DR SHWE SIN

M.Med.Sc
FMHS

OVERVIEW OF INFLAMMATION
INFLAMMATION : is a protective
response involving host cells, blood
vessels, and proteins and other
mediators that is intended to eliminate
the initial cause of cell injury as well as
the necrotic cells and tissues resulting
from the original insult and to initiate
the process of repair.

PURPOSE OF INFLAMMATION
To bring phagocytic cells to the injured area

to engulf invading bacteria

To bring in factors from the serum to
neutralize the infectious agents
To serve to destroy, dilute, wall of the
injurious agent and tissue cells that it may
have destroyed

 Although inflammation clear infections,

noxious stimuli & initiate repair

cause harm (capable of injuring normal
tissue)
Inflammation is induced by chemical
mediators in response to injurious
stimuli that are produced by host cells
The main components are vascular

reaction and cellular response

CLASSIFICATION OF INFLAMMATION
I. Based on duration:

i) Acute inflammation
ii) Chronic inflammation
II. Based on characteristic of exudates:
i) Serous inflammation
ii) Fibrinous inflammation
iii) Suppurative or Purulent inflammation
iv) Haemorrhagic inflammation
v) Mixed
III. Based on location:
i) Abscess
ii) Ulcer
iii) Membranous inflammation
iv) Catarrhal inflammation
v) Cellulitis

Features of Acute and Chronic Inflammation***

Feature

Acute

Chronic

Onset

Fast: minutes or hour

Slow: days

Cellular infiltrate

Mainly neutrophils

Monocytes/ macrophages
& lymphocytes

Tissue injury, Fibrosis

Usually mild and selflimited

Often severe and

progressive

Local & Systemic signs

Prominent

Less prominent; may be

subtle

Local Cardinal Signs of Inflammation

Heat (calor)
Redness (rubor)
Swelling (tumor)
Pain (dolor)
Loss of function (functio laesa)

CHEMICAL MEDIATORS
May be produced by cells or may be

circulating in the plasma.

Cell-derived mediators are sequestered in
intracellular granules (histamine,
prostaglandins and cytokines)
Plasma-protein-derived mediators
(complement proteins and kinins)

Cell-Derived Mediators
1.
2.
3.
4.
5.
6.
7.
8.
9.

Vasoactive amines
AA metabolites
Platelet activating factors
Cytokines
Chemokines
Reactive oxygen species
Nitric oxide
Lysosomal Enzymes of Leukocytes
Neuropeptides

Plasma Protein-Derived Mediators

1. Complements
2. Coagulation and Kinin System

General Principles of Chemical

Mediators
* Mediators originate either from plasma
or cells
* Most mediators perform their biologic
activity by initially to binding to
specific receptors on target cells
* A chemical mediator can stimulate the
release of mediators by target cells
themselves

* Mediators can act on one or few target

cell types
* Once activated and released from the
cell, most of these mediators are shortlived
* Most mediators have the potential to
cause harmful effects

Systemic Effects of
Inflammation
I. Acute Phase Response
i) Fever (Prostaglandin PG)
ii) Elevated levels of acute-phase
proteins (C-reactive protein CRP,
fibrinogen and serum amyloid A (SAA)
iii) Leucocytosis (rise in number of
immature neutrophils in the blood (shift
to left)

II. In Chronic Inflammation:

i) Disseminated intravascular
coagulation (DIC)
ii) Hypoglycemia
iii) Hypotensive shock

REFERENCE
Robbins Basic Pathology, 8th Edition
Robbins Basic Pathology, 9th Edition