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Our chronic inflammation

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Inflammation is a "hot" topic right now, pun intended. It's one of the body's responses to injury.  It is considered acute (temporary and innate), when you get hurt playing sports or have an infection, but chronic (long-term, persistent and adaptive) in a disease like MS. 
 
Inflammation can become chronic when it stops being an acute response and continues on as a constant low-level physiological response.  But the chronic form can also result from, in our case, an autoimmune response when our immune systems mistakenly attack healthy tissue. I rarely get sick and, in fact, tell people I never get a flu shot because my immune system doesn't need any help! 
 
(Momentary digression: Scientists may even specialize in neuroinflammation, inflammation specific to nerve tissue!)
 
How it presents in MS 
 
Researchers believe that MS begins with inflammation, that infection-fighting white blood cells are triggered by some unknown force to enter the central nervous system (CNS) and attack the nerve cells which results in the inflammatory response.
 
The attacking white blood cells damage the myelin that protects nerve fibers.  Imagine a damaged electrical cord with the sheath ripped open and the wires exposed. This process in the body is called demyelination and wherever it occurs in the brain affects what kind of symptoms the MSer might experience.
 
In the early stages, an MSer will usually have flare-ups (called exacerbations or relapses) then experience remissions with no symptoms. Hence the term Relapsing-Remitting MS (RRMS). During this time, the nerves will attempt to repair themselves, and may even form new pathways to get around the damaged nerve cells.
 
Once a diagnosis of multiple sclerosis has been made, disease-modifying drugs (DMD) are often prescribed. One of the things the medication may be used for is to reduce inflammation in the brain.  
 
  "In multiple sclerosis (MS), there is good evidence that the inflammatory reaction mediated through adaptive immune responses initiates the disease and drives disease progression together with additional age- and disease-burden-related amplifications factors. Thus, anti-inflammatory or immunomodulatory treatments are effective at least in the early stages of the disease."
 
Who says it is bad?
 
According to the book Neuroinflammation: New Insights into Beneficial and Detrimental Functions,  "(t)here are three levels of inflammation: activation of microglia in response to tissue injury, vascular inflammation,...and blood–brain barrier damage..."  So there's that.
 
On team Detrimental, during a period of neuroinflammation in MS, attacking white blood cells kill glial cells: "Glial cells surround nerve cells and provide support and insulation between them. They keep nerve cells healthy and produce new myelin when it is damaged..." As more and more glial cells are killed, the body becomes less able to keep up with myelin repair. So some of the new research for an MS cure is focused on transporting new glial cells to the site of myelin damage to help encourage rebuilding.
 
So too, in an attack, increases in many different inflammatory chemicals occur.  These inflammatory chemicals may weaken the blood-brain-barrier, which normally tries to block inflammation from getting into the brain. Once this barrier is penetrated, inflammatory chemicals can enter the brain with greater ease.  
 
As far as team Beneficial, "inflammatory responses in brain lesions may be...instrumental in removing tissue debris and in facilitating repair processes."
 
Researchers have just started to discover other beneficial functions of neuroinflammation in certain diseases. So stay tuned.
 
Ways to test
 
If you want to test for the existence of chronic inflammation in your brain, know that there isn’t a "single silver bullet test" for chronic inflammation. But there are a series of tests that might give you an idea of the levels of inflammation in your body.

The main test for chronic inflammation is a blood test called C-Reactive Protein, or CRP.

Another test for chronic inflammation is an inflammatory marker test, the IL-6.

Other common inflammatory markers you can ask your doctor to test for:

- Elevated High Sensitivity C-Reactive Protein (HS-CRP)
- SED Rate
- High levels of Homocysteine
- Elevated Ferritin in the blood
- Elevated HDL
- Elevated Monocytes can be a secondary indicator of inflammation
- Elevated Blood Glucose is a leading indicator of inflammation
 
What else can I do 
 
Ultimately, many of the questions concerning the causes and effects of chronic inflammation have yet to be proven. What you can do, though, is to avoid certain things that cause inflammation and are already proven unhealthy, like smoking or eating excessive refined white sugar.
 
But one of the things we do know now is that "(t)he gut, including the small and large intestine, is the largest immune organ in mammals, including people." Read more here.
 
And according to a recent press release by the National MS Society,"an international team...describes a pathway by which substances in the diet and bacteria in the gut can act to suppress inflammation in the brain of mice with MS-like disease, and also show evidence that this pathway exists in people with MS."  The MS Society concludes "This [study] opens up an area that’s largely been unknown until now: how the gut controls brain inflammation.”
 
So it seems like, at the very least, we should try to keep our guts happy.  :)
 
I found articles that counseled that "by eating a diet rich in fresh fruits and vegetables, whole grains, nuts and seeds, lean proteins, and low-fat dairy, you can reduce inflammation in your body naturally."
 
Also, "(c)arbohydrates provide glucose, which is your body's main dietary source of energy...Low-glycemic carbs, which have a mild impact on your blood sugar levels, can help reduce inflammation...High-glycemic carbs, on the other hand, can cause blood sugar irregularities and trigger or worsen inflammatory responses."
 
In the end, I think that if you want to reduce inflammation in your whole body (including your brain), you should make changes to what and how you eat.
  1. Replace refined foods like sugary breakfast cereals with low-glycemic foods like steel-cut oats
  2. Limit dried fruits and canned fruit stored in heavy syrup that are high-glycemic, choose whole, fresh fruits more often
  3. Avoid processed meats, high-fat cheeses, stick margarine, whole milk and commercially-prepared cookies, pastries and crackers.
  4. Try to regularly eat omega-3 fatty acids (prevalent in coldwater fish, such as salmon and mackerel; flaxseeds; and walnuts).
  5. Drink green tea and 1-2 glasses red wine daily.
  6. Take other supplements as you like (Evidence suggests that inflammatory chemicals can be inhibited by natural substances, including resveratrol, St. John’s Wort, fish oil, vitamin D, and alpha lipoic acid).
 
"Aim for balanced meals and snacks that emphasize nutritious foods. When you do indulge in refined grains, sweets or fatty foods, stick to modest portions."  Read whole article here.
 
Related resources
Nothing found here should be considered medical advice. Please consult your doctor before making any changes.

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