~~As we discussed in my last installment on autoimmunity there are multiple causes for the autoimmune process. I would like to key in on one of the main contributors of the multiple events that promote and often initiate the processes that occur in the autoimmune cascade.
The process that I would like to focus on in this article is that of inflammation, and how and why it develops in our bodies. You see we all have a burden of inflammation in our systems at all times and we will talk about some of the primary causes of this "inflammatory load" soon. But right now I want you to know how you can tell if you have inflammation in your body, and to what level it exists.
There is one test that you should all be having run when you have your standard blood work done. I run it in the center on most if not all of my patients. It is called C-reactive protein (CRP). There is however a newer more reliable form of this test which we run. It is much more specific and definitive relative to the level of inflammation that you are carrying. It also is much more dependable when running follow up studies for comparison. It is the hsCRP, or high sensitivity C-reactive protein. This is the most accurate marker of systemic inflammation. It is also a powerful predictor of coronary heart disease, as well as other diseases of the cardiovascular system. hsCRP is a predictor of not only heart attack, also stroke, peripheral arterial disease, and sudden cardiac death, and yes my favorite, Alzheimer's. It is predictive of these life threatening conditions in apparently healthy appearing individuals. And, we all have seen or at least heard of friends, family members, or acquaintances who have seemed to be totally healthy outwardly to us, but then suddenly were found dead on the floor.
This simple test is a strong predictor of not only your potential for life threatening cardiovascular disease, but also the best indicator of your "inflammatory load" at any given point. It is indicative of these conditions totally independent of other factors such as cholesterol, metabolic syndrome, and high blood pressure.
The normal level for a male is 0-3 mg/L, with an optimal range of less than 0.55 mg/L. The level for a female is also 0-3 mg/L as well, however the optimal range is a little more liberal for a female at less than 1.5 mg/L.
I apologize for spending so much time in this installment on hsCRP, but it is important for you to understand the significance of this marker before we move forward with our discussion of autoimmune conditions.
You see, C - reactive protein is manufactured throughout the body, but especially by immune cells called T-cells and the liver, which is where the majority of CRP is produced. We will discuss that in a minute. The other cells that produce CRP are fat cells, which are also known as "adipocytes". Remember that last statement because you will see that it is very important as we come full circle with this whole autoimmune process.
So, let's start with a site of inflammation such as an injury site, or perhaps your gut, which may be damaged by poor diet choices, imbalanced gut flora, or a side effect of a certain medication and as a result becomes inflamed. This acute phase inflammatory process sends out marker molecules to circulate throughout the body. These markers stimulate a process in the liver which in turn produces CRP. This is where the majority of CRP is produced.
Stick with me now because we are going to double back to the fact that CRP is also produced by fat cells. As you all know, obesity is directly correlated with an increased incidence of heart disease. Now, I need to describe to you one more important piece of this seemingly convoluted puzzle. But as you will see, this fascinating puzzle will make a lot of sense to you once you put it all together.
So, here is the unbelievable relationship between inflammation, obesity, and heart disease, and don't worry I will come back to autoimmunity. As I just said fat cells or adipose, produce CRP. Now I need to describe one more hormone that comes into play here. It is called "Leptin". Leptin is a hormone produced in the fat cells, which signals the brain, and reduces the sensation of hunger.
Here is the problem in a nut shell. CRP binds to leptin, which in turn prevents leptin from crossing what is called the "blood brain barrier". This means that the leptin never gets to the brain, and therefore cannot stimulate "satiety". Meaning that you do not feel "full", or "satisfied" regardless of how much you eat.
Do you get what this all means???? O.K., to capsulize, CRP production is due to inflammation. That is why it is such a good marker for the "inflammatory load". CRP is also the best blood test indicator of cardiovascular disease. CRP is also produced in adipose (fat) tissue. Now let's add in the hormone "leptin" which is produced by the fat cells as well, and then signals the brain, which stops us from feeling full when we eat. But, when CRP binds to the leptin, it does not reach the brain. Without the signal to the brain that we are full we continue to eat. This causes us to get fatter, and produce more CRP. This then causes us to become more and more inflamed. This process increases the secondary effects of inflammation including stroke, sudden cardiac failure, and heart attack, and yes autoimmune disorders.
O.K., I promise that I will get into the autoimmune treatments in Part III.