Chronic Inflammation (Chronic Inflammation)

What is Chronic Inflammation (Chronic Inflammation)?

Inflammation is how your body defends itself. It’s what your immune system does to recognize and get rid of harmful or foreign things, and to start healing. Inflammation can happen quickly and go away (acute) or can last a long time (chronic).

Acute Inflammation

Acute inflammation is when your body responds quickly to tissue damage caused by an injury, an infection, or harmful substances. It comes on fast, can get severe quickly, and its symptoms may last for a few days as in cases of skin infection (cellulitis) or severe pneumonia. Subacute inflammation is a period that comes after acute inflammation and before chronic inflammation. This stage can last 2 to 6 weeks.

Chronic Inflammation

Chronic inflammation, on the other hand, is slow and lasts a long time, from several months to years. The severity and effects of this type of inflammation depend on what caused it and how well your body can repair the damage and recover. This text gives an overview of chronic inflammation.

What Causes Chronic Inflammation (Chronic Inflammation)?

Chronic inflammation can occur due to a few reasons:

1. It can happen when the body is unable to get rid of the cause of an initial, shorter-term inflammation. This is often because of infection-causing organisms such as Mycobacterium tuberculosis, protozoa, fungi, and parasites. These microorganisms can resist the body’s defense mechanisms and stay in the tissue for a long time.

2. If a person is exposed to small amounts of an irritant or foreign substance that the body can’t break down or remove, chronic inflammation may also occur. This includes substances such as industrial chemicals that can be inhaled over a long period, like silica dust.

3. Another cause of chronic inflammation is when the immune system mistakes normal components of the body as foreign material and starts to attack healthy tissue. This can lead to diseases like rheumatoid arthritis and systemic lupus erythematosus, which are autoimmune disorders.

Chronic inflammation can also be caused by a defect in the cells that control inflammation leading to lasting or recurring inflammation, such as in auto-inflammatory disorders like Familial Mediterranean Fever. There can also be recurring episodes of short-term inflammation. However, in some cases, chronic inflammation is a separate response and doesn’t follow a short-term inflammation. This is the case in diseases like tuberculosis and rheumatoid arthritis.

Finally, substances that cause inflammation and biochemical reactions can cause oxidative stress and damage to the mitochondria, the powerhouses of cells. These substances can include free radical molecules, advanced glycation end products (AGEs), uric acid crystals, oxidized lipoproteins, homocysteine, and others.

Risk Factors and Frequency for Chronic Inflammation (Chronic Inflammation)

Chronic inflammatory diseases are the leading cause of death worldwide, acknowledged by the World Health Organization (WHO). In America, these diseases are projected to keep increasing over the next 30 years. In fact, by 2000, roughly 125 million people had chronic conditions, and by 2014, nearly 60% of Americans had at least one chronic condition, with a shocking 12% having five or more. Globally, chronic inflammatory diseases are responsible for the death of three out of five people. These diseases include conditions such as stroke, chronic respiratory diseases, heart disorders, cancer, obesity, and diabetes.

Below are some examples of chronic inflammatory diseases and their prevalence:

• Diabetes: In 2015, the American Diabetes Association reported that 9.4% of Americans (or 30.3 million people) were living with diabetes, making it the 7th leading cause of death in America.
• Cardiovascular diseases: According to the 2017 report from the American Heart Association, cardiovascular diseases cause 1 out of every 3 deaths. These are more than 800,000 people, while worldwide, they account for 31% of all deaths.
• Arthritis and Joint Diseases: These affect around 350 million people globally. In America, nearly 43 million people, or nearly 20% of the population, suffer from these diseases. This number is expected to reach over 60 million by 2020.
• Allergies: These are among the top six causes of chronic diseases in America and affect over 50 million Americans every year. More than 24 million people, including over 6 million children, have asthma. In 2015, 8.2% of adults and 8.4% of children were diagnosed with hay fever.
• Chronic Obstructive Pulmonary Disease (COPD): This was the third most common cause of death in the US in 2014, with approximately 15.7 million Americans, or 6.4% of the population, diagnosed with it.

