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Acute versus chronic inflammation Bacteria found in sarcoidosis granuloma_Nilsson et al.

Inflammation can occur whether the immune system functions normally or abnormally. Acute inflammation may be good because it promotes the mobilization of large white cells (phagocytes) to an injured or infected area to kill extracellular bacteria (pathogens) and this results in healing.

Chronic inflammation occurs when an intracellular infection is not resolved. This is undesirable because it can cause tissue damage and eventual loss of function in any organ or body system.

See also:

Intracellular Bacteria

Persistent Pathogen Premise of Autoimmune and Inflammatory Diseases

Intracellular Bacterial Disease Process

When Doctors Act on Tradition and Emotion Over New Science

Bacterial species

Chronic inflammatory illnesses are most likely multifactorial with many pleomorphic, intracellular species involved. The various species can work in concert and may have even mutated specifically for the host by sharing genetic information by horizontal transfer of DNA. This makes eradication or control more difficult than eliminating a single species of bacteria.

Exposure

From birth, we're exposed to very tiny (smaller than viruses) bacteria (L-forms) which are found in many sources (body fluids, soil, insects, etc.). When these bacteria invade the phagocytes they cause chronic inflammation because they are able to evade being killed (phagocytosis).

Disabled immune system

InflammationSimpleWe theorize that intracellular bacteria disable a crucial part of the innate immune system, the Vitamin D Receptor (VDR) which is located in the nucleus of the phagocytes. We believe they do this by producing substances (perhaps capnine) that prevent the VDR from producing anti-microbial peptides such as cathelicidin, which kill invading pathogens (microbes). Thus, the intracellular bacteria are allowed to multiply, and also inhibit a number of other important functions the VDR would normally perform. We think these bacterial substances also induce the phagocytes to release Th1 cytokines which causes Th1 inflammatory symptoms.

This theory was inspired by the gliding bacteria discovered in this study. "Identification of bacteria on the surface of clinically infected and non-infected prosthetic hip joints removed during revision arthroplasties by 16S rRNA gene sequencing and microbiological culture"

Gliding bacteria live in biofilms and are very difficult to culture. The gliding motion is associated with a unique lipid called capnine.

Computer (in-silico) modeling on capnine has been done by one researcher who concluded that capnine is a strong inhibitor (antagonist) of VDR transcriptional activity. He posits that other pleomorphic bacteria also produce substances that inhibit VDR actions.

This study supports the theory that there are more than one species of gliding bacteria, and that capnine seems common to many of the species of gliding bacteria.

Sulfonolipids of gliding bacteria. Structure of the N-acylaminosulfonates.

The veracity of the computer modeling has not been verified by scientists but the numerous anecdotal reports of Inflammation Therapy efficacy suggests this is a viable theory.

Even though the immune system may become overactive in an attempt to kill the pathogens, the result is an ineffective response. External factors (e.g. corticosteroids) which suppress the immune system also contribute to chronic inflammation.

Identifying pathogens

BacteriaMicroscopeIdentification of specific pathogens isn't necessary to begin Inflammation Therapy. Trying to pinpoint a specific organism and testing for antibodies is futile and unnecessary because bacteria living within the monocytes and macrophages can't be detected by routine lab tests.

Cell wall deficient (CWD) bacteria only move out of the infected cells when the cells die. They use biochemical mechanisms to delay apoptosis (cell death) and make the cell stay intact as long as possible. When the cells die (apoptosis or phagocytosis) it might be possible to see them at that point with PCR (polymerase chain reaction) testing if the PCR probe sequence is general enough. But PCR testing is expensive and only done in specialty labs.

Antibodies found in the blood are due to the pathogens which were unsuccessful, the ones that were killed by the immune system. These are not the pathogens that cause Th1/Th17 inflammation. The intracellular bacteria which cause Th1/Th17 inflammation do not appear in antibody assays.

Biopsy testing doesn't usually look for intracellular bacteria and they would be difficult to identify because the bacteria are destroyed when taken out of the body; their protective homeostasis is lost and the lysosomes in the immune system kill them.

Diagnosing probable intracellular infection

Detection of inflammation putatively caused by these intracellular bacteria is accomplished with two basic blood tests called the D metabolites: specifically 25-D and 1,25-D.

25-D is the less active precursor to 1,25-D which is a secosteroid hormone, critical to many functions throughout the body. Normally, 25-D is converted to 1,25-D only in the kidneys, where the body has processes that regulate the conversion rate to control the level of 1,25-D. In some chronic inflammatory conditions however, there can be direct formation of 1,25-D in the skin from sunlight and in inflamed tissues.

When the innate immune system capability is reduced, we become more susceptible to other chronic infections such as viruses, fungi and protozoa.

Ideally, the immune system will generate an appropriate inflammatory response when needed to kill invaders in a reasonably short time. But the intracellular forms of bacteria have developed the ability to evade immune system attack and cause chronic inflammation which leads to chronic, degenerative diseases. Inflammation Therapy was designed to overcome this strategy and help resolve symptoms of chronic, inflammatory illness.

For further reading:

The History of Research Into Cell Wall Deficient Bacteria (L-forms)

Mysteries of the Bacterial L-Form: Can Some of Them Be Unveiled?

Infectious Determinants of Chronic Disease

Bacterial Strategies for Overcoming Host Innate and Adaptive Immune Responses

AMPed Up immunity: how antimicrobial peptides have multiple roles in immune defense

Purdue biologists identify new strategy used by bacteria during infection

Updated September 7, 2014