INFLAMMATION,
INFLAMMATORY
RESPONSE, &
FEVER
Module II
Regie De Jesus, MAN
College of Health Sciences
PATHOPHYSIOLOGY
Inflammation
• An innate, automatic response to cell injury
that:
• Neutralizes harmful agents (bacteria, etc…)
• Removes damaged and dead tissues
• Generates new tissues
• Promotes healing
• Minimizes the effects of injury or infection
INFLAMMATION IS NECESSARY,
BUT IF PROLONGED CAN LEAD TO
UNWANTED EFFECTS
Inflammation
• Damaged cells release inflammatory
mediators
• Local responses
• Vascular Stage
• Cellular Stage
• Systemic (whole-body) responses
• White blood cell response
• Acute-phase response
White Blood Cells (Leukocytes
in Inflammation
• Granulocytes
• Neutrophils – first responder – most plentiful
(60-70%) – short lived – pus
• Eosinophils – associated with parasites(worms)
involved in allergic response
• Mast cells – localized in tissue of allergic
responses – (involved in anaphylaxis)
• Basophils – amplification of allergic response
• Depending on the cell, the granules contain a
range of chemicals including
• Histamine(local inflammatory trigger)
• Heparin (prevents clotting)
• Toxins to kills invaders (like bacteria & worms)
• Proteases
• Enzymes to synthesize Prostaglandin &
Leukotrienes
• Signal molecules – cytokines and chemokines
Agranulocytes
• Monocytes – Macrophages:
• Inactive monocytes circulate until they receive
a chemotaxic signal that something has
occurred
• Then they move into the interstitial space as
macrophages
• Macrophages phagocytose (eat) & digest
invaders rather than secreting toxins. They also
produce signal molecules to prolong the
immune response
Agranulocytes
• Lymphocytes
• T lymphocytes – kill infected or damaged
cells
• B lymphocytes – plasma cells (antibody
producers)
• Lymphocytes communicate with each other
and with other leukocytes for a prolonged
and targeted immune response
INFLAMMATION
• Normally (no injury or inflammation)
• The endothelial cells form a selective
barrier that keeps most microbes out &
controls what can move into & out of the
vessels (vessel environment & insterstitial
environment)
• The endothelial cells lining the vessels
produce agents that keep them open &
unobstructed (constriction or dilation)
• The blood vessels are non-thrombogenic (do
not promote clotting)
• Platelets are unable to bind to other platelets
& cells so clotting does not occur
• Many cells & other chemical factors are
circulating but do not cause inflammation
Acute Inflammatory Response
• The early or immediate local reaction to injury
(associated with innate immune system)
• Designed to remove injurious agent and limit
tissue damage
• Triggered by:
• Infections
• Immune reactions
• Physical or chemical trauma
Cardinal signs of inflammative
(from 1 & 2 century AD)
st nd
• Rubor – REDNESS
• Tumor – SWELLING
• Calor – HEAT (localized)
• Dolar – PAIN
• Functia laesa – Loss of function
2 stages of Acute Inflammation
• Vascular (fluid moves to tissues)
• Cellular (leukocytes move into tissues)
Vascular
• Quick period of
vasoconstriction followed
by vasodilation
• Increased blood flow
(but slower)
• Redness and heat
• Increased blood
flow leads to net
flow & plasma
proteins out of
vessels and into
tissue, creating
swelling, triggering
pain, & impairing
function
& Pain
