Blood vessel dilation, increased vascular permeability and leakage, white blood cell (WBC) adherence to the inner walls of the vessels, and migration through the vessels. Limit and control the inflammatory process. Prevent and limit infection and further damage. Interact with components of the adaptive immune system. Prepare the area of injury for healing.
vascular inflammatory response
migration through the vessels
provide a biochemical barrier against invading pathogens are the
First proenzyme is converted to an active enzyme. The activation of the first component of a system results in sequential activation of other components.
Sequentially activated cascade
Can destroy pathogens directly Activates or collaborates with every other component of the inflammatory response. Anaphylatoxic activity resulting in mast cell degranulation; leukocyte chemotaxis; opsonization; cell lysis
Antibodies and antigens in complement system
Mannose-containing bacterial carbohydrates in complement system
Gram-negative bacterial and fungal cell wall polysaccharides in complement system
Plasma protein system that Forms a fibrinous mesh at an injured or inflamed site Prevents the spread of infection. Keeps microorganisms and foreign bodies at the site of inflammation for removal. Forms a clot that stops the bleeding. Provides a framework for repair and healing.
Clotting (coagulation) system
main substance of clotting coagualation system
in clotting coagulation system Is activated by the tissue factor outside the vascular space.
in clotting coagulation system Is activated in the vascular space when the vessel wall is damaged.
Functions to activate and assist inflammatory cells. primarily bradykinin, degraded by kininases, case dilation of blood vessels, pain, smooth muscle contraction, vascular permeability, and leukocyte chemotaxis
2 mechanisms are available to either activate or inactivate (regulate) these 3 plasma protein systems (clotting cascade, complement system, kinin proteins)
hageman factor-activates mechanism
C3a and C5a
histaminase and arylsulfatase inhibits
C1 esterase inhibitor inhibits
Mast cells Granulocytes (neutrophils, eosinophils, basophils) Monocytes and macrophages Natural killer (NK) cells and lymphocytes Cellular fragments (platelets) are all examples of
Are responsible for vascular changes. Modulate the localization and activities of other inflammatory cells.nInclude histamine, chemotactic factors, leukotrienes, prostaglandins, and the platelet-activating factor.
Is initiated when tissue injury occurs or when PAMPs are recognized by PRRs (pattern recognition receptors) on cells of the innate immune system.
cellular products that Regulate innate or adaptive resistance by affecting other neighboring cells. synergistic or antagonistic, proinflammatory and antiinflammatory. includes interleukins, interferons, and tumor necrosis factor (TNF). (2)
chemokines or cytokines actions are ______ : The same molecule may have a large variety of different biologic activities, depending on the particular target cell to which it binds.
Are produced primarily by macrophages and lymphocytes in response to a microorganisms or stimulation by other products of inflammation. Help regulate inflammation
IL (interleukin) 1 is a ______ cytkine that causes _____
IL 6 is _____ cytokine that helps with ____
2 antiinflammatory cytokines
IL 10 and TGF-B (transforming growth factor-beta
nProtects against viral infections. Is produced and released by virally infected host cells in response to viral double-stranded ribonucleic acid (RNA). Does not directly kill viruses but prevents them from infecting additional healthy cells.
Type of interferon that produces antiviral prorteins (2)
INF-a and INF-b
Type of interferon that increases microbiocidal activity of macrophages
Cytokine that Is secreted by macrophages in response to PAMP by TLR recognition. Produces local and systemic effects. Induces fever by acting as an endogenous pyrogen. Increases synthesis of proinflammatory proteins. Causes muscle wasting and intravascular thrombosis. Is probably responsible for fatalities from shock caused by gram-negative bacterial infections.
TNF - alpha or tumor necrosis factor
Another word for muscle waisting
Induce WBC chemotaxis.nAre produced by macrophages, fibroblasts, and endothelial cells. More than 40 different kinds exist.
chemokine that affect monocytes, lymphocytes, eosinophils
Chemokine that affect neutrophils
Are cellular bags of granules located in loose connective tissues close to blood vessels. Skin, digestive lining, and respiratory tract. Activation by Physical injury, chemical agents, immunologic processes, and TLRs (toll like receptors)
Mast cell chemicals are released in two ways
1.Degranulation 2.Synthesis of lipid-derived chemical mediators
Releases histamine which Causes temporary and rapid constriction of the large blood vessels and dilation of the postcapillary venules. Endothelial cells that line the capillaries are retracted.
mast cell degranulation
mast cell degranulation receptor present in smooth muscle cells of the bronchi. Induces bronchoconstriction. proinflammatory
mast cell degranulation receptor Is present on parietal cells of the stomach mucosa. Induces the secretion of gastric acid. antiinflammatory
Attract neutrophils and eosinophils of anaphylaxis (ECF-A)
Cellular and humoral responses (are/arenot) independent. Humoral immunity is ____ with a ___ antibody. and cell-mediated immunity is ______ differentiation
are not, fluid, circulating
Are the product of arachidonic acid from mast cell membranes. Have similar effects to histamine. Are more important in the later stages of inflammation.
Have similar effects to leukotrienes; they also induce pain.
