Is Systemic Chronic Inflammation Public Health Enemy No. 1?

Taming chronic inflammation improves well-being and could save countless lives.

Posted Dec 06, 2019

Back in 2013, I wrote a blog post, "Cortisol: Why the 'Stress Hormone' Is Public Enemy No. 1," which offered five simple ways to lower cortisol levels without drugs. Flash forward to 2019. Although chronically high levels of cortisol are still a major public health issue, it appears that systemic chronic inflammation (SCI) may, in fact, be our top "catch-all" public health enemy.

A new Perspective article (Furman et al., 2019), published on December 5 in the journal Nature Medicine, puts a spotlight on inflammation-related diseases. The authors estimate that SCI plays a role in roughly 50 percent of all deaths at a global level.

 decade3d - anatomy online/Shutterstock
Source: decade3d - anatomy online/Shutterstock

The international group of scientists who contributed to this Perspective piece, "Chronic Inflammation in the Etiology of Disease Across the Life Span," are affiliated with over two dozen institutions around the globe.

In alphabetical order, here are a few of these authors' affiliations: Buck Institute for Research on Aging, Columbia University Medical Center, Emory University School of Medicine, Harvard Medical School, National Institutes of Health, Skåne University Hospital, Stanford University School of Medicine, UCLA, and University College London.

The authors of this article strongly recommend the prevention, early diagnosis, and treatment of severe chronic inflammation to "not only extend life but also help reduce chronic disease worldwide and improve health."

Naturally occurring acute inflammation is a healthy short-term process that is vital for limiting tissue damage and fighting off infections. However, when systemic inflammation becomes chronic, it significantly increases disease risk and mortality rates.

"Although intermittent increases in inflammation are critical for survival during physical injury and infection, recent research has revealed that certain social, environmental, and lifestyle factors can promote systemic chronic inflammation," the authors said. "In turn, [SCI] can lead to several diseases that collectively represent the leading causes of disability and mortality worldwide, such as cardiovascular disease, cancer, diabetes mellitus, chronic kidney disease, non-alcoholic fatty liver disease, and autoimmune and neurodegenerative disorders."

In their Perspective piece, the authors describe a variety of multi-level mechanisms underlying SCI along with several risk factors that promote chronic inflammation such as psychological stress, lack of exercise, poor diet, sleep disorders, and environmental toxicants.

George Slavich, who is the director of the UCLA Laboratory for Stress Assessment and Research and a research scientist at the Norman Cousins Center for Psychoneuroimmunology, is the senior author of this paper.

"Chronic inflammation is influenced by many social, environmental, and lifestyle factors. It is important to make people aware of the risk factors for chronic inflammation, which include obesity, physical inactivity, social isolation, chronic stress, and inadequate or poor sleep," Slavich said in a news release. "If we make people aware of these risk factors, our hope is that individuals will reduce the factors that apply to them."

"It's important to recognize that inflammation is a contributor not just to physical health problems, but also mental health problems such as anxiety disorders, depression, PTSD, schizophrenia, self-harm, and suicide," Slavich added. "This is a substantial public health crisis."

To the best of my knowledge, there are currently very few biomarkers found in blood plasma that are known indicators of inflammation such as elevated levels of C-reactive protein (CRP) and interleukin-6 (IL-6).

"Research should focus on identifying new biomarkers or substances in the body that will enable doctors to screen, better diagnose, and treat severe chronic inflammation," Slavich said. "There are potentially hundreds of other substances in the body's immune system that may indicate chronic inflammation, but they have yet to be identified."

The authors conclude by strongly recommending an international research effort that focuses on identifying better ways to prevent, diagnose, and treat systemic chronic inflammation.

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David Furman, Judith Campisi, Eric Verdin, Pedro Carrera-Bastos, Sasha Targ, Claudio Franceschi, Luigi Ferrucci, Derek W. Gilroy, Alessio Fasano, Gary W. Miller, Andrew H. Miller, Alberto Mantovani, Cornelia M. Weyand, Nir Barzilai, Jorg J. Goronzy, Thomas A. Rando, Rita B. Effros, Alejandro Lucia, Nicole Kleinstreuer & George M. Slavich. "Chronic Inflammation in the Etiology of Disease Across the Life Span." Nature Medicine (First published: December 5, 2019) DOI: 10.1038/s41591-019-0675-0