Acute Inflammation Chronic Inflammation

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  • INFLAMMATION

    The infalmmation is a universal and ancient form of host defence.

    The inflammation is not a disease.

    Inflammation is not equal with infection

    Immunity: Innate (~inflammation): delaying the need for adaptive immunity,

    (mechanisms are coded in genome)

    Recognizes infectious non self

    Execution

    Serves to alert the clonal, adaptive immune system (dendritic cells!!)

    Adaptive: it recognizes fine details of pathogenic organisms,

    It is highly specific and remembers (but not heritable), gene rearrangement is

    necessary

    It is responsible for allergy, autoimmunity, rejection.

  • Other defence mechanisms: Haemostasis

    Regeneration

    Innate immunity recognizes Pathogen Associated Molecular Patterns (PAMP)

    e.g. LPS, CpG DNA

    PAMPs are recognized by pattern recognition receptors (PRP) (cell surface,

    intracellular, serum)

    Principal functions of PRPs: activation of complement, coagulation, phagocytosis

    pro inflammatory signaling cascades

    induction of apoptosis

  • Terminology: +itis

    Most common extraordinary names

    /tissue

    tongue glossitis

    oral mucose stomatitis

    cornea keratitis

    lung pneumonia

    stomach gastritis

    small intestine enteritis

    coecum typhlitis

    rectum proctitis

    testis orchitis

    vagine colpitis

    fallopian tube salpingitis

    belly bottom omphalitis

    breast mastitis

    adipose tissue panniculitis

    brain encephalitis

  • Characteristics of acute inflammation: rubor, tumor, calor, dolor

    The purpose of the inflammatory vascular reactio is to deliver the humoral and

    cellular factors to the site of defence reaction

    Mechanism of active hyperaemia : arteriole dilatation, reduced venous outflow,

    dilatation of capillary network

    Tumor (swelling) exsudation early phase (histamin, bradykinin)

    postcapillary venule

    Late phase (TNF, IL-1, IFN g) capillaries

    Vascular damage

    Exit of cellular elements

    Chemotaxis bacteriale-, necro-, endogn chemotaxins

    Margination integrins, ICAM, VCAM

    Diapedesis (in venules)

    Activation

    Execution opsonisation, phagocytosis, killing (oxign dependent and independent

    mechanisms)

  • Cellular elements of inflammmaton:

    Neutrophil gr, Eosinophil gr, Basophil, Mastcell,

    Macrophages, Endothel, Fibroblasts

    Thrombocyte, Lymphocyte

    Humoral elements

    Vasoactive amins: histamine, serotonine (vasodilatation, permeability, pain)

    Vasoactive peptids: bradykinin

    complementr (MAC, vasodilatation, permeability, chemotaxis, opsonisation

    Clotting, fibrinolitic cascade

    Immunglobulins

    Arahidonic acid derivatives

    Cyclooxigenase prostaglandins

    Lipoxigenase leukotrins

    Cytokins TNF, IL-6, IL-1

    Exogn meditors: fMLP, endotoxin, superantigens

  • Classification of acute inflammation based on the exudate

    Serous common cold, pleuritis exs., burns

    Fibrinous serous membranes peuritis sicca

    Mucous memebranes Diphtery, typhoid fever, dysentery

    Purulent folliculitis, furuncule, carbuncule

    Abscess: circumscibed pus in tissue

    Empyema circumscribed pus in preformed body cavity

    Phlegmone inflammation spreading in tissue spaces

    Haemorrhagic: plague, smallpox, anthrax, flue

    Gangraenous, - failure of inflammation

  • Fibrines gyullads

    Diphteria

    Typhus

    abdominalis

    Peritonitis fibrinosa

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  • Tonsillitis follicularis

  • Classification of acute inflammation

    based on the exudate

    Serous common cold, pleuritis exs., burns

    Fibrinous serous membranes

    peuritis sicca

    Mucous memebranes

    Diphtery, typhoid fever, dysentery

    Purulent folliculitis, furuncule, carbuncule

    Abscess: circumscibed

    pus in tissue

    Empyema

    circumscribed pus in preformed body

    cavity Phlegmone inflammation

    spreading in tissue spaces

    Haemorrhagic: plague, smallpox,

    anthrax, flue

    Gangraenous, - failure of inflammation

  • Purulens gyullads

    Abscessus

    Carbunculus

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