The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
inflammation / dental implant courses by Indian dental academy Indian dental academy
Description :
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Inflammation / dental implant courses by Indian dental academy Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
inflammation / dental implant courses by Indian dental academy Indian dental academy
Description :
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Inflammation / dental implant courses by Indian dental academy Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Localised protective response elicited by injury or destruction of tissues which serves to destroy , dilute or wall off (sequester) both injurious agent and the injured tissues (Dorlands medical dictionary). Cardinal signs of inflammation
Celsus 1st century AD
Rubor – redness
Tumor -swelling
Calor -heat
Dolor -pain
Virchow
“function laesa”- loss of function
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Localised protective response elicited by injury or destruction of tissues which serves to destroy , dilute or wall off (sequester) both injurious agent and the injured tissues (Dorlands medical dictionary). Cardinal signs of inflammation
Celsus 1st century AD
Rubor – redness
Tumor -swelling
Calor -heat
Dolor -pain
Virchow
“function laesa”- loss of function
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Sterilization and disinfection in dental clinics /certified fixed orthodontic...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Wound healing / dental implant courses by Indian dental academy Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
series of events which takes place at the time of acute inflammation includes two different kinds of, one at the vascular level and other one is at the cellular level. which works as the primary level of immunity protection and leads to the phagocytosis of the pathogenic microbes. The presence of foreign bodies such as bacteria within the bodies provokes a protective inflammatory response...characterized by redness, swelling, warmth and the pain at the site of infection. These signs are due to increased blood flow, increased capillary permeability and the escape of fluid and cells into the tissue spaces. The increased permeability is due to several chemical mediators of which histamines, prostaglandins and leukotriens are the most important ones.
Mistry Shivangi,M.Pharm Pharmacology, Assistant Professor, Bhagwan Mahavir College of Pharmacy, clinical sign of inflammation, type, chemical mediator of inflammation, wound healing
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
This is PPT is Second part of Hematology. It covers Hemostasis, Blood Clotting, Blood Groups and blood type, Rh system, Innate immunity and Adaptive immunity
Similar to Acute and chronic inflammation (1) / dental implant courses by Indian dental academy (20)
Opportunity for Dentists (BDS/MDS )to relocate to United kingdom -Register as a DENTAL HYGIENIST/ DENTAL THERAPIST without Board exams and after approval you can register in GDC as a DH/DT and start working as a DH/DT Immediately and get paid.
You can complete the whole process in 3-4 months.Salary range for DH/DT is around 2500-3500 Pounds per month.
Eligibility / requirements-
1. An International English Language Testing System (IELTS) certificate
at the appropriate level.(Within 2 yrs of application date )
2: A recent primary dental qualification that has been taught and examined in English..(Within 2 yrs of application date )
3: A recent pass in a language test for registration with a regulatory authority in a country where the first language is English.
If you are interested Please contact us for more details.
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...Indian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals
who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry,
Periodontics and General Dentistry.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
I –Aligners are made with FDA approved transparent thermoplastic materials using 3D scanning, 3D Printing and finally Trays with Pressure vacuum formers.
Dear Doctor,
Indian Dental Academy Now offers comprehensive online Orthodontics course.
Course includes:
1.whiteboard lecture presentations
2.Case Discussions
3.with hundreds of pictures.
4.Demo on Models
5.Demo on Patients
6. subtitles in your own language
12 months unlimited access and support @350 USD only.
For Demo please visit :www.idalectures.com/preview/
For more details visit: www.idalectures.com
Please contact us for any clarifications:
idalectures@gmail.com
indiandentalacademy@gmail.com
Thanks & Regards
Indian Dental Academy
--
Indian Dental Academy
Leader in continuing dental education
www.indiandentalacademy.com
skype:indiandentalacademy
+919248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Diagnosis and treatment planning in completely endntulous arches/dental coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Properties of Denture base materials /rotary endodontic coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Use of modified tooth forms in complete denture occlusion / dental implant...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
3. Introduction
Injurious stimuli cause a protective
vascular connective tissue reaction
called “inflammation”
Dilute
Destroy
Isolate
Initiate repair
Acute and chronic forms
www.indiandentalacdemy.com
4. Acute inflammation
Immediate and early response to tissue
injury (physical, chemical, microbiologic,
etc.)
