inflamation - 3


Inflammation is a complex response that indicates the surrounding tissue that something is going wrong.

Can be a response to damage or an Immune Process.

An increase of blood flows to the particular area is observed.

A foreign object, pathogen, irritant, or damage may be seen.

Is both a protective measure as well as a factor that begins the healing process.

Without Inflammation, it would be virtually impossible for a wound to heal.

But chronic inflammation can lead to serious consequences as well.

Therefore the body will typically closely monitor and control inflammation – to start it on time and
to stop the chronic occurrence as well.


1.  Acute Inflammation

–  Cellular response of monocytes and macrophages
–  Immediate response to cause
–  Few days is expected for response
–  Often will be resolved shortly
–  May turn into chronic inflammation

2.)  Chronic Inflammation

–  Cellular response of monocytes, macrophages, fibroblast, lymphocytes, plasma cells and other.
–  Response is typically delayed and may occur a time amount after involvement.
–  Duration can be weeks to months to years.
–  If severe enough tissue can be damaged.

Causes of inflammation

–  Physical injury
–  Virus infection
–  Other infections
–  Bacteria infection
–  Hypersensitivity
–  Burns
–  Frostbite
–  Chemical irritants
–  Foreign bodies
–  Arthritis
–  many others

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5 main signs

1.) Rubor (redness)
2.) Calor  (increased heat)
3.) Tumor  (swelling)
4.) Dolor  (pain)
5.) Functio laesa  (loss of function)


–  Caused by molecules such as protein, fibrin, and immunoglobulins into tissue.
–  Dilation and increased permeability of the blood vessels is seen.
–  Fluid enters the tissue causing swelling.

Vascular changes

1.) Vasodilation
2.) Slowing of blood flow

–  The result of these changes include redness and heat around the inflammation.
–  Both are more often seen than not.
–  Stasis occurs– this allows cell that help fight infection to cross from the passage way of the arteries to the targeted tissues where the infection or trauma has occurred.

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Inflammation Classifications:

1.) Purulent Inflammation

–  Results in a large amount of “pus”
–  Pus consists of large amount of neutrophils, dead cells, fluid and other molecules.
–  Typical infection is staphylococci
–  Abscess or boils can be seen in the surrounding tissues

2.) Serous inflammation

–  Results in a minimal to large amount of clear to cloudy colored fluid
–  Not as far along as having “pus”
–  Produced by mesothelial cells
–  May be caused by blood plasma
–  Blisters are an example

3.)  Granulomatous Inflammation

–  Formation of granulomas
–  Is a collection of immune cells such as macrophages
–  The body attempts to wall off the area
–  Typically is a small nodule
–  Pathology report will differentiate between this and other disease processes
–  Is seen in a variety of diseases

4.) Fibrinous Inflammation

–  Large amount of the molecule fibrin enters that inflammation area
–  Results in a cavity formation
–  Fibrin is deposited in the area

5.)  Ulcerative Inflammation

–  Damage or ulceration of the tissue involved
–  The top lay over the epithelium is damaged
–  This exposes the lower layers
–  Ulcers are formed

Many Cells, proteins, or moleucles are involved in inflammation:

 1.)  Bradykinin 

–  A protein that helps with vasodilation and smooth muscle contraction.
–  Often results in pain

2.)  Plasmin 

–  Helps break down clots and activates Factor XII

3.)  Thrombin

–  Breaks down fibrinogen molecule
–  Helps form blood clots

4.)  C3 

–  Produces C3a and C3b
–  Causes histamine response
–  Causes target control of bacteria which leads to an attack on the bacteria

5.)  C5a 

–  Causes histamine response

6.)  Factor XII 

–  Protein that activates the plasma systems


Factors involved in mediating inflammation

1.)  Histamines

–  Are released by certain cells (Mast cells, Basophils and platelets)
–  This releases often causes the inflammation process to begin

2.)  Lysosome granules 

–  Enzyme action that causes breakdown of substances.
–  Helps mediate inflammation

3.)  Nitric Oxide 

–  Released from Macrophages and Endothelial cells
–  Relaxes smooth muscles
–  Causes a decrease in platelet aggregation  (grouping)
–  Help increase the recruitment of Leukocytes
–  Increases vasodilation

4.)  Prostaglandins 

–  Arise from Mast Cells
–  Can cause pain
–  Can result in fever
–  Increases vasodilation

5.) TNF-alpha 

–  Released from Macrophages
–  Can result in fever
–  Increases production of cytokines
–  Causes Leukocyte adherence
–  May increase heart rate
–  May decrease appetite

6.)  IL-1 

–  Released from Macrophages
–  Can result in fever
–  Increases production of cytokines
–  Causes Leukocyte adherence
–  May increase heart rate
–  May decrease appetite

7.)  IL-8

–  Released from Macrophages
–  Causes attraction of Neutrophils

8.)  IFN-Y

–  Complicated response
–  Helps in the maintenance of chronic inflammation
–  Has antiviral properties
–  Has anti-tumor properties



Cells involved in inflammation

1.)  Leukocytes

–  Must get from the blood circulation to the site of inflammation
–  This process is known as “Extravasation”

1.) Localization and Recruitment  –  become attached to the side of arterial wall
2.) Migration –  the movement between the blood vessel wall and into the adjacent tissue
3.) Chemotaxis within the tissue  –  Attraction allows this cell to move within the tissue to
the source of inflammation

2.)  Phagocytosis

–  Cells that take bacteria, viruses, dead or damaged cells, debris, parasites and other particles/molecules and destroyed them.
–  Several cells, acids, factors, processes are involved

3.)  Monocytes

–  Type of white blood cell
–  They replenish macrophages and dendritic cells
–  Help with immune response at the site of inflammation

4.)  Termination of inflammation

–  This process must be turned off in order to end properly
–  When this does not occur the result is often chronic inflammation along with the potential for tissue damage

5.)  TGF-beta

– Released by macrophages

6.)  Anti-inflammatory Lipoxins

7.)  Prostaglandins

8.)  Leukotrines


Several disorders associated with Inflammation exist

Allergic reactions and immune system disorders are seen in this category

Is a rather broad category


–  Asthma
–  Allergies
–  Autoimmune disorders
–  Artherosclerosis
–  Cancers
–  Chronic prostatitis
–  Crohn’s DiseasePelvic Inflammatory Disease
–  Rheumatoid
–  Arthritis
–  Ulcerative Colitis
–  others


Anti-Inflammatory medication

Treatment options that reduce inflammation include:

–  Rest
–  Ice
–  Elevation
–  Ace Wrap



1.)  Steroids

2.)  Non-Steroidal Anti-Inflammatory Drugs

–  Also referred to as NSAIDs
–  Method of Action:  –  affecting cyclooxygenase (COX) enzymes
–  Prevents the synthesis of prostaglandins
–  Cox-I and Cox-II are affected

.   Ibuprofen (IBU, Motrin)
.   Naproxen
.   Diclofenac
.   Sulindac

3.)  COX-2 Inhibitiors

.   Celecoxib  (Celebrex)  –  FDA alert

4.)  Cancelled medications

.   Etoricoxib  [Withddrawn by FDA]
.   Valdecoxib (Bextra)  [Withddrawn by FDA]
.   Rofecoxib  (Vioxx) [Withddrawn by FDA]

5.)  Aspirin

.   Affects Cox-1
.   Stops platelet aggregation  (grouping)

6.)  Herbs

.   Ginger
.   Willow bark
.   Arnica montana
.   Turmeric


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