Inflammation

Inflammation:
The Protective reaction of living, vascularized tissues to injury and the goal is to
dilute, destroy, or wall off the injurious agent.
OR
Inflammation is the immune system's natural response to injury and illness.

Acute inflammation Acute inflammation is an immediate and early response to an

injurious agent and it is relatively of short duration, lasting for minutes, several hours
or few days.

The five cardinal signs of acute inflammation are

1. Redness (rubor) which is due to dilation of small blood
2. Heat (calor) which results from increased blood flow (hyperemia)
3. Swelling (tumor) which is due to accumulation of fluid
4. Pain (dolor) which results from the stretching & destruction of tissues. Some
chemicals like bradykinins, prostaglandins and serotonin are also known to
induce pain.
5. Loss of function: The inflamed area is physically immobilized by pain and
swelling

Events of acute inflammation:

• Acute inflammation has three main events:

Vascular Response:
(1) Hemodynamic changes (vascular changes that lead to an increase in blood flow)
(2) Increased vascular permeability (permit plasma proteins and leukocytes to leave
the circulation)

Cellular Response:
(3) Emigration of the leukocytes from the microcirculation to eliminate the offending
agent
The cellular response has the following stages:
A. Migration, rolling, pavementing , & adhesion of leukocytes
B. Transmigration of leukocytes
C. Chemotaxis
D. Phagocytosis

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Types of inflammation on the basis of exudate

Characteristically, the acute inflammatory response involves production of exudates.

An exudate is an edema fluid with high protein concentration, which frequently
contains inflammatory cells.
A transudate is simply a non-inflammatory edema caused by cardiac, renal,
Under-nutritional, & other disorders.

Serous This is characterized by a secretion of a thin fluid that is derived

inflammation from either the blood serum or mesothelial cells of the serous
membranes (peritoneum, pleura, pericardium)
Catarrhal Characterized by a discharge of mucus and epithelial debris,
inflammation affect mainly a mucous surface.

Fibrinous Characterized by fibrin deposition, and exudation of a high

inflammation concentration of the plasma protein fraction. More severe injuries
result in greater vascular permeability that ultimately leads to
exudation of larger molecules such as fibrinogens through the
vascular barrier.

Suppurative This type of inflammation is characterized by the production of a

(Purulent) large amount of pus. Pus is a thick creamy liquid, yellowish or
inflammation blood stained in color and composed of:
 A large number of living or dead leukocytes (pus cells)
 Necrotic tissue debris
 Living and dead bacteria
 Edema fluid

Hemorrhagic Exudative inflammation involving microvascular injury with

inflammation massive microvascular bleeding, producing an exudate with a
high erythrocyte content.

Chronic inflammation

Definition: Chronic inflammation is a prolonged inflammatory process (weeks or

months)
Causes of chronic inflammation:
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Persistent infections
Prolonged exposure to non-degradable but partially toxic substances
Progression from acute inflammation
Autoimmunity
Cells of chronic inflammation:
1. Monocytes and Macrophages
2. T-Lymphocytes
3. B-lymphocytes and Plasma cells
4. Mast cells and eosinophils
5. Neutrophils (also present)
Differentiation points between acute and chronic inflammations include:
Characteristics Acute inflammation Chronic inflammation
Duration Short Relatively long
Predominant cell Neutrophils Plasma cells , Macrophages,
Lymphocytes
Tissue destruction Mild to moderate Marked
Fibrosis Absent Present

Classification of chronic inflammation:

Granulomatous inflammation

Definition: Granulomatous inflammation is characterized by the presence of

granuloma
A granuloma is an organized and compact immunological structure rich with
immune cells, such as macrophages, monocytes, dendritic cells, neutrophils,
epithelioid cells, foamy macrophages, and multi-nucleated giant cell
Types of giant cells:
a. Foreign body-type giant cells which have irregularly scattered nuclei in presence
of indigestible materials.
b. Langhans giant cells in which the nuclei are arranged peripherally in a horse –shoe
pattern