5 ms·

How can a symptom be the "cause" of a disease? Gingivitis is "inflammation of the gums", but it's "caused" by bacteria, plaque, tarter, etc... inflammation is

How can a symptom be the "cause" of a disease? Gingivitis is "inflammation of the gums", but it's "caused" by bacteria, plaque, tarter, etc... inflammation is the description of what is happening (ie, symptom) not the "cause".

iron0013 8y ago
Lots of things that have upstream causes also have downstream effects.
- RobertRoberts 8y ago
  Yes, but if you cure the "cause" then the symptoms go away too.
  - iron0013 8y ago
    Well, sometimes, but sometimes it's like closing the barn door after the cattle have escaped--too late!
    - RobertRoberts 8y ago
      Eventually you will get the cattle back and it's best to have the door fixed when you do. If you don't the cattle will just run back out.
Someone1234 8y ago
This article suggests that it might be the symptom of one disease while being the cause of another disease (or range of diseases). For example the "fat cell leak": The body is correctly responding to a real problem, but the response is so heavy handed it causes other problems. Which is why suppressing inflammation might be an interesting area of research, but we wouldn't want to completely eliminate it because the body may lose a vital tool needed to fight illnesses and normal maintenance.
- RobertRoberts 8y ago
  That doesn't change the fact that the "cause" of the whole issue is not a symptom. For example, you can get a blood infection from really bad gingivitis. But it's quite a leap to blame inflammation as the "cause" when it's really plaque (or a myriad of other related things). I think this is the foundational problem with health sciences. There is a lot money to be made treating symptoms, very money little to be made curing people.
  - artemisyna 8y ago
    I think what the other poster is saying that the bi-products of the inflammation response in themselves can also cause a problem. Yes, the obesity is probably the "cause" in the first place, but telling a person to go on a weight loss diet is going to be a bit late if that's not going to save them before the inflammation kills them. If you've got 2 or 3 different things killing you at once, you're gonna have to deal with the "most killing" one the most, so to speak.
    - RobertRoberts 8y ago
      While I don't disagree with the concept of prioritization, that's not the same as cause and effect. Inflammation is an effect that _can_ cause other problems. But as far as I know, inflammation is a symptom of other problems, not a cause in and of itself.
      - artemisyna 8y ago
        Did you read the article? The article claims that inflammation is both a symptom of other problems (when in reasonable ranges of signalling) and a causer of problems (when signalling too much). I know the title of the article itself is a bit sensationalist, but I would assume that any tests aiming to determine if inflammation is the cause of a problem in specific would also check to make sure that the inflammation was in the "starting to cause harm" range rather than merely in the "signalling" range.
will_brown 8y ago
Inflammation is tricky because you have accute (a hard work out, an injury, gingivitis) or chronic/dietary inflammation which is more akin to a reversible disease. It’s like saying type2 diabeties or fatty liver disease are not diseases but symptoms caused by certain dietary habits. Though as I write this...maybe you are correct and we should look at these things like symptoms of poor diet and not diseases.
- RobertRoberts 8y ago
  I think it's a hard problem, especially if you have to tell someone they have control over the cause. (certainly not always the case) Recently a couple of friends had heart issues. One event went so far as the Mayo clinic and the doctors there said that she needed to stop eating white sugar (one issue at least) because it was scratching her arteries and causing inflammation. Is inflammation really the problem she is having? She is overweight and didn't want to change her diet. All she heard was "inflammation is the problem", not "change your diet".
losteric 8y ago
If one system's inflammation causes another system to degrade and inflame, and so on, until the body has systemic inflammation without an infection... that over-sensitivity/self-reinforcement mechanism is arguably the problem, but also a moot point without advanced gene editing. The "fix" may be reducing inflammation so those systems can recover homeostasis.
- RobertRoberts 8y ago
  Sure, but if you cure the first problem, then the inflammation goes away, then you cure two problems instead of one. So is inflammation really the actual problem? This is like saying water damaged my carpet without acknowledging the real problem... that firemen were putting out the fire. No one cares about a mold problem in carpet if your house burns down. If we treated health issues in the same common sense way we would not focus on symptoms, but on causes.
  - losteric 8y ago
    I think it's analogous to overwhelming tech debt - stuck in an operational hell because there is no reprieve to actually put out any of the fires. The root cause is all the little issues, but you can't get there without first tackling the inability to fix any of the issues (labor shortage/unreasonable expectations/so on).
refurb 8y ago
Inflammation is not just a symptom, but also an underlying process. Lots of things can cause inflammation, but the underlying process can be similar. And it can have good and bad effects.
- RobertRoberts 8y ago
  Can you provide an example where inflammation _is_ the problem and isn't a symptom caused by something else (ie, disease, damage, toxicity, etc...)?
  - refurb 8y ago
    Immune disorders like MS. The immune system attacks the persons own tissues. It’s the inflammation that causes the damage. Prevent inflammation and you stop the disease.
    - RobertRoberts 8y ago
      It seems that a faulty immune system is the cause in MS, and inflammation is the symptom... can you clarify your example?
      - refurb 8y ago
        Sure, the immune system is at fault, but it’s the inflammation that causes the damage. Since we don’t have great tools to tweak the immune system, if we prevent inflammation, we can stop the disease.
        RobertRoberts 8y ago
        It seems illogical to attempt to redefine inflammation from a symptom to a cause because of the inability to cure the known cause. Suppressing inflammation is still temporary relief, not a cure for the root cause.
  - cik2e 8y ago
DoreenMichele 8y ago
So, what I think is happening is that excess acidity (and other chemical derangement) causes inflammation which promotes infection which causes more inflammation. It's a vicious cycle with a positive feedback loop.
tim333 8y ago
The gum disease thing is actually one of the best bits of evidence for the inflammation does bad stuff hypothesis: >People with gum disease (also known as periodontal disease) have two to three times the risk of having a heart attack, stroke, or other serious cardiovascular event. https://www.health.harvard.edu/heart-health/gum-disease-and-heart-disease-the-common-thread https://www.health.harvard.edu/heart-health/gum-disease-and-... The idea is bacteria in the gums cause inflammation (red swollen flesh, more white cells, metabolic changes) causes clogged arteries causes heart attacks.
- Tharkun 8y ago
  I'm sure I remember reading an article on HN linking gum disease to alzheimer's...
- RobertRoberts 8y ago
  The symptoms of gum disease (a generic term) can be inflammation (I am not a dentist). But suppressing the symptom of inflammation doesn't cure gum disease.
naasking 8y ago
> inflammation is the description of what is happening (ie, symptom) not the "cause" If you chemically turn off inflammation and the negative downstream effects disappear, then inflammation is arguably a cause of those negative effects. Inflammation is supposed to be a healthy response to various conditions, but that isn't always the case, so when it's causing negative effects it becomes a pathology and arguably a cause. Now if you're trying to argue some sort of infinite regress, then the Big Bang tautologically caused everything and nothing else is a meaningful cause.
- mhkool 8y ago
  The term "root cause" was not invented for nothing. One should always try to find the root cause since if you do not find it you are fighting a symptom instead of a cause. There is a huge amount of research about what causes inflammation so it is correct to say that inflammation is a symptom not a cause.
  - naasking 8y ago
    > There is a huge amount of research about what causes inflammation so it is correct to say that inflammation is a symptom not a cause. It is not necessarily just a symptom, that's the point. So no, it's not necessarily correct because sometimes inflammation is exactly the cause.
    - RobertRoberts 8y ago
      I think because a symptom can be part of a cascade of problems doesn't mean we should ignore or dismiss the root cause as the most important thing. As far as I know suppressing inflammation is a temporary stop-gap, not a cure. Can you demonstrate where inflammation does not have a root cause?

