Inflammation: Preventing the Good, Dealing with the Bad

About Author: Dr. Anju Dave Vaish specializes in scientific communications with a special focus on healthcare, technology, and sustainability. While she holds a Ph.D. in Botany-Biotechnology, holistic health and well-being are her special interest areas.

Inflammation- a difficult word to register and comprehend in common parlance! But we all understand swelling, redness, heat and pain which we have experienced being injured. While there is no simpler word for it, the term is gaining wider recognition. Derived from the latin word inflammare it means ‘to set on fire.’

Inflammation is a response by our body to protect us from any injury, or microbial infection or any other toxin. The blood rushes (heat) towards the site, the blood vessels dilate (redness), the cells accumulate where it needs attention (swelling) and releases chemicals (pain) guided by our immune system. The pain, swelling or fever which is misunderstood as the problem, is actually our body holding the signage “Immune System at Work.” This is ‘Acute Inflammation’ which generally lasts for two weeks or less.

Inflammation becomes a problem when our immune system stays on guard unnecessarily, and worst is when it is not just patrolling, but starts firing too, without any foreign invasion. The result is damaging of our own healthy cells or tissues. This is clearly “Immune System Gone Berserk.” This is ‘Chronic Inflammation.’ Commonly this is a case in autoimmune disorders and diseases.

Poor diet, repetitive stress and leaving the acute inflammation unchecked, can cause pain and tissue destruction and develop into chronic inflammation. Chronic inflammation is also the mediator for many other disorders and diseases like allergies, stroke, heart disorders, cancer, obesity, Type 2 diabetes etc. Aging process is also inflammatory. “Inflammaging” (Franceschi et al., 2000) is a term for inflammation associated with aging causing range of diseases including cardiovascular diseases, dementia, sarcopenia, osteoarthritis, chronic kidney disease etc. One of the key differences between acute and chronic inflammation is that the latter always leads to necrosis.

The main organs of our immune system are Bone Marrow, Thymus, Spleen, Lymphatic vessels, Lymph nodes, Tonsils and Appendix. Released from our bone marrow there are about 4000-11,000 LEUKOCYTES (white blood cells) in every microliter of our blood which constantly monitor any suspicious activity in our body. WBCs are mainly classified as Phagocytes and Lymphocytes. Phagocytes consume any foreign cells and identify the Antigens on them, and pass on this information to Lymphocytes. They in turn send T cells and B cells which produce Antibodies for each of the antigen and kill the invaders while memorizing them to build immunity and resistance for any future invasions. Both the cells are produced in bone marrow; but T cells are sent to Thymus for schooling to learn to differentiate between own body cells and foreign invaders. In case of auto-immune diseases, it is often said to be T cells’ misjudgment – which is own and what is foreign.

These autoimmune diseases are known to run in ethnic groups and families which means that it is in the genetic make-up. The incidences are more in women. With Interacting with environmental factors they get triggered. Type-1 Diabetes, Multiple Sclerosis, Rheumatoid Arthritis, Lupus, Psoriasis, Scleroderma are some widely known autoimmune diseases. Including the rare ones, there are about 80 types of autoimmune diseases.  It is a major health crisis in the world that affects 7.6- 9.4% population.  Unfortunately, there is no known cause for this behavior of our immune system. And thus there is no cure either. It is also difficult to get a clear diagnosis in autoimmune diseases in many cases as the symptoms are similar- low fever, body ache etc. Also, the symptoms are mostly episodic in the form of flare ups, and they remit. Once diagnosed, there are different types of treatment for different diseases. But the most important goal in all of them is to reduce inflammation in the first place.

Sometimes to reduce inflammation doctors advice corticosteroids for a short period. Corticosteroids are similar to our body hormones that secrete to fight stress due to injuries or inflammation. In case of Covid-19 also, it is the inflammation of lungs that gets too far to create cytokine storm. It is the hyper inflammation that causes difficulty in breathing. Treatment with anti-inflammatory drugs that does not interfere with the adaptive immunity of the body is preferred. But resolving inflammation has become a priority, even if it needs steroids intervention.

