Corrine Metzger, M.S.
An uncontained fire can quickly spread and wreak havoc on areas both near and far to the instigating source. Under the right conditions, one flame can set a whole forest on fire and soon spread beyond its confines. In a similar way, inflammation can start at a local region in the body, but the damaging effects can spread to distant sites. One example of far spread damage of inflammation is the bone loss concurrent with inflammatory bowel disease. Inflammatory bowel disease (IBD) compromises a group of chronic conditions, including Crohn’s disease and ulcerative colitis, causing inflammation and significant tissue damage in the large and small intestines. However, the damaging effects of the inflammation are not localized to the gastrointestinal tract, but spread to other parts of the body. In bone, inflammation causes an increase in the breakdown of bone and a decrease in the formation of new bone creating a situation where bones are more likely to fracture. Up to 50% of IBD patients have low bone mass due to inflammation (Bernstein). In addition, these individuals have a 40% greater incidence of fracture which is higher than the lifetime fracture risk for postmenopausal women, a population with significant bone loss.
The spread of inflammation from the gut to the bone impacts the cellular mechanisms of bone critical to keeping it healthy. Researchers at Texas A&M University have discovered that osteocytes, the primary regulatory cell in bone tissue, respond to inflammation with altered quantities of key proteins responsible for maintaining balance between bone formation and resorption. The out-of-balance state of these key proteins leads to an increase in bone resorption and a decrease in bone formation promoting overall bone degradation.
Unfortunately, IBD is a chronic condition with no current cures. Most current treatments are designed to manage the disease, but some treatments designed to lessen inflammation exacerbate bone loss. Other treatments have significant negative side effects like increased risk of infections. Lifestyle interventions that could mitigate inflammation and improve bone health would be of great benefit due to holistic improvement of health and reduction of negative side effects. In addition, understanding the mechanisms behind the beneficial effect of lifestyle treatments could lead to development of future treatments for IBD and other inflammatory conditions. Researchers at Texas A&M University are currently examining the use of physical activity and a moderately-high protein diet to both reduce inflammation and increase pro-growth factors that are beneficial to bone. It is hypothesized a combination of diet and exercise will both lessen the systemic inflammation caused by IBD and beneficially alter osteocytes to lead to overall better bone health.
Inflammation, like a forest fire, can quickly spread its damage to widespread regions of the body causing major concerns secondary to the primary disease. However, evidence is accruing to show that lifestyle interventions could aid in fighting back and potentially stamping out the inflammation without any unwanted side effects. It is hopeful that diet and exercise could aid in extinguishing the fire of inflammation and improve overall health.