iron0013 8y ago

Lots of things that have upstream causes also have downstream effects.

RobertRoberts 8y ago
Yes, but if you cure the "cause" then the symptoms go away too.
- iron0013 8y ago
  Well, sometimes, but sometimes it's like closing the barn door after the cattle have escaped--too late!
  - RobertRoberts 8y ago
    Eventually you will get the cattle back and it's best to have the door fixed when you do. If you don't the cattle will just run back out.

Someone1234 8y ago

This article suggests that it might be the symptom of one disease while being the cause of another disease (or range of diseases). For example the "fat cell leak": The body is correctly responding to a real problem, but the response is so heavy handed it causes other problems. Which is why suppressing inflammation might be an interesting area of research, but we wouldn't want to completely eliminate it because the body may lose a vital tool needed to fight illnesses and normal maintenance.

RobertRoberts 8y ago
That doesn't change the fact that the "cause" of the whole issue is not a symptom. For example, you can get a blood infection from really bad gingivitis. But it's quite a leap to blame inflammation as the "cause" when it's really plaque (or a myriad of other related things). I think this is the foundational problem with health sciences. There is a lot money to be made treating symptoms, very money little to be made curing people.
- artemisyna 8y ago
  I think what the other poster is saying that the bi-products of the inflammation response in themselves can also cause a problem. Yes, the obesity is probably the "cause" in the first place, but telling a person to go on a weight loss diet is going to be a bit late if that's not going to save them before the inflammation kills them. If you've got 2 or 3 different things killing you at once, you're gonna have to deal with the "most killing" one the most, so to speak.
  - RobertRoberts 8y ago
    While I don't disagree with the concept of prioritization, that's not the same as cause and effect. Inflammation is an effect that _can_ cause other problems. But as far as I know, inflammation is a symptom of other problems, not a cause in and of itself.
    - artemisyna 8y ago
      Did you read the article? The article claims that inflammation is both a symptom of other problems (when in reasonable ranges of signalling) and a causer of problems (when signalling too much). I know the title of the article itself is a bit sensationalist, but I would assume that any tests aiming to determine if inflammation is the cause of a problem in specific would also check to make sure that the inflammation was in the "starting to cause harm" range rather than merely in the "signalling" range.

will_brown 8y ago

Inflammation is tricky because you have accute (a hard work out, an injury, gingivitis) or chronic/dietary inflammation which is more akin to a reversible disease. It’s like saying type2 diabeties or fatty liver disease are not diseases but symptoms caused by certain dietary habits. Though as I write this...maybe you are correct and we should look at these things like symptoms of poor diet and not diseases.

