A chronic, low-grade, systemic state characterized by the persistent elevation of inflammatory signaling molecules, such as specific cytokines and chemokines, in the absence of acute infection or trauma. This sustained inflammatory environment, often subclinical, disrupts normal cellular function, impairs hormone signaling, and is a foundational pathology for numerous chronic diseases, including cardiovascular disease and neurodegeneration. It is a critical target for longevity interventions.
Origin
This term is derived from immunology and pathology, recognizing that many chronic non-communicable diseases share a common root in persistent, unresolved inflammation. ‘Milieu’ refers to the internal environment or surrounding conditions, emphasizing the pervasive nature of the inflammatory state throughout the body. The concept is central to the theory of “inflammaging.”
Mechanism
The milieu is typically driven by factors like visceral adiposity, chronic stress, poor diet, and gut dysbiosis, which lead to the activation of immune cells and the NF-kappaB pathway. This activation results in the continuous transcription and release of pro-inflammatory cytokines like IL-6, TNF-alpha, and CRP. These circulating molecules then interfere with insulin receptor signaling and disrupt the delicate balance of the hypothalamic-pituitary axes, contributing to widespread endocrine dysfunction.
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