ABSTRACT
Inflammatory and immunologic mechanisms at the endothelial level are the driving force behind cardiovascular disease, especially atherosclerosis and its clinical sequelae. Originally identified in the 1870s as a lipid-storage disease of the arterial wall, atherosclerosis was recognized as a chronic inflammatory disease in 1986.
Therapeutic decision making for the clinician must take into account the differentiation of cardiac inflammation from systemic inflammation. The causes of cardiac inflammation may vary depending on the part of the heart that is affected—the endocardium, the myocardium, or the pericardium. However, a wheat related disorder has been identified as initiating inflammation in cardiac tissue by at least 7 different mechanisms. We now recognize CVD as an acute presentation of a chronic inflammatory disease. Thus, the clinician now is faced with separate, distinct, necessary lines of thought—stabilize the acute manifestations and address the underlying chronic inflammation. Since the 1950s, the worldwide increase in loss of immune tolerance to wheat has exploded! With its global impact in the body and lack of isolated tissue vulnerability, a high degree of suspicion is required for a clinician to investigate a presenting patient for a WRD. This Chapter will summarize the mechanisms of an inflammatory cascade which may occur secondary to a wheat related disorder.
