Joseph R. Anticaglia MD
Medical Advisory Board
Unchecked chronic inflammation damages your immune system and shortens your lifespan. It’s a low grade infection that often works under the radar for many months or years. It stealthily compromises the immune system making you susceptible to chronic diseases such as diabetes, heart disease, stroke and cancer.
The immune system is our body’s ‘Department of Defense’ .. Whether threatened by outside invaders (foreign antigens) or internal culprits (autoimmune diseases), the immune system activates inflammatory cells to identify, kill and dispose of the wrongdoers. The invaders might be bacteria, viruses, fungi or foreign material. At times, the enemies are within the body, such as cancer cells that go berserk and multiply uncontrollably. Sometimes, the internal enemies are due to autoimmune diseases such as rheumatoid arthritis, that mistakenly attack the body’s healthy tissue.
Inflammation causes a series of reactions by the immune system’s specialized white blood cells (WBCs). Besides protecting us from harmful agents outside and within the body, WBCs help repair tissue damage. The inflammatory reaction may be acute or chronic.
Acute Inflammation
A scraped knee a bruise or a cut causes the immune system to respond with inflammatory cells to fight the infection and begin the healing process. We’re familiar with the redness, swelling, heat and pain that can accompany tissue damage. In a similar fashion, a person with a common cold or acute pneumonia activates the immune system to ward off the infection. In the above examples, symptoms appear quickly, and the healing process usually takes two weeks or less. Chronic inflammation is a different, long lasting problem.
Chronic Inflammation
Unchecked chronic inflammation sets you up for chronic diseases that cuts years off your life. It’s the “inflammation that won’t go away.” It’s a low a grade infection that quietly and relentlessly compromises your immune system making you susceptible to chronic diseases lasting months, years or a lifetime.
Unlike acute inflammation, which quickly identifies the problem and sets in motion actions to fight and resolve the infection and promote health, chronic inflammation saddles individuals with long term treatments and the risk of developing life-threatening diseases.
In chronic inflammation, inflammatory cells circulate and multiply throughout the body in spite of no outward danger. These proteins cells are thought to damage a person’s DNA making individuals susceptible to persistent infections and diseases,
Causes of Chronic Inflammation
- Autoimmune diseases, for example, multiple sclerosis, rheumatoid arthritis (RA), type 1 diabetes and systemic lupus erythematosus (SLE),
- Exposure to a foreign material that the body can’t dispose of, such as exposure to industrial chemicals or silica dust found in sand, rock and gravel
- Unsuccessful treatment of an acute inflammation that becomes a chronic problem, such as secondary to a back injury.
Risk Factors for Chronic Inflammation
The following risk factors promote low-level inflammation which include:
- Obesity is associated with low level inflammation.
- Diets low in fruits and vegetables and high in processed foods, saturated fats or refined sugar promote inflammation
- Smoking induces inflammation.
- Chronic Stress and sleep disorders are associated with inflammatory cytokine release. (Cytokines increase the production inflammatory cells).
- Excessive alcohol intake
- Low Testosterone Levels in men have been linked to chronic diseases
- Age: Getting old is correlated with low-grade inflammatory senescent (old) cells
Signs and Symptoms
Acute Inflammation may cause at the site of injury (e. g. a cut finger)
Rubor — Redness
Calor — Heat
Tumor — Swelling
Dolor — Pain
Chronic Inflammation’s signs and symptoms are more general, which might include arthralgia, myalgia, frequent infections, mood disorders, G. I. complaints, weight problems, fever, skin rash or chronic fatigue. A more detailed history and physical examination are necessary to understand the cause of the problem
Chronic Inflammation and Related Diseases
- Arthritis — In the United States 24% of adults, or 58.5 million people have arthritis. In rheumatoid arthritis the joints are chronically inflamed.
- Type 2 Diabetes- About one in ten, or 37.3 million Americans have diabetes
- Cardiovascular disease — chronic inflammation is linked to heart disease. It’s the leading cause of death in the U. S.
- Stroke — Atherosclerosis is a disease of chronic inflammation causing narrowing and scarring of the arteries.
- Allergies — Millions of Americans suffer from seasonal allergic rhinitis (hay fever).
- Cancer — chronic inflammation can cause DNA damage and lead to certain cancer, for instance, genital cancer (papillomaviruses), stomach cancer (H. pylori).
- Chronic kidney disease — The kidneys don’t filter blood the way they should causing a buildup of toxic substances in the body.
- Chronic Obstructive Pulmonary Disease (COPD) makes breathing difficult for millions of people.
- Crohn’s disease is correlated with chronic inflammation of the bowel.
Lab tests
Often people are unaware that they have inflammatory cells working to undermine their health. It might be useful to include one of the following blood tests on your next general physical examination to find out if you have inflammation. Threse inexpensive tests are:
- C-reactive protein — the liver makes this protein which increase when inflammation is present.
- Erythrocyte sedimentation rate (ESR, Sed Rate) — when inflammation is present, red blood cells fall faster to the bottom of a vertical test tube of blood.
- Fibrinogen — levels rise in the presence of inflammation
- Ferritin — levels increase when inflammation is present.
Treatment For Inflammation
Acute Inflammation secondary to mild trauma can be managed by over-the-counter analgesics for pain, rest, ice used within the first 24 hours, limb elevation and wound care. If an infection is suspected, consult your physician for appropriate treatment.
Chronic Inflammation is treated by following a healthy lifestyle. We need to control the risk factors for chronic diseases as noted above. Your physician may recommend over-the-counter anti-inflammatory products like the spices turmeric or ginger, suggest vitamins such as C or D, or omega-3 fatty acids (fish oil). She/He may recommend Aleve (naproxen) or Advil (ibuprofen) to reduce inflammation. People with rheumatoid arthritis are familiar with corticosteroid injections; for example, in the knee to reduce swelling and minimize pain — frequently, medications are needed to treat this type of inflammation.
Acute inflammation commonly works to restore health. It ordinarily completes the job in a few weeks. Chronic inflammation over time undermines our health. It’s implicated in many diseases which has caused the deaths of millions of people. Although more work needs to be done to completely understand the connection between chronic inflammation and disease, there are steps we can take to make our lives healthier.
References
- Roma Pahwa, et al; Chronic Inflammation; StatPearls Publishing, Jan. 2022
- David Furman, George Slavich et al; Chronic inflammation in the etiology of disease across the life span; Perspective, nature medicine, December 5, 2019
- Joseph R. Anticaglia, MD; A Snapshot of the Immune system; Doctor’s Column HC Smart, December 2017
- CDC; Arthritis, October 12, 2021
- CDC; Diabetes, January 24, 2022
This article is intended solely as a learning experience. Please consult your physician for diagnostic and treatment options.