Discussion of inflammation and causes
What is the definition of inflammation?
There a various types of inflammation that can manifest themselves in different ways (bruising and injury, infection, cold and flu). It occurs when the body senses danger and send out immune cells to the area (to either help repair damage or destroy bacteria or virus). Inflammation is therefore good today but dangerous tomorrow and in the long term- getting the flu once now can increase the risk of heart disease and cancer in a few decades time just because of the inflammation associated with it. In a study where people with high cholesterol were given statins to prevent its synthesis, it was very effective. The same study for health people led to less heart disease and -40% less cancer cases. Statins also helped people with swine flu by preventing their lungs from collapsing due to inflammation. The key is to PREVENT NOT TREAT disease where possible. This can be don by having flu jabs, considering statins and aspirin also.
What is inflammation?
A brief discussion on inflammation which is a term that most people think is just the reddening of the skin, when in actual fact, is a lot more. Inflammation can occur during a lot of day to day activities such as playing a sport and bumping into someone/something, having the flu and having your throat inflamed, having a foot infection which causes reddening of the toes. Inflammation is actually the body's way of sending its 'army' to take care of a potential threat. This army is called the immune cells. Having inflammation and active immune cells may be a great thing for today, but it may also have negative ramifications later on in life, maybe a decade or 2 from now. Coming down with a flu may increase your chances of developing cancer or heart disease later on in your life. There is a drug called "statin" which is usually used to block cholesterol in the body, but studies show that people who took this drug, had less chances of developing cancer (reduced by 40%) and also reduced chances of heart disease. There are other forms of drugs which would usually be overlooked but actually benefit us in the long run by reducing the chances of negative conditions such as heart disease, cancer, Alzheimer's etc. examples of these drugs are Aspirin and astonishingly, the flu shot/vaccine. So this lecture shows us that the long-term effects of conditions such as inflammation and fevers are not entirely known by medical professionals, but families should discuss with their doctors if they should take these drugs which may change the future of their health conditions.
S: I'm here with Dr. Agus who is a professor of engineering and medicine here at USC.
We're looking at pictures of things that seem very different to me. What is the commonality?
Dr: The commonality is inflammation. Inflammation can be manifested by a runny nose or the flu,
it could be manifested by an infection in your toes, it could be hitting your head playing football,
or hitting your arm when you fall while playing a sport
All of those can cause inflammation.
S: Inflammation has a certain meaning in everyday language: It means something is swollen and red.
But here we're talking about inflammation in the medical or scientific sense where it's not things are swollen and red BECAUSE of inflammation.
S: So what is inflammation? It isn't just swollen and redness. Football players get red and swollen.
Dr: Inflammation occurs when your body senses danger.
So when something is wrong--whether it be infection, whether it be trauma--in the case of football players
your body senses danger and sends in its front-line soldiers which are its immune cells
in order to fight whatever is causing it.
So, if it's trauma, the immune cells go in there and they help rebuild the tissue that is damaged.
If it's bacteria, they go in there and try to take away the bacteria so you can get over that cold or that flu.
So, that whole process is what we call inflammation, it's the "danger process".
S: So the immune cells go to the site of danger to either fight the danger itself or repair the aftermath of the danger.
That sounds like a good thing!
Dr: It's an awesome thing. The problem is your body, all of us; we care about what happens today, not down the road.
One of the take home points that astonished me when I start to think about it,
is that nature, evolution selects out for who has good kids, and that's what evolution is about: it's about having children; about progeny.
It's not about what happens when we're 80yrs-old or 90yrs-old.
And so, inflammation is fantastic at dealing with today's ramifications.
The problem is if you get the flu today, your risk of cancer and heart disease a decade or a two decades from now are up.
S: If I get the flu just once?
Dr: If you get the flu once. So those five, six days where you feel horrible, your inflammation is through the roof.
That's having ramifications down the road.
S: This is already getting a little scary for me, because I've had the flu...so I already feel a little worried about my cancer risk.
Dr: I can tell by looking at you!
S: The symptoms we get when we have the flu or cold, it's not the virus that's causing it.
The virus is causing the inflammation, which is causing the symptoms.
Dr: Yes. That's what's wild. When you get a virus, your immune system attacks it, and then you get a fever.
I still don't know why we get fevers. It's one of those things where cytokines,
which are proteins the immune cells make to send out and get more reinforcements and tell the body what to do,
it causes a fever. Is a fever good, is a fever bad? I don't know!
We take Tylenol to lower a fever, but is that a good thing? Nobody has really looked at the long-term ramifications.
We've looked at the short-term, but how does that effects will there be a decade from now? We just don't know.
S: What you're saying is the reason we have inflammation is, something is happening to my body,
I have some trauma or an injury, but I might have to run away from a lion tomorrow.
So fix-fix-fix Sal now or fix David up so he can run away from a lion tomorrow, but in the wild I might not have lived to 40 anyway.
