SIRS

Billy Daniel Messakh

Surgeon
 INFLAMATORY RESPONSE
• The inflammatory response to injury is
designed to restore tissue function and
eradicate invading micro organisms
• This chapter addresses the hormonal,
immunologic, and cellular responses to injury
 THE SYSTEMIC INFLAMMATORY RESPONSE
SYNDROME
• The systemic response to injury can be broadly
compartmentalized into two phases:
(1) a proinflammatory phase characterized by
activation of cellular processes designed to restore
tissue function and eradicate invading
microorganisms,
(2) an antiinflammatory (counterregulatory phase) that
is important for preventing excessive
proinflammatory activities and restoring homeostasis
in the individual
CENTRAL NERVOUS SYSTEM REGULATION OF
INFLAMMATION
• Reflex Inhibition of Inflammation
• Afferent Signals to the Brain
• Cholinergic Antiinflammatory Pathways
HORMONAL RESPONSE TO INJURY
• Hormone Signaling Pathways
• Adrenocorticotropic Hormone
• Cortisol and Glucocorticoids
• Macrophage Inhibitory Factor
• Catecholamines
• Aldosterone
• Insulin
 MEDIATORS OF INFLAMMATION
• Cytokines
• Heat Shock Proteins
• Reactive Oxygen Metabolites
• Eicosanoids
• Fatty Acid Metabolites
• Kallikrein-Kinin System
• Serotonin
• Histamine
 CELLULAR RESPONSE TO INJURY
• Gene Expression and Regulation
• Cell Signaling Pathways
1. Heat Shock Proteins
2. G-Protein Receptors
3. Ligand-Gated Ion Channels
4. Receptor Tyrosine Kinases
5. Janus Kinase/Signal Transduction and
Activator of Transcription (STAT) Signaling
 Cell-Mediated Inflammatory Response

• Platelets
• Lymphocytes and T-Cell Immunity
• Eosinophils
• Mast Cells
• Monocytes
• Neutrophils
 ENDOTHELIUM-MEDIATED INJURY
• Neutrophil-Endothelium Interaction
• Nitric Oxide
• Prostacyclin
• Endothelins
• Platelet-Activating Factor