INFLAMMATION
DR. KANWAL IFTIKHAR, RPH, PHARM. D, [Link]/PH.D.
(PHARMACOLOGY)
WHAT IS INFLAMMATION?
Inflammation is the reaction of living
tissues to all forms of injury.
WHAT IS INFLAMMATION?
• Inflammation is the body's normal, protective response to
injuries or infections.
• It is triggered by the immune system, which is a cellular system
within the body.
• The immune system monitors for injuries to the body and
detects “intruders” such as bacteria and viruses.
WHAT IS INFLAMMATION?
• If the immune system detects an injury or intruder, it mounts a
response called an inflammatory response and signals cells to
the site of injury or infection.
• Excessive inflammation, however, can result in local tissue
damage and, in severe cases, may even become deadly.
WHAT IS INFLAMMATION?
• Inflammation allows for recruitment of the cellular defenses needed
to:
• Eliminate pathogens.
• Remove damaged and dead cells
• Initiate repair mechanisms.
INFLAMMATION & INFECTION
Infection refers to the
Inflammation is the
invasion and
body's protective
multiplication of bacteria
response against
or viruses within the
infection
body
CAUSES OF INFLAMMATION
• This includes:
• Infections
• Tissue necrosis
• Foreign bodies
• Trauma
• Immune responses
Removal of
the agent
Recruitment
of leukocytes Regulation of
(white blood the response
cells)
Recognition
of injurious
Five Resolution
(repair)
tissue steps
STEPS OF INFLAMMATORY RESPONSE
SIGNS OF INFLAMMATION
INFLAMMATION
When a microbe enters a tissue or the
tissue is injured, the presence of the
infection or damage is sensed by
resident cells, including macrophages,
dendritic cells, mast cells, and other cell
types.
These cells secrete molecules (cytokines
and other mediators) that induce and
regulate the subsequent inflammatory
response.
Mast cells release histamine that initiate
vasodilation.
It increases vascular permeability and
migration of neutrophils and monocytes
to the site of injury.
The accumulation of fluid and cells at
the site of injury results in edema
formation.
Macrophages and neutrophils eliminate
microbes and dead cells.
After the removal of the culprit, the
repairing of the tissue is initiated.
TYPES OF INFLAMMATION
There are 2 types of inflammation:
• Acute inflammation
• Chronic inflammation
ACUTE
INFLAMMATION
Acute inflammation is the immediate & early
response to injury
A critical function of this response is to
WHAT deliver leukocytes to the site of injury where
IS they help clear invading infectious agents
ACUTE
INFLAMMATION? It is regarded as the “first line of defense”
against injury
It has a short duration
CHANGES IN ACUTE INFLAMMATION
• Following types of changes are observed in acute
inflammation:
oVascular events
oCellular events
VASCULAR EVENTS
Slowing or
Initial Transudation
stasis of
vasoconstricti Increased of fluid into
microcirculati
on followed vascular the
on &
by persistent permeability extracellular
leukocytic
vasodilation space
margination
CELLULAR EVENTS
• Following cellular events occur in acute inflammation:
• Margination: It is the process in which leukocytes move to the outer
margin of blood flow adjacent to the vascular endothelium
• Adhesion: leukocytes adhere to the endothelial cells
• Emigration: cells move through the vessel wall to the affected area.
CELLULAR EVENTS
• Chemotaxis: leukocytes are attracted to the site of injury.
• Phagocytosis: it is a process by which the microorganism & other
foreign particles are engulfed & destroyed by neutrophils &
macrophages.
MORPHOLOGY OF ACUTE INFLAMMATION
• Characteristically, the acute inflammatory response
involves production of exudates.
• An exudate is an edema fluid with high protein
concentration, which frequently contains inflammatory
cells.
Cellular Mediators Cells of Origin Functions
Histamine Mast cells Vascular Leakage
Bacterial & Tissue
Lysosomal Enzymes Neutrophils
Destruction
Prostaglandins All Leukocytes Vaodilation, Pain, Fever
Leukocytes Activation &
Leukotriene All Leukocytes
Vasoconstriction
Platelet Activating Factor All Leukocytes Chemotaxis
Leukocytes Activation,
Nitric Oxide Macrophages
Vasodilation
Lymphocytes,
Cytokines Leukocytes Activation
Macrophages
CHRONIC INFLAMMATION
WHAT IS CHRONIC INFLAMMATION?
• Chronic inflammation can be defined as a prolonged inflammatory
process (weeks or months).
• It can happen when body cannot remove the harmful substance or
heal an injury.
• Hence body stays in a state of inflammation for several months or
even years.
• It can also happen if the harmful substance is gone but the body
remains in an inflammatory state.
Persistent infections: Certain microorganisms associated with
intracellular infection such as tuberculosis, are difficult to
eradicate and characteristically cause chronic inflammation.
Prolonged exposure to indigestible but partially toxic
substances either endogenous lipid components which result in
atherosclerosis or exogenous substances such as silica, causes
inflammatory lung disease called silicosis.
Progression from acute inflammation: Acute inflammation
almost always progresses to chronic inflammation.
Autoimmunity: Autoimmune diseases such as rheumatoid
arthritis and systemic lupus erythematosis are chronic
inflammations from the outset.
MORPHOLOGY OF CHRONIC
INFLAMMATION
Cells of Chronic Inflammation
• Monocytes and Macrophages are the (primary cells) in chronic
inflammation.
• These cells are then diffusely scattered in various parts of the
body.
• Macrophages are scavenger cells of the body.
Other Cells in Chronic Inflammation
T-Lymphocytes are primarily involved in cellular immunity with
lymphokine production, and they are the key regulator and effector
cells of the immune system.
B-lymphocytes and Plasma cells produce antibody directed either
against persistent antigen in the inflammatory site or against
altered tissue components.
Mast cells and eosinophils appear predominantly in response to
parasitic infestations & allergic reactions
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