Inflammation

What is inflammation? The word comes from the Latin word inflammare, which means to set on fire. Inflammation is a protective response involving host cells (your cells), blood vessels and proteins. Its goals are to:

• Eliminate the initial cause of cell injury
• Remove necrotic cells and tissue
• Initiate the process of repair

Inflammation is also a potentially harmful process, since its components are capable of destroying microbes and can also injure bystander normal tissue.

Why is controlling inflammation so important? Inflammation is the final common pathway for cardiovascular disease, cancer, neurodegenerative disease, autoimmune disease, diabetes mellitus and obesity.

The components of the inflammatory process include white blood cells and plasma proteins that are normally present in the blood. The goal of an inflammatory reaction is to bring these to the site of infection and/or tissue damage. Chemical mediators including cytokines produced by damaged host cells induce inflammation, which is normally controlled and self-limited.

An inappropriate inflammatory response occurs when there are no foreign substances to fight off and leads to autoimmunity, where an individual’s own tissue is destroyed, such as autoimmune thyroiditis (Hashimoto’s Disease).

The inflammatory process must be tightly regulated by the immune system to avoid excessive tissue damage and spillover to normal tissue.

Nomenclature
-itis (- after name of tissue) e.g.
Appendix – Appendicitis
Dermis – Dermatitis
Gallbladder – Cholecystitis
Duodenum – Duodenitis
Meninges – Meningitis, etc.

What are the body’s natural defenses against inflammation?

The first line of defense is the skin and mucus membranes.

The second line of defense is phagocytosis, inflammation, fever and antimicrobial substances.

The third line of defense is immunity or specific resistance, which refers to defenses (antibodies) against specific microorganisms.

Skin and Mucus Membranes

The structure of intact skin and the waterproof protein keratin provide resistance to microbial invasion.

The lacrimal apparatus protects the eyes from irritating substances and microorganisms.

Saliva washes microorganisms from teeth and gums.

Mucus traps many microorganisms that enter the respiratory and gastrointestinal tracts; in the lower respiratory tract, the ciliary escalator moves mucus up and out.

Chemical Factors

Sebum contains unsaturated fatty acids that inhibit the growth of pathogenic bacteria. Some bacteria commonly found on the skin can metabolize sebum and cause the inflammatory response associated with acne.

Perspiration washes microorganisms off the skin.

Lysozyme is found in tears, saliva, nasal secretions and perspiration.

The high acidity (pH 1.2-3.0) of gastric juice prevents microbial growth in the stomach.

Transferrins bind iron. (Bacteria need iron for continued growth.)

Normal microbiota (normal beneficial bacteria in the gastrointestinal tract) prevent the growth of many pathogens.

Normal Microbiota and Nonspecific Resistance

Normal microbiota change the environment, which can prevent the growth of pathogens.

If any of the above factors are inadequate, the body is more likely to be invaded by a foreign substance and initiate an inflammatory response!
What are the causes of inflammation? Potential causes are:
Microbial infections:  bacteria, viruses, fungi, parasites
Immunologic: hypersensitivity (contact with some substances), autoimmune reactions
Physical agents:  trauma, heat, cold, ionizing radiation, etc.
Chemical agents: acids, alkali, bacterial toxins, metals, etc.
Foreign materials: sutures, dirt, etc.
Tissue necrosis: ischemic (lack of adequate blood supply to a tissue or organ) necrosis
Gut microbiota (abnormal bacteria in the bowel)
Leaky gut
Diet (e.g., gluten, excess sugar, etc.)
Stress
Vitamin D deficiency
Obesity
Environmental chemicals:
Air pollution – POPs
Arsenic – Pesticides
BPA – Phthalates
Flame retardants – Solvents
Heavy metals  – Nitrate/nitrite

The Inflammatory Process Participants

1. White blood cells and platelets
   Neutrophils, monocytes, lymphocytes, eosinophils, basophils
2. Plasma proteins
   Coagulation/fibrinolytic system, kinin system, complement system
3. Endothelial cells and smooth muscles of vessels
4. Extracellular matrix and stromal cells
   Mast cells, fibroblasts, macrophages, lymphocytes
   Structural fibrous proteins, adhesive glycoproteins, proteoglycans, basement membrane

Figure 4 depicts the complexity of the inflammatory process.

The various cells involved in the inflammatory response and their functions are listed in Figure 5.

Macrophages play a major role in the inflammatory process called phagocytosis as depicted in Figure 6.  Phagocytosis is a process of ingestion and digestion by cells of solid substances, e.g., other cells, bacteria, necrotic tissue, or foreign material.

The five classic signs of acute inflammation are:

Heat
Redness
Swelling
Pain
Loss of function

Figure 7 illustrates the physiologic processes that cause these signs to appear.

Figure 8 depicts these reactions in more detail. Start at the top of the page with tissue injury.

The inflammatory process is depicted in Figure 9.

The effect of acute inflammation may be beneficial or harmful as listed in Figure 10.

Ideally, this acute inflammatory response would proceed as designed, and healing would occur.

Robbins Basic Pathology, 9th Ed.

If the inflammation persists, it is called chronic inflammation. Chronic inflammation, which means long-term inflammation, can last for several months and even years. It can result from failure to eliminate whatever was causing an acute inflammation. An autoimmune response to a self-antigen means the immune system attacks healthy tissue, mistaking it for harmful pathogens.

Chronic inflammation can be triggered by cellular stress and dysfunction, such as that caused by excessive calorie consumption, elevated blood sugar levels, and oxidative stress. It is clear to almost all that chronic inflammation is the major killer in the world causing cancer, heart disease, arthritis, diabetes and many more.

Treatment of Inflammation

A detailed history and physical exam is needed to attempt to determine the cause of the inflammation. Does the individual being evaluated consume an inflammatory diet? Figures 16 to 19 list foods that are pro-inflammatory and ones that are anti-inflammatory.

