Introduction To Inflammation

Inflammation is a vital short-term response to a sudden insult, which can be a physical injury or an infection. Messenger proteins, known as cytokines, are released to signal a danger to the body so that our bodies can respond appropriately.

Pain, swelling, redness and heat are signs associated with a physical insult or irritant. When the insult is a pathogen such as viruses or bacteria, the response involves the immune system that dispatches white blood cells to fight off or kill the infection.

If all goes well, the inflammation subsides, and our bodies return to homeostasis. But inflammation is a Goldilocks condition, in that too little can mean our bodies are overwhelmed by infection; too much can cause an overactive immune response and lead to crippling health problems. When inflammation goes into overdrive, even when the danger is no longer present, this is known as chronic inflammation which can lead to many chronic diseases. Inflammation can be a symptom of injury but can also be the cause of debilitating symptoms. This persistent low-grade inflammation produces low grade inflammation throughout the body and causes an increase in immune system markers.

 When inflammation is allowed to run wild, it can damage the body by creating too many pro-inflammatory cells and molecules, such as tumour necrosis factor (TNF), interleukins, nuclear factor-kappa B, prostaglandins, and free radicals.

Low levels of inflammation can be triggered by a perceived internal threat even when there isn’t a disease to fight or an injury to heal. As a result, immune cells swarm but have no target as such, so they may eventually start attacking internal organs or other healthy tissues and cells. A larger array of cells, such as macrophages, lymphocytes (type of white blood cell) and plasma cells infiltrate tissues.

Chronic inflammation can result from; pathogens that remain in the tissue for extended periods of time, exposure to low level irritants in the air, an autoimmune disorder or be induced by oxidative stress and mitochondria dysfunction.

Mitochondria are considered to be the powerhouse of the cell as they have the ability to generate ATP which provides the energy for cell survival and functions. The mitochondria may also have a non‐energetic role in regulating metabolism, apoptosis (cell death), innate immunity, inflammatory responses and aging.

Mitochondria are the main source of reactive oxygen species. These highly reactive molecules act as physiological signals that contribute to various cellular functions but when produced in excess, can lead to cell dysfunctions and/or death. Mitochondria are an important source of reactive oxygen species especially when they are malfunctioning, Mitochondria are central hubs of inflammation regulation. Mitochondrial derived reactive oxygen species can cause activation of inflammatory proteins and exacerbate mitochondrial deterioration and oxidative stress. Reactive oxygen species have a deleterious effect on many cellular components, including lipids, proteins and DNA. Chronic inflammation due to oxidative damage is thought to trigger numerous chronic diseases

Non-infectious diseases that are increasing worldwide in recent years share basic mechanisms of mitochondrial defects, systemic inflammation, and oxidative stress.

There is a growing understanding that many prevalent diseases are linked to chronic systemic inflammation. Many of these diseases are the significant cause of death in the world. These are diseases such as: diabetes, cardiovascular diseases, arthritis and joint diseases, and allergies. Chronic low-level inflammation also appears to participate in many types of cancer. 

There are risk factors associated with chronic low level inflammatory responses and these are: increasing age, obesity, diet, smoking, stress, lack of exercise and low sex hormones (such as oestrogen and testosterone).

The symptoms associated with low level chronic inflammation include body and joint pain, chronic fatigue, insomnia, mood disorders, gastrointestinal complications, weight loss resistance, brain fog and frequent infections.

The gut can be severely affected by inflammation and can lead to a host of symptoms including gas, bloating, bowel movement irregularities, sleep disturbances, chronic fatigue, food intolerances and autoimmune conditions. Gut microbiota comprises bacteria, fungi and protozoa. The gut microbiota plays such a critical role in human health that it has been called ‘the forgotten organ’. Changes in the gut microbial composition can result in chronic inflammation and inflammation also results in disruption of the gut microbes, so a deleterious cycle can be at work.

Chronic inflammation throughout the body can also contribute to leaky gut syndrome. Leaky gut, also known as increased intestinal permeability, is a digestive condition in which bacteria and toxins are able to “leak” through the intestinal wall which can trigger an inflammatory response. Leaky gut can also contribute to ‘brain fog’ that involves memory problems and an inability to focus.

The gut and the brain are connected via nerve cells and neurotransmitters. The vagus nerve is one of the biggest nerves connecting your gut and brain. It sends signals in both directions. People with irritable bowel syndrome (IBS) or Crohn’s disease had reduced vagal tone, indicating a reduced function of the vagus nerve.

Inflammation may play a role in migraines in women. Migraine diagnosis has been shown to be associated with elevated levels of inflammation markers. There is the hypothesis that migraine are a neuro-inflammatory disease.

Painful joints can be due to arthritis, hypothyroidism, tendinitis and gout. Sometimes joint pain can be localised to one joint in the body, and this is conditions such as tennis elbow or chronic knee pain.  When there is inflammation in the body, this can be felt in the osteo-skeletal system.

There are theories put forward that ageing itself is a risk factor for disease and that inflammation plays a role in ageing. Inflammaging is a new term used for this theory,

inflammaging is defined as the chronic, low-grade (subclinical) and sterile inflammation that is observed in older people that may lead to non-infectious diseases.

Since there are no “one-size-fits-all” approaches to your health, it’s important to listen to your body as much as possible and become health aware and health responsible, it is a personal journey. Everyone is unique and inflammation can present in many different ways or not be an issue at all.

There is a lot that can be done to keep your inflammation levels low, triggers including stress, toxin exposure, and poor dietary habits have a major impact.

The next blog in this series will cover the myriad ways that you can reduce inflammation in your body.

Dr. Amanda Wiart (Oxon)