Lecture 7- The Inflammatory Process

Question 1

Inflammation

Answer 1

Protective reaction by the body; in response to some physical/chemical injury
-stops function and initiates healing process e.g. microbial infection

-usually in a form of swelling, painful/uncomfortable situation- in the joints, sinus or intestine
-can occur without any symptoms

Question 2

Diseases related to inflammation

Answer 2

*connective tissue;
-rheumatoid arthritis
-osteoarthritis
-ankylosing spondylitis

*respiratory;
-asthma
-chronic obstructive pulmonary disease

*gastrointestinal system;
-inflammatory bowel disease
-Crohn’s disease

*metabolic;
-metabolic syndrome

*CNS;
-neurodegenerative disorders

Question 3

Acute and chronic inflammation

Answer 3

*acute inflammation= body’s initial response to a physical/chemical stress that requires healing + repair

*chronic inflammation= abnormal condition usually associated with ill health + disease

-when AI does not/cannot complete its task= CI results; may take place due to continued physical/chemical stress e.g. smoking

*chronic inflammation= white blood cells are involved

Question 4

Acute inflammatory response

Answer 4

-occurs in tissues in response to a pathogen/noxious substance
-2 components; innate non-adaptive/ adaptive immunological response
-reactions= protective but can be deleterious if inappropriately deployed
-normal outcome= healing with/without scarring- if injurious agent persists = CI
-diseases that require drug treatment= involve inflammation

Question 5

Vascular events of the inflammatory response

Answer 5

-include dilation of the small arterioles= increased blood flow caused by mediators; histamine, PGE2, PGI2 produced by the interaction of the microorganisms with tissue/injury

-slowing—>stasis of blood + increase in the permeability of the post-capillary venules with exudation of fluid

Question 6

Cellular events of the inflammatory response

Answer 6

Endothelial + mast cells + tissue macrophages = preset in tissues whilst others (platelets + leucocytes) = gain access from the blood

*leucocytes= actively motile cells + are of 2 classes;
^squeeze out of blood vessels to spaces to participate in chronic inflammation

*polymorphonuclear cells= cells with multi-lobed nuclei; granulocytes -> subdivided into neutrophils, eosinophils and basophils based on their properties of granules in their cytoplasm

*mononuclear cells= cells with single-lobed nuclei —> subdivided into monocytes and lymphocytes

Question 7

Polymorphonuclear leucocytes

Answer 7

*neutrophil polymorphs= ‘shock troops’ of inflammation= first of the blood leucocytes that enter the inflamed area
-roll along the activated endothelium -> adhere + migrate out of the blood vessel -> extravascular space
-attracted to the invading pathogen by chemicals; chemotaxins/ local cells; macrophages
-can engulf, kill + digest microorganisms
-if neutrophil is inappropriately activated= toxic oxygen products + proteolytic enzymes cause damage to the tissues

Question 8

Monocytes/macrophages

Answer 8

*monocytes= arrive at sites of inflammation hours after the polymorphs
-in tissues; blood monocytes differentiate into macrophages

-mono = arrive first
-macro= arrive later = take care of debris and leftover pathogens

Question 9

Monocytes/macrophages

Answer 9

Innate reactions;
Macrophages bind lipopolysaccharide + other pathogen associated molecular patterns (PAMPs) by using specific cell surface receptors —> generation + release of inflammatory mediators (cytokines, chemokines etc)

*wbc= recognise through pattern recognition receptors
*INOS= enzyme that produces larger amounts of nitric oxide

Question 10

Monocytes/macrophages

Answer 10

*cytokines + chemokines= act on vascular endothelial cells = attract other leucocytes + give rise to systemic manifestations of the inflammatory response; fever

-activated macrophages= inhibit pathogen replication by releasing nitric oxide = which contributes to the amplification of the inflammatory process

Question 11

Therapeutic strategies in inflammation; anti inflammatory drugs

Answer 11

-associated with disorders; rheumatoid arthritis
-inappropriate inflammatory/immune reactions= form diseases
Treatment goals;
- relief of symptoms + maintenance of function
- arrest of the tissue-damaging process

-reduction of inflammation with *non-steroidal anti-inflammatory drugs= pain relief + treat acute/chronic inflammatory conditions

*anti-inflammatory steroids= strong effects during long term treatment of chronic inflammatory conditions