What did your doctor get from this to stop the inflammation in your arteries from grabbing cholesterol out of the bloodstream?
Three common assumptions about inflammation, aging, and health that are probably wrong
Contributed
by Thomas W. McDade; received October 4, 2023; accepted November 2,
2023; reviewed by Jennifer B. Dowd and Daniel E. Lieberman
This
contribution is part of the special series of Inaugural Articles by
members of the National Academy of Sciences elected in 2021.
Significance
Inflammation
is one of the most important, and potent, physiological systems in the
human body. It is widely assumed that levels of inflammation increase
with age and that chronic inflammation contributes to cardiovascular
diseases. This understanding of inflammation is based on studies of
people living in affluent, industrialized settings with low burdens of
infectious disease. A broader view, based on research conducted across a
wider range of ecological settings globally, indicates that chronic
inflammation is not necessarily a “normal” part of aging and that the
association between inflammation and age-related diseases is not
inevitable. It also suggests that environments early in development have
lasting effects on the regulation of inflammation in adulthood, with
implications for diseases of aging.
Abstract
Chronic
inflammation contributes to the onset and progression of cardiovascular
disease and other degenerative diseases of aging. But does it have to?
This article considers the associations among inflammation, aging, and
health through the lens of human population biology and suggests that
chronic inflammation is not a normal nor inevitable component of aging.
It is commonly assumed that conclusions drawn from research in affluent,
industrialized countries can be applied globally; that aging processes
leading to morbidity and mortality begin in middle age; and that
inflammation is pathological. These foundational assumptions have
shifted focus away from inflammation as a beneficial response to
infection or injury and toward an understanding of inflammation as
chronic, dysregulated, and dangerous. Findings from community-based
studies around the world—many conducted in areas with relatively high
burdens of infectious disease—challenge these assumptions by documenting
substantial variation in levels of inflammation and patterns of
association with disease. They also indicate that nutritional,
microbial, and psychosocial environments in infancy and childhood play
important roles in shaping inflammatory phenotypes and their
contributions to diseases of aging. A comparative, developmental, and
ecological approach has the potential to generate novel insights into
the regulation of inflammation and how it relates to human health over
the life course.
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