The usual signs of inflammation are not a stranger to most of us – symptoms of redness, swollenness, burning hot sensation and pain, all of which make one terribly uncomfortable. Who in the world would enjoy having an inflammation? But the fact is, the moment man loses this immune mechanism that cascades to produce inflammation at the site of injury, we would never recover from open wounds and infections which left on their own, will ultimately lead to death. And this is the brilliance of our human body design, making use of inflammation as a means to remove infectious pathogens and heal wounds. To put it simply, the purpose of inflammation is to eliminate and repair.

So what happens in our body when inflammation occurs?

When bacteria and pathogens invade our body through open wounds or other pathways of infection, our immune response is immediately activated. Once white blood cells in the bloodstream or lymph circulation detect the presence of pathogens, they will surround and engulf the invaders, secreting highly acidic substances to destroy them. These highly acidic substances are known as lysosomes which contain reactive oxygen species that are made up of unstable atoms – free radicals. These free radicals behave like lethal bullets and disintegrate the pathogens instantaneously in the moment of contact.

It is wonderful that our immune system has such powerful weapons in the form of reactive oxygen species that effectively destroys pathogens, however, these free radicals are also like a double-edged sword that may “kill the innocent” by randomly injuring the surrounding cells and tissue; in mild cases, the acute inflammatory process fails to be resolved properly and slowly develops into a chronic inflammatory condition, a precursor of various chronic diseases; in the worst case scenario, these free radicals damage cell membranes or even our DNA which causes premature aging and even cancer.

Why these free radicals may end up damaging our cellular tissues is due to the early release of lysosomes even before the white blood cells have completely enveloped the pathogens. As the lysosomes erupt, it brings about a possible spill of its reactive oxygen contents into the surrounding extracellular matrix. Such a small spillage makes a world of difference whether we remain healthy or not. In other words, in order to prevent the normal inflammatory process from developing into a chronic inflammatory condition and more so to maintain youthfulness, the simplest way is to protect our body from free radical damage.

Many people assume that conditions associated with inflammation are usually wound infection, tonsillitis, appendicitis, bronchitis, sinusitis, arthritis or the worse being meningitis. In fact, a medical research study from Harvard University in the year 2000 has revealed that even chronic health conditions that we are familiar with, such as myocardial infarction, stroke, dementia, type 2 diabetes, obesity and skin allergies, are all closely related to inflammation.

Since the inflammatory process is a protective mechanism in the body, how does it end up becoming the trigger that leads to the development of chronic diseases?

Well, having inflammation itself is not the issue but the key point is whether the inflammatory process can be concluded neatly and speedily. If the inflammation does not end within a few days, it will usually evolve into a nasty case of chronic inflammation. As it drags on over time, once the body is no longer able to cope with the cellular demands of disintegration and healing, it will break out under the guise of a chronic disease. That is why it is important that we understand the difference between acute inflammation and chronic inflammation.

Let’s dig deeper into the process of acute inflammation

Now let’s take a moment to recall: what happens to your skin if you accidentally cut yourself? You have a bleeding wound and this becomes “an open door” for foreign particles such as infectious bacteria, dust particle or rust to invade your body. Even if no infection arises, it will surely cause an inflammation. Now we need to clarify a biological concept, which is, inflammation is not equivalent to infection. Infection can trigger an inflammatory response and is usually caused by microorganisms such as virus, bacteria or fungi.

During the course of acute inflammation, the damaged skin becomes red and swollen because the surrounding blood capillaries dilate which raises osmotic pressure. Cytokines are released by various cell types that produces the burning sensation. If the peripheral nerves are being stimulated, pain will be felt. This is why redness, swollenness, burning sensation and pain are the four typical symptoms of acute inflammation.

When a foreign object invades the body through an open wound, its presence immediately triggers the onset of acute inflammatory response. Within 24 hours, neutrophils originally circulating in the blood vessels will make their way en masse into the cell tissues through a series of cellular reactions whereby the blood vessels dilate and constrict, the vascular cell walls shrink, osmotic pressure rises and the rate of blood flow decreases. Furthermore, the neutrophils are directed to migrate towards the site of cellular damage through an intracellular signalling pathway known as chemotaxis such that help reaches the “accident scene” without fail.

The moment neutrophils arrive, they immediately set to engulf the foreign invaders, using reactive oxygen species (free radicals) to destroy the “enemies” one by one. Usually for superficial wounds, skin cells will start to regenerate within 48 hours. If the neutrophils fail to eliminate every single foreign invader properly, then around 72 hours later, the macrophages will come in response to take over the unfinished task.

