kuliah inflamasi

8/11/2019 kuliah inflamasi

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Inflammation/peradangan


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Definitions

Inflammation is essentially a protective

response intended to eliminate both theinitial cause of cell injury (e.g., microbes ortoxin) and the necrotic cells and tissuesarising as a consequence of such injury.


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Acute/Chronic Inflammation

Acut Inflammation: relatively short duration, lastingfrom a few minutes up to a few days, and ischaracterized by fluid and plasma protein exudation,

and by a predominatly neutrophil accumulation.

Chronic Inflammation: longer duration (weeks toyears), is manifested histologically by influx of

macrophages, lymphocytes and plasma cells,and bytissue destruction and repair, the later is associatedwith vascular proliferation and fibrosis.


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Acute inflammation

There are 3 major

components :

1. Vasodilatation

2. Structural changes in

the microvasculaturethat permit plasmaprotein to leave thecirculation

3. Neutrophil emigration


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Heat Red Swelling Pain Loss Of

Func.

5 Cardinal Signs


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Classic Signs of Inflammation

Rubor: erythema due to capillary dilation

Calor: warmth due to increased blood flow

Tumor: edema and accumulation of fluid in theextravascular space and cells migrating intothe tissue

Dolor: pain due to local pressure andstimulation of nerve endings

Functio laesa: alteration in function Due tothe physical swelling and the pain present


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Mouth Aphthous ulcer

Calor, Rubor, Dolor, Tumor, Loss of function


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Mediators in vivo of acute inflammation

*Vasodilatation

prostaglandins, nitric oxide (NO)

* Increased vascular permeability

vasoactive amines, C3a and C5a, bradykinin, Leukotiene, PAF

Chemotaxis, leucocyte activation

C5a, Bacterial product, chemokines (IL-8)

Fever

IL-1, IL-6, TNF alfa

Pain

prostaglandin, bradykinin

Tissue damage

Neutrophil & macrophage lysosomal enzymes

Oxygen metabolites, NO


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Migration of Leucocytes

Leucocytes attracted to the area (especially Neutrophils)

These leave the blood vessel and enter the damaged

area. This is called DIAPEDESIS

Leucocytes attracted by CHEMOTAXIS,chemicalsreleased from the damaged tissues

Leucocytes phagocytose the invading bacteria and dead

tissue. Antibodies help with this job.

Fibrin walls the damaged area off preventing further

damage or extending the infected area


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These are usually firstto inflammation Bothin serum and mucosal,will function much asmacrophages


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Granulocytes

Neutrophils

Eosinophils

Basophils


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Neutrophils

Polymorphonuclear neutrophils (PMNs)

First to arrive at the inflamed site

Phagocytize bacteria, dead cells, cellulardebris.

Kill living cells

Digest foreign material


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Eosinophils

Functions

respond to chemical messengers

phagocytosis

kill certain microorganisms

Special functions

parasite infections

allergic reactions


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Basophils

Functions

respond to chemical messengers

release granules containing chemical into the

injured site

have functions similar to mast cells


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Agranulocytes

Monocytes

Lymphocytes

T lymphocytes

B lymphocytes


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Monocytes

Attracted to the area by PMNs

Blood: Monocytes

Exudate and RES: Macrophages Skin: Histiocytes

Respond to the lymphocytes

produce monokines, interferons, TNF more effective phagocytosis


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Lymphocytes

Important in immunity

Less important in inflammation


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Mast Cells

Basophils

The most important activator of the

inflammatory response

Mast cells are cellular bags of granules located

in loose connective tissue near blood vessels.


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Outcomes of acute inflammation

Complete resolution

little tissue destruction and capable ofregeneration

Scarring of fibrosis

do not regenerate

Abscess formation

in the setting of certain bacterial or

fungal infections Progression to chronic inflammation


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Chronic Inflammation

Persistent infections

Tubercle bacilli, Treponema pallidum Prolonged exposure to potentially toxic agents

inhaled silica, chronically elevated plasma lipid

Autoimmune diseases

immune response to self antigens


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Systemic effects of inflammation

Fever

Higher erythrocyte sedimentation rate

Leukocytosis/leukopenia Neutrophilia, eosinophilia, lymphocytosis


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Inflammation Cancer

Arthritis

Atherosclerosis

Colitis

Psoriasis

Infection

Diabetes

Chronic inflammation plays a role inmany disease conditions

Eczema

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