Vasodilation
Vascular leakage and edema
Leukocyte emigration (mostly PMNs)
www.indiandentalacdemy.com
5. Vasodilation
Brief arteriolar vasoconstriction followed
by vasodilation
Accounts for warmth and redness
Opens microvascular beds
Increased intravascular pressure causes
an early transudate (protein-poor filtrate of
plasma) into interstitium (vascular
permeability still not increased yet)
www.indiandentalacdemy.com
6. Vascular leakage
Vascular permeability (leakiness)
commences
Transudate gives way to exudate (protein-
rich)
Increases interstitial osmotic pressure
contributing to edema (water and ions)
www.indiandentalacdemy.com
7. Vascular leakage
Five mechanisms known to cause
vascular leakiness
Histamines, bradykinins, leukotrienes
cause an early, brief (15 – 30 min.)
immediate transient response in the form
of endothelial cell contraction that widens
intercellular gaps of venules (not arterioles,
capillaries)
www.indiandentalacdemy.com
8. Vascular leakage
Cytokine mediators (TNF, IL-1) induce
endothelial cell junction retraction through
cytoskeleton reorganization (4 – 6 hrs post
injury, lasting 24 hrs or more)
Severe injuries may cause immediate
direct endothelial cell damage (necrosis,
detachment) making them leaky until they
are repaired (immediate sustained
response), or may cause delayed damage
as in thermal or UV injury,
www.indiandentalacdemy.com
9. Vascular leakage
(cont’d) or some bacterial toxins (delayed
prolonged leakage)
Marginating and endothelial cell-adherent
leukocytes may pile-up and damage the
endothelium through activation and release
of toxic oxygen radicals and proteolytic
enzymes (leukocyte-dependent endothelial
cell injury) making the vessel leaky
www.indiandentalacdemy.com
10. Vascular leakage
Certain mediators (VEGF) may cause
increased transcytosis via intracellular
vesicles which travel from the luminal to
basement membrane surface of the
endothelial cell
All or any combination of these events
may occur in response to a given
stimulus
www.indiandentalacdemy.com
11. Leukocyte cellular events
Leukocytes leave the vasculature routinely
through the following sequence of events:
Margination and rolling
Adhesion and transmigration
Chemotaxis and activation
They are then free to participate in:
Phagocytosis and degranulation
Leukocyte-induced tissue injury
www.indiandentalacdemy.com
12. Margination and Rolling
With increased vascular permeability, fluid
leaves the vessel causing leukocytes to
settle-out of the central flow column and
“marginate” along the endothelial surface
Endothelial cells and leukocytes have
complementary surface adhesion molecules
which briefly stick and release causing the
leukocyte to roll along the endothelium like a
tumbleweed until it eventually comes to a
stop as mutual adhesion reaches a peak
www.indiandentalacdemy.com
13. Margination and Rolling
Early rolling adhesion mediated by
selectin family:
E-selectin (endothelium), P-selectin
(platelets, endothelium), L-selectin
(leukocytes) bind other surface molecules
(i.e.,CD34, Sialyl-Lewis X-modified GP)
that are upregulated on endothelium by
cytokines (TNF, IL-1) at injury sites
www.indiandentalacdemy.com
14. Adhesion
Rolling comes to a stop and adhesion results
Other sets of adhesion molecules participate:
Endothelial: ICAM-1, VCAM-1
Leukocyte: LFA-1, Mac-1, VLA-4
(ICAM-1 binds LFA-1/Mac-1, VCAM-1 binds VLA-4)
Ordinarily down-regulated or in an inactive
conformation, but inflammation alters this
www.indiandentalacdemy.com
15. Transmigration (diapedesis)
Occurs after firm adhesion within the
systemic venules and pulmonary
capillaries via PECAM –1 (CD31)
Must then cross basement membrane
Collagenases
Integrins
www.indiandentalacdemy.com
16. Transmigration (diapedesis)
Early in inflammatory response mostly
PMNs, but as cytokine and chemotactic
signals change with progression of
inflammatory response, alteration of
endothelial cell adhesion molecule
expression activates other populations
of leukocytes to adhere (monocytes,
lymphocytes, etc)
www.indiandentalacdemy.com
17. Chemotaxis
Leukocytes follow chemical gradient to site of
injury (chemotaxis)
Soluble bacterial products
Complement components (C5a)
Cytokines (chemokine family e.g., IL-8)
LTB4 (AA metabolite)
Chemotactic agents bind surface receptors
inducing calcium mobilization and assembly
of cytoskeletal contractile elements
www.indiandentalacdemy.com
18. Chemotaxis and Activation
Leukocytes:
extend pseudopods with overlying surface
adhesion molecules (integrins) that bind
ECM during chemotaxis
undergo activation:
Prepare AA metabolites from phospholipids
Prepare for degranulation and release of
lysosomal enzymes (oxidative burst)
Regulate leukocyte adhesion molecule affinity
as needed
www.indiandentalacdemy.com
19. Phagocytosis and
Degranulation
Once at site of injury, leukocytes:
Recognize and attach
Engulf (form phagocytic vacuole)
Kill (degrade)
www.indiandentalacdemy.com
20. Recognition and Binding
Opsonized by serum complement,
immunoglobulin (C3b, Fc portion of IgG)
Corresponding receptors on leukocytes
(FcR, CR1, 2, 3) leads to binding
www.indiandentalacdemy.com
21. Phagocytosis and
Degranulation
Triggers an oxidative burst (next slide)
