What is Chronic Inflammation?

chronic inflammation with increased thromboxane a2 activity atherosclerosis stroke heart disease peripheral arterial disease infection aids erectile dysfunction chronic obstructive pulmonary disease asthma alzheimers cancer smoking obesity type 2 diabetes

Chronic inflammation is a distortion of a normal body response that is associated with the diseases of aging.

Internists, cardiologists, oncologists and nutritionists continue to find evidence linking chronic inflammation with the diseases of aging. The effects of chronic inflammation accumulate over a lifetime to manifest themselves in a number of disorders, including heart disease, cancer, diabetes, pulmonary disease, arthritis, erectile dysfunction and Alzheimer's disease.

Chronic inflammation is poles apart from normal acute inflammation. Acute inflammation is the familiar beneficial response of our healthy immune system to such stimuli as injury, infection or shock. Chemicals called cytokines are released by our cells to trigger local reactions known even to the ancients: redness, heat, swelling and pain. In acute inflammation the cytokines trigger the immune, complement, kallikrein and clotting systems, which cause discomfort but which rapidly restore the body to health.

The failure of acute inflammation to "turn off" frequently is the beginning of chronic inflammation, also called silent, systemic, hidden or low-grade inflammation. Chronic inflammation harms the whole body, injuring our cells, and fueling chronic diseases.

The contribution of smoking and overeating to chronic inflammation is well known. Less recognized as factors influencing chronic inflammation:

  • fat tissue is a source of cytokines
  • certain foods provide inflammatory fats
  • stress
  • sleeping disorders
  • chronic minor infections such as gum disease, stomach ulcers, and upper respiratory infections

Arachidonic Acid and Eicosanoids

Chronic inflammation may arise from fatty acids in the diet.

arachidonic acid

Arachidonic acid, known as Omega-6 fatty acid, is a key metabolic source for inflammation. Arachidonic acid is the primary component of peanut oil, but is also produced from the transformation of other fatty acids by metabolism. How is arachidonic acid produced?

Fatty acids in the diet, such as linoleic acid, transform in the body to gamma-linolenic acid (GLA) by the action of a cellular enzyme delta-6-desaturase. GLA rapidly converts to dihomo-gamma-linolenic acid (DGLA). DGLA produces many desirable eicosanoids with strong anti-inflammatory effects. However, DGLA is also the substrate for the delta-5-desaturase enzyme that produces arachidonic acid.

Arachidonic acid is converted by both platelet cyclooxygenase-1 (COX-1) and the inflammatory enzyme cyclooxygenase-2 (COX-2) into the powerful and dangerous thromboxane A2. Thromboxane A2 makes platelets sticky, leading to blood clots, and causes blood vessels to constrict, raising blood pressure. Thromboxane A2 rapidly converts in the blood to inactive thromboxane B2, which is metabolized by the liver to 11-dehydrothromboxane B2 and is filtered by the kidneys into the urine.

Treating Chronic Inflammation?

The effectiveness of dietary and lifestyle improvements can be monitored using the chronic inflammation test

arachidonic acid reduction thromboxane a2 suppression

Prescription drugs and integrative therapies used individually or in combination can have powerful effects. Initiation or change of any treatment must be under the direction of a licensed healthcare professional.

Dietary Omega-6 fatty acids like arachidonic acid initiate a cascade of events that end with inflammation. The Omega-3 fatty acids eicosapentanoic acid (EPA) and dihomo-gamma-linolenic acid (DGLA) compete with arachidonic acid to reduce chronic inflammation. Reducing arachidonic acid and regulating its activity is essential to the prevention, control or elimination of chronic inflammation.

Chronic inflammation may be prevented or reduced by selecting foods rich in EPA and DGLA that reduce arachidonic acid production and effect. Diet may be enhanced with supplements, for example, fish oil rich in Omega-3 fatty acids. Exercise can reduce production of cytokines that trigger arachidonic acid metabolism, and weight loss may reduce the number of cytokine-producing fat cells.

Dietary changes take time and discipline. Many integrative therapies have been shown to reduce cylooxgenase-2 activity.

In all cases, progress may be monitored in regular intervals using the chronic inflammation test to measure 11-dehydrothromboxane B2.