrorhiza (Picrorhiza kurroa)
Picrorhiza kurroa is an Ayurvedic herb traditionally used to treat disorders of the liver and upper respiratory tract,
reduce fevers, and treat dyspepsia, chronic diarrhea, and scorpion sting. Current research on Picrorhiza kurroa is
being conducted on its liver-protective, antioxidant, and immune-modulating activity.*
Conclusion
The components of REBOUND can help decrease the negative side efects of intense exercise and physical
training, including increases in hormone imbalances (cortisol to DHEA and testosterone), immune imbalances,
and infammatory response imbalances, thus leading to improved sports performance and faster recovery.*
Suggested Use
Two capsules, 2-3 times daily.
Risk Information
Components of REBOUND are reported to be safe within its suggested use.
If you are allergic to any component in REBOUND talk to your health-care practitioner before using.
Because components of REBOUND might increase the risk of bleeding in sensitive individuals, if you are taking
an anticoagulant and/or antiplatelet medication such as aspirin or warfarin (Coumadin), only use REBOUND
under the supervision of a health-care practitioner.
Copyright Integrative Health Resources, 2012
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> continued from page 1
15 Kimmatkar N, Thawani V, Hingorani L, Khiyani R. Efcacy and
tolerability of Boswellia serrata extract in treatment of
osteoarthritis of knee a randomized double-blind
placebo-controlled trial. Phytomedicine 2003;10:3-7.
16 Hammad FT, Al-Salam S, Lubbad L. Curcumin provides
incomplete protection of the kidney in ischemia reperfusion
injury. Physiol Res 2012. [Epub ahead of print]
17 Zhong F, Chen H, Jin Y, et al. Analysis of the gene expression
profle of curcumin-treated kidney on endotoxin-induced renal
infammation. Infammation 2012. [Epub ahead of print]
18 Goel A, Kunnumakkara AB, Aggarwal BB. Curcumin as
curecumin: from kitchen to clinic. Biochem Pharmacol
2008;75:787-809.
19 Abe Y, Hashimoto S, Horie T. Curcumin inhibition of
infammatory cytokine production by human peripheral blood
monocytes and alveolar macrophages. Pharmacol Res
1999;39:41-47.
20 Surh YJ, Chun KS, Cha HH, et al. Molecular mechanisms
underlying chemopreventive activities of anti-infammatory
phytochemicals: down-regulation of COX-2 and iNOS through
suppression of NF-kappa B activation. Mutat Res 2001;480-
481:243-268.
21 Jobin C, Bradham CA, Russo MP, et al. Curcumin blocks
cytokine-mediated NF-kappa B activation and
pro-infammatory gene expression by inhibiting inhibitory
factor I-kappa B kinase activity. J Immunol 1999;163:3474-
3483.
22 Huang MT, Lysz T, Ferraro T, et al. Inhibitory efects of curcumin
on in vitro lipoxygenase and cyclooxygenase activities in
mouse epidermis. Cancer Res 1991;51:813-819.
23 Belcaro G, Cesarone MR, Dugall M, et al. Product evaluation
registry of Meriva
, a curcumin-phosphatidylcholine complex,
for the complementary management of osteoarthritis.
Panminerva Med 2010;52:2-8.
24 Cuomo J, Appendino G, Dern S, et al. Comparative absorption of
a standardized curcuminoid mixture and its lecithin
formulation. J Nat Products 2011;74:664-669.
25 Atal CK, Sharma ML, Kaul A, Khajuria A. Immunomodulating
agents of plant origin. I: preliminary screening. J Ethnopharma-
col 1986;18:133-141.
26 Subedi BP. Plant profle: Kutki (Picrorhiza scrophulariifora).
Himalayan Bioresources 2000;4.
*These statements have not been evaluated by the Food and Drug Administration.
This product is not intended to diagnose, treat, cure, or prevent any disease.