Signs and Symptoms of Chronic Inflammation (Chronic Inflammation)

Chronic inflammation is a prolonged inflammatory response in the body which can be caused by a variety of risk factors. These include:

• Age: As a person gets older, levels of inflammatory molecules in the body tend to increase. This can be due to things like mitochondrial dysfunction and accumulation of free radicals over time, as well as other factors related to aging such as increased body fat.
• Obesity: Fat tissue behaves like an organ that secretes various substances, which can include inflammatory mediators. An individual’s body mass index has been found to correlate with the amount of these pro-inflammatory substances secreted.
• Diet: Foods high in saturated fats, trans fats, or refined sugars can lead to an increased production of inflammatory molecules. This is particularly the case for individuals who have diabetes or are overweight.
• Smoking: Smoking cigarettes can reduce the production of anti-inflammatory molecules and increase inflammation in the body.
• Low Sex Hormones: Sex hormones like testosterone and estrogen can decrease the production and release of inflammatory markers. Keeping sex hormone levels balanced can help reduce the risk of inflammatory diseases.
• Stress and Sleep Disorders: Both physical and emotional stress can lead to the release of inflammatory substances. Similarly, having irregular sleep schedules can lead to chronic inflammation.

The symptoms associated with chronic inflammation can vary, but typically include:

• Body pain
• Chronic fatigue and trouble sleeping
• Depression, anxiety and mood disorders
• Digestive problems such as constipation, diarrhea, and acid reflux
• Weight fluctuations
• Frequent infections

Testing for Chronic Inflammation (Chronic Inflammation)

Diagnosing chronic inflammation can be tricky because we don’t have any highly effective lab tests specifically for it. Usually, doctors only detect chronic inflammation when it’s connected to another medical issue. However, there are some tests that can be done.

One of these is the Serum Protein Electrophoresis (SPE), which can detect lower levels of albumin and increases in gamma globulins in your blood – a condition known as polyclonal gammopathy.

Also, there are two blood tests – high-sensitivity C-reactive protein (hsCRP) and fibrinogen – which are inexpensive and can signal inflammation in the body. Elevated levels of hs-CRP can indicate inflammation, but this marker isn’t specific for chronic inflammation as it also rises during acute inflammation caused by a recent injury or illness. Normal levels of hsCRP are typically less than 0.55 mg/L in men and less than 1.0 mg/L in women. For fibrinogen, normal levels are usually between 200 to 300 mg/dl.

Additionally, we can check for an inflammation marker called Serum Amyloid A (SAA), although this test isn’t standardized.

Lastly, we have more expensive tests that detect specific pro-inflammatory substances, or cytokines, like tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1beta), interleukin-6 (IL-6), and interleukin-8 (IL-8). These may help pinpoint what’s causing the chronic inflammation, but the tests aren’t standardized like hs-CRP, fibrinogen, and SPE.

Treatment Options for Chronic Inflammation (Chronic Inflammation)

Maintaining a healthy lifestyle and diet can help reduce chronic inflammation and alleviate its triggers. Losing weight has proven to be especially beneficial in minimizing inflammation, as shown in patients with psoriatic arthritis, a type of chronic inflammatory arthritis where weight loss has significantly improved disease activity and inflammation.

Following a low-glycemic diet by avoiding foods like soda, refined carbs, and corn syrup that can lead to inflammation can be beneficial. Such diets can also prevent the risk of stroke, heart diseases, and type-2 diabetes. It’s also important to reduce the intake of saturated and trans fats which can worsen inflammation. Instead, opt for foods rich in omega-3 polyunsaturated fats that have anti-inflammatory properties.

Consuming fruits, vegetables and berries that are high in natural antioxidants and polyphenols, and other anti-inflammatory compounds can help protect against inflammation. High fiber intake along with foods like almonds, green and black tea, fish oil, mung beans, cherries and turmeric can also be beneficial. Vitamins and minerals like magnesium, vitamin D, vitamin E, zinc, selenium, and ingredients found in sesame oil can help offset inflammation.

Physical exercise also contributes to combatting inflammation. It has been shown through clinical trials to reduce pro-inflammatory molecules and cytokines irrespective of weight loss.

In terms of medication, drugs like metformin, statins, non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and certain herbal supplements can help to combat chronic inflammation. However, these should always be used under the supervision of a medical expert, and caution should always be exercised when using certain herbs.

What else can Chronic Inflammation (Chronic Inflammation) be?

Chronic inflammation isn’t a disease itself, but a bodily process that can be connected to many different diseases. Diseases this process commonly links to include heart and vascular disease, diabetes, cancer, autoimmune diseases, and chronic liver and kidney disease, among others.

