This document summarizes acute and chronic inflammation. It describes the immediate response to tissue injury, including vasodilation, vascular leakage leading to edema, and leukocyte emigration. It then details the mechanisms of vascular leakage, leukocyte adhesion and transmigration, chemotaxis, phagocytosis, and the roles of inflammatory mediators like histamine, kinins, complement, eicosanoids, cytokines, and nitric oxide. Chronic inflammation is characterized by mononuclear cell infiltration and attempts at repair that can lead to fibrosis. Complications include abscess formation or progression to chronic inflammation and granuloma formation.
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
Acute and chronic inflammation (1) / dental implant courses by Indian 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
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.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.
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
Acute and chronic inflammation (1) / dental implant courses by Indian 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
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.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.
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.
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
Dr. ihsan edan abdulkareem alsaimary
PROFESSOR IN MEDICAL MICROBIOLOGY AND MOLECULAR IMMUNOLOGY
ihsanalsaimary@gmail.com
mobile : 009647801410838
university of basrah - college of medicine - basrah -IRAQ
Biochemistry of Hair fall, A complete review of hair fall cause, Types, Current methods of treatment, Natural methods of treatment,
for more detail text see :https://iiopinion.blogspot.in/2017/01/hair-fall-scientific-way-of-treatment.html
Non-Specific Immune Response, Innate immunity, inherent immunity, Role in overall immunity of individual, Significance, components involve in Non-Specific Immune Response,
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
Telegram: bmksupplier
signal: +85264872720
threema: TUD4A6YC
You can contact me on Telegram or Threema
Communicate promptly and reply
Free of customs clearance, Double Clearance 100% pass delivery to USA, Canada, Spain, Germany, Netherland, Poland, Italy, Sweden, UK, Czech Republic, Australia, Mexico, Russia, Ukraine, Kazakhstan.Door to door service
Hot Selling Organic intermediates
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
4. Immediate and early
response to tissue
injury (physical,
chemical,
microbiologic, etc.)
Vasodilation
Vascular
leakage and
edema
Leukocyte
emigration
(mostly PMNs)
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)
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)
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, or
some bacterial toxins (delayed prolonged
leakage)
9. Vascular 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
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
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
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
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
14. Adhesion
Rolling comes to a stop
and adhesion results
• Endothelial: ICAM-1, VCAM-1
• Leukocyte: LFA-1, Mac-1, VLA-4
• (ICAM-1 binds LFA-1/Mac-1, VCAM-1 binds
VLA-4)
Other sets of adhesion
molecules participate:
Ordinarily down-
regulated or in an
inactive conformation,
but inflammation
alters this
15. Transmigration (diapedesis)
Occurs after firm
adhesion within the
systemic venules and
pulmonary capillaries
via PECAM –1 (CD31)
Must then cross
basement membrane
CollagenasesIntegrins
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)
17. Chemotaxis
• Soluble bacterial products
• Complement components (C5a)
• Cytokines (chemokine family e.g.,
IL-8)
• LTB4 (AA metabolite)
Leukocytes
follow chemical
gradient to site
of injury
(chemotaxis)
Chemotactic agents bind
surface receptors inducing
calcium mobilization and
assembly of cytoskeletal
contractile elements
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
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
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)
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)
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
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
25. Leukocyte granules
Other antimicrobials in leukocyte granules:
• Bactericidal permeability increasing protein (BPI)
• Lysozyme
• Lactoferrin
• Defensins (punch holes in membranes)
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)
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)
30. 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)
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
Serotonin: vasodilatory effects similar to those of histamine;
platelet dense-body granules; release triggered by platelet
aggregation
Plasma proteases
• Clotting system
• Complement
• Kinins
32. Clotting cascade
• 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
Cascade of
plasma
proteases
33. • Vascular permeability
• Arteriolar dilation
• Non-vascular smooth muscle
contraction (e.g., bronchial
smooth muscle)
• Causes pain
• Rapidly inactivated
(kininases)
Leads to
formation
of
bradykinin
from
cleavage of
precursor
(HMWK)
34. 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)
36. • 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)
37. Cytokines
• Protein cell products that act as a message to other
cells, telling them how to behave.
• IL-1, TNF- and -, IFN- are especially important
in inflammation.
• Increase endothelial cell adhesion molecule
expression, activation and aggregation of PMNs,
etc., etc., etc.
38. 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
39. 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.
40. Complete resolution
• Little tissue damage
• Capable of regeneration
Scarring (fibrosis)
• In tissues unable to regenerate
• Excessive fibrin deposition organized into fibrous
tissue
41. Abscess formation occurs with some
bacterial or fungal infections
Progression to chronic inflammation
(next)
42. 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)
43. 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
44. 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
46. 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
47. 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
48. 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
49. Ulceration
• Necrotic and eroded epithelial surface
• Underlying acute and chronic inflammation
• Trauma, toxins, vascular insufficiency
50. Fever
• One of the easily recognized cytokine-mediated
(esp. IL-1, IL-6, TNF) acute-phase reactions
including
Anorexia
Skeletal muscle protein degradation
Hypotension
Leukocytosis
• Elevated white blood cell count