engulfment and formation of vacuole
which fuses with lysosomal granule
membrane (phagolysosome)
Granules discharge within
phagolysosome and extracellularly
(degranulation)
www.indiandentalacdemy.com
22. Oxidative burst
Reactive oxygen species formed
through oxidative burst that includes:
Increased oxygen consumption
Glycogenolysis
Increased glucose oxidation
Formation of superoxide ion
2O2 + NADPH → 2O2
-rad
+ NADP+
+ H+
(NADPH oxidase)
O2 + 2H+
→ H2O2 (dismutase)
www.indiandentalacdemy.com
23. Reactive oxygen species
Hydrogen peroxide alone insufficient
MPO (azurophilic granules) converts
hydrogen peroxide to HOCl-
(in
presence of Cl-
), an
oxidant/antimicrobial agent
Therefore, PMNs can kill by
halogenation, or lipid/protein
peroxidation
www.indiandentalacdemy.com
24. Degradation and Clean-up
Reactive end-products only active
within phagolysosome
Hydrogen peroxide broken down to
water and oxygen by catalase
Dead microorganisms degraded by
lysosomal acid hydrolases
www.indiandentalacdemy.com
25. Leukocyte granules
Other antimicrobials in leukocyte
granules:
Bactericidal permeability increasing protein
(BPI)
Lysozyme
Lactoferrin
Defensins (punch holes in membranes)
www.indiandentalacdemy.com
26. Leukocyte-induced tissue
injury
Destructive enzymes may enter
extracellular space in event of:
Premature degranulation
Frustrated phagocytosis (large, flat)
Membranolytic substances (urate crystals)
Persistent leukocyte activation (RA,
emphysema)
www.indiandentalacdemy.com
27. Defects of leukocyte function
Defects of adhesion:
LFA-1 and Mac-1 subunit defects lead to
impaired adhesion (LAD-1)
Absence of sialyl-Lewis X, and defect in E-
and P-selectin sugar epitopes (LAD-2)
Defects of chemotaxis/phagocytosis:
Microtubule assembly defect leads to
impaired locomotion and lysosomal
degranulation (Chediak-Higashi Syndrome)
www.indiandentalacdemy.com
28. Defects of leukocyte function
Defects of microbicidal activity:
Deficiency of NADPH oxidase that
generates superoxide, therefore no
oxygen-dependent killing mechanism
(chronic granulomatous disease)
www.indiandentalacdemy.com
29. Chemical mediators
Plasma-derived:
Complement, kinins, coagulation factors
Many in “pro-form” requiring activation
(enzymatic cleavage)
Cell-derived:
Preformed, sequestered and released
(mast cell histamine)
Synthesized as needed (prostaglandin)
www.indiandentalacdemy.com
30. Chemical mediators
May or may not utilize a specific cell surface
receptor for activity
May also signal target cells to release other
effector molecules that either amplify or
inhibit initial response (regulation)
Are tightly regulated:
Quickly decay (AA metabolites), are inactivated
enzymatically (kininase), or are scavenged
(antioxidants)
www.indiandentalacdemy.com
31. Specific mediators
Vasoactive amines
Histamine: vasodilation and venular
endothelial cell contraction, junctional
widening; released by mast cells,
basophils, platelets in response to injury
(trauma, heat), immune reactions (IgE-
mast cell FcR), anaphylatoxins (C3a, C5a
fragments), cytokines (IL-1, IL-8),
neuropeptides, leukocyte-derived
histamine-releasing peptides
www.indiandentalacdemy.com
32. Specific mediators
Serotonin: vasodilatory effects similar to
those of histamine; platelet dense-body
granules; release triggered by platelet
aggregation
Plasma proteases
Clotting system
Complement
Kinins
www.indiandentalacdemy.com
33. Clotting cascade
Cascade of plasma proteases
Hageman factor (factor XII)
Collagen, basement membrane, activated
platelets converts XII to XIIa (active form)
Ultimately converts soluble fibrinogen to
insoluble fibrin clot
Factor XIIa simultaneously activates the
“brakes” through the fibrinolytic system to
prevent continuous clot propagation
www.indiandentalacdemy.com
34. Kinin system
Leads to formation of bradykinin from
cleavage of precursor (HMWK)
Vascular permeability
Arteriolar dilation
Non-vascular smooth muscle contraction
(e.g., bronchial smooth muscle)
Causes pain
Rapidly inactivated (kininases)
www.indiandentalacdemy.com
35. Complement system
Components C1-C9 present in inactive form
Activated via classic (C1) or alternative (C3)
pathways to generate MAC (C5 – C9) that punch
holes in microbe membranes
In acute inflammation
Vasodilation, vascular permeability, mast cell
degranulation (C3a, C5a)
Leukocyte chemotaxin, increases integrin avidity (C5a)
As an opsonin, increases phagocytosis (C3b, C3bi)
www.indiandentalacdemy.com
36. Specific Mediators
Arachidonic acid metabolites
(eicosanoids)
Prostaglandins and thromboxane: via
cyclooxygenase pathway; cause
vasodilation and prolong edema; but also
protective (gastric mucosa); COX blocked
by aspirin and NSAIDS
www.indiandentalacdemy.com
37. Specific Mediators
Leukotrienes: via lipoxygenase pathway;
are chemotaxins, vasoconstrictors, cause
increased vascular permeability, and
bronchospasm
PAF (platelet activating factor)
Derived also from cell membrane
phospholipid, causes vasodilation,
increased vascular permeability, increases
leukocyte adhesion (integrin conformation)
www.indiandentalacdemy.com
38. More specific mediators
Cytokines
Protein cell products that act as a message
to other cells, telling them how to behave.