So why even worry about whether that person might get cancer if they get to 40 or 50? Once they're past the point of reproduction.
Dr: Right, the body has to choose priorities. The priority is today rather than tomorrow.
An amazing study was done where we gave patients what we call a "statin".
Statins are drugs that were developed to block the synthesis of cholesterol.
We thought, you know, people with higher cholesterol--particularly the bad one, LDL--those people have a higher incidence of heart disease.
So, if we block the synthesis, we're going to affect heart disease.
What do you know? We did! A dramatic effect: We lowered the death from heart disease with these drugs.
S: so it seems like they worked!
Dr: Right. Then a company, or a very clever group did a trial where they gave people with normal cholesterol these drugs.
It also had a dramatic effect, in that it delayed heart attack and stroke by almost a dozen years,
and it reduced the incidence of cancer by about 40%.
S: So cancer, something we don't normally associate with cholesterol.
Dr: So it turns out these drugs, which are the biggest drugs in terms of sells we ever had,
worked by lowering inflammation.
So the affected heart disease wasn't by lowering cholesterol, it was predominantly by lowering inflammation.
And the affect on cancer was by lowering inflammation.
In fact, remember when the swine flu came out a couple of years ago?
If you got the swine flu, the only thing that protected you from your lungs collapsing going on what we call
a ventilator, a breathing machine, was being on one of these statins.
S: Because it would stop the inflammation. Because with swine flu, people were dying from inflammation going nuts.
S: Fascinating. The people who are dying of heart disease, is it the cholesterol that's killing them or the inflammation?
Dr: I think it's a chicken-and-the-egg phenomenon where the inflammation allows the cholesterol to deposit; and they go together.
S: It's really the statins affect inflammation, which then reduces cancer by stopping the inflammation.
Dr: Exactly. One of the problems we have in Biology and Medicine is what you can measure.
So, I can measure cholesterol. I don't really know how to measure inflammation well.
So while we can make these associations in big studies where we look back,
if I had a metric, a blood test or something to look at for inflammation, I could optimize this.
S: Can you not just measure the amount of cytokines or other inflammatory types of things?
Dr: There are different types of inflammation. So, some inflammation can be good, some can be bad.
Some can be really causal, some can be a little causal.
So we're putting them all into one basket now, which is inflammation, the key is to start to tease them out,
and be able to modulate them.
You can develop a drug, but then you would have to optimize it for a particular purpose.
So, these were optimized to lower cholesterol. They do that very well.
It also lowers inflammation, and they work beautifully in that regard.
But how do we optimize that going forward?
It also means that when you look at your lifestyle and my lifestyle, we have to limit inflammation.
So, what are the easy ways to do that?
One is, which I think should be mandatory, is things like the flu shot.
So again, the flu shot will certainly delay you from having or prevent you from having a bad flu...
S: Which is good today and good tomorrow.
Dr: Yes, it lowers heart disease and cancer down the road.
S: I had no clue. I thought the flu shot was just a nice thing to avoid a week of the sneezing.
But flu shot can actually reduce your cancer...
Dr: ...and heart disease down the road. And we have to think long-term as a society.
S: What about statins? I mean, it seems things like Lipitor, etc.--
no one should take medical advice based on a thing in a video--
but, are taking it, just for heart disease? Or are people taking it more broadly now?
Dr: Listen: I'm a believer that these drugs have such a profound affect on cancer, heart disease, stroke,
potentially Alzheimer's, that you should consider taking it to prevent these diseases.
And again, giving no recommendations, but what I say is, you and parents should talk to your doctor and say,
"Why shouldn't I be on this drug? "
S: And there are some side effects? Are they easy to test for?
Dr: They test for them, and they're reversible.
You have to do a risk-benefit analysis. Have to look at you and say, are you at high risk for XYZ?
If you are, what can prevent it or delay it?
The name of the game is not treating disease, it's preventing disease.
S: This is fascinating. But no advice here, everyone should talk to their doctor.
Dr: Btw, another great medicine that reduces inflammation is aspirin.
S: Aspirin, I've heard of that!
Dr: It's a helluva drug! Again, there are side effects to aspirin, it can effect bleeding,
but at the same time, it gives dramatic effect by lowering inflammation.
S: Right. And that is the main side effect, it's an age-old drug, and it's a blood thinner,
if you get a cut or you bleed while taking aspirin, you might bleed more.
Dr: Right. Blood thinner is a funny word, I'm not sure what it means.
I keep thinking paint thinner when you say that.
S: That's how I imagine it.
Dr: It binds to the platelets and blocks them from activating, it stops them from working very well.
S: It's more anti-clotting?
Dr: Right. And platelets are one of the key components in clotting, and they certainly affect it.
S: So your blood will have the same viscosity, it just won't clot as easily.
Dr: Exactly. And you could certainly paint a wall with either one.
S: That's a little morbid. Thanks so much
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