What is Inflammation?
Inflammation refers to the way the body responds to harmful stimuli such as pathogenic microorganisms like bacteria, viruses, and fungi, and irritants such as chemicals. The process of inflammation is a complex body response biologically, that involves the immune system, the blood cells, vessels, and molecular mediators (1).
The major reason for inflammation in the body is the eradicate cellular injury, remove the dead cells, that is the unredeemable damaged tissues from insults, and cause the process of tissue repair to start (1).
When there is an insult to the body system, which most time is an offending microorganism, such as bacteria and viruses, the immune system gets activated, which leads to the release of cytokines and other substances called inflammatory cells to start the process of curbing the pathogenic microorganisms or to heal the damaged body tissue, which can manifest as pain, edema, heat in the affected area, and sometimes loss of function on that part (2).
A lot of people mistake inflammation for infection when in the real sense they are two different entities. Infection is the terminology explaining the interaction between the microorganisms and the inflammatory cells. While inflammation strictly defines the immunology response of the body to the microorganisms irrespective of the cause. Clinically, words ending with the suffix -itis are used to describe the inflammation of that particular thing.
For instance, urethritis which denotes inflammation of the urethral is also referred to as infection of the urethral by some healthcare professionals because the cause is traceable to pathogenic microorganisms (1).
Interestingly, there are times the immune system causes inflammation without a trigger or stimuli, which means the body’s immune cells are attacking the normal body cells refers to as autoimmunity. Examples of such are type 1 diabetes mellitus, rheumatoid arthritis, and celiac disease (3).
Types Of Inflammation
There are two main types of inflammation, that is acute and chronic inflammation (4). Acute inflamation is often regarded as positive inflammation because it is involved with the healing process while chronic inflammation is seen as negative inflammation because it is often seen with chronic diseases. It is interesting to know that the two types of inflammation have different causes and different clinical manifestations (3).
- – Acute inflammation: This is the immediate, and first response of the body to injury, and it is done by the transportation of the white blood cells, and plasma to the affected area in the body. This process is a combined action of both the blood cells and the immune cells to aid repair.
- – Chronic inflammation: This is also known as prolonged inflammation, is characterized by changes in the kind of cells at the inflammatory site, and it involves repair and damage going on together at the same time. Most times, chronic inflammation is associated with chronic and autoimmune diseases (1).
Signs Of Inflammation
Clinically, there are four cardinal signs of inflammation, and these include redness, heat, swelling, and pain.
- – Redness: Redness is gotten from the Latin word which means rubor and it results from blood vessels dilatation at the site of inflammation
- – Heat: this result from the exaggerated movement of blood through the injury site and it is mostly felt in the skin. Fever, that is, elevated body temperature occurs as a result of the effects of the chemical mediators on the inflamed area.
- – Swelling: clinically referred to as edema is mainly due to the retention of fluid in the tissues.
- – Pain: pain is brought about by chemicals released during the inflammation process. Examples of such chemicals are serotonin, prostaglandins, and bradykinin (5).
Symptoms Of Acute Inflammation
Acute inflammation may result in the following manifestations:
- – Change in skin color to red
- – Pain at the inflamed site
- – Swelling/edema
- – Heat (2).
A classical acute inflammation manifests the general signs of inflammation.
Symptoms Of Chronic Inflammation
A chronic inflammatory process is sometimes difficult to identify when compared to acute inflammation. The following features are seen in chronic inflammation:
- – Generalized body weakness as in lupus
- – Hyperthermia (fever) as in tuberculosis
- – Joint pain
- – Joint stiffness
- – Chest pain
- – Others are skin rashes, and mouth ulcers (2).
Acute inflammation usually lasts for a few days, subacute inflammation extends to weeks, between two to six weeks, and chronic inflammation can be ongoing for months or years and is usually associated with recurrence (4).
Causes Of Inflammation
Inflammation results when injury triggers the immune system, causing an immune reaction to occur. When inflammation occurs, it does not translate to mean there is an active infection, although an infection process can lead to inflammation.
