When Acute Becomes Chronic
Inflammation in the acute, short-term sense is crucial to survival. It's also complex and imprecise. It could be best described as a high cost, high benefit process. Because when we are sick or endangered (right down to the very molecular level), the body needs inflammation.
Inflammation (which, in Latin, translates literally to “setting on fire”) must be finely balanced -- just like a gas-lit flame, turned on at just the right moment and, just as precisely, turned off.
When blood vessels respond to an insult by way of inflammation, it is doing what it is supposed to do. It is an acute response, the correct response. It’s applying its most basic defense mechanism against an invader. And when done acutely, it works almost magically.
Too little inflammation, and microbes fester and spread in the body, meaning wounds and sickness stick around far too long, or never truly heal. But if this response continues indefinitely becoming chronic, it’s counterproductive. Cells, tissues, and whole organs are degraded or destroyed entirely.
This continual response to an ongoing insult actually becomes a dysfunctional problem; later, as the body progresses, that dysfunction evolves into disease.
But how do we get here? How does this slow-burning flame develop into full-blown dysfunction?
Chronic Inflammation and Its Triggers
Inflammation can become chronic in many ways:
- Untreated infection or injury
- Inappropriate activation (e.g. autoimmune disease)
- Continual exposure to a triggering factor
- Certain social, environmental and lifestyle factors
- Excessive visceral white adipose tissue (a very specific type of fat, like the kind found around the waist)
Chronic Inflammation (CI) is often not local to any specific area. Rather, it’s widespread, silently surging through your veins.
CI continues to emerge as a unifying component of some of the most challenging mental and physical diseases of our time. In fact, chronic inflammatory diseases have been declared the most significant cause of death in the world by the World Health Organization. These conditions induced by chronic inflammation -- which are currently the greatest threat to human health -- include (but are not limited to):
- neurodegeneration, mental health, cognitive decline
- metabolic syndrome/dysfunction
- autoimmune diseases
- heart disease
To a degree, chronic inflammation can explain the surge in modern-day malaise and vague symptoms of just being not quite right. You don’t even have to give it a name -- like diabetes or Alzheimer’s or rheumatoid arthritis -- to know that our current, western state of affairs is chronically underwhelming as it pertains to health (and lack thereof).
But what triggers this sickening, smoldering flame? Chronic inflammation needs a trigger. And that trigger must be persistent.
It’s not exactly binary but, like a 6th sense, your immunity is constantly surveying your cells and tissues looking for signs of anything not-quite-right. Triggers might be several and hard to define.
Inflammation is triggered by molecules called Danger Associated Molecular Patterns (DAMPs). These are released from our own cells when they are damaged, transformed, mutated, or dying, activating an immune response. Then, there are PAMPs: Pathogen Associated Molecular Patterns, molecules unique to microorganisms that are not associated with human cells.
More recently, though, a new type of inflammatory-response molecule has come under fire: LAMPs. Technically a subset of DAMPS, LAMPs are Lifestyle-Associated Molecular Patterns, inflammation-stimulating molecules that emerge when other biomarkers from within are disordered: elevated amounts of bad cholesterol or uric acid, a damaged gut microbiome, or chronic overconsumption of energy (food), which puts stress on cells and sends a warning signal to the immune system.
This is the type of chronic inflammation that is most rampant. It's also the type we can prevent.
These LAMPs are ignited by sugars, simple carbohydrates, a diet high in processed (more than 1 ingredient) foods, hidden food allergens, lack of exercise, chronic stress, lack of sleep, and hidden infections. And these LAMPs are what ultimately lead to all the major inflammatory conditions: diabetes, heart disease, cognitive decline, cancer, and more.
Correlation or Causation?
It is increasingly evident that inflammation plays some kind of role in all sorts of health conditions. But correlation is not causation. Just because inflammation is apparent amongst cancer cells does not mean the inflammation is directly causing the cancer. It doesn’t rule it out, either.
The cause versus consequence has yet to be fully unraveled in the case against chronic inflammation. More often than not, though, chronic inflammation is always present where there is chronic disease. These conditions are all extremely complex and multifactorial; likewise, there are multiple mechanisms underlying chronic inflammation and several (preventable) risk factors that promote this health-damaging inflammation.
While exact pathologies have yet to be determined, it is safe to say that chronic inflammation does not bode well for the body. Whether it exists in tandem with inflammatory conditions or causes them directly, ridding the body of chronic inflammation is a first step towards better health.