A simple cut would appear to be healed the next day but in actual fact, the cell repair process is still ongoing underneath. Day five marks the formation of granulation tissue and by the 2^nd week, collagen fibres will replace the granulation tissue; week 4, the cell repair process will reach its most energy-consuming stage until it finally comes to an end. If the wound cuts deeper and wider or it is complex, it will take much longer to heal and the repair process is less efficient which leaves behind a scar.

Different immune cell types will be signalled to arrive at the site of wound in batches with the goal to destroy the “ enemies” completely. Doesn’t this look like the mobilisation of troops on the battlefield? This is precisely the wonder of our human body in which the existence of different cell and tissue types is critical to our survival as each plays its cellular role according to the negative feedback loop. However, should this negative feedback loop go haywire and the biological signals become distorted, it will produce disastrous consequences.

Next, let’s have a quick understanding of how acute inflammation may be resolved in the body

First outcome: Subside

Mild case of acute inflammation with a short duration whereby the red and swollen parts subside within a few hours. There is complete healing without leaving any scars and the functions of the tissue remain intact. This is the most perfect outcome of an inflammatory process.

Second outcome: Become fibrous

Widespread cellular damage or poor self-healing ability which prevents the interstitial cells that connects different functional cell types in the tissues from regenerating or complete their cellular repair, and this forms a fibrous scar. As these scars are not composed of normal interstitial cells, the organ functions may be affected. For example, liver cirrhosis, myocardial infarction, surgical scars.

Third outcome: Form pus

If the wound is infected by pathogens, the end result of the “warfare” between white blood cells and pathogens is the production of large amount of pus. This delays the cell repair process and the wound takes a very long time to heal.

Fourth outcome: Chronic inflammation

If the foreign particles which trigger irritation in the body cannot be removed successfully or the healing process is being interfered, acute inflammation will gradually transform into chronic inflammation.

Acute inflammation that does not end neatly is just like a battlefield that has gone out of control with endless battles going on day and night and there is no clear winner between the immune cells and the foreign invaders. As time drags on, cellular casualties only get worse yet the war can’t seem to end. This is the truth behind chronic inflammation.

Three unique characteristics of chronic inflammation:

• Because the body cannot proceed with healing effectively, large number of different immune cell types continues to gather at the site of cellular damage such as the macrophages, lymphocytes, plasma cells, mast cells and eosinophils
• Cells affected by inflammation continue to secrete cytokines that damage cellular tissue severely and prevent it from functioning properly
• Growth of numerous blood capillaries and sign of fibrosis at the site of cellular damage as the body tries repeatedly to heal and repair affected tissue yet fails to complete the healing process

Throughout the progression of chronic inflammation, other than affecting the cellular tissue to become fibrous, festering with pus or cysts, macrophages at the site of damage will also be pulled to cluster around the foreign particles to form granulomas in a bid to destroy the enemies effectively. However, this recurrent state of inflammation within the affected tissue will ultimately cause it to gradually lose its cellular functions. Certain long term chronic inflammatory conditions will also produce gene mutations in the cells that may lead to cancer. If the chronic inflammatory mechanism fails to help the damaged tissue from healing fully, the unfortunate outcome would be death of the cells – necrosis.

Currently, there is a growing body of scientific research proving that a majority of chronic diseases is really a case of chronic inflammation that has gone wild. For example, conditions such as myocardial infarction and stroke are a result of blood vessels being damaged by long term chronic inflammation. Even for dementia patients, when their cerebral blood vessels are being examined under the microscope, the state of hardening found in them is almost similar to that of atherosclerosis in coronary blood vessels. In other words, brain damage and shrinkage are also caused by inflammation. The true nature of skin allergies and autoimmune diseases is chronic inflammation too as mast cells and eosinophils take the place of macrophages as the main immune cell types involved in the inflammatory process. Other conditions closely related to uncontrolled chronic inflammation include chronic fatigue syndrome which may result in sudden death, liver cirrhosis, liver cancer as well as infertility problems in both male and female.

In conclusion, in order to reverse the rampant occurrence of various chronic diseases in our body, we must find out those underlying factors that leads to the development of chronic inflammation, break away from this vicious cycle and then using specialised treatment for each chronic disease.

Are You At Risk From Chronic Inflammation Damaging Your Body? (For Adult Females Only)

Are You At Risk From Chronic Inflammation Damaging Your Body? (For Adult Males Only)

Are You At Risk From Chronic Inflammation Damaging Your Body? (For General Public)