Primary chronic vs. secondary chronic inflammation – what are the causes and differences?
Inflammation is the part of our immune response that is noticeable and visible to the outside world and an important component of wound healing. Inflammation is an extremely powerful tool. Anything that could disrupt the balance of the body's processes is successfully combated within a few hours to a few days. Normally. Sometimes, however, this does not work and inflammation becomes chronic. In this article, you will find out what this means and how you can protect yourself from it.
Chronic inflammations are those that last longer than three to four weeks.
What are chronic inflammations?
Chronic inflammation is inflammation that lasts longer than three to four weeks. It is also characterized by the fact that three specific cell types dominate the inflammatory process at the site of inflammation, namely lymphocytes (white blood cells), macrophages (giant phagocytes) and plasma cells. In contrast to silent inflammation, laboratory diagnostics also show elevated values of classic inflammatory markers (CRP). It is assumed that most of the so-called common diseases such as diabetes, obesity or Alzheimer's are caused by chronic inflammation. Diseases such as ADHD or depression are now also associated with chronic inflammation. A distinction is made between primary chronic inflammation and secondary chronic inflammation.
primary chronic inflammations
Primary chronic inflammations are inflammations that are not preceded by acute inflammation. There are various possible causes:
- Infection with bacteria or viruses.
- Endogenous (body's own) materials. These can be dead fat cells, bone fragments or, as in the case of gout, deposits of uric acid crystals caused by too much uric acid in the blood.
- Exogenous (foreign to the body) materials, such as asbestos but also suture material from operations or implants.
- Hypersensitivity reactions, i.e. allergies.
- autoimmune diseases.
Primary chronic inflammations often begin slowly and unnoticed and then either progress or become inflammatory. In many cases, a cure is not possible. Chronic inflammatory bowel diseases (IBD) such as Crohn's disease, neurodermatitis, multiple sclerosis and most rheumatic diseases are typical examples of primary chronic inflammations.
Secondary chronic inflammations
Secondary chronic inflammations are much rarer. They begin with an acute inflammatory reaction which does not heal completely and therefore continues on and on. Most commonly, purulent inflammations tend to become chronic, as pus that cannot drain properly keeps re-infecting wounds. Bacteria or viruses can also cause secondary chronic inflammations. Typical examples are tonsillitis, bronchitis or gingivitis (periodontitis). The problem with such excessive inflammatory reactions is that healthy tissue around the source of inflammation is also attacked and removed by the phagocytes. This can lead to considerable damage if the inflammation is not contained. If periodontitis is left untreated, the jawbone can be attacked, which in turn can lead to tooth loss. In addition, as with silent inflammation , the body is in a constant state of alarm, which soon becomes noticeable through exhaustion. At the same time, the immune system becomes more susceptible to other pathogens.
special case of autoimmune disease
All autoimmune diseases belong to the group of primary chronic inflammations. They are a special case in this category of inflammations. The tricky thing about autoimmune diseases is not only the excessive inflammatory reaction, but also that the immune system recognizes the body's own cells as foreign bodies and attacks them. Some of the attacks are very specific, such as those against the myelin layer of nerve cells in MS or against insulin-producing cells in type 1 diabetes. But they can also occur non-specifically throughout the body, as in rheumatoid arthritis. Despite intensive research, the mechanisms behind many autoimmune diseases have not yet been fully unraveled. As a result, often only the symptoms of the disease can be treated. Alternatively, anti-inflammatory or immune system-suppressing (immunosuppressive) drugs are used. However, this always carries the risk of susceptibility to other pathogens.
How are chronic inflammations treated?
The list of diseases that are caused by chronic inflammation is as extensive as the treatment methods. The lowest common denominator for most therapies is treatment with antibiotics and mild, antipyretic and anti-inflammatory agents such as acetylsalicylic acid or ibuprofen. In cases of severe inflammation, medications containing cortisone are often used. Cortisone is based on the body's own hormone cortisol and has strong anti-inflammatory properties. If the cause of the inflammation is foreign bodies or dead (necrotic) tissue, this is removed surgically if possible. A review of lifestyle has also proven useful.
A healthy lifestyle with exercise and a varied diet are important in the fight against chronic inflammation.
What can I do about chronic inflammation?
Two factors are believed to be at the forefront in the development of chronic inflammatory diseases:
- The genetic disposition
- living conditions & environmental influences
There is little that can be done about genes, but there is something that can be done about living conditions. If you are already exposed to high levels of fine dust at work and are also prone to bronchitis, you should probably not be a heavy smoker as well. While regular exercise is generally good for your health, belly fat promotes the formation of pro-inflammatory hormones. A diet rich in fiber, with a high proportion of fruit and vegetables, can support the anti-inflammatory processes in the body, while fatty foods, meat and sugar can promote the pro-inflammatory processes. Since stress also has a negative effect on the course of inflammation, it should also be avoided. The best way to combat inflammation is to have a stress-free, healthy and varied lifestyle. That doesn't really sound like the bitter pill...
