The clinical process of reducing the overall burden of chronic, low-grade, systemic inflammation within the body, often referred to as the ‘inflammatory milieu.’ Attenuation aims to shift the physiological state away from a pro-inflammatory baseline toward a more homeostatic, anti-inflammatory one. This is a critical therapeutic objective in longevity and hormonal health, as chronic inflammation is a known driver of metabolic dysfunction, cellular senescence, and age-related disease progression.
Origin
This terminology merges the immunological concept of ‘inflammation’ with the clinical strategy of ‘attenuation,’ which means to reduce the force or effect of something. The term ‘milieu’ emphasizes the pervasive, systemic nature of this chronic inflammatory state, which is distinct from acute inflammation. Its prominence in clinical practice grew from the recognition of inflammaging, the age-related increase in pro-inflammatory markers.
Mechanism
Attenuation is achieved by modulating the expression and activity of key pro-inflammatory cytokines, such as Interleukin-6 (IL-6) and Tumor Necrosis Factor-alpha (TNF-α). This often involves nutritional and pharmacological interventions that target nuclear factor kappa B (NF-κB) signaling, a master regulator of the inflammatory response. Furthermore, enhancing gut barrier function and promoting the resolution phase of inflammation are essential components of effectively calming the systemic inflammatory environment.
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