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4. Tissue: The Living Fabric: Part B. Inflammatory Response. Triggered whenever body tissues injured Prevents spread of damaging agents Disposes of cell debris and pathogens Alerts adaptive immune system Sets the stage for repair. Inflammatory Response.
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4 Tissue: The Living Fabric: Part B MDufilho
Inflammatory Response • Triggered whenever body tissues injured • Prevents spread of damaging agents • Disposes of cell debris and pathogens • Alerts adaptive immune system • Sets the stage for repair MDufilho
Inflammatory Response • Cardinal signs of acute inflammation: • Redness • Heat • Swelling • Pain (Sometimes 5. Impairment of function) MDufilho
Inflammatory Response • Begins with chemicals released into ECF by injured tissues, immune cells, blood proteins • Macrophages and epithelial cells of boundary tissues bear Toll-like receptors (TLRs) • 11 types of TLRs recognize specific classes of infecting microbes • Activated TLRs trigger release of cytokines that promote inflammation MDufilho
Inflammatory Response • Inflammatory mediators • Histamine (from mast cells) • Kinins, prostaglandins (PGs), and complement • Dilate local arterioles (hyperemia) • Causes redness and heat of inflamed region • Make capillaries leaky • Many attract leukocytes to area • Some have inflammatory roles MDufilho
Inflammatory Response: Edema • Capillary permeability exudate to tissues • Fluid containing clotting factors and antibodies • Causes local swelling (edema) • Swelling pushes on nerve endings pain • Pain also from bacterial toxins, prostaglandins, and kinins • Moves foreign material into lymphatic vessels • Delivers clotting proteins and complement MDufilho
Inflammatory Response • Clotting factors form fibrin mesh • Scaffold for repair • Isolates injured area so invaders cannot spread MDufilho
Clinical Applications • Benadryl (an antihistamine) – blocks receptor site (H1) for histamine receptors • Aspirin/Ibuprofen – inhibits formation/action of prostaglandins – reduces pain and fever Cortisone cream – inhibits release/action of inflammatory chemicals • Naproxen – prevents formation of prostaglandins MDufilho
Figure 4.12. Tissue repair of a nonextensive skin wound: regeneration and fibrosis. Slide 1 Scab Epidermis Vein Blood clot in incised wound Inflammatory chemicals Migrating white blood cell Artery Inflammation sets the stage: • Severed blood vessels bleed. • Inflammatory chemicals are released. • Local blood vessels become more permeable, allowing white blood cells, fluid, clotting proteins, and other plasma proteins to seep into the injured area. • Clotting occurs; surface dries and forms a scab. 1 MDufilho
Tissue Repair • Necessary when barriers are penetrated • Cells must divide and migrate • Occurs in two major ways • Regeneration • Same kind of tissue replaces destroyed tissue • Original function restored • Fibrosis • Connective tissue replaces destroyed tissue • Original function lost MDufilho
Figure 4.12. Tissue repair of a nonextensive skin wound: regeneration and fibrosis. Regenerating epithelium Area of granulation tissue ingrowth Fibroblast Macrophage Budding capillary 2 Organization restores the blood supply: • The clot is replaced by granulation tissue, which restores the vascular supply. • Fibroblasts produce collagen fibers that bridge the gap. • Macrophages phagocytize dead and dying cells and other debris. • Surface epithelial cells multiply and migrate over the granulation tissue. Slide 2 MDufilho
Steps in Tissue Repair: Step 3 • Regeneration and fibrosis • The scab detaches • Fibrous tissue matures; epithelium thickens and begins to resemble adjacent tissue • Results in a fully regenerated epithelium with underlying scar tissue MDufilho
Figure 4.12. Tissue repair of a nonextensive skin wound: regeneration and fibrosis. Slide 3 Regenerated epithelium Fibrosed area Regeneration and fibrosis effect permanent repair: • The fibrosed area matures and contracts; the epithelium thickens. • A fully regenerated epithelium with an underlying area of scar tissue results. 3 MDufilho
Regenerative Capacity in Different Tissues • Regenerate extremely well • Epithelial tissues, bone, areolar connective tissue, dense irregular connective tissue, blood-forming tissue • Moderate regenerating capacity • Smooth muscle and dense regular connective tissue • Virtually no functional regenerative capacity • Cardiac muscle and nervous tissue of brain and spinal cord • New research shows cell division does occur • Efforts underway to coax them to regenerate better MDufilho
Aging Tissues • Normally function well through youth and middle age if adequate diet, circulation, and infrequent wounds and infections • Epithelia thin with increasing age so more easily breached • Tissue repair less efficient • Bone, muscle and nervous tissues begin to atrophy • DNA mutations possible increased cancer risk MDufilho