University of Southampton, Southampton, Reino Unido
Inflammation is a normal process and there are a number of cells and mediators involved. These markers are involved in, or are produced as a result of, the inflammatory process irrespective of its trigger and its location and are common to all inflammatory situations. Exaggerated or uncontrolled inflammation is a feature of many common conditions. The level of the on-going inflammation may vary: some conditions are characterised by continuous or intermittent high grade inflammation that is directly linked to pathological changes. Other conditions include a low grade inflammatory component that is less clearly linked to pathology, but seems to be important nevertheless. Since obesity and many other lifestyle related diseases of ageing have such a low grade inflammatory component there is much interest in monitoring low grade inflammation. Such monitoring requires valid biomarkers. Currently, there is no consensus as to which markers of inflammation best represent low-grade inflammation or differentiate between acute and chronic inflammation or between the various phases of inflammatory responses. There are a number of modifying factors that affect the concentration of an inflammatory marker at a given time, including age, diet and body fatness, among others. Measuring the concentration of inflammatory markers in the bloodstream under basal conditions is probably less informative compared with data related to the concentration change in response to a challenge. A number of inflammatory challenges have been described. However, many of these challenges are poorly standardised. Patterns and clusters may be important as robust biomarkers of inflammation. Therefore, it is likely that a combination of multiple inflammatory markers and integrated readouts based upon kinetic analysis following defined challenges will be the most informative biomarker of inflammation. Many foods and food constituents (both nutrients and non-nutrients) affect inflammation. They may act as inflammatory triggers or as modulators (up- or down-regulation) of the response triggered by other factors. Healthy eating patterns are associated with lower circulating concentrations of inflammatory markers. Among the components of a healthy diet, whole grains, vegetables and fruits, and fish are all associated with lower inflammation. Saturated fatty acids and trans monounsaturated fatty acids are pro-inflammatory, while polyunsaturated fatty acids (PUFAs), especially long chain n-3 PUFAs are antiinflammatory. Hyperglycaemia induces both post-prandial and chronic low grade inflammation. Vitamin C, vitamin E and carotenoids decrease the circulating concentrations of inflammatory markers.
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