The Fuel that Feeds the Flames

Off

Chronic inflammation has been hailed by some as a new ‘unifying theory’ of disease with the potential to not only transform our understanding of the causes of disease but also to improve risk assessment and prevention and to inform the management of a wide range of degenerative conditions. This approach to understanding the ‘epidemic’ of degenerative disease, marked by inequalities related to class, race, age, and gender, opens up new lines of enquiry and action for scientists, clinicians, public health researchers and policy makers.

There is also a growing public awareness of the connection between inflammation and health, with popular discourse emphasizing the importance of adopting an anti-inflammatory lifestyle by way of diet, supplements, exercise, and managing exposure to potential inflammatory agents. This offers people the promise that the power to reduce or even prevent degenerative diseases is in their control.

These are producing a broader ‘anti-inflammatory imaginary’. In this context, the ‘imaginary’ is a shared vision of the future where chronic inflammation is key to understanding and managing degenerative conditions and this guides and coordinates biomedical research, clinical work, and shapes public and popular culture framings of degenerative disease.

This Wellcome Trust-funded programme, led by Dr Julia Swallow, and with Dr Andrew Bartlett as RF, is a 6-year qualitative research project that will produce the first sociological account of chronic inflammation as ‘medicine’s new frontier’ and of how this is changing the ways in which degenerative disease is understood, approached, and managed. 

Research

This project has three ‘work strands’:

These three areas cover the bench, the bedside, and beyond. It might seem that these exist in a straight line - from bench, to bedside, and on to beyond - this is not necessarily the case. Through qualitative research we will explore the ways in which our understanding of the relationship between chronic inflammation and health and illness is constituted by work across, and at the intersection of, these domains.

The fieldwork concentrates on four disease case studies where inflammation is emerging as a key site of study and in clinical practice; multiple sclerosis, rheumatoid arthritis, Alzheimer’s disease, and cancer. Comparison between them will enable examination of how a focus on inflammation represents a possible shift in disease knowledge, understandings, perspectives, and experiences.

All four degenerative conditions are increasingly associated with lifestyle, for example, smoking and obesity and are the focus of research into the role of infection and chronic inflammation.

This research has been reviewed by ethics committees within the University of Sheffield and the NHS.

Bench: Chronic inflammation in the laboratory

This strand involves qualitative interviews with scientists and ethnographic observation of laboratory work, seminars, workshops, and conferences. We will examine the way in which chronic inflammation is understood and approached within scientific communities, as well as scientists’ perspectives on public and popular cultural discourse around inflammation.

Bedside: Chronic inflammation in the clinic and as therapeutic intervention

This strand involves interviews with clinicians and clinical researchers, patients, and their accompanying persons, as well as observations of clinical settings. We will examine changing understandings of disease classification, risk and management, and the way in which ‘inflammation’ figures as part of the embodied experiences of degenerative and debilitating conditions. 

Beyond: Chronic inflammation in public and popular culture discourse

This strand traces public and popular culture discourse concerning chronic inflammation and degenerative disease. We will describe the emergence of anti-inflammatory discourse and how it is related to wider (biomedical) understandings and framings of health, illness, and degenerative disease. This will involve research on ‘inflammation’ in (social) media, as well as interviews with ‘lay experts’, i.e. people living with the four conditions and active in patient organisations and disease charities.