Inflammation II: The basics

As Dr. Jerome Groopman says in “Inflamed” (New Yorker article), “Inflammation occurs when the body rallies to defend itself against invading microbes or to heal damaged tissue. The walls of the capillaries dilate and grow more porous, enabling white blood cells to flood the damaged site. As blood flows in and fluid leaks out, the region swells, which can put pressure on surrounding nerves, causing pain; inflammatory molecules may also activate pain fibres. The heat most likely results from the increase in blood flow.” As I mentioned in last week’s post, the classic symptoms of inflammation are redness, swelling, heat, and pain.

Inflammation is both good and bad for us. If we have too little inflammation, we fail to heal. With too much inflammation, healthy tissue can be degraded or destroyed. Inflammation needs to turn on at the right moment and also turn off. Unfortunately our standard weapons against inflammation are imprecise. Anti-inflammatory drugs, such as ibuprofen, are, according to Groopman, the equivalent of peashooter, while steroids, are more like cannons, shutting down the immune system, raising the risk of infection, and eroding the bones.

The topic of inflammation is all the rage right now—mostly with regard to “anti-inflammation” diets (next week’s discussion). But it's also all the rage because the National Institutes of Health recently designated inflammation a priority. Several hundred scientists and hundreds of millions of dollars are now devoted to understanding the role of inflammation in health and disease. In this case, the inflammation in question is the “smoldering” type—the kind that simmers quietly in the absence of trauma or infection.

The reason for all the attention is that low-level inflammation seems to be implicated in heart disease, diabetes, Alzheimer’s, depression, and other disorders. In cases such as these, the inflammation is local: confined to the arteries, or brain, or pancreas, for example. But scientists are a long way from knowing the nature of the relationship between the diseases and inflammation. As Michael Gottseman, a director of research at the N.I.H. says, “We really don’t know how much inflammation contributes” to the disorders.  “Because you find an inflammatory protein in a certain disorder, it doesn’t mean that it is causing that disorder. Correlation is not causation.”

So it’s too soon to get all excited. But lots of people are trying an “anti-inflammatory diet,” the subject of next week’s post.

Incidentally, in last week's post, I mentioned that, at the recommendation of a doctor, I started a regimen of taking four Advil twice a day to help with hip pain. After two week of this, I came down with a cold--something I rarely get. Because I was suspicious about this, I did some research and discovered that Advil and other non-steroidal anti-inflammatory drugs inhibit antibody production. Antibodies are our primary immune defense!

Next week: Inflammation III: Anti-inflammatory diets

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.