IL-1, TNF-α and -β, IFN-γ are especially
important in inflammation.
Increase endothelial cell adhesion
molecule expression, activation and
aggregation of PMNs, etc., etc., etc.
www.indiandentalacdemy.com
39. Specific mediators
Nitric Oxide
short-acting soluble free-radical gas with
many functions
Produced by endothelial cells,
macrophages, causes:
Vascular smooth muscle relaxation and
vasodilation
Kills microbes in activated macrophages
Counteracts platelet adhesion, aggregation,
and degranulation
www.indiandentalacdemy.com
40. Specific mediators
Lysosomal components
Leak from PMNs and macrophages after
demise, attempts at phagocytosis, etc.
Acid proteases (only active within
lysosomes).
Neutral proteases such as elastase and
collagenase are destructive in ECM.
Counteracted by serum and ECM anti-
proteases.
www.indiandentalacdemy.com
41. Possible outcomes of acute
inflammation
Complete resolution
Little tissue damage
Capable of regeneration
Scarring (fibrosis)
In tissues unable to regenerate
Excessive fibrin deposition organized into
fibrous tissue
www.indiandentalacdemy.com
42. Outcomes (cont’d)
Abscess formation occurs with some
bacterial or fungal infections
Progression to chronic inflammation
(next)
www.indiandentalacdemy.com
43. Chronic inflammation
Lymphocyte, macrophage, plasma cell
(mononuclear cell) infiltration
Tissue destruction by inflammatory cells
Attempts at repair with fibrosis and
angiogenesis (new vessel formation)
When acute phase cannot be resolved
Persistent injury or infection (ulcer, TB)
Prolonged toxic agent exposure (silica)
Autoimmune disease states (RA, SLE)
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44. The Players (mononuclear
phagocyte system)
Macrophages
Scattered all over (microglia, Kupffer cells,
sinus histiocytes, alveolar macrophages,
etc.
Circulate as monocytes and reach site of
injury within 24 – 48 hrs and transform
Become activated by T cell-derived
cytokines, endotoxins, and other products
of inflammation
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45. The Players
T and B lymphocytes
Antigen-activated (via macrophages and
dendritic cells)
Release macrophage-activating cytokines
(in turn, macrophages release lymphocyte-
activating cytokines until inflammatory
stimulus is removed)
Plasma cells
Terminally differentiated B cells
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46. The Players
Produce antibodies
Eosinophils
Found especially at sites of parasitic
infection, or at allergic (IgE-mediated) sites
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47. Granulomatous Inflammation
Clusters of T cell-activated
macrophages, which engulf and
surround indigestible foreign bodies
(mycobacteria, H. capsulatum, silica,
suture material)
Resemble squamous cells, therefore
called “epithelioid” granulomas
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48. Lymph Nodes and Lymphatics
Lymphatics drain tissues
Flow increased in inflammation
Antigen to the lymph node
Toxins, infectious agents also to the node
Lymphadenitis, lymphangitis
Usually contained there, otherwise bacteremia
ensues
Tissue-resident macrophages must then
prevent overwhelming infection
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49. Patterns of acute and chronic
inflammation
Serous
Watery, protein-poor effusion (e.g., blister)
Fibrinous
Fibrin accumulation
Either entirely removed or becomes fibrotic
Suppurative
Presence of pus (pyogenic staph spp.)
Often walled-off if persistent
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