Causes Of Acute Inflammation
The process of acute inflammation can result from physical injury, an infection, insect bites, stings, and dust. The acute inflammation reactions are:
- – The body tissues build up plasma proteins that will cause fluid to be retained in the tissues. This usually manifests as swelling.
- – The white blood cells, mainly neutrophils, move towards the inflamed area to fight the pathogenic microorganisms
- – Dilatation of the blood vessels occurs around the inflamed area and this ensures there is adequate transportation of the white blood cells and plasma proteins to the area.
Examples of conditions associated with acute inflammation are enteritis, tonsilitis, appendicitis, common cold, sore throat, physical injury, burns, and other illnesses ending with the suffix -itis (4).
Causes Of Chronic Inflammation
The following are the known causes of chronic inflammation
- – Physical inactivity: physical inactivity is a risk factor for a lot of chronic diseases and age-related diseases. For anti-inflammatory processes to take place, it requires your muscles to be in active motion, and if you don’t meet this requirement, it will be difficult. Hence, chronic inflammation occurs.
- – Diet: In overweight and obese people, taking diets containing high sugar levels, and high fatty acids increases the susceptibility to inflammation.
- – Obesity: Central obesity is the most dangerous form of obesity, and this refers to increase visceral fat around the abdomen. Visceral obesity enhances the secretion of pro-inflammatory agents (3).
- – Hormonal level: low level of sex hormones, especially estrogen and progesterone increases the risk of inflammatory diseases. Ordinarily, sex hormones reduce or decrease the inflammatory process
- – Stress: high-stress level, especially psychological stress increases inflammatory chemicals in the body.
- – Inadequate sleep: studies have shown that people with inadequate and irregular sleep are more prone to high inflammatory markers than those with regular sleep of eight hours or more per night.
- – Age: age is a non-modifiable risk factor for getting chronic inflammatory conditions. The older the more one is at risk (3).
- – Persistent acute inflammation: studies have shown that some people do not get total healing from acute inflammation, and in some cases, it translates to chronic inflammation.
- – Exposure: continuous exposure to certain irritants, especially industrial chemicals result in chronic lung and skin inflammations.
- – Sensitivity: allergy results when the body gets hypersensitive to an external trigger. The external trigger present stimulates the inflammatory process because the body sees it as something foreign that should not be there (4).
Conditions Associated With Chronic Inflammation
Chronic inflammation is responsible for the majority of chronic diseases and their associated complications. The most common link conditions to chronic inflammation have been typed 2 diabetes mellitus and hypertensive heart diseases.
Other conditions associated with chronic inflammation are:
- – Hypertension
- – Elevated cholesterol
- – Acute and chronic kidney diseases
- – Cancers
- – Alzheimer’s disease
- – Autoimmune diseases (e.g., rheumatoid arthritis, lupus)
- – Others are Liver diseases, depression, and osteoporosis (3).
Inflammation Breast Cancer
Inflammation breast cancer, otherwise known as inflammatory breast cancer, is one of the chronic diseases in women traceable to chronic inflammation. Inflammation breast cancer is not common and it rapidly progresses with the signs of inflammation present. The patient often complains of pain and swelling on the affected breast, and on examination, the breast appears red and tender when touched (6).
This chronic disease result from the cancer cells obstructing the lymphatic drainage of the skin above the breast (6). When this blockage occurs, it results in inflammation, which if not adequately investigated will be mistaken for infection.
Who Is Prone To Inflammation Breast Cancer?
There is no restriction as to who can develop inflammatory breast cancer but certain factors make some people at more risk of inflammatory breast cancer (IBC) than the rest. Such factors are:
- – Age: Younger women are more prone to inflammation breast cancer compared to the remaining types of breast cancer where the older, the risk exist. The average age of diagnosis recorded from studies is 57 years.
- – Weight: women with obesity, that is, BMI greater than 30, are more at risk of inflammatory breast cancer than the normal weight women.
- – Gender: inflammation breast cancer is commonly seen in females, although breast cancer is associated with both genders.
- – Race: Black race is a non-modifiable risk factor for having inflammation breast cancer, and more mortality has been recorded in blacks (7).
