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Stanford University School of Medicine

The biggest killer of them all: Inflammaging

For the past several hundred thousands of years of human evolution, our biggest killers have been infectious diseases. But, as I wrote in my just-published Stanford Medicine, "Inflammation Implication," the gears have shifted:

Medical and public-health advances have so vastly reduced the death toll from microbes that today’s leading killers spring from within. People are living long enough to acquire debilitating bug-free disorders such as heart disease, strokes, cancer, osteoarthritis, Type 2 diabetes and neurodegenerative syndromes such as Alzheimer’s.

A common element in all of these, I wrote, appears to be inflammation:

...not the intense, temporary, ad hoc (or, as immunologists say, acute) variety that’s actually helpful when you run a fever while you’re fighting off an infection, but another kind that’s stealthy, steady and pernicious, like a leaky faucet. It doesn’t seem like a big deal until the water bill comes.

Our most prevalent diseases these days are diseases of inflammaging, set in motion by our immune systems' ever-increasing tendency to go haywire with the passage of time. Even cardiovascular disease, the world's number-one killer, is less a passive matter of fatty junk chunking up in our arteries as we over-consume this or that fast-food item than the active result of a steady transformation of immune cells from Dr. Jekyll to Mr. Hyde.

The same characterological warpage of our aging immune systems from protector to usurper of our bodily integrity applies from osteoarthritis to autoimmunity to Alzheimer's disease. The good news is that there are encouraging signs of success in understanding of what's going on in there. In my article, I describe work and analysis by Stanford researchers including rheumatologists Connie Weyand, MD, and Jorg Goronzy, MD; cardiovascular surgeon Nick Leeper, MD; and gut-microbe immunologist Justin Sonnenburg, PhD, that is zeroing in on the causes, connections, and consequences of the inflammatory immune-system shuffle step taking place inside all of us as the years fly by.

I also offer a few tips gleaned from these and other researchers for staving off that subtle drip-drip-drip that eventually becomes a flood. Who knows: If only there were a way to slow, reverse or even prevent this gradual progression, who knows? Maybe we'll all still be pumping iron at 90.

Previously: Strive, thrive and take five: Stanford Medicine magazine on the science of well-beingAlzheimer's puzzle pieces are coming togetherThe die-off within us: Are our low-fiber diets ruining our descendants' lives?, Glucose-guzzling immune cells may cook up coronary artery disease, Stanford study finds and Double agent: Anti-tumor drug already in clinical trials may combat atherosclerosis
Illustration by Mark Smith

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