Chronic low-grade and systemic inflammation

Inflammation is a normal defence mechanism that protects the body from various insults and pathogens, as well as the tissue repair processes, and helps restore the physiology of infected or damaged sites. It is a mechanism, characterised by redness, swelling, heat and pain, that involves the interaction among multiple cells as well as the response by several chemical mediators (primarily by the immune system) and the autonomic response (anti-inflammatory cholinergic system, RMSSD - PPG Stress Flow - BioTekna). Self-regulation of the inflammatory response is necessary to stay healthy and maintain homeostasis.

Chronic inflammation, on the other hand, can be caused by:

• non-resolution of inflammatory processes; [1]
• an increase in inflammatory markers as a result of lifestyle and/or physio-pathological changes, such as chronic stress, nutrition, ageing, epigenetics, changes in body composition and autonomic nervous system. [6] 

Figure 1: How body composition changes over time

While the existence of inflammatory diseases is widely recognised in scientific literature, the definition of chronic low-grade inflammation, especially in relation to chronic persistent stress, obesity, metabolic syndrome and cardiovascular disorders, is very recent. [2]
Chronic low-grade inflammation is characterised by high concentrations of inflammatory markers in the systemic circulation, that causes at the same time a systemic involvement and a sharp increase in capillary permeability. (PPG Stress Flow - BioTekna)
It has been shown that some processes such as chronic stress, a diet rich in simple sugars, saturated fats and industrially processed food (defined, for this reason, as “pro-inflammatory”), high levels of fat mass and/or infiltrated fat (FM, IMAT - BIA-ACC - BioTekna) and dysregulation of circadian biorhythms may not only keep an inflammatory process activated, but even exacerbate it (cortisol-HPA axis, Sympathetic Nervous System - BIA-ACC, PPG Stress Flow - BioTekna).
At the same time, it has been shown that there are effective recovery methods. [3,4,5,6]
The use of some specific tools can help us identify which processes maintain or cause inflammatory processes, while many others such as nutrition, physical activity (especially HIIT), hydration and supplementation can be valuable allies in triggering a quick recovery so as to significantly improve the quality of life.
Chronic inflammatory processes are not identified by a specific symptom, but by various signs, some of which may be tiredness, fatigue, nausea, mood disorders, insomnia (Medically Unexplained Symptoms - MUS) or non-specific chronic pain. [7]
A negative PRAL diet (Clinical Nutrition - BioTekna Plus) following circadian rhythms, defined in scientific literature as “anti-inflammatory”, aiming at consuming functional food and following precise indications on the rhythmicity of glycaemic and insulinemic loads, is an important recovery tool.
Some supplements can accelerate the recovery processes with clear benefits for the body.
The use of high titrated EPA and DHA and Humulus Lupulus before each meal and negative PRAL L-arginine after dinner can be crucial for the body’s ability to modulate inflammation.

Authors: Dario Boschiero, Mariantonietta Lucafò - Date: 19/01/2021

Attention: these contents can be freely used for personal learning purposes only. The use is regulated by Law No. 633/1941 and subsequent amendments, as well as by the copyright and patent legislation in force. Any use for commercial and profit-making purposes is forbidden.

References

1. Calder PC, Bosco N, Bourdet-Sicard R, Capuron L, Delzenne N, Doré J, Franceschi C, Lehtinen MJ, Recker T, Salvioli S, Visioli F. Health relevance of the modification of low grade inflammation in ageing (inflammageing) and the role of nutrition. Ageing Res Rev. Nov;40:95-119. 2017
2. Minihane AM, Vinoy S, Russell WR, Baka A, Roche HM, Tuohy KM, Teeling JL, Blaak EE, Fenech M, Vauzour D, McArdle HJ, Kremer BH, Sterkman L, Vafeiadou K, Benedetti MM, Williams CM, Calder PC. Low-grade inflammation, diet composition and health: current research evidence and its translation. Br J Nutr. 14;114(7):999-1012. 2015
3. Calder PC1, Ahluwalia N, Brouns F, Buetler T, Clement K, Cunningham K, Esposito K, Jönsson LS, Kolb H, Lansink M, Marcos A, Margioris A, Matusheski N, Nordmann H, O'Brien J, Pugliese G, Rizkalla S, Schalkwijk C, Tuomilehto J, Wärnberg J, Watzl B, Winklhofer-Roob BM. Dietary factors and low-grade inflammation in relation to overweight and obesity. Br J Nutr. 106 Suppl 3:S5-78. 2011
4. Erridge C1, Attina T, Spickett CM, Webb DJ. A high-fat meal induces low-grade endotoxemia: evidence of a novel mechanism of postprandial inflammation. Am J Clin Nutr. 86(5):1286-92. 2007
5. Saltiel AR, Olefsky JM. Inflammatory mechanisms linking obesity and metabolic disease. J Clin Invest. 3;127(1):1-4. 2017
6. George P. Chrousos Stress and disorders of the stress systems. Nature Reviews Endocrinology 5, 374-381. 2009
7. George P. Chrousos and Dario Boschiero. Clinical validation of a non-invasive electrodermal biofeedback device useful for reducing chronic perceived pain and systemic inflammation. Hormones (Athens). 18(2): 207–213. 2019
8. L. Delmulle, A. Bellahcène, W. Dhooge, F. Comhaire, F. Roelens, K. Huvaere, A. Heyerick, V. Castronovob, D. De Keukeleirea. Anti-proliferative properties of prenylated flavonoids from hops (Humulus lupulus L.) in human prostate cancer cell lines. Phytomedicine. Volume 13, Issues 9-10, Pages 732-734. 2006
9. Veera R Konda, Anuradha Desai, Gary Darland, Jeffrey S Bland and Matthew L Tripp. Rho iso-alpha acids from hops inhibit the GSK-3/NF-B pathway and reduce inflammatory markers associated with bone and cartilage degradation. Journal of Inflammation. 6:26; 2009
10. Mori TA, Beilin LJ. Omega-3 fatty acids and inflammation. Curr Atheroscler Rep. 6(6):461-7; 2004
11. Wall R, Ross RP, Fitzgerald GF, Stanton C. Fatty acids from fish: the anti-inflammatory potential of long-chain omega-3 fatty acids. Nutr Rev. 68(5):280-9. 2010
12. Calder PC. n-3 polyunsaturated fatty acids and cytokine production in health and disease. Ann Nutr Metab.41(4):203-34; 1997
13. E Brown, R. Jaffe. Acid-alkaline balance and its effect on bone health. International Journal of Integrative Medicine.Vol.2, No6; 2000
14. Manz F. History of nutrition and acid-base physiology. Eur J Nutr. Oct; 40 (5):189-99; 2001
15. J Lemann et al. The Effects of Chronic Acid Loads in Normal Man: Further Evidence for the Participation of Bone Mineral in the Defense against Chronic Metabolic Acidosis. Journal of Clinical Investigation. 45, 1608–1614. 1966
16. A Bordoni, et al. Dairy products and inflammation: A review of the clinical evidence. Critical reviews in food science and nutrition. vol. 57, n.12, 2497 - 2525. 2017
17. Racciatti D, et al., Chronic fatigue syndrome: circadian rhythm and hypothalamic-pituitary-adrenal (HPA) axis impairment. Int J Immunopathol Pharmacol, 14(1):11-15. 2001