Effect is similar to leukotrienes; they also activate platelets.
maintains normal blood flow, produces nitric oxide (NO) and prostacyclin (PGI2). During inflammation it expresses receptors that help leukocytes leave circulation, retracts to allow fluid to pass into tissues, if damaged it promotes clotting
maintain blood flow and pressure and inhibit platelet activation (2)
NO and PG12
Maintans vascular tone
NO (nitric oxide)
Are cellular fragments formed from megakaryocytes, are also called thrombocytes. Activation stops bleeding and degranulation, contain alpha and dense granules.
a phagocyte Predominate in early inflammatory responses. Ingest bacteria, dead cells, and cellular debris. Are short lived and become components of the purulent exudate (pus). Removal of debris in sterile lesions and Phagocytosis of bacteria in nonsterile lesions
neutrophils or polymorphonuclear neutrophils
Phagocyte that Provide the defense against parasites and regulate vascular mediators. Help control vascular effects of inflammation.
Phagocytes Are similar to but are not mast cells. Are an important source for cytokine IL-4. Are associated with allergies and asthma. Their role is uncertain.
phagocyte that are produced in the bone marrow, enter circulation, migrate to the inflammatory site, and develop into macrophages. are precursors to macrophages in tissues
Kupffer cells (liver);
alveolar macrophages (lungs);
and microglia (brain)
larger than monocytes, are more active than phagocytes, and are important cellular initiators of inflammation; they help in wound healing. Activation results in increased phagocytic activity, size, plasma membrane area, glucose metabolism, and number of lysosomes; they predominate in late inflammation.
phagocytes that Recognize and eliminate cells that are infected with viruses and cancer cells in the blood.
phagocytes that are the main component of adaptive immune response
Is the process by which a cell ingests and disposes of foreign material. Is the destruction of microorganisms and cellular debris. Production of adhesion molecules occurs.
during phagocytosis leukocytes adhere to endothial cells (2 names)
margination or pavementing
during phagocytosis, cells emigrate through the endothelial junctions
result from vascular changes and corresponding leakage of circulating components into the tissue.
2 manifestations of inflammation From vasodilation and increased blood flow
heat and redness
Severe manifestation of inflammation
loss of function
Manifestations of inflammation From exudate accumulations and fluid from capillary permeability
Manifestations of inflammation From pressure exerted by exudate accumulations, prostaglandins, and bradykinins
Functions of inflammation: Dilute ___, carry plasma ____ and _____ to injury site, carry bacterial _____ and ____ away from site
toxins, proteins, leukocytes, toxins and debris
Fluid and cells such as protein and debris
Watery exudate: Indicates early inflammation
Thick, clotted exudate: Indicates more advanced inflammation
Pus exudate: Indicates a bacterial infection in exudate (2 names)
purulent / suppurative
Exudate containing blood: Indicates bleeding.
Caused by exogenous and endogenous (IL-1) pyrogens. Acts directly on the hypothalamus
Increased numbers of circulating leukocytes, Left shift, increase in immature cells (bands)
Acute-phase reactants, C-reactive protein, fibrinogen, haptoglobin, amyloid A, and ceruloplasmin are all caused by ______
increased plasma protein synthesis
Is inflammation that lasts from 2 weeks to months to years. Is often related to an unsuccessful acute inflammatory response. Other causes are High lipid and wax content of a microorganism Ability to survive inside the macrophage, Toxins, Chemicals, particulate matter, or physical irritants
Dense infiltration of lymphocytes and macrophages, Granuloma formation, Epithelioid cell formation, Giant cell formation are all examples of
resolution and repair most favorable outcome
returning injured tissue to original structure and fuction
replacement of destroyed tissue with scar tissue
Primarily composed of collagen to restore the tensile strength of the tissue
Cleaning up dissolved clots, microorganisms, erythrocytes, and dead tissue cells
filling in the wound
sealing the wound
shrinking the wound
Wounds that heal under conditions of minimal tissue lossnOriginal tissue structure and function that have been restored are _____ intention healing
Wounds that require significantly more tissue replacement, like Open wounds, Wounds that cause scar formation need _____ healing intention
Healed wound is remodeled. This phase begins several weeks after injury and may last for 2 years. Cellular differentiation continues. Scar tissue forms. Scar remodeling occurs.
Hemorrhage Fibrous adhesion Infection Excess scar formation Wound sepsis Hypovolemia Hypoproteinemia Antiinflammatory steroids are all examples of
dysfunction during inflammatory response
T helper lymphocytes (differences based on cytokine production)
______ provide help in cell mediated immunity
______ provide help in developing humoral immunity
Causes malnutrition, keloids, hypertrophic scar
impaired collagen matrix assembly
Caused by Antiinflammatory steroids, hypoxemia, and nutritional deficienciesnCleaning with povidone-iodine and hydrogen peroxide
Results from excessive myofibroblast derived tension
impaired contraction or contractures
Wound pulls apart at the suture line.Causes: Excessive strain, wound sepsis, and obesity Occurs 5 to 12 days after suture. Characteristics Serous drainage is increased. Feels like something “gave way.”Surgery is required.
Have transiently depressed inflammatory and immune function. Have neutrophils that are not capable of efficient chemotaxis. Have a deficient complement system. Are deficient in collectins and collectin-like proteins. Are susceptible to bacterial infections.