Is inflammation related to chronic disease?

June 21, 2016 Providence Health Team

There is a lot of talk about inflammation and its relationship to chronic diseases. Anti-inflammatory diets have become popular, and prescription drugs such as statins, used to lower cholesterol, are also recognized for their anti-inflammatory qualities. But is all inflammation bad?

In fact, without acute inflammation wounds would fester, viruses would thrive and damaged tissue would not repair itself. The swelling, redness and sometimes pain associated with acute inflammation are healthy responses–the body’s natural healing process in action.

Chronic inflammation, however, is very different. When inflammation goes wrong or lingers on too long, it’s known as chronic or systemic inflammation and can trigger diseases, ranging from asthma to Crohn’s disease and psoriasis. Researchers also have connected chronic inflammation to cardiovascular disease.

What is inflammation

In general terms, inflammation is the body’s immune system fighting something that may be harmful. It could be a wound such as a cut, or even a thorn in the finger. Chemicals and radiation can cause inflammation, as well as pathogens like bacteria, viruses or fungi. To fend off potential harm to the body, the immune system sends an army of white blood cells to the affected area to destroy the threat and repair tissue. This healing process, called the inflammatory response, is the body’s basic survival instinct.

Diseases can cause inflammation, as well. Bronchitis is an inflammation of the bronchi–the air passages that lead from the trachea to the lungs; dermatitis is a disease where the skin is inflamed; cystitis is inflammation of the bladder and periodontal disease is inflammation of the gums.

There are five hallmark signs that may indicate an acute inflammation in the body:

  • Redness
  • Heat
  • Swelling
  • Pain
  • Loss of function (e.g., movement, hearing, smell)

Chronic inflammation explained

Chronic inflammation occurs when the body perceives a threat and mistakenly responds, putting your body on “high alert.” If the body remains in this state for long periods of time, natural protective mechanisms are disrupted. In some cases, the faulty response is a reaction to a condition, other times it’s the cause. In other words, chronic inflammation can be both a cause and an effect of some disorders, thereby creating a vicious cycle that is counter to good health.

There are a number of factors that can contribute to chronic inflammation, including:

  • Poor diet
  • Smoking
  • Lack of exercise
  • Stress
  • Poor oral health
  • Excessive alcohol consumption
  • Pollution

Chronic inflammation and heart disease

Although it has not been proven that inflammation directly causes cardiovascular diseases, studies show that chronic inflammation plays a role in the development of plaque in the walls of the arteries.

Atherosclerosis occurs as low-density lipoprotein (LDL) cholesterol, known as "bad" cholesterol, moves into the innermost layer of the vessel wall. White blood cells (the cells of the immune system), fatty substances produced by the body and found in food, and cellular waste products follow LDL cholesterol into the vessel wall. These substances layer in the blood vessels as plaque that subsequently inflames and weakens the vessel wall. The body perceives the plaque as an injury, sending cells to the site to “rescue” the vessel. If the plaque ruptures within the vessel or a clot forms and breaks off, this can lead to heart attack or stroke.

“We’re in the developing period of understanding [the connection between] chronic inflammation and cardiac disease,” says Timothy Bishop, M.D., cardiologist at Providence Spokane Cardiology. “But we’re standing on the edge of understanding.”

Psoriasis and heart disease

Indeed, a new study has associated psoriasis with an increased risk of abdominal aortic aneurysm, an unhealthy, enlarged area in the lower part of the aorta. Danish researchers found similarities in the inflammatory processes that cause the abdominal aortic aneurysm and those occurring in psoriasis.

The lead author of the study, Usman Khalid, Gentofte Hospital in Hellerup, Denmark, said psoriasis should be considered a systemic or chronic inflammatory disease rather than an “isolated skin disease,” and that people with psoriasis should be made aware of the added risk of cardiovascular diseases.

Although more studies are needed before researchers know what might help reduce the risk of cardiovascular disease in people with psoriasis, the study shines a new light on the role chronic inflammation plays in compromising health.

“This news provides a strong link between inflammation and vascular disease,” says Dr. Bishop. It’s still too early for doctors to make specific recommendations to patients, he says, but this type of research shows a paradigm shift is underway.

Test for inflammation

There is a way to test for inflammation, which could signal infection or a chronic inflammatory disease, such as rheumatoid arthritis or heart disease. C-reactive protein (CRP) is produced by the liver and rises when there is inflammation in the body. A CRP test is designed to measure the amount of CRP in the blood. The test is not specific, however, so CRP levels can be elevated in the blood due to acute inflammation such as gum disease or a viral infection. Also, the test doesn’t pinpoint the exact location of inflammation. A more sensitive CRP test, called a high-sensitivity C-reactive protein (hs-CRP) test, is designed to determine if a person is at risk for heart disease.

If you’re concerned about chronic inflammation and associated health risks, ask your doctor about a CRP test or hs-CRP test, along with a cholesterol screening or other routine blood work.

If you don’t have a primary health care provider, you can find a Providence provider here.

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