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I would argue that inflammation does not cause disease, not only because most inflammation is good, natural, and localized, but because it is the body’s main immune response to invading pathogens. It causes increased blood flow to injuries, bringing healing molecules, precipitating calcium out of the blood solution, automatically. Good for broken bones, so it lasts about seven days. Lipids, like cholesterol, only become sticky when warmed, and all cells are contained within secure fat membranes (cholesterol stuff), always necessary for repairing injuries.
It is automatic, controlled by the survival lower-brain that controls breathing, hormones, digestion, blinking, heartbeat and pressure, body temp., all things we can’t otherwise control with our relatively massive upper brain. It’s been around a long time, going back to the first vertebrates, possibly invertebrates too.
If it caused disease, mammals would not have survived to evolve into man, and he’s been around, as a species, for 1.5 million years. Considering that fact, maybe some (now) chronic diseases are more likely caused by changed life-style (from hunter-gatherer to desk jockey). Muscle activity generates chemistry; inactivity has to influence our chemical machine. This is understood, generally, but blaming a symptom as cause, is not really what science usually does.
It is time for the professionals, who provide the care, to start connecting the dots, clearly shown in the statistics and individual medical records and think scientifically. Is something that was beneficial for 40,000 generations suddenly poisonous to a species, in one or two generations? At least, ask the question.
Let’s first define what it means to have inflammation.
Inflammation is the body’s signal for addressing areas in the body that need repair. Sprained your ankle and feel the symptoms of pain and swelling? Bruised a knee and see discolouration and feel pain and swelling? Feeling your body temperature rise as you battle a flu? All these are typical symptoms of localised acute inflammation.
What happens during these bouts of acute inflammation is that cytokines such as TNF-α and interleukin-6 are released en masse. These signal the immune system to send the macrophages over to attack the foreign invaders and carry out their repairs. Once the repair is completed, the cytokine signals die off and everything goes back to normal.
However, the more worrying problem is chronic low-grade inflammation. In a healthy person, the circulating level of TNF in the blood can be as low as 1 mg/L. In acute inflammation, the TNF concentration can spike up to 1000 mg/L and reduce as the healing proceeds. In chronic low-grade inflammation, the TNF concentration may only be 3 mg/L, but that already generates a whole load of extra risk with regards to the degenerative diseases that many people are facing.
Why would that be the case? Let’s look at various diseases to find out.
- Type 2 Diabetes. TNF can bind to healthy cells and interfere with their ability to take in glucose from the blood. When they take in less glucose, there will be an accumulation of glucose in the blood. If this increased blood glucose concentration ain’t diabetes, I don’t know what else you’d call it.
- Alzheimer’s. Elevated TNF levels in the brain can cause brain cells to commit suicide prematurely, leaving one with a reduced cognitive function and an impaired memory. If this impaired cognitive function ain’t Alzheimer’s, I have no idea what else to call it.
- Osteoporosis. The TNF concentration in the blood determines the equilibrium point between bone formation and bone resorption. Slightly elevated TNF concentrations push the equilibrium towards bone resorption. As we age, we inflammage. Hence it isn’t surprising to see why older people are at risk of osteoporosis and hip fractures, especially those who are suffering from other diseases related to chronic inflammation. Also of note is women undergoing menopause – their blood levels of estrogen (which is anti-inflammatory) decrease with menopause, which shifts the inflammation balance in their body to a more pro-inflammatory state. Perhaps that is why they will lose calcium 4 times faster than a normal human, because elevated TNF levels promote bone resorption and inhibit bone formation?
Of course, there are so many other diseases that I could cover, including high cholesterol and hypertension. These are more related to the precursor of chronic inflammation, which is oxidative stress.
And this is also why when one develops a disease, the next one can follow suit quickly if the only “solution” to this disease is to take symptom relieving drugs instead of targeting the root causes of oxidative stress and inflammation.
For more information, please visit my Instagram page at thethinkingscientist and feel free to leave me a DM if there is something else that you would like me to explore for you.
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The acute inflammatory response is generally good for the body, as it can kill for example pathogenic microbes that could cause infection, heal a wound etc.
It is chronic inflammation is damaging to the body and serves no useful purpose.
Chronic inflammation shares many similar features in different diseases, due to the similarity of immune cells and their effects.
Differences arise because the cells in different tissues are not identical, so inflammatory cells may have different effects on different tissues.
In addition, there may be different types of immune cells involved (or proportions of immune cells e.g. T-cells vs. B-cells) depending on the tissue.
For example, the inflammatory response of bronchial tissue might produce shortness of breath, coughing and wheezing.
The inflammatory response in rheumatoid arthritis might produce pain.
Inflammation may lead to disease because for example secretions from inflammatory cells (such as nitric oxide, hydrogen peroxide), designed to kill foreign invaders may be destructive to certain tissues and produce pathological changes.
These changes differ between tissues and body systems; for example inflammation of the prostate may lead to benign prostatic hyperplasia (prostate enlargement). Inflammation of the bronchial tree due to smoking may lead to lung cancer. And so on.
The inflammatory response one the side of the initiator, the immune system, is similar across different diseases. The effects on the different body systems and organs differ due to the structural differences in cells and tissues and the different responses of the cells and tissues to changes brought on by immune cells that are part of the inflammatory response.
This is how the inflammatory response is responsible for several different diseases.
Inflammation is a general process that occurs in response to many different conditions. Basically, inflammatory cells (white blood cells and mast cells in the tissues) are activated, and set off a cascade of reactions that attracts and activates other immune-related cells, causing the inflammatory response. This has local (redness, swelling) and systemic (fever, malaise) effects.
Lots of things could cause all this to kick off.
A classical example might be a “strep throat”. Basically, the streptococcus bacteria gets into a tonsil, the body recognizes the bacteria as an antigen (foreign protein), white cells invade the tonsil from the blood stream and start to make antibodies that bind to antigen, and the infected cells and bacteria are ingested and dissolved by other white cells, which have been attracted by the antibody/antigen complex. As all this is happening the tonsil’s blood flow increases (redness and swelling) and the person gets a fever and feels unwell.
You can tip the battle in the body’s favour with antibiotics that kill the bacteria, but it’s the body’s inflammatory response that will finish it off.
Disorders of white cells like leukemia interfere with the inflammatory response, and can lead to fatal infections, where bacteria run rampant through the body, unopposed.
Things can also go wrong in the opposite direction. In auto-immune conditions, the body’s inflammatory response is activated against the body’s own cells, with generally unpleasant results.