Questions that should be asked in the investigative process include:

• Is there a breach in our natural defense mechanisms, such as the skin? The skin microbiota is a very important for the barrier skin to protect an individual from infection. Antibacterial soaps will decrease the number of healthy skin bacteria that are needed to prevent skin inflammation.
• Are the tear ducts working properly?
• Is there adequate saliva to washout the bacteria in the mouth?
• Does the individual have any conditions that cause dry mouth such as Sjogern’s Syndrome?
• Is the individual taking any medication that decreases saliva production?
• Is there dental inflammation present, i.e., gingivitis, dental caries or unrecognized abscesses?
• Have the cilia in the trachea been damaged by smoking?
• Does the individual have COPD or other diseases?
• Is the individual taking any medication that would decrease stomach acid, i.e, Nexium or something similar, or is stomach acid decreased by age?
• Does the individual have a stomach infection with H Pylori?
• Is there an infection in the small intestines with an abnormal bacteria, yeast or parasite?
• Does the individual have Crohn’s Disease, ulcerative colitis, celiac disease, leaky gut or other bowel problems?
• Does the individual have multiple food allergies?
• Are there micronutrient deficiencies that impair the immune response?
• Is the individual under excessive stress? If the cause is not determined, the chance of therapy improving the individual’s condition is markedly reduced. The root cause must be determined!

Until the root cause is determined and treated appropriately, the individual should be placed on an anti-inflammatory diet. Weight loss and exercise are critical to reduce inflammation.

Recommended Supplements

Curcuminoid CR

Immune Support and Antioxidant Activity

Research has demonstrated that curcumin has antioxidant activity, is an immune cell modulator, and has inhibitory effects on COX-2, iNOS enzymes, TNF-α, IL, and NF-ĸB[2,3], making it applicable to a wide array of clinical presentations. Various animal and human studies support its use in promoting health in joints, gastrointestinal mucosa, and the eye’s uveal tract. [2-8]

Other research suggests curcumin may support balanced immune response in the nervous, cardiovascular, GI, and respiratory systems. [2,3,9]

For references and additional information, go to http://medicaldetectivemd.com/product/curcuminoid-cr/.

Dose: one twice a day

Curcuminoid BCM-95

Provides Antioxidant and Cell-Protective Activity*

Supports Joint Health and Helps Relieve Minor Pain*
Supports the Health of Organs and Systems by Modulating the production of Cytokines and Other Signaling Molecules
Supports Growth-Inhibitory Effects and Cell Death in Certain Cell Lines
Supports Brain/Neuronal Health and a Healthy Mood
Supports a Healthy Microbial Environment

For references and additional information, go to http://medicaldetectivemd.com/product/curcuminoid-bcm-95/.

Dose: one twice a day

D3 Active 5,000

Supports Bone Strength and Dental Health
Supports Modulation of Immune Function
Supports Healthy Cell Differentiation
Supports Neurologic and Cognitive Health
Supports Musculoskeletal Comfort
Supports Cardiovascular Health and Healthy Blood Sugar Metabolism
Supports Vitamin D Repletion in Cases of Dietary Deficiency, Limited Sunlight Exposure, or Use of Depleting Therapies

For references and additional information, go to http://medicaldetectivemd.com/product/d3-active-5000/.

Dose: one to two a day depending the directions of your healthcare professional

Green Tea Extract

Provides Antioxidant Support

Supports Healthy Immune Function
Supports Healthy Endocrine Function

Provides Alternative to Consumption of Multiple Cups of Green Tea

For references and additional information, go to http://medicaldetectivemd.com/product/green-tea-extract-60-capsules/.

Dose: one twice a day

ResveraTri

Methylation Helps Improve Absorption and Stability
Powerful Antioxidant Support
Supports Healthy Cellular Function
Produces Changes Associated with Longer Lifespan (including activation of sirtuins)
Supports Cardiovascular/Neurological Health

For references and additional information, go to http://medicaldetectivemd.com/product/resveratri/.

Dose: one twice a day

Zinc Glycinate

Supports Enzymatic Reactions and Protein Metabolism
Promotes Immune and Reproductive Health
Supports Antioxidant Activity
Plays a Role in Sensory Perception

For references and additional information, go to http://medicaldetectivemd.com/product/zinc-glycinate/.

Dose: one twice a day

Immuni-T ASAP

Antioxidant Support
Supports Healthy Immune Function
Supports the Body’s Defenses against Seasonal Immune Challenges

For references and additional information, go to http://medicaldetectivemd.com/product/immuni-t-asap/.

Dose: two twice a day or as suggested by healthcare professional

Onco Defense

Provides Concentrated Glucoraphanin from Broccoli Seed Extract
Supports Healthy Cell-Life Cycles
Supports Phase II Detoxification Enzymes
Supports Extended Antioxidant Activity
Supports the Body’s Normal Response to Inflammation

For references and additional information, go to http://medicaldetectivemd.com/product/onco-defense/.

Dose: one twice a day

MicroBiome Acute (15 Stick Packs)

Supports a Healthy Microbiome
Replenishes Good Bacteria in the Gut
Supports the Natural Immune Response
Supports Lactose Digestion
Supports Bowel Regularity

For references and additional information, go to http://medicaldetectivemd.com/product/microbiome-acute-15-stick-packs/.

Dose: One stick pack per day

Micro-Biome Complete DF (30 Capsules)

Helps Maintain a Healthy Intestinal Microecology*
Supports the Natural Immune Response*
Supports Bowel Regularity*
Supports Lactose Digestion*

For references and additional information, go to http://medicaldetectivemd.com/product/micro-biome-complete-df/.

Dose: One capsule per day