INFLAMMATION is a localized reaction that produces redness, warmth, swelling and pain as a result of infection, irritation, or injury.

Inflammation can be external or internal. It is also known as the bodys attempt at selfprotection; the aim is simply to remove harmful stimuli, including damaged cells, irritants, or pathogens and begin the healing process. Biological response will try to remove any harmful or irritating that affects our body. The body is said trying to heal itself

INFLAMMATION

According to medical dictionary :

A fundamental pathologic process consisting of a dynamic complex of histologically apparent cytologic changes, cellular infiltration, and mediator release that occurs in the affected blood vessels and adjacent tissues in response to an injury or abnormal stimulation caused by a physical, chemical, or biologic agent, including the local reactions and resulting morphologic changes; the destruction or removal of the injurious material; and the responses that lead to repair and healing.

Inflammation
Acute Inflammation

Chronic Inflammation

 Acute inflammation - starts rapidly (rapid onset) and quickly becomes severe. Signs and symptoms are only present for a few days, but in some cases may persist for a few weeks. Examples of diseases, conditions, and situations which can result in acute inflammation include: acute bronchitis, infected ingrown toenail, sore throat from a cold or flu, a scratch/cut on the skin, exercise (especially intense training), acute appendicitis, acute dermatitis, acute tonsillitis, acute infective meningitis, acute sinusitis, or a blow.

 Chronic inflammation - this means long-term inflammation, which can last for several months and even years. Examples of diseases and conditions with chronic inflammation include: asthma, chronic peptic ulcer, tuberculosis, rheumatoid arthritis, chronic periodontitis, ulcerative colitis and Chrons disease, chronic sinusitis, and chronic active hepatitis (there are many more)

Chronic Inflammation cause:

The five cardinal signs of acute inflammation - "PRISH"

Pain - the inflamed area is likely to be painful, especially when touched. Chemicals that stimulate nerve endings are released, making the area much more sensitive. Redness - this is because the capillaries are filled up with more blood than usual Immobility - there may be some loss of function Swelling - caused by an accumulation of fluid Heat - as with the reason for the redness, more blood in the affected area makes it feel hot to the touch

ACUTE INFLAMMATION
Causative agents - harmful bacteria or injury to tissue Major cells involved - mainly neutrophils, basophils (in the inflammatory response), and eosinophils (response to parasites and worms), and mononuclear cells (macrophages, monocytes) Primary mediators - eicosanoids, vasoactive amines Onset (when does the inflammation start) - straight away Duration - short-lived, only a few days Outcomes - the inflammation either gets better (resolution), develops into an abscess, or becomes a chronic inflammation

CHRONIC INFLAMMATION
Causative agent - non-degradable pathogens that cause persistent inflammation, infection with some types of viruses, persistent foreign bodies, overactive immune system reactions Major cells involved - Macrophages, lymphocytes, plasma cells (these three are mononuclear cells), and fibroblasts Primary mediators - reactive oxygen species, hydrolytic enzymes, IFN- and other cytokines, growth factors Duration - from several months to years Outcomes - the destruction of tissue, thickening and scarring of connective tissue (fibrosis), death of cells or tissues (necrosis)

What Causes Pain?

Inflammation primarily causes pain because the swelling pushes against the sensitive nerve endings, which send pain signals to the brain.

Stages involved in Inflammation

INFLAMMATION IRRITATION And SUPPURATION

GRANULATION (formation of wound)

PHYSIOLOGY

Inflammation

Why??
Dispose foreign material at the site of injury from spreading to another tissue. Prepare the site for tissue repair in an attempt to restore tissue homeostasis.

Symptoms of inflammation
PAIN

REDNESS
HEAT

SWELLING

Generally,inflammation has three basic stages:1) Vasodilation and Increased Blood Vessel Permeability 2) Emigration of Phagocytes

3) Tissue Repair

Substances responsible to vasodilation and permeability:

Histamine
Kinins Prostaglandins Leukotrienes Complement

CHEMICAL RELEASED DURING INFLAMMATION

Prostaglandins
lipid autacoids derived from arachidonic acid play a key role in the generation of the inflammatory response , eg : fever , pain , redness , cause increased blood flow, chemotaxis (chemical signals that summon white blood cells) When tissues are damaged, white blood cells flood the site to try to minimise tissue destruction. Prostaglandins are produced as a result.

Leukotrienes
Where it is came from? - Synthesise from arachidonic acid (eicosanoids) through lipoxygenase. - Come from leukocytes.

How do they help in inflammation? - Have chemotactic effect on the neutrophils in the blood stream which mean it can causes the WBC to travel to the area of intrusion and damage. - Prolong the lives of WBC. - Increase the activity of macrophages.

LEUKOTRIENES
When they go wrong? - Allergies are disorder of the immune system when unharmful substances triggers the immunity responses. - Sensitive to allergens which cause I.S to overreact to a perceived attack. - Can cause constriction of airway, make us harder to breathe. - Cause blood vessels in the nose to dilate, which makes the nasal tissues to swell up and cause nasal congestion. - Luekotrienes inhibitor or luekotrienes receptor antagonist stops the luekotrienes from being detected. - They bind to protein receptors rather than leukotrienes which will stop the triggering of inflammatory responses (allergic).

CYTOKINES
A small protein that are secreted by specific cells of the immune system which carry signals locally between cells, and thus have an effect on other cells, which trigger inflammation and respond to infections. When they are released by their creator cells into tissue or into the circulatory system, they locate their target cells and interact with specific receptors, called binding sites, on the target cells by attaching to them. This interaction triggers a particular action or response by the target cell.

 In the case of inflammation, certain cytokines trigger responses to fight infection or injury. The body responds by targeting the injured or infected area with other cells to fight the damage.

The body then becomes red, swollen, and warm in the affected area, due primarily to increased blood flow.
There are two types of inflammation, acute and chronic. Acute inflammation is primarily due to injury or infection, whereas chronic inflammation is usually caused by a malfunction of the bodys immune system. Chronic inflammation can lead to long term damage.

 Cytokines involved in acute inflammation: Interleukin Tumor necrosis factor Chemokines Eotaxin Colony stimulating factors Cytokines involved in chronic inflammation: Interleukin Transforming growth factor-b Interferons IFN-g-inducing factor

 They function not only to incite inflammation, but also to inhibit it.
In cases of acute inflammation, there is usually no need for intervention other than reduction of symptoms, as it will eventually stop.

In chronic inflammation, which can cause long term damage, the medications used are often ones that inhibit cytokine production or function. These work by blocking the receptor sites on cells that bind to a specific cytokine. Overproduction of certain cytokines can lead to disease often involving inflammation

ANTI INFLAMMATORY DRUGS

Aspirin, ibuprofen, naproxen Provide analsegic effect (painkillers) Inhibiting prostaglandins synthesis which can cause pain.