In a recent Editorial, Gerald Weissmann, in his typical elegant and provocative style, mingles Hollywood stars and movie characters with some major pathology phenomena.
The recent movie ‘It’s Complicated’ inspired the Editor-in-Chief of the FASEB journal to find some striking similarities between some of the movie’s features and the cardinal signs of inflammation: redness and swelling with heat and pain, leading to loss of function.
In the last few decades inflammation has been implicated in an increasing number of pathological conditions. The author poses some scientific and philosophical questions about this old medical term: What is the status of our current understanding and vision about inflammation; do we have a modern contemporary definition of inflammation or should we still use the old one established by Celsus and Virchow; does ‘the increase of a mediator or cytokine of some type,’ that ‘cry for attention from its array on the chip,’ constitute inflammation?
In the late 19th and early 20th century, Ilya Mechnikov’s and Paul Ehrlich’s work on cellular and humoral immunity established that the body uses both strategies to identify and destroy microbial invaders. At that time, the preponderant view shifted. It became understood that ‘inﬂammation served to defend us against microbes, not miasmas.’
Weissmann asks: What if ‘evolutionary inﬂammation was primarily designed to protect the species from lethal epidemics’; and ‘what if Metchnikoff’s little aggressors, the microbes, really are responsible’ for many conditions related to inflammation’? Weissman then links the old view describing inﬂammation in terms of 19th century warfare, such as ‘struggle’, ‘aggressor’, ‘invader’ etc., with our modern knowledge about ‘brigades of ILs, IFNs, inﬂammasomes, JAKs and the STATs’.