Many Americans are getting on board with the idea that inflammation is a root problem that underlies most (perhaps all) chronic disease. Certainly there is a wealth of research that now supports the role of inflammation in disease states such as heart disease, Type II Diabetes, Multiple Sclerosis, Alzheimer’s disease, bowel diseases and even dental decay. However, the standard response in much medical practice is still to look for a Magic Bullet solution, a panacea in a pill. Statins, for instance, are an anti-inflammatory solution that have been advertised to lower cholesterol, but evidence of their unintended negative effects continues to mount. Another example is the baby aspirin many Americans have been advised for decades to take once per day as a way of lowering the risk of heart disease. Our Magic Bullet is that we think we just need to take an anti-inflammatory pill to fix the problem rather than resolve the multiple causes of systemic, chronic inflammation.
There is indeed a problem
It’s not as though our body is just imagining that there’s a problem and deciding to create chronic runaway inflammation for no good reason. There is indeed a problem.
It is the chronic inflammatory response that is problematic. When inflammation continues beyond its intended period of time, cell and tissue damage can result. Chronic inflammation can be a result of acute inflammation if the body can’t stop the injury. We mentioned cytokines—the messenger cells that signal both when to start inflammation and when to shut it down. It’s the imbalance in these two signals that can leave inflammation ongoing. Research has shown us how complex the interplay between acute and chronic inflammation is, but it might help to think of this complicated interplay as if it were disrupted communication on the battlefield between the attack site and the immune system’s command and control center.
Pro-inflammatory cytokines are messenger cells in our immune system that help kill invader cells (using oxidative chemicals such as hydrogen peroxide). They respond to signals to keep up the cell killing and the other pro-inflammatory activities. They also respond to signals that call for a “cease and desist.” When these cytokines don’t get a signal to stop, they can continue to kill cells in the body, and eventually the cells marked for death are not just invader cells. For example, cytokines might begin attacking cartilage in your knees, resulting in unchecked joint inflammation. You might try to resolve this situation with an anti-inflammatory medication, but you are only taking care of the symptom and not the root problem. There is an underlying reason the body is continuing to signal the presence of invader cells and continuing to release pro-inflammatory cytokines.
As another example, macrophages that are supposed to be deactivated by anti-inflammatory cytokines (messenger cells, specifically including interleukin 10 or IL-10 and transforming growth factor beta) are sometimes not deactivated and therefore continue to send out pro-inflammatory signals. Because the immune system is interdependent, one cell action can set off other cell actions. For example, when macrophages don’t get the message to stop, and continue their work of killing enemy cells, they also stimulate the activity of more fighters called lymphocytes, small white blood cells that include B cells, T cells and natural killer cells.
So, poor communication between vital healing components in the cells resulting in non-deactivated macrophages or cytokines, can be one path to chronic inflammation. Other paths include injuries that cause ongoing damage resulting in constant repair processes, persistent infections, toxin exposure or problematic autoimmune responses.
Excessive production of collagen
One example of the kinds of problems that can occur due to chronic inflammation is the excessive production of collagen tissue. Collagen is kind of like spackle—it’s a repair attempt of the body that can result in scar tissue when healing doesn’t fully occur. Did you know that scar tissue doesn’t always happen on the surface of the skin where it’s visible? Invisible scar tissue can interfere with the normal functioning of the surrounding tissue. It then becomes, to continue our military analogy, a barrier to good cell communications.
Damage to blood vessels
Chronic inflammation is particularly damaging to blood vessels. The endothelial layer of the blood vessel (the single thick cell lining inside the vessel) is what blood flows directly over, and is therefore very vulnerable to whatever is in the bloodstream. Some examples of substances that potentially damage the endothelial layers of blood vessels are: microbes, excessive blood sugar, low oxygen, high levels of acidity, and tobacco-related toxins. Obesity creates belly fat that produces its own inflammatory cytokines. Periodontal, or gum disease, also releases acids and infectious toxins from the mouth into the bloodstream. Even household cleaning supplies can trigger inflammatory responses. The resultant damage to blood vessels is a primary cause of heart disease.