Anti-Inflammatory Strategies–Achieving Homeostasis
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The mouth is a unique bio-environment for bacteria and other microorganisms. The oral cavity must always be in microbial and immune homeostasis (balance).. Hundreds of types of bacteria need to be properly balanced to protect the mouth from infection or severe gum disease can result from microbial imbalances or “dysbiosis”.

Oral Disease
Many microorganisms in the mouth attach to the teeth. The accumulation of microbes on the surface of teeth is called a “biofilm”, which may eventually calcify into a matrix of hard material called “plaque”.

If not removed, biofilms can lead to inflammation of the gums; a first step in the development of dental caries and “gingivitis”. This mild form of gum disease results in swollen and red gums that may exude pus and bleed easily upon brushing. If left untreated, gingivitis may escalate to periodontitis. In periodontitis, pockets of microbes form and the infection spreads and grows below the gum line, damaging bone, and loosening teeth.

Oral Inflammation
Periodontal-causing pathogens in the mouth trigger defense mechanisms resulting in defensive inflammation. However, when inflammation is not controlled, bone and connective tissues are damaged; the gums pull away from the teeth and leave them in danger of falling out.

When dysbiosis occurs, pathogenic periodontal bacterial communities may overpopulate the mouth. The bacteria are able to circumvent immune cell attacks. As the number of bacteria increase, they stimulate more inflammatory responses leading to bone loss and worsening periodontitis.
As might be expected, treating periodontitis decreases the biomarkers of inflammation throughout the body.

Atherosclerosis and cardiovascular disease
Inappropriate levels of inflammation in the mouth can lead to inflammation throughout the body. It is therefore not surprising that periodontal disease increases the risk of having other inflammatory conditions such as atherosclerosis and cardiovascular disease. Indeed, individuals with atherosclerosis and periodontitis share genes that appear to stimulate similar inflammatory pathways.

Alzheimer’s Disease (AD).
Amyloid plaque accumulation in the brain is a major feature of Alzheimer’s disease (AD); heightened levels of amyloid have been associated with greater risk of periodontal disease. Even in seemingly healthy elderly individuals, those with periodontal disease have more amyloid in their brains than those without oral disease.

Individuals with strong immune responses to periodontal pathogens are at greater risk of developing Alzheimer’s than people who have more limited responses. This has led investigators to suggest that inflammation-associated periodontal disease may be a contributor to Alzheimer’s.

Homeostasis
A major function of the immune system is to keep the numerous bacterial communities on and throughout the body in check. To accomplish this, the body maintains immune homeostasis, exquisitely balanced inflammatory responses.

One might predict that maintaining good oral health would decrease one’s risk of inflammatory diseases including diseases such as cardiovascular and Alzheimer’s Disease.

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Pancreatic cancer is an aggressive and treatment-resistant cancer that appears to be driven by pancreatitis, inflammation of the pancreas.   Although most people with pancreatitis never go on to develop pancreatic cancer, drinking alcohol in excess, obesity, and particularly smoking, has long been associated with a greater risk of having pancreatic disease.

The Role of The Pancreas
The pancreas is a digestive organ with two main functions.  It produces digestive enzymes to break food down in our intestines, and it contains clusters of cells, Islets of Langerhans, that help the body regulate its blood sugar levels.

Inflammation as a Contributor to Pancreatic Cancer
Inflammation is a complex immune response.  Pancreatic inflammation, mediated by cytokines, immune messengers, up-regulate (increase) inflammation which may lead to pancreatic cancer. Once inflammation is triggered, more immune cells are attracted to the inflamed pancreas and additional cytokines are released that damage pancreatic tissue and attract other damage-causing immune cells.

One of the roles of the immune system is to recognize and destroy cancer cells.  There is a significant amount of “cross-talk” between cancerous cells and immune cells.  On one hand immune cells track down cancer cells in an attempt to destroy them.  They can “turn-on” (up-regulate) or “turn-off” (down-regulate) cancerous cells.  Signals from cancerous cells can result in marked imbalances of immune cells, or make them function in odd ways.

