What is Inflammation in the Body? Key Lab Tests Used to Assess Inflammation

Inflammation is a crucial immune response to harmful stimuli like pathogens or damaged cells. However, excessive or chronic inflammation can lead to a wide range of health issues. Laboratory testing helps identify and monitor inflammatory conditions.

What is Inflammation in the Body?

Inflammation is the body's immune response to harmful stimuli such as infection, damaged cells, toxins, and trauma. It is a complex biological process that aims to remove injurious substances and promote healing.

The key features of inflammation include:

• Immune cells (e.g. neutrophils, macrophages) migrate to the site of injury or infection. This causes redness, heat, swelling and pain.
• Vasodilation occurs, increasing blood flow to the area to transport immune cells and proteins.
• Increased permeability of blood vessels allows leakage of plasma and immune system proteins into tissues. This causes swelling.
• Release of inflammatory mediators like cytokines and histamine that elicit immune cell responses.
• Removal of pathogens and damaged/dead cells by phagocytic cells.
• Tissue healing through regeneration of new blood vessels and collagen.

Acute inflammation is rapid and short-lived, resolving once the threat is neutralized. Chronic inflammation persists over months to years, causing organ damage.

Diseases associated with chronic inflammation include rheumatoid arthritis, asthma, inflammatory bowel disease, and atherosclerosis. Testing inflammatory markers like CRP helps diagnose and monitor inflammatory conditions.

The inflammatory response, while protective in intent, must be tightly controlled to avoid unnecessary damage. Short-term it is beneficial, but long-term it can disrupt homeostasis and lead to serious health problems.

Common Causes of Inflammation

Inflammation can arise from:

• Infections - bacteria, viruses, fungi
• Autoimmune disorders - rheumatoid arthritis, lupus, IBD
• Injuries and tissue damage
• Toxins - smoking, air pollution, heavy metals
• Metabolic conditions - obesity, diabetes
• Stress and inadequate sleep
• Poor diet - highly processed foods

Persistent low-grade inflammation is linked to diseases like cardiovascular disease, cancer, depression, and neurodegeneration.

Signs and Symptoms of Inflammation

General symptoms of inflammation include:

• Joint pain, stiffness, swelling
• Fever, chills
• Fatigue, brain fog
• Skin redness, rashes
• Digestive issues
• Shortness of breath
• Weight changes

Testing helps determine the underlying inflammatory condition.

How to Test Inflammation in the Body?

Some common lab tests checked for inflammation evaluation:

1. Complete Blood Count (CBC): Measures white blood cell (WBC) count and types. High WBCs indicate an immune response against inflammation. Specific cell elevations can point to certain conditions.
2. C-reactive protein (CRP): Made by the liver, CRP levels rapidly increase during acute inflammation and infection. Checking CRP helps monitor inflammatory disease activity and treatment efficacy.
3. Erythrocyte Sedimentation Rate (ESR): ESR measures how quickly red blood cells sediment in a tube over time. Faster settling indicates increased inflammation. Often used with CRP.
4. Serum Amyloid A (SAA): SAA increases in the blood within hours of tissue injury or infection. It may be more sensitive than CRP for detecting early inflammation.
5. Plasma Viscosity: This checks the thickness of blood plasma. Inflammation increases plasma viscosity due to higher protein levels like fibrinogen and immunoglobulins.
6. Cytokine Panel: Pro-inflammatory cytokines like IL-6, IL-1, and TNF-alpha become elevated during chronic inflammatory diseases and can indicate specific conditions.
7. C3 and C4 Complement: Part of the innate immune response. Low C3/C4 levels may signal immune complex diseases while high levels can indicate acute inflammation.
8. Ferritin: Ferritin stores and releases iron in the body. Very high ferritin typically signals inflammatory diseases rather than iron overload.
9. Haptoglobin: This protein binds free hemoglobin. Decreased haptoglobin indicates hemolysis and inflammation.

When to Test for Inflammation?

Doctors may order inflammatory marker testing if patients have:

• Prolonged fever, fatigue, or new pain
• Suspected autoimmune or rheumatologic disorders
• Recurring infections
• Digestive problems like Crohn’s or ulcerative colitis
• Cardiovascular disease risks
• Unexplained weight loss or gain
• Anaemia or abnormal blood cell counts

Testing helps diagnose inflammatory conditions and monitor the effectiveness of treatments.

