PATHOPHYSIOLOGY

Dr.Wasfi Dhahir Abid Ali

Department of medical sciences –College of Nursing –

University of Basrah

INFLAMMATION

Inflammation is a immune system 'response to stimulus. This can

be bacteria colonizing a wound or a splinter piercing your finger, for

example. Inflammation happens when the immune system fights against

something that may turn out to be harmful.

And also inflammation define as apart of the complex biological and

a protective response of body tissues to harmful stimuli, such as

pathogens, damaged cells, or irritants. It involves immune cells,

blood vessels, and molecular mediators.

Inflammation

Type of defenses First - Non-Specific defenses

Defenses Against Infection. Natural barriers and the immune

system defend the body against organisms that can cause

infection. Natural barriers include the skin, mucous

membranes, tears, earwax, mucus, and stomach acid. Also, the

normal flow of urine washes out microorganisms that enter the

urinary tract.

Second:Humoral Defense This line of defense against infection specifically targets molecules called antigens B

cells are primarily responsible for humoral immunity (relating to

antibodies).The molecules responsible for humoral immunity to disease are

called immunoglobulins, also known as antibodies,They are proteinaceous cell

markers. humoral response mainly protects against extracellular

pathogens and toxins

There are five major classes of immunoglobulins

1- Immunoglobulin G (IgG) accounting for over 80% of all of the circulating

immunoglobulins.

2- Immunoglobulin A (IgA) composes about 15% of the circulating

antibodies.

3- Immunoglobulin E (IgE) has a structure similar to that of IgG.

4- Immunoglobulin D (IgD) is also a single molecule, and is found in very

small (0.2%) concentrations.

5- Immunoglobulin M (IgM) is the largest of the immunoglobulins,

composing about 5% of the total quantity of circulating antibodies

Third: Cell-Mediated Defense (CMI)

Several cell types are responsible for the cell-mediated

immune response . CMI is responsible for detecting and

destroying intracellular pathogens

1-Natural killer cells (N-K cells) They target and destroy

host cells which have been invaded by viruses.

2- CytotoxicT cells have CD8 markers and kill any cell

expressing foreign antigens.

3- T memory cells retain genetic information about specific

antigens.

4-T helper and T suppressor cells regulate the activities of

other specific immune cell types.

1-Pain(Dolor) due to fluid pressure on nerve ends

2-Heat(Calor)

3-Redness(Ruber)due to increase blood flow

4-swelling(Edema) accumulation of protein and

fluids in the interstitial space.

5-loss of function(lake of nutrition)

local effects(inflammatory response)

1-vascular stage: increases increase blood flow ,vessels

permeability led to edema,

2-Cellular stage :immigration of leukocytes, cell release

chemical mediators(bradykinin,histamine and prostoglandin

3-chemotaxic stage(distribution of chemotaxic factors

(cytokinin)

4-phagositosis:phagositosis of debris by microphages

5- microbial killing :killing of bacteria by lysosome,

complements,H2O2

Stages of inflammation

Acute inflammation

Is a short-term process, usually appearing within a

few minutes or hours and begins to cease upon the

removal of the injurious stimulus. It is characterized

by five cardinal signs include pain, redness,

immobility (loss of function), swelling and heat

Types of inflammation

Chronic inflammation

If the injurious agent persists then chronic inflammation will

ensue. This process, marked by inflammation lasting many days,

months or even years, may lead to the formation of a chronic

wound. Chronic inflammation is characterized by the dominating

presence of macrophages in the injured tissue. These cells are

powerful defensive agents of the body, but the toxins they release

(including reactive oxygen species) are injurious to the organism's

own tissues as well as invading agents. As a consequence, chronic

inflammation is almost always accompanied by tissue

destruction.

Physical:

Burns ,Frostbite ,Physical injury, blunt or penetrating ,Foreign bodies,

including splinters, dirt and debris Trauma ,Ionizing radiation

Biological:

Infection by pathogens ,Immune reactions due to hypersensitivity

,Stress

Chemical:

Chemical irritants. Toxins and alcohol

Psychological:

Embarrassment and Excitement

Causes of inflammation

Granulomatous inflammation: Characterized by the

formation of granulomas, they are the result of a limited but

diverse number of diseases, which include among others

tuberculosis, leprosy, sarcoidosis, and syphilis.

Fibrinous inflammation: Inflammation resulting in a large

increase in vascular permeability allows fibrin to pass through

the blood vessels. tubes can be formed.

Morphological type of inflammations

Purulent inflammation: Inflammation resulting in large

amount of pus, which consists of neutrophils, dead cells, and

fluid. Infection by pyogenic bacteria such as staphylococci is

characteristic of this kind of inflammation. Large, localized

collections of pus enclosed by surrounding tissues are called

abscesses.

Serous inflammation: Characterized by the copious

effusion of non-viscous serous fluid, commonly produced by

mesothelial cells of serous membranes, but may be derived

from blood plasma. Skin blisters exemplify this pattern of

inflammation.

Ulcerative inflammation:

Inflammation occurring near an epithelium can result in the

necrotic loss of tissue from the surface, exposing lower layers.

The subsequent excavation in the epithelium is known as an

ulcer.

Comparison between acute and chronic inflammation

A chronic Acute

Persistent acute inflammation Bacterial pathogen , injured tissue Cause

Macrophage , lymphocytes

,fibroblast, monocytes and

plasma cells

Neutrophils(primarily,

basophils(inflammatory response)

eosinophils(worms and

parasites),monocytes and macrophages

Cells

involved

Delayed Immediate Onset

Up to month or years Few days Duration

Tissues destruction, fibrosis,

necrosis

Resolution. Abscess formation ,chronic

inflammation

Outcomes