Many of the major medical conditions that we face in our lives share an underlying cause: chronic inflammation.

In fact, it’s the single largest driver of disease and disability. For years, therapies have been aimed at treating the symptoms of chronic inflammation, but existing therapies do not act to prevent disease progression or directly treat the disease pathway without severely impacting the immune system.

There stands a large opportunity to develop preventative therapeutics that tackle chronic inflammation before it leads to disease progression and to treat diseases at their source. We will break down our analysis today by discussing startups that are tackling holistic approaches, which create solutions to treat and prevent chronic inflammation, as well as systemic approaches where companies are working to use specific pathways and an organ system to develop a curative treatment for chronic inflammation. And in today’s deep dive, we’ll really explore companies that are developing therapies to prevent and cure chronic inflammation.

What is inflammation?

Inflammation is a process where the immune system recognizes and removes harmful stimuli, whether that’s from infection or injury and begins the healing process and a normal acute inflammatory response. We’ll see increased activity in the immune system when a threat is present and that will resolve once the threat has passed.

In cases of chronic inflammation, there are factors such as social, psychological, environmental, or biological that prevent the resolution of that acute inflammation. The result? Systemic chronic inflammation. It’s essentially like a problem that never gets resolved, so it remains in an inflamed state waiting for resolution.

We see this in diseases ranging from cardiovascular, to autoimmune to neurological and more.

The trouble with chronic inflammation

Chronic inflammatory diseases have been recognized as the most significant cause of death in the world today, with more than 50% of deaths being attributable to inflammation-related diseases. This includes conditions such as heart disease, stroke, cancer, diabetes, chronic kidney disease, autoimmune and neurodegenerative conditions and more.

It is far more common – and deadly – than many people realize.

For example, LDL cholesterol is inflammatory and often gets recognized by the immune system after it’s oxidized, which can lead to heart disease. It’s the same thing in diabetes. Several large observational studies have shown that patients with high levels of C reactive protein, which is a measurement of inflammation, are more likely to develop insulin resistance. In addition, researchers have discovered that in patients with type two diabetes cytokine levels are elevated inside fat tissue and excess body fat, especially in the abdomen. This can cause continuous chronic low levels of abnormal inflammation, which alters insulin activity kind of contributes to diabetes.

Overall, chronic inflammation is a leading driver of the nation’s $3.5 trillion in annual healthcare costs.

The good news is that we already know what causes most chronic inflammation. Lifestyle factors including inactivity, poor diet, harmful environmental factors, industrial toxicants and psychological stress are at the root of most of these issues.

However, we’re not likely to see any decreases in these causes anytime soon. That’s because another key contributor to chronic inflammation is literally impossible to stop: aging. The aging process overall has been found to be a general inflammatory cause that involves the whole body and provokes the diseases we associate with age, including Alzheimer’s, atherosclerosis, cancer and more.

New therapeutic solutions

The fact is, the effects of chronic inflammation can be observed throughout life and are known to increase the risk of death. That means we really need to find strategies for early diagnosis, prevention and treatment of chronic inflammation.

Existing solutions to tackle inflammation are typically focused on treating symptoms and sometimes adversely affect the immune system. Steroids are among the more commonly used anti-inflammatories and they work by suppressing inflammation and treat symptoms but do not prevent the underlying inflammatory condition. This causes patients to often become reliant on them to manage their symptoms, and this can lead to unpleasant side effects. Steroids, for example, can cause fluid retention, weight gain and high blood pressure after just short-term use. Over the long-term, patients experience cataracts, high blood sugar, elevated osteoporosis risk and more.

There are alternatives, however.

DMARDs (Disease Modifying Anti-Rheumatic Drugs) are immunosuppressives that are designed to slow damage to tissues or organs. By targeting the immune system, they generally interfere in combinations of critical pathways in the inflammatory cascade.

Biologics are a subset of the DMARDs that are usually engineered drugs designed to block cytokines, which are the proteins needed to cause an immune response.

Regardless of the solution, the market for anti-inflammation therapeutics is large and growing, expected to reach $106 billion this year. Therapeutics are valuable because they can play a large role in helping to prevent and cure inflammation before disease progression can occur. This could represent a huge decrease in the cost of our healthcare system and an improvement in the quality of patient’s lives.

However, getting to this future will require new approaches to targeting inflammation. On this podcast we look at what this means for drug developers, physicians, patients and more, and what’s coming next in the world of inflammation therapeutics.