Chronic inflammation: the fine line between protection and disease

While acute inflammation can be a beneficial and self-limiting response, a defense and repair mechanism activated when tissues are damaged, chronic inflammation represents a failure of the immune system to return to its resting state.

“When the body is unable to completely eliminate a harmful stimulus, whether it is a persistent pathogen, an environmental toxin, or an altered metabolic trigger, the affected tissue begins to change. Immune cells remain at the site and continue to release chemical messengers known as cytokines. Over time, these substances lead to the breakdown of the extracellular matrix, the structural framework that keeps tissues functional and intact and promote the formation of fibrous tissue (fibrosis).

In this scenario, inflammation ceases to be a repair mechanism and becomes a driving force of disease itself,” explains Dr. Bizzi.

The causes of chronic inflammation are diverse and often interconnected. They include:

• genetic factors;
• lifestyle habits;
• poor nutrition in terms of quality, quantity, and meal timing;
• environmental factors;
• autoimmune diseases;
• autoinflammatory diseases;
• infections that the body cannot fully eradicate on its own.

“Modern medicine recognizes the crucial role of lifestyle and environmental factors. Stress and chronic inflammation are closely intertwined: persistent activation of the hypothalamic-pituitary-adrenal axis due to prolonged stress alters cortisol production, compromising the body's natural ability to ‘switch off’ inflammatory processes,” emphasizes the specialist.

Recognizing a chronically inflamed body is not as straightforward as identifying acute inflammation. Symptoms are often subtle and may include:

• fatigue that does not improve with rest;
• vague muscle or joint pain, often shifting from one part of the body to another;
• mild but persistent digestive disturbances;
• a sensation of brain fog;
• anxiety, depression, or apathy.

“From a biochemical perspective, we may be dealing with mild chronic inflammation, detectable only through specific blood markers, or with severe inflammation, in which organ damage begins to manifest clinically through symptoms that vary depending on the affected organ.

Examples include:

• rheumatoid arthritis, where inflammation attacks the joints, causing pain and stiffness;
• inflammatory bowel diseases such as Crohn’s disease;
• psoriasis, where inflammation becomes visible through skin lesions.

Similarly, chronic inflammation is also at the root of very common conditions such as:

• gastritis;
• irritable bowel syndrome;
• Hashimoto’s thyroiditis.”

Understanding how to reduce inflammation does not mean looking for a quick fix or an immediate solution. Instead, it involves embarking on a process of biological rebalancing. Dr. Bizzi explains:

“Managing chronic inflammation requires an approach that integrates targeted pharmacological therapy with lifestyle:

• medications, ranging from traditional anti-inflammatory drugs to modern biologic therapies depending on disease severity, often supported by selected supplements such as omega-3 fatty acids, curcumin, or vitamin D, can help modulate pro-inflammatory cytokines;
• clinical nutrition and regular physical activity act as true epigenetic signals capable of ‘educating’ the immune system toward resolving the inflammatory process.”

Classic examples of chronic inflammation include:

• cardiovascular diseases;
• type 2 diabetes;
• metabolic syndrome;
• neurodegenerative diseases such as Alzheimer’s disease;
• chronic respiratory disorders such as COPD and severe asthma.

“In these conditions, chronic inflammation forms the foundation upon which atherosclerotic plaques or insulin resistance develop. Likewise, modern research has shown that low-grade chronic inflammation is a key factor in the cognitive decline associated with Alzheimer’s disease and in the progressive damage to the airways seen in chronic respiratory illnesses.”

Given the complexity of chronic inflammation, self-diagnosis or indiscriminate use of supplements may be counterproductive. When persistent, unexplained symptoms raise suspicion of an underlying inflammatory process, medical evaluation becomes essential.

“Depending on the predominant manifestations, specialists such as immunologists, rheumatologists, and internists work together to define the patient's inflammatory profile. The goal is not simply to ‘eliminate inflammation,’ but to identify its root cause and prevent progression toward more disabling chronic diseases.

Today, early diagnosis and careful monitoring remain the most effective strategies for transforming a state of vulnerability into a path toward informed and lasting health,” notes the specialist.