Identifying whether chronic inflammation is present involves several steps. First, your doctor will ask you about your health history and perform a physical examination. Routine lab tests, such as blood sugar tests, kidney function tests, liver function tests, rheumatoid factor tests (for a type of arthritis), complete blood counts, and tests for antinuclear antibodies (a type of protein associated with autoimmune diseases) can then confirm or eliminate many possible diagnoses.

In some cases, imagery or a more specialized test may be useful. For instance, a colonoscopy is often used if inflammatory bowel disease is suspected. In other words, a diagnosis, in these cases, isn’t a simple process, but the culmination of several tests and observations.

What to expect with Chronic Inflammation (Chronic Inflammation)

If chronic inflammation isn’t treated, the outlook isn’t typically good. The likelihood of getting sick and the risk of death depend on what exactly is causing the chronic inflammation in the first place.

Possible Complications When Diagnosed with Chronic Inflammation (Chronic Inflammation)

Chronic inflammation is often a silent progressor, but it’s a significant cause behind a majority of chronic diseases, posing severe health risks. Chronic inflammation can be a key player in developing a wide variety of diseases. Some examples include:

• Cardiovascular diseases: Numerous clinical studies have established a strong connection between inflammation indicators like hsCRP and cardiovascular disease risks. Atherosclerosis, characterized by chronic low-grade inflammation, increases the likelihood of heart attacks and strokes.
• Cancer: Chronic low-level inflammation has been implicated in various cancers, including kidney, prostate, ovarian, liver, pancreatic, colon, lung, and mesothelioma.
• Diabetes: Inflammation plays a role in diabetes when immune cells infiltrate pancreas tissues and release inflammatory molecules. Diabetes also comes with chronic complications like microvascular and macrovascular disorders.
• Rheumatoid arthritis: A byproduct of genetic susceptibility and environmental factors like smoking and infections, chronic inflammation can lead to a systemic autoimmune response that exacerbates the progression of the disease.
• Allergic asthma: This is a complex, chronic inflammatory disorder associated with improper immune responses, inflammation in conducting airways, tissue remodeling, and a decline in airway function.
• Chronic Obstructive Pulmonary Disease (COPD): COPD is an obstructive lung disease that arises due to chronic inflammatory reactions to inhaled irritants. It typically results in long-term breathing issues.
• Alzheimer’s disease: For older adults, chronic low-level inflammation is linked to cognitive deterioration and dementia.
• Chronic kidney disease (CKD): Mild inflammation is common in CKD, leading to the buildup of several inflammatory particles in the blood that contribute to CKD progression and mortality. Inflammation could also lead to Amyloidosis, causing severe kidney complications.
• Inflammatory Bowel Disease (IBD): IBD, a group of chronic inflammatory disorders affecting the digestive tract, can result in long-lasting inflammation and ulcers in the intestinal lining.

These examples underscore the serious damage that chronic inflammation can cause over time. It’s a vital consideration in the prevention and treatment of many chronic diseases.

Preventing Chronic Inflammation (Chronic Inflammation)

Chronic inflammation can negatively affect the body and is a primary factor contributing to almost all long-term diseases. However, there are several effective ways to prevent this.

Eating anti-inflammatory foods is one method. Avoiding simple sugars, refined carbs, foods with a high glycemic index, and unhealthy fats like trans fats and hydrogenated oils can curb inflammation. Replacing these with whole grains, natural foods, a lot of fruits and vegetables (like avocados, cherries, and kale), and fatty fish like salmon can help fight off inflammation.

Reducing the consumption of antibiotics and NSAIDs like antacids is another way to prevent inflammation. These can damage the ecosystem of good bacteria in our gut, leading to inflammation in the gut wall, otherwise known as “leaky gut”. This inflammation can further result in the release of toxins, causing chronic inflammation throughout the body.

It’s also important to exercise regularly to keep a healthy weight. Obesity and being overweight can lead to ongoing, low-level inflammation in the body. Regular exercise reduces this risk, plus it helps control weight and strengthens the heart, muscles, and bones.

Getting plenty of sleep, ideally around 7 to 8 hours per night, can also help curb inflammation. Adequate sleep stimulates the production of beneficial hormones such as human growth hormones and testosterone which help the body regenerate.

Furthermore, lessen the stress. Chronic psychological stress can increase the risk of depression, heart disease, and negatively affects the body’s ability to control inflammation. Relaxation techniques like yoga and meditation can help reduce the harmful effects of stress-induced inflammation.