Basic and Clinical Immunology for the Busy Clinician

Basic and Clinical Immunology for the Busy Clinician

Issue: April 2020
Disclosures: Calabrese report consulting as well as teaching and speaking fees from AbbVie, Bristol-Myers Squibb, Genentech/Roche, Janssen and Novartis; consulting fees from GlaxoSmithKline, Horizon, Pfizer, Regeneron, Sanofi Aventis and UCB; and teaching and speaking fees from Crescendo.
March 04, 2020
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Behavioral, Lifestyle Choices are ‘Cornerstone’ of Immune Health

Issue: April 2020
Disclosures: Calabrese report consulting as well as teaching and speaking fees from AbbVie, Bristol-Myers Squibb, Genentech/Roche, Janssen and Novartis; consulting fees from GlaxoSmithKline, Horizon, Pfizer, Regeneron, Sanofi Aventis and UCB; and teaching and speaking fees from Crescendo.
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Leonard H. Calabrese, DO
Leonard H. Calabrese

SCOTTSDALE, Ariz. — Of all the sources of chronic inflammation, from immune aging to chronic infections and developmental factors, lifestyle and behavioral choices represent the “cornerstone” of good immune health, as they can actually be controlled by the patient, according to Leonard H. Calabrese, DO, of the Cleveland Clinic.

“Some of the sources of this chronic inflammation are things we have total control over, like how we diet and how we exercise, as well as some things we may have less control over, such as our stresses and our sleep,” Calabrese, who is RJ Fasenmyer chair of clinical immunology at the Cleveland Clinic, and chief medical editor of Healio Rheumatology, told attendees at the Basic and Clinical Immunology for the Busy Clinician annual symposium.

Further, while he stressed that age, and the immune changes that occur as people age, continues to be the biggest risk factors for most chronic diseases, the links between sleep and immune health are “startling.”

“The data on sleep and immune health, and the connection between sleep and health in general, is actually startling,” he said. “If you look at three populations — those who get less than 6 hours of sleep, those who get 6 to 9 hours and those who get more than 9 hours — it’s kind of a bell-shaped curve. The data are much stronger on the low-sleep end.”

 
Of all the sources of chronic inflammation, from immune aging to chronic infections and developmental factors, lifestyle and behavioral choices represent the “cornerstone” of good immune health, as they can actually be controlled by the patient, according to Calabrese.
Source: Healio Rheumatology

“There are a lot of people who brag about how little sleep they get, and there are a lot of societies that deprive people of sleep because of the way their schedules work,” he added. “However, in poor sleep, particularly the kind associated with non-refreshing sleep, that is low in hours, the mortality is stronger than immune health graphs or Framingham Risk Score. It’s profound.”

According to Calabrese, basic sleep hygiene can mitigate these effects. This can include refraining from watching television or reading with artificial light — such as from a computer or phone — before going to bed, and reserving the bed itself for “sleeping and sex,” rather than for lounging and relaxation.

Other important immune health factors include diet, exercise and mental-spiritual health, he added. He characterized the typical modern Western diet as a “danger signal to the immune system, and noted some evidence that suggests a “fasting-mimicking diet” could reduce some markers and risk factors for aging and age-related diseases.

Calabrese also stated there is strong evidence of an associated physical inactivity and all-cause mortality. Physical inactivity is linked to obesity, inflammation and inflammatory cytokines, he said.

These inflammatory cytokines, such as TNF and IL-6, induce fat and liver insulin resistance and lipolysis, and contribute to accelerated aging, autoimmune disease, cancer, cardiovascular disease and neurodegenerative diseases.

To lower their risk, Calabrese said providers, fitness professionals and public health practitioners should encourage adults to adopt and maintain physical activity at recommended levels.

“If you look at how we lived 300 years ago, it’s unrecognizable to how we live today,” Calabrese said. “We slept differently, we ate food that was real food, our stresses were different. Now, we are in an evolutionary mismatch. Our genes are the same as they were 300 years ago, and this may be a driver of systemic chronic inflammation. Diet is important, but so is exercise, sleep and mental and spiritual health.” – by Jason Laday

Reference:

Calabrese L. Human behavior and immunity — slowing out aging? Presented at: Basic and Clinical Immunology for the Busy Clinician; Feb. 28-29, 2020; Scottsdale, Arizona.

Disclosure: Calabrese report consulting as well as teaching and speaking fees from AbbVie, Bristol-Myers Squibb, Genentech/Roche, Janssen and Novartis; consulting fees from GlaxoSmithKline, Horizon, Pfizer, Regeneron, Sanofi Aventis and UCB; and teaching and speaking fees from Crescendo.