RobertRoberts 8y ago
I think it's a hard problem, especially if you have to tell someone they have control over the cause. (certainly not always the case) Recently a couple of friends had heart issues. One event went so far as the Mayo clinic and the doctors there said that she needed to stop eating white sugar (one issue at least) because it was scratching her arteries and causing inflammation. Is inflammation really the problem she is having? She is overweight and didn't want to change her diet. All she heard was "inflammation is the problem", not "change your diet".

losteric 8y ago

If one system's inflammation causes another system to degrade and inflame, and so on, until the body has systemic inflammation without an infection... that over-sensitivity/self-reinforcement mechanism is arguably the problem, but also a moot point without advanced gene editing. The "fix" may be reducing inflammation so those systems can recover homeostasis.

RobertRoberts 8y ago
Sure, but if you cure the first problem, then the inflammation goes away, then you cure two problems instead of one. So is inflammation really the actual problem? This is like saying water damaged my carpet without acknowledging the real problem... that firemen were putting out the fire. No one cares about a mold problem in carpet if your house burns down. If we treated health issues in the same common sense way we would not focus on symptoms, but on causes.
- losteric 8y ago
  I think it's analogous to overwhelming tech debt - stuck in an operational hell because there is no reprieve to actually put out any of the fires. The root cause is all the little issues, but you can't get there without first tackling the inability to fix any of the issues (labor shortage/unreasonable expectations/so on).

refurb 8y ago

Inflammation is not just a symptom, but also an underlying process. Lots of things can cause inflammation, but the underlying process can be similar. And it can have good and bad effects.

RobertRoberts 8y ago
Can you provide an example where inflammation _is_ the problem and isn't a symptom caused by something else (ie, disease, damage, toxicity, etc...)?
- refurb 8y ago
  Immune disorders like MS. The immune system attacks the persons own tissues. It’s the inflammation that causes the damage. Prevent inflammation and you stop the disease.
  - RobertRoberts 8y ago
    It seems that a faulty immune system is the cause in MS, and inflammation is the symptom... can you clarify your example?
    - refurb 8y ago
      Sure, the immune system is at fault, but it’s the inflammation that causes the damage. Since we don’t have great tools to tweak the immune system, if we prevent inflammation, we can stop the disease.
      - RobertRoberts 8y ago
        It seems illogical to attempt to redefine inflammation from a symptom to a cause because of the inability to cure the known cause. Suppressing inflammation is still temporary relief, not a cure for the root cause.
- cik2e 8y ago

DoreenMichele 8y ago

So, what I think is happening is that excess acidity (and other chemical derangement) causes inflammation which promotes infection which causes more inflammation. It's a vicious cycle with a positive feedback loop.

tim333 8y ago

The gum disease thing is actually one of the best bits of evidence for the inflammation does bad stuff hypothesis: >People with gum disease (also known as periodontal disease) have two to three times the risk of having a heart attack, stroke, or other serious cardiovascular event. https://www.health.harvard.edu/heart-health/gum-disease-and-heart-disease-the-common-thread https://www.health.harvard.edu/heart-health/gum-disease-and-... The idea is bacteria in the gums cause inflammation (red swollen flesh, more white cells, metabolic changes) causes clogged arteries causes heart attacks.

Tharkun 8y ago
I'm sure I remember reading an article on HN linking gum disease to alzheimer's...
RobertRoberts 8y ago
The symptoms of gum disease (a generic term) can be inflammation (I am not a dentist). But suppressing the symptom of inflammation doesn't cure gum disease.

naasking 8y ago

> inflammation is the description of what is happening (ie, symptom) not the "cause" If you chemically turn off inflammation and the negative downstream effects disappear, then inflammation is arguably a cause of those negative effects. Inflammation is supposed to be a healthy response to various conditions, but that isn't always the case, so when it's causing negative effects it becomes a pathology and arguably a cause. Now if you're trying to argue some sort of infinite regress, then the Big Bang tautologically caused everything and nothing else is a meaningful cause.

mhkool 8y ago
The term "root cause" was not invented for nothing. One should always try to find the root cause since if you do not find it you are fighting a symptom instead of a cause. There is a huge amount of research about what causes inflammation so it is correct to say that inflammation is a symptom not a cause.
- naasking 8y ago
  > There is a huge amount of research about what causes inflammation so it is correct to say that inflammation is a symptom not a cause. It is not necessarily just a symptom, that's the point. So no, it's not necessarily correct because sometimes inflammation is exactly the cause.
  - RobertRoberts 8y ago
    I think because a symptom can be part of a cascade of problems doesn't mean we should ignore or dismiss the root cause as the most important thing. As far as I know suppressing inflammation is a temporary stop-gap, not a cure. Can you demonstrate where inflammation does not have a root cause?