Symptoms Of Inflammation Breast Cancer
Unlike the other forms of breast cancer where a breast lump is usually the first sign observed, inflammation breast cancer does not usually form a lump (3). The following are signs and symptoms observed in patients presenting with inflammation breast cancer:
- – Physical swelling of the affected beast
- – The heaviness of the affected beast
- – Change in color of the affected breast, usually appearing as color red or pink on examination.
- – Orange peel appearance of the skin over the breast
- – Painful breast or tenderness on examination
- – Differential warmth when compared to the other breast
- – Lymphadenopathy, is an enlargement of lymph nodes around the breast, for example, the armpit, and above or below the collar bone.
- – The nipple becomes flat or turns inward (6).
Some or all of the above symptoms must be present for at least six months before a clinical diagnosis of inflammation breast cancer can be made (6). If after treatment with antibiotics, the symptoms persist, the doctor should request a mammogram and other investigations to assess the patient. A definitive diagnosis is made after a breast biopsy is done and histopathology results confirm it to be inflammatory breast cancer (6).
Treatment Of Inflammation
There are varieties of treatments available for the management of patients presenting with inflammation. These may include rest, adequate exercises, and the use of medications, and in some cases, surgical and radiotherapy may be employed.
The treatment of each patient will be dependent on the type of inflammatory disease, the age of the patient, and the presence or absence of other co-morbidities. For every treatment, the aim is to achieve the following:
- – Slow the cancer progression to the bear minimum
- – Remove and decrease pain, and pain radiation to other parts of the body
- – Enhance joint stability and remove immobility
- – Help patients get more comfortable by employing the use of splints, and braces (8).
The following medications are used in the treatment of inflammation
Non-steroidal anti-inflammatory drugs (NSAIDs)
Although taking NSAIDS will not eliminate the etiology of the inflammation but it will help alleviate the pain resulting from the inflammation. Examples of such drugs are ibuprofen, diclofenac, and aspirin. The doctor should ensure there is no contraindication to the use of any of the drugs before prescribing such to the patient. For example, diclofenac is not encouraged in patients with peptic ulcer disease, and aspirin should not be used in patients with blood thinners (4).
Corticosteroids are synthetic steroid hormones in form of drugs, such as prednisolone, and dexamethasone. They are important drugs that alter the pathway of inflammation. They help to relieve the swelling in the affected part. They are also useful in the management of conditions associated with chronic inflammation such as lupus, allergic rhinitis, dermatitis, and inflammatory bowel disease. Corticosteroids should not be used for a long time because of the side effects such as immunosuppression. Therefore, its duration of use should be based on the doctor’s prescription (4).
Inflammation management is not only based on the use of drugs. The following lifestyle changes will help relieve the symptoms of inflammation:
- – Diet: studies reveal that patients with inflammation should take foods rich in olive oil, tomatoes, and fatty fish like mackerel, and salmon. Others are almonds, blueberries, and spinach (4).
- – Exercises: in some chronic diseases associated with inflammation such as rheumatoid arthritis, exercises will be required to aid movement and stability. The physical therapist will prescribe the required exercise to the patient (4).
- – Surgery: In some cases, surgery will be required to aid recovery. If inflammation breast cancer is not amendable to medications, surgery alongside radiotherapy may be required to help the patient get better and for a better prognosis (8).
- 1. https://en.wikipedia.org/wiki/Inflammation
- 2. https://my.clevelandclinic.org/health/symptoms/21660-inflammation
- 3. https://www.verywellhealth.com/what-is-inflammation-187934
- 4. https://www.medicalnewstoday.com/articles/248423#causes
- 5. https://www.britannica.com/science/inflammation/Cellular-changes
- 6. https://www.mayoclinic.org/diseases-conditions/inflammatory-breast-cancer/symptoms-causes/syc-20355413#:~:text=Inflammatory%20breast%20cancer%20is%20a,swollen%20appearance%20of%20the%20breast.
- 7. https://my.clevelandclinic.org/health/diseases/17925-inflammatory-breast-cancer
- 8. https://www.webmd.com/arthritis/about-inflammation