Inside the Inflammation Factory

A newly discovered structure in cells underlies inflammation wherever it occurs—an insight that may lead to new treatments for ailments as diverse as atherosclerosis, Alzheimer's and fatty liver disease

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Anyone who has ever had a pimple is familiar with the tissue redness, swelling, warmth and pain that mark an infection. This response, known as inflammation, has been recognized since ancient times. But the process, which is often set in motion by cells of the immune system, can also occur whenever tissue is damaged—even in the absence of a pathogenic organism—as, for example, when you stub your toe or, more seriously, suffer a heart attack. This second condition is called sterile inflammation, and when it goes awry, it contributes to a wide range of seemingly unrelated medical conditions, from Alzheimer's disease to diabetes to various liver conditions.

Although prolonged inflammation and its role in disease have been known for decades, research over the past few years has yielded surprising and important insights into its origins. Among the most intriguing: inflammation is not an automatic reaction but requires the active assembly of molecular structures before it can be launched. Cells involved in inflammation build the structures—called inflammasomes—quickly and then quickly disassemble them, usually within a day of the injury. (Imagine assembling a factory in a few minutes when a product is needed and then breaking it down once the need has passed, and you get the picture.) Presumably the rapid disassembly helps the body to avoid excessive damage. Some inflammation is helpful; it kills pathogens and blocks their spread in the body. But too much can harm nearby healthy tissues and thus extend any initial injury.

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