Difference Between Infection and Inflammation

The key differences between infection and inflammation are:

• Infection - Caused by invasion of pathogens like bacteria, viruses, and fungus. Inflammation is the immune system's response to contain infection.
• Inflammation - General immune reaction to harmful stimuli like trauma, toxins, and damaged cells. Can occur without infection.
• Timeline - Infection precedes inflammation. The inflammation arises shortly after the body detects infection.
• Causation - Infection causes inflammation, but inflammation can occur without active infection.
• Symptoms - Infection symptoms depend on the pathogen but often include fever, fatigue, and nausea. Inflammation symptoms are systemic - pain, swelling, redness, immune cell rise.
• Diagnosis - Infection identified by positive culture, PCR, or antigen detection tests. Inflammation is diagnosed by testing inflammatory markers like CRP, and cytokines.
• Treatment - Antibiotics, antivirals, antifungals used to treat infections. Anti-inflammatories, steroids, immune-modulators used for inflammation.
• Outcomes - Infection resolved by eliminating pathogens. Inflammation resolves by controlling immune response and underlying causes.
• Effects - Uncontrolled infection can spread, and cause sepsis. Unchecked inflammation leads to tissue damage, and chronic disease.

In summary, infection triggers inflammation as a response, but inflammation can arise without active infection from other immune provocation. Doctors use testing to distinguish the cause and guide targeted treatment.

FAQs About Inflammation Testing

Inflammatory marker blood tests like CRP, ESR, cytokines, and immunoglobulins help diagnose and monitor conditions driven by inflammation.

Why test inflammatory markers?

Checking markers like CRP, sedimentation rate, cytokines, etc. helps diagnose and monitor inflammatory conditions and diseases.

What is considered a normal CRP level?

Usually, CRP under 3 mg/L is normal. Levels between 3-10 mg/L indicate moderate inflammation. Over 10 mg/L signifies substantial inflammation.

How can you tell if inflammation is causing symptoms?

There are often no definitive outward symptoms. Lab testing of inflammatory markers is key to identifying if inflammation is present and causing health issues.

What are the limitations of testing for inflammation?

Results can be nonspecific and must be interpreted in the context of clinical presentation. Levels may become elevated from non-inflammatory causes like ageing and obesity.

How can you reduce inflammation through diet and lifestyle?

Diets high in fruits, vegetables, omega-3s, and antioxidants help lower inflammation. Regular exercise, good sleep, stress management, and maintaining a healthy weight also help.

Tips for Preparing for Inflammatory Marker Blood Tests

Proper preparation ensures accurate, useful inflammatory marker test results:

• Fast for 8–12 hours before testing to prevent dietary fats from skewing results. Water is okay.
• Avoid strenuous exercise for 12–24 hours pre-testing as exertion can temporarily raise inflammatory markers.
• Have blood drawn in the morning as inflammatory markers can fluctuate throughout the day.
• Note any recent injuries or illnesses as acute inflammation can impact results. Testing may need to be delayed.
• Inform your doctor about medications like NSAIDs, steroids, or immunosuppressants that can lower certain markers.
• Avoid alcohol for at least 24 hours before testing as alcohol levels can falsely elevate markers.
• Reduce stress to help prevent stress-induced inflammation that could mask your normal baseline levels.

Proper preparation provides the most accurate picture of your body's inflammatory status for your doctor to make appropriate treatment decisions.

Key Takeaways About Inflammation Testing

• Inflammation marker lab tests aid diagnosis and management of inflammatory conditions.
• CBC, CRP, ESR, cytokines, complement proteins, and other markers reflect immune activity.
• Levels outside the normal range can signify disorders like infections, autoimmunity, and chronic diseases.
• Doctors analyse trends in inflammatory markers to assess disease progression and treatment efficacy.
• Proper patient prep through fasting, timing, medication management, and reducing acute inflammation optimizes results.
• Anti-inflammatory diets, exercise, sleep, and stress reduction help counter high inflammation.

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