What medicine has long ignored about healing

A recent discovery has changed our understanding of how inflammation ends

One morning in 1984, in an Australian hospital, a man was doubled over in pain.

Nausea, vomiting, burning stomach. The symptoms of acute gastritis, an inflammation of the stomach lining.

And Barry Marshall knows exactly why he's sick, because he made himself sick. A few days earlier, he swallowed a glass full of bacteria in one gulp.

He wanted to prove something that almost no one believed. At the time, stomach ulcers were mainly explained by stress, anxiety, excess acidity, and a stressful lifestyle. Patients were treated with medications that reduced this acidity.

Marshall, for his part, was convinced that a bacterium played a central role. But the idea was poorly received. For many doctors at the time, imagining that a microbe could cause an ulcer seemed as absurd as claiming that the Earth was flat.

So he drank the potion. He fell ill, exactly as he had predicted. This was only the first piece of evidence, and it took the work done with his colleague Robin Warren, and then further studies, to truly establish it. But little by little, a deeply entrenched explanation began to be challenged. In 2005, Marshall and Warren received the Nobel Prize.

This story is not an exception. Medicine often progresses in this way: an explanation seems obvious for years, until a discovery forces us to look at the mechanism differently.

A few years later, another mechanism that was thought to be well understood would also be looked at in a new light: the way in which inflammation ends.

We knew very well how to ignite the flames

For a very long time, research has focused on understanding how inflammation begins.

And we know this well today. An injury, an infection, any kind of aggression. The body reacts, sends out its defense cells, triggers heat, swelling, redness. This lengthy warning mechanism has been studied in detail.

But what followed was much less interesting.

We assumed it would happen naturally. The danger disappears, the warning signs diminish, the defense cells withdraw, and everything returns to normal. A natural extinction. Like a fire that dies out once it has consumed everything it had to burn.

This phase was long described as an essentially passive extinction. Then research showed that it also had its own biology.

Researchers have gradually identified molecules produced by the body, including resolvins, protectins and maresins, which participate in another phase of the response: limiting its prolongation, organizing the cleanup of debris and helping the tissue regain its balance.

The end of inflammation is therefore not a simple exhaustion. It is an organized process.

What does the body do when it finishes an inflammation?

What exactly happens when the body stops an inflammation?

In reality, finishing properly requires almost as much work as starting the process.

Let's consider a fire department intervention. A fire under control doesn't mean everything is over. It's still necessary to stop sending reinforcements that are no longer needed, evacuate what has burned, clear the rubble, and begin repairing what can be salvaged.

The body does exactly that. It stops calling new defense cells to the area. It eliminates those that have done their job and are no longer needed. Other cells, responsible for cleaning, come in to absorb the debris. And the tissue, once cleared, can enter its repair phase.

This concluding work has a name: resolution.

And it helps us understand a subtle but important distinction. Inhibiting