Prostaglandins (a group of lipids) are released from our body tissues that dilate blood vessels to release other pro-inflammatory substances- chemokines, cytokines, and interleukins. These guide WBCs (white blood cells) to begin attacking foreign invaders or damaged cells. They get soon suppressed by the anti-inflammatory cytokines from neighboring T cells that stop the production of antibodies. In this whole process there is a role of Specialized Pro-Resolving Mediators (SPMs) which are a new hope to fight chronic inflammation. SPMs are naturally occurring lipid mediators associated with omega 3 polyunsaturated fatty acids (PUFA) including EPA and DHA. When the battle between foreign invader and our defense mechanism happens, the dead bacteria or toxic substances and other cells need to be removed to go back to the normal course- repair and regeneration of damaged tissue. This is where the pro-resolving factors come into the picture. These are M2 macrophages and other chemicals resolvins, maresins, protectin (from omega 3 fatty acids) and lipoxins (from omega 6 fatty acids) which do the regeneration and repair work. SPMs don’t inhibit inflammation but regulate to resolve it.

There are many over-the-counter drugs such as aspirin, paracetamol, ibuprofen which are used for acute inflammation (short term). However, for chronic inflammation generally caused by autoimmune diseases, there are no medications as such for long-term usage. Continuous use of OTC drugs can be rather harmful. The conventional medical treatments to treat autoimmune diseases have generally been through immunosuppression. Sounds a little too unacceptable-Right! Because on one hand, we talk about boosting immunity to better our health; but in autoimmune diseases, we talk about suppressing the immune system. Well, it’s true, even though with better research the pharmaceuticals claim that these drugs for treatment are rather immunomodulatory and not suppressive. Nonetheless, their long term usage comes with warnings of minor to severe side effects and constant monitoring of blood and liver profiles. Looking at the bigger picture of taking risk leading to quality life and probably body’s ability to adapt these drugs might actually help. But there could be answers in reducing the inflammation through an integrative lifestyle as well.

Diet and lifestyle modification plays a huge role in inflammation and chronic inflammation. Eliminating deep-fried and processed foods, controlling blood sugar by going lean on high-calorie and carbohydrate foods such as white flour, white rice, and refined sugar is common advice by health experts and dietitians. Managing weight and following an exercise routine is known to prevent inflammation. Exercising outdoors is a great way for breathing fresh air and soaking sun. Vitamin D deficiency is highly linked with autoimmune diseases. However, one should avoid heat as that can aggravate stress and inflammation. Hydrotherapies are a great way to prevent that. Meditation, yoga and recreation are well known to de-stress.

Antioxidants remove free radicals from our body that are produced during cell metabolism and are responsible for inflammation. This means they can keep inflammation in check. Fruits, vegetables and spices have a load of them. Tomatoes, Peppers, Berries- the sweet sour colorful vegetables and fruits have abundance of lycopenes, anthocyanins, carotenoids etc. Indian golden herb turmeric is widely recognized for curcumin. Nature has unlimited bounty of these amazing herbs which we consume as beverages and spices or even supplements such as Guggul, Ashwagandha, Ginkgo biloba, Flaxseeds, Green tea, Ginger, Garlic, Anantmool etc. that are anti-inflammatory due to their anti-oxidative properties.

Anti-inflammatory food, on the other hand, is primarily the essential fatty acids such as Omega-3 which has been identified to play important role in resolving inflammation as described above. We can’t synthesize them in our bodies so we must include them in our diet. Flaxseeds, Walnuts, Fish oil, Algae oil, Soybeans, Eggs are rich in Omega-3 that helps in reducing inflammation.

It can get all very confusing with what must be in diet or supplements or as medication to prevent inflammation. Social media, groups, Google can make it all overwhelming.  It is best to consult a health expert; especially people with prior health conditions. What is important is that the way we acknowledge AI (Artificial Intelligence) in technology, we must also recognize the role of AI (Anti-Inflammatory) in our diet and daily consumption. It is time that we get more and more experts in integrative preventive care and healing especially to deal with chronic and complex diseases.

**The article has information and insights from various scientific journals. Views expressed by the author are her own.