Inflammation and Its Management Today

Inflammation is not inherently good or bad, said Jeffrey Bland, PhD, president of the Personalized Medicine Institute, at the 2023 Integrative Healthcare Symposium in New York City. 

The landscape of inflammation is changing from a cellular perspective, Bland said. It is essentially a process of responding to internal and external factors, or signals. The immune system is one of three systems in the body that interacts with the outside world and responds to external factors. Biometric devices allow us to measure how the body responds to information, he said. 

“The signals that we can respond to are so remarkable, from the whole length of the electromagnetic spectrum, plus vibratory energy and emotional energy,” said Bland. “We have those receptors that are capable of transducing that information into function.” 

There are different types of inflammation, Bland said, including acute and chronic inflammation. Acute inflammation is tissue damage due to trauma, microbial invasion, or toxic compounds that produce rapid and significant effects. Most patients experience chronic inflammation, he said. 

“It's important to recognize that this is intimately connected to the functional state of your immune system,” Bland said, “the immune system is throughout all of your body, you have immune cells in your muscles and in your liver and in your brain, and that they're all crosstalk and so the immune system is throughout all of our systems physiology.” 

Inflammation can be produced by a number of things, including exposure to a triggering event that signals the immune system, an alteration in the immune system differentiation between self and non- self, an alteration in immune cell architecture through mutational or epigenetic changes, immunosenescence that alters immune cell differentiation and activity, and alteration in metabolic networks that cross-talk to immune cell function, Bland said. 

“Physiology is generally not a one-way street,” he said. “The body has its own built-in resilience process that we’ll refer to as rejuvenation.” 

Conditions associated with inflammation include virtually every chronic age-related condition we experience in our culture, Bland said, including type 2 diabetes and non-alcoholic fatty liver disease (NALFD), cardiovascular diseases, autoimmune diseases, osteoporosis Alzheimer's disease, chronic obstructive lung disease, inflammatory bowel disease (IBD), allergies, and cancer, he said. 

“It's related to imbalances in this process of communication that I've described,” said Bland. “We sometimes don't understand, like chronic inflammation is in our body.” 

Inflammation increases risk for obesity, dietary insufficiencies, xenobiotic exposures, gut microbiome metabolites, altered sex hormones, sleep deprivation, and loss of thymus function. 

“This is the network biology construct as we keep moving up the ladder asking, “where do these signals start, what’s the communication that’s creating these downstream things that translate into all sorts of ICD-10 [codes]?”

A personalized diet and lifestyle approach must be tailored to the inflammatory state, Bland said. The standard of care for managing chronic inflammation includes:

• A low glycemic diet
• Reducing saturated fat, particularly palmitic acid, and trans fats
• Increasing omega-9 and omega-3 fats
• Increasing fruits and vegetables with a Mediterranean diet concept
• Increasing soluble and insoluble fiber and prebiotics
• Increase spices such as curcumin, gingerol, sesamin
• Green and Black tea polyphenols 
• Increase bean intake
• Attention to specific nutrients: vitamins B, C, D, E, Zinc, Selenium, Magnesium 

“In the context of this concept of signals,” Bland said, “it's all around signals, reception, and translation.” 

Tools to assess chronic inflammation in a patient care practice include, according to Bland:

• sIgA
• Fecal calprotectin
• Serum hsCRP
• Neutrophil:Lymphocyte ratio
• Serum cytokines (IL-6, TNFa)
• Serum LPS
• Specific serum antibody arrays 
• Stool metagenomic analysis
• Immune epigenome methylation analysis

For practitioners, Bland offered several key takeaways:

1. Inflammation is a generic term that needs personalized assessment based upon an individual’s immune identity
2. Immune identity is in part related to epigenetic modulation of the immune cell genome through exposure to triggering agents and events
3. Epigenetic changes in immune cell genomics can be reversed through diet, lifestyle, environment, and medical nutrition intervention 
4. A medical nutrition support program for immune rejuvenation and reduction of inflammation incorporates a polyphenol-rich diet, prebiotics, and omega-3 fatty acids containing proresolving mediators, and vitamins A and D.

“Our immune system has its unique architecture, defined by our environment, our lifestyle, and this is not a class effect, this is an individual effect,” said Bland. “If it doesn't work for one, then we try something else. There’s not this one-size-fits-all approach.” 

Editor's note: This article is part of Integrative Practitioner's live coverage of the 2023 Integrative Healthcare Symposium at the Hilton Midtown in New York City. Click here to catch up on the live coverage.