Association between Acute and Chronic Inflammatory States: A Case-Control Study

Abstract

Background Fever is the hallmark of efficient acute inflammatory response, which may be disrupted in chronic inflammatory conditions. The “continuum theory” proposes that the return of acute inflammatory states with high fever predicts improvement in chronic diseases during treatment. Our objective was to investigate the observation made, during classical homeopathic treatment, that such an association exists between chronic inflammation and efficient acute inflammation.

Methods In a case-control study, the reports of patients diagnosed with chronic inflammatory conditions with at least 6 months of follow-up under homeopathic treatment were retrospectively sampled from homeopathic medical practices from Greece, India, Romania and Russia. Twenty patients who improved under homeopathic treatment and 20 age-matched controls of those who did not improve were selected. The occurrence of common acute infectious diseases with fever during the follow-up period was investigated.

Results The average age of the cases and controls was 28.4 (SD: 16.64) and 27.9 (SD: 17.19) years respectively. 18/20 cases and 4/20 controls developed common infectious diseases with fever. Cramer's V co-efficient value was found to be 0.551 (p < 0.01), indicating that improvement was more in patients with fever than without. Odds ratio of improving with respect to development of acute infectious diseases was 36.0 (95% CI: 5.8 to 223.5). The binary logistic regression model indicated significant contribution of occurrence of acute infections with fever as a predictor for improvement in chronic inflammatory disease.

Conclusions Classical homeopathic clinical observations indicate an association between chronic inflammatory status in the body and the ability to mount efficient acute inflammation. In this case-control study, the occurrence of common infections with fever during treatment heralded improvement in chronic inflammatory disease. Further powered studies are necessary to substantiate this finding.

Keywords

inflammation - fever - homeopathy

Preprint

Initial ethical clearance for data collection was for a larger retrospective analysis of a clinical database including 11,800 cases, as described in a preprint publication: https://doi.org/10.22541/au.160269741.18547290/v1

The present study utilised data from the above repository for a different study design (case-control study) and its preprint is available online: https://doi.org/10.21203/rs.3.rs-2083679/v1, posted on November 22nd, 2022. The later alteration to the study's data analysis did not require specific additional ethical approval. Changes made to the current manuscript compared with the preprint were as follows:

The title was changed from “Correlation” to “Association” between Acute and Chronic Inflammatory States, a Case-control Study. The abstract is structured and the homeopathic paradigm was added to the hypothesis. Further clarification on inclusion/exclusion criteria, including clarity on the meaning of “chronic inflammatory state”, was added. Ethical clearance statements were clarified to reflect the nature of the original approval. The graphs in the Results section of the 20 cases and controls were removed as they did not add to the understanding of the findings. Statistical analysis was enhanced, along with the calculation of odds ratio, Pearson's chi square was calculated and correlational statistical analysis was performed. A binary logistic regression model was also developed and described in Results. The context of homeopathy was added to conclusions.

Availability of Data and Material

The datasets generated and/or analysed during the current study may be requested by writing to the authors.

Authors' Contributions

S.M., M.M., V.V., V.S., E.S., N.K., D.C., D.T., L.J., and A.J. were the primary physicians who collected and analysed the data. S.M. wrote the manuscript and attended to the referencing. G.V. is the approver and guarantor of the work. All authors read the final version of the manuscript and approved its submission to the journal.

Publication History

Received: 12 April 2023

Accepted: 05 October 2023

Article published online:
09 February 2024

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