Inflammatory Response Acute & Chronic Flashcards
Inflammation
Local response of tissue to injury/trauma/insult
Stimulus of inflammation
Microbial
Immunological
Physical
Chemical agents
Acute inflammation
Quick response
Short duration
Mainly neutrophils
Cardinal signs likely to be present
Causes of acute inflammation
Tissue necrosis
Foreign bodies
Immune
Trauma
Infections
Cardinal signs of inflammation
Rubor - redness
Calor - heat
Tumor - swelling
Dolor - pain
Loss of function
Patterns of inflammation
Serous - blister/fluid
Fibrinous - big leakage/body cavities
Suppurative - pus/necrotic tissue
Ulcerative - break in surface of epithelial tissue.
Chemical mediators what do they do?
Chemical messengers that act to cause inflammatory response.
Need a trigger- usually a blood vessel.
Endogenous chemical mediators
Come form body host response, send out chemical mediators to call upon more cells.
- plasma
- leukocytes
- endothelial cells
- fibroblasts
Exogenous chemical mediators
Come from microbial insult.
What produces cytokines
Macrophages
B lymphocytes
Epithelial cells
Gingival fibroblasts
Osteoblasts
Cytokines
Chemical proteins produced by many PMNs.
Mediate and regulate immune and inflammatory reactions.
Make a certain set of events happen to call upon more cells.
Can be pro or anti inflammatory.
Prostaglandins
Produced by mast cells, macrophages, endothelial cells.
Fat based cytokine.
Vascular and systemic reactions.
Vasodilation, fever and pain
Pro inflammatory
Leukotrienes
Produced by leukocytes and mast cells through lipoxygenase.
After as chemotatic for neutrophils.
Releases lysosomal enzymes.
Usually accompanied by histamine.
Vasoconstriction- anti inflammatory
Chemokines
Small proteins.
Act as chemo attractants for specific leukocytes.
Enhance chemotaxis - attracting leukocytes.
Chemotaxsis
Leukocyte recruitment to site
Examples of chemical mediators
Cytokines
Prostaglandins
Leukotrienes
Chemokines
Vasoactive amine
Histamine - comes from mast cells.
Acts in blood cells to cause dilation of arterioles and increase permeability.
2 types of phagocytic cells
PMNs - early inflammatory response
Monocytes and macrophages
Opsonisation
Coating of antigen - marking it to become engulfed
First events of acute inflammation
Vascular event- Vasodilation.
Redness occurs when blood vessels get bigger to try and recruit more white blood cells to injury.
What causes an increase in vascular permeability
Endothelial cell contraction.
Endothelial injury - trauma or leukocytes trying to break through.
Increase in transcytosis fluid.
Cellular events of acute inflammation
Chemotaxsis
Phagocytosis
What cells release proteolytic enzymes at inflamed tissue site
Neutrophils and macrophages
What are proteolytic enzymes
Protease
Collagenase
Elastase
Lipase
The neutophils and macrophage release proteolytic enzymes that break down the collegen and leads to tissue destruction.
Chronic inflammation
Occurs after delay
Longer duration
Less obvious - can sit there for long periods of time and go unnoticed.
Chronic inflammation conditions examples
Periodontitis
Rheumatoid arthritis
Cancer
Autoimmune disease
Cardiovascular disease
Chronic fatigue syndrome
Osteoporosis
Chronic inflammation considerations
Process is longer - likely to have more tissue damage.
More fibrotic appearance
Granulomas may be present
Patient may have no symptoms or be unaware of.
Granuloma
Extension of tissue with own blood supply which allows it to keep alive and nutrient supply.
Usually seen in chronic inflammation.
Angiogenesis
Formation of new extended blood vessels.