Role of Cytokines in Pancreatic Cancer.
For example, pancreatic tumor cells are able to dampen some of the immune responses of the immune system leaving pancreatic cancer cells to multiply more easily. Cytokines from immune cells can change the environment around tumor cells and act directly on them, triggering their growth and migration to other parts of the pancreas and body. Some cytokines transform cancer cells into becoming resistant to chemotherapy.

Others may act either to trigger inflammation or stop inflammation depending on circumstances. In one study of pancreatic cancer, the most invasive parts of a tumor were found in the midst of heavily inflammatory centers.

Bacteria May Drive Inflammation and Cancer
Interestingly, the studies of our microbiome, the bacteria that inhabit our digestive tracts and other parts of the body, suggest that the bacteria that inhabit us may trigger inflammation, thereby promoting the growth of cancers.

In summary, limiting inappropriate inflammation and achieving a state of immune balance, homeostasis, may be a significant contributor in reducing the risk of pancreatic disease.

Dr. Greenblatt  looks forward to assisting you in reaching your health goals:   http://drhellengreenblatt.info/contact-dr-hellen or 1.302-265.3870 [USA, ET].

 

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We humans exist in sea of microorganisms. According to the American Society for Microbiology, there are 10 fold the number of bacteria living in and on our bodies as cells that make up our bodies. Wherever our bodies are exposed to the outside world, for example our digestive tracts, skin, mouth, vagina, etc. we find specific varieties of bacteria and other organisms.

The totality of all the bacteria and other microorganisms that populate our bodies is called the microbiome. The microbiome is highly individualized, with the spectrum of bacteria differing from one person to another; much like an individual’s fingerprints. All people display wide variations in the kinds of bacteria that inhabit them. The types and numbers of bacteria in and on our bodies differ depending on our genetic makeup, our diet, and environmental factors.

Immune cells are found throughout the body where they are always on alert defending the body against infection. Inflammation is the primary way that the immune system controls infections and healing, but overactive immune responses can lead to debilitating inflammatory diseases such as atherosclerosis, diabetes, and bowel disorders.

There is considerable “cross-talk” between the microbiome and the immune cells. Microorganisms influence the responses of the immune system, and the immune system in turn affects the populations of the organisms that inhabit us. For example, evidence suggests that certain bacteria in the gut can decrease inflammation in the gut and decrease chronic disease. [Whether the organisms themselves are producing these molecules, or whether they are triggering immune cells to release anti-inflammatory compounds is not clear.]

Celiac Disease and Diabetes:
Individuals with celiac disease are highly sensitive to foods containing gluten, a protein found in barley, rye, and wheat. People with celiac disease have significant quality of life issues such as bloating, diarrhea, and/or constipation.

When the immune cells of celiacs see gluten, they mount an inflammatory response to try to eliminate the gluten from the intestines. The immune cells produce antibodies that attach to the inner surface of the gut and through inflammatory responses cause direct damage of the gut lining. Inflammatory responses against the body’s own tissues lead to autoimmune (against oneself) disease.

Diabetes is also the result of an autoimmune condition. Inflammatory immune cells destroy specialized cells in the pancreas that produce insulin, a hormone needed to control blood sugar.

Individuals with celiac disease have more than digestive issues, since they have almost 2.5 times a greater chance of developing diabetes than those without intestinal problems. Such conditions are associated with antibodies directed against the insulin-producing cells. When Individuals with celiac disease go on a strict gluten-free diet, they produce fewer anti-insulin-antibodies, suggesting that they are producing less of an inflammatory response.

Gluten intake changes the kinds of bacteria found in the gut. Diabetic-prone mice that eat regular mouse chow containing gluten are more likely to get diabetes than diabetic-prone mice on gluten-free chow. In addition, when the gut bacteria are analyzed, the diabetic-prone mice on gluten have the type of bacteria more often associated with inflammation, than the mice not on gluten. Thus, diet affects the responses of the immune cells and the microbiome.

As followers of this blog are aware, in the face of constantly changing external and internal challenges, the immune system of a healthy person makes adjustments to maintain immune balance, immune homeostasis.

One would expect that if inflammatory and autoimmune responses were better controlled by the body, that individuals with celiac disease and diabetes would experience a far better quality of life.

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