Inflammation
plays significant role in major diseases
including heart disease, cancer, stroke
and Alzheimer. Autistic disorder,
cancers, arthritis, fibromyalgia and
chronic fatigue are all due to
inflammation.
Tuesday,
October 9, 2007
By SUZANNE BOHAN
MCCLATCHY NEWS SERVICE |
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Researchers call it the "unifying
theory" behind the major killers of our
times -- cardiovascular disease, cancer
and diabetes -- as well as scores of
other diseases.
It's inflammation, which most people
know by the red, painful swelling that
follows an injury, bug bite or other
surface wound. But it also exists in
tissue far below the skin, and
scientists are now convinced this
below-the-eye inflammation is the
culprit that worsens many chronic
diseases.
And while inflammation is the immune
system's response for beating back
invaders in the body, inflammation gone
awry can lead to heart attacks and
strokes, aid cancers in turning deadly,
cause Alzheimer's disease by destroying
brain cells, and usher in diabetes.
Out-of-kilter inflammation is also
linked to clinical depression,
schizophrenia, Parkinson's disease,
asthma, osteoarthritis, liver disease
and hypertension, among others
disorders.
"Retrospectively, it's what we should
have been looking it," said Lisa
Coussens, a cancer biologist at the
University of California, San Francisco.
"It's a major area of research."
Coussens and several other medical
experts spoke last week at a conference
sponsored by the University of
California, San Francisco, that gave its
audience a snapshot of research to date
on the connections between inflammation
and chronic diseases.
The speakers emphasized the promise
inherent in the remarkable realization
that one condition links so many
diseases: Fundamentally similar
treatments could be used to control
them.
Some of the best evidence to date of
inflammation's crucial role in
exacerbating chronic diseases comes from
studies on cancer rates in patients who
were counseled to lower their risk for a
heart attack by regularly taking
anti-inflammatory medicines like
aspirin. That population has a
significantly lower rate of cancer,
compared to a similar population not
taking anti-inflammatory medicines,
Coussens pointed out.
"They were compelling," Coussens
said.
As another example of the beneficial
effect of controlling inflammation with
over-the-counter medicines, regular use
of ibuprofen is associated with lowered
rates of Alzheimer's disease, noted
Cynthia Lemere, a professor of neurology
at Harvard Medical School, who spoke at
the San Francisco conference.
Coussens emphasized, however, that
long-term use of aspirin and other
anti-inflammatory drugs may cause other
severe health complications or dangerous
drug interactions, and a physician
should be consulted before taking any
medicine on a regular basis.
The growing knowledge of chronic
inflammation's underlying role in so
many diseases gives added urgency to the
well-known advice to maintain a
healthful lifestyle, including getting
adequate exercise and sleep, maintaining
a balanced diet and avoiding undue
stress.
Deficits in nutrition and sleep are
linked to increased inflammation, as is
excess stress. Among other benefits,
exercise wards off weight gain, which
can also triggers chronic inflammation.
And once a disease reaches a serious
stage, there's far less optimism among
scientists that controlling inflammation
can undo the damage.
"We're all talking about prevention,
not reversal," said Lemere.
But there's also excitement among
researchers that if a disease is caught
early enough, then taming inflammation
could provide an effective tool for
stopping the disease's advance.
Chronic inflammation is caused by the
persistent presence of pathogens and
environmental pollutants, lifestyle and
genetics, among others factors.
When the immune system is functioning
normally, its front line fighters
swiftly respond to any injury, such as a
splinter puncturing the skin, or an
invasion of microbes from a scrape or
bug bite. These thug-like warriors,
which go by names like natural killer
cells and macrophages, shoot out an
arsenal of chemicals, rip holes into
cell walls of invaders, or even consume
them whole.
But these fighters, part of the more
primitive "innate immune system," lack
the discriminate nature of their more
sophisticated immune system
counterparts, called the adaptive immune
system. But the latter takes longer to
mobilize before sending out its more
targeted arsenal.
In the meantime, these brutish
cellular warriors sometimes take out
healthy cells, a form of collateral
damage. (The more sophisticated fighters
aren't without their flaws -- they too
can damage healthy cells.)
An immune system that's off-kilter is
rarely the direct cause of a chronic
disease, researchers emphasize. Instead,
it can perform a devastating secondary
role.
In the case of Alzheimer's disease,
explained Lemere, the Harvard
neurologist, an innate immune cell works
to ingest a type of plaque outside brain
cells of people with the disease.
But sometimes these immune cells
ineffectively resort to chemical warfare
against the plaque, which then destroy
nearby brain cells. It's this brain cell
death that causes the symptoms of
Alzheimer's disease, including severe
memory loss and mood swings.
"I don't consider inflammation the
cause of the disease," said Lemere. "But
it certainly drives it forward. (The
immune cells) are initially trying to
help, but they get disregulated. They
get revved up. It's sort of this big,
vicious feedback loop."
Innate immune cells can cause
cardiovascular disease by ingesting "bad
cholesterol" that's begun to literally
go rancid. These immune cells can then
get trapped in arterial walls, and
contribute to plaque build up. They may
also stay on the attack, causing chronic
inflammation. The plaque can then break
off due to inflammation, and form a
blood clot that triggers a heart attack
or stroke.
With Type 2 diabetes, molecules
released by both innate immune cells and
fat cells are implicated in interfering
with the normal function of insulin,
which regulates blood sugar levels.
When immune cells drop their armor
after detecting danger has passed, they
take on a healing role by secreting
substances that promote blood vessel and
tissue growth.
But tumor cells can send signals that
confuse these immune cells, causing them
to switch allegiance and aid and abet
tumor growth instead of normal tissue
growth. Tumors, like any other tissue,
need a supply of oxygen and nutrients
that's provided by blood.
Most cancers don't become deadly
until they spread, or metastasize.
Researchers believe it's these hijacked
immune cells that foster the spread of
cancer. And if caught before the tumor
has spread, anti-inflammatory treatment
may be able to contain the tumor,
creating the prospect of cancer becoming
a manageable disease.
"That's precisely the point," said
Coussens. |