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Inflammation & Repair

Inflammation & Repair. Inflammation. Acute Inflammation. Cardinal signs Red (rubor) Swelling (tumor) Warm (calor) Tender (dolor) Loss of function (functio laesa). Neutrophils Polymorphonuclear Lekocytes (PMN). Margination Pavementing Adhesion

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Inflammation & Repair

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  1. Inflammation & Repair

  2. Inflammation

  3. Acute Inflammation • Cardinal signs • Red (rubor) • Swelling (tumor) • Warm (calor) • Tender (dolor) • Loss of function (functio laesa)

  4. NeutrophilsPolymorphonuclear Lekocytes (PMN) • Margination • Pavementing • Adhesion • Complementary adhesion molecules on leukocytes and endothelial cells

  5. Leukocyte-Endothelial Adhesion

  6. Neutrophils Rolling

  7. Emigration & Chemotaxis Mediators • Bacterial products - LPS • Complement derivatives - C5a • Arachidonic acid derivatives • leukotriene B4 • Cytokines - IL-8

  8. Emigration & Chemotaxis Mediators Neutrophil Chemotaxis in vitro

  9. Emigration & Chemotaxis Defects • WBC defects - • Chediak-Higashi Syndrome • Diabetes mellitus • Chemotactic factor defects • C5 or immunoglobulin deficiency • Serum chemotaxis inhibitors • C5 inactivators -  in cirrhosis, sarcoidosis, and other diseases • WBC locomotion inhibitors • Chloroquine, cancer and other chronic diseases

  10. Phagocytosis & Degranulation • Phagocytosis requires three distinct steps • Recognition • Attachment • Engulfment

  11. Recognition & Attachment • Opsoninzation • Opsonins • Fc fragment of IgG • C3b • Mannose-binding protein (produced in the liver) • Covers the surface of microorganisms and is recognized by neutrophils and macrophages

  12. Phagocytosis & Degranulation

  13. Phagocytosis & Degranulation

  14. Activation and Destruction (killing) • Oxygen dependent killing • myeloperoxidase requires hydrogen peroxide and halide (e.g., Cl-) to produce HOCl • Hydrogen peroxide and ferrous ion without myeloperoxidase will generate OH free radical

  15. Chemical Mediators of Inflammation

  16. Chemical Mediators of InflammationPreformed & Newly Synthesized

  17. Arachidonic Acid System

  18. Noninflammatory and Inflammatory Conditions • Transudate - fluid with low protein content and a specific gravity <1.012 • Exudate - inflammatory extracellular fluid composed of plasma proteins, principally albumin, cells and cellular debris, and a specific gravity >1.020

  19. Transudate - Pulmonary Edema

  20. Pitting Edema

  21. Laryngeal Edema

  22. Pulmonary Edema

  23. Ascites

  24. Ascites

  25. Noninflammatory and Inflammatory Conditions • Anasarca - edema which is severe and generalized • Abscess - localized collections of pus caused by suppuration buried in a tissue, organ, or confined space • Cellulitis - spreading suppurations in subcutaneous tissue

  26. Types of Exudates • Serous - blister in thermal burn • Fibrinous - uremic pericarditis, viral/chemical pneumonitis, idiopathic • Purulent - meningococcal meningitis • Eosinophilic - IgE mediated - asthma & parasitic infection • Hemorrhagic - rickettsial • Pseudomembranous- diptheria & pseudomembranous enterocolitis

  27. Serous Exudate - Blister

  28. Serous Exudate - Blister

  29. Fibrinous Exudate - Pericarditis

  30. Fibrinous Pericarditis

  31. Acute Inflammation - Purulent

  32. Acute Inflammation - Purulent

  33. Acute Inflammation - Purulent

  34. Acute Inflammation - Purulent

  35. Pseudomembranous ExudateDiphtheria

  36. Pseudomembranous ExudateDiphtheria

  37. Diphtheria

  38. Outcomes of Acute Inflammation

  39. Outcomes of Acute Inflammation

  40. The End Acute Inflammation

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