INFLAMMATION

Dr. HEMA KINI

Pathology Department
Kasturba Medical College,
Mangaluru,
MAHE
 INFLAMMATION
Definition
Purpose
Etiology
Types
Cardinal signs (Gross features)
Tissue alterations (Microscopic features)
 INFLAMMATION
 
DEFINITION

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The local reaction of living tissues and

its microcirculation to injury.

Latin,  īnflammō, ="i ignite, set alight“ Suffix -itis

 INFLAMMATION
 
DEFINITION

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• It is the response of vascularized tissues

• Delivers defense cells and molecules in vessels
• To tissue sites of injury (outside the circulation)
• In order to eliminate the offending agent.
 INFLAMMATION
Definition
Purpose
Etiology
Types
Cardinal signs (Gross features)
Tissue alterations (Microscopic features)
 INFLAMMATION
PURPOSE
•Protective response
•Fluid & cells in the •Dilute
extravascular space •Isolate
•Wall off/ destroy •Destroy
inciting agent •Initiate repair
•Clear damaged /
necrotic tissue
•Repair & return tissue
to normal
 INFLAMMATION
Definition
Purpose
Etiology
Types
Cardinal signs (Gross features)
Tissue alterations (Microscopic features)
 INFLAMMATION
ETIOLOGY
EXOGENOUS AGENTS:
• Physical: Mechanical, Temperature
• Chemical: toxic gases, acids, bases
• Biological: bacteria, virus, parasite, fungus
ENDOGENOUS:
• Circulatory disorders: thrombosis, infarction,
hemorrhage
• Immune reactions: Immune complex deposits
• Enzyme activation – e.g. acute pancreatitis
• Metabolic wastes – uric acid, urea
 INFLAMMATION
Definition
Purpose
Etiology
Types
Cardinal signs (Gross features)
Tissue alterations (Microscopic features)
 INFLAMMATION
TYPES
ACUTE
• Short lived process, few hours to days
• Single episode of injury
• Neutrophils √
CHRONIC
• Long lasting, months to years
• Continuous/ repeated injury/ scarring
• Lymphocytes/ macrophages
 INFLAMMATION
Definition
Purpose
Etiology
Types
Cardinal signs (Gross features)
Tissue alterations (Microscopic features)
 CARDINAL SIGNS OF
INFLAMMATION
• RUBOR (REDNESS)

• CALOR (HEAT)

• TUMOR (SWELLING)

• DOLOR (PAIN)

• FUNCTIO LAESA (LOSS

OF FUNCTION)

CELSUS VIRCHOW
https://www.infodentis.com/images-eng/abscessed_tooth.jpg
 INFLAMMATION
Definition
Purpose
Etiology
Types
Cardinal signs (Gross features)
Tissue alterations (Microscopic features)
Normal I Circulation
II
 III ENDOTHELIAL CELLS

IV
Normal V
VI

22
 INFLAMMATION
TISSUE ALTERATIONS
• Vascular events

• Cellular events
 INFLAMMATION
• VASCULAR EVENTS
– Changes in Calibre
– Structural changes • Transient
vasoconstriction
• Vasodilatation
• CELLULAR EVENTS
 Edema

Congested
vessels

TRANSUDATE
 INFLAMMATION
Prostaglandins
• VASCULAR EVENTS Histamine
Nitric oxide
– Changes in Calibre • Transient
– Structural changes vasoconstriction
• Vasodilatation
• CELLULAR EVENTS
• Increased vascular
Histamine
permeability Kinins
Leukotrienes
CELL OF ACUTE INFLAMMATIONWHY
NEUTROPHILS? ? ?
• TNF - recruitment
• Numerous in circulation
• Appear 6-24 hrs
• Disappear 24-48 hrs Monocytes
• Respond rapidly to chemokines
• Attach more firmly to rapidly induced
adhesion molecules
LEUKOCYTE CELLULAR
EVENTS
–Margination
–Rolling
–Adhesion
–Transmigration
–Chemotaxis and
activation
–Phagocytosis
LEUKOCYTE CELLULAR
EVENTS
–Margination
–Rolling
–Adhesion
–Transmigration
–Chemotaxis and
activation
–Phagocytosis
MARGINATION
LEUKOCYTE CELLULAR
EVENTS
–Margination
–Rolling
–Adhesion
–Transmigration
–Chemotaxis and
activation
–Phagocytosis
LFA-1
MAC-1
VLA-4
LEUKOCYTE CELLULAR
EVENTS
–Margination
–Rolling
–Adhesion
–Transmigration
–Chemotaxis and
activation
–Phagocytosis
LEUKOCYTE CELLULAR
EVENTS
–Margination
–Rolling
–Adhesion
–Transmigration
–Chemotaxis and
activation
–Phagocytosis
 CHEMOTAXIS
• Locomotion along a chemical gradient
• Chemoattractants
– Bacterial products ( N- formylmethionine)
– Cytokines (IL-8)
– Complement (C5a)
– Arachidonic Acid metabolites(LTB4)
• Polymerisation of actin
• Extend pseudopods with
overlying surface adhesion
molecules (integrins)
 Edema

Congested
vessels
 CHEMOTAXIS

Neutrophil activation
 ACTIVATION
NEUTROPHILS
• Prepare AA metabolites from phospholipids (PG, LT)
• Prepare for degranulation and release of lysosomal
enzymes (oxidative burst)
• Regulate leukocyte adhesion molecule affinity as
needed
• Secrete cytokines
PHAGOCYTOSIS AND INTRACELLULAR
DEGRADATION
 Inflammation - Summary
• Response of living vascularized tissue to injury.
• Celsus - 4 cardinal signs : dolor, tumor, rubor and
calor.
• Virchow –5 sign: function laesa
• Tissue: vascular and cellular events.
• Vascular events consists of: 1) vasodilatation and
2) increased vascular permeability.
Summary
 INFLAMMATION
Dr. HEMA KINI
Pathology Department, KMC, Mangaluru,
MAHE

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