1	One Step Further Inflammation OSF - 1 Pages 12 - 14
2	Inflammation - 2 Definition: a non-specific immune response to any type of tissue injury or invasion of an infectious agent Events occuring during inflammation: eSystemic events Žincreased blood supply to area of injury Žincreased capillary permeability Žincreased concentration of acute phase reactants eHematopoietic events Žincreased leukocyte count Žincreased number of immature neutrophils - shift- to-left Žincreased levels of fibrinogen (Factor I) Žincreased Factor XII activation (coagulation) Žincreased Erythrocytic Sedimentation Rate (ESR)
3	Inflammation - 3 Events occuring during inflammation: - continued eCellular events Žleukocytes migrate out of capillaries under influence of chemotactic attraction Žleukocytes accumulate at site of injury due to: adhesion molecules (new surface receptors) that are induced by TNF (tumor necrosis factor) Types of inflammatory reactions: eAntibody-Mediated Inflammation - type I hypersensitivity eImmune-complex-Mediated Inflammation - type III hypersensitivity eT cell-Mediated Inflammation - type IV hypersensitivity
4	Inflammation - 4 Types of inflammatory reactions: - continued eAntibody-Mediated Inflammation - type I hypersensitivity Žobserved as an immediate skin reaction Žcaused by mast cells/basophils releasing mediators such as: histamine vasodilator & smooth muscle constrictor prostaglandins increased vascular permeability & platelet aggregator cytokines products produced by one cell that affects another cell
5	Inflammation - 5 Types of inflammatory reactions: - continued eAntibody-Mediated Inflammation - type I hypersensitivity ŽMechanisms of response: IgE produced in response to initial stimulation of immune system IgE binds to IgE (Fc) receptors on mast cells/basophils ("sensitization") when allergen (antigen) binds with more than two IgE molecules on mast cell/basophil it causes cell to release granular contents ("degranulation") granular mediators released ŽMediator induced changes that take place: infiltration by cells erythema, heat, & itching
6	Inflammation - 6 Types of inflammatory reactions: - continued eAntibody-Mediated Inflammation - type I hypersensitivity ŽClinical expressions: immediate hypersensitivity asthma allergies hay fever eImmune-complex-Mediated Inflammation - type III hypersensitivity Žinflammation that occurs when immune- complexes (ag-ab) are formed in the circulatory system and then are deposited in or on tissue ŽMechanisms of response: next slide #
7	Inflammation - 7 Types of inflammatory reactions: - continued eImmune-complex-Mediated Inflammation - type III hypersensitivity ŽMechanisms of response: IgG capable of activating complement or IgM that does activate complement, are formed and react with the inducing antigen to form ag-ab complexes within the circulatory system. These immune-complexes are then deposited on or in various tissues such as: ]glomerular basement membrane (Goodpasture's syndrome) ]endothelial cells of blood vessels
8	Inflammation - 8 Types of inflammatory reactions: - continued eImmune-complex-Mediated Inflammation - type III hypersensitivity ŽMechanisms of response: continued When complement is activated, fragments C3a, C4a, and C5a are released and cause: ]chemotactic attraction of neutrophils ]increased vascular permeability ]aggregation of platelets ]infiltration by mononuclear cells ŽClinical expression: Arthus reaction ]localized edema ]inflammation Systemic serum sickness
9	Inflammation - 9 Types of inflammatory reactions: - continued eT cell-Mediated Inflammation - type IV hypersensitivity Žinteraction of antigen with specific T cells plus class II MHC molecules ŽMechanisms of response: immune cells infiltrate site of antigen stimulation where coagulation/kinin system is activated resulting in: ]fibrin formation ]hardened fibrous tissue ŽClinical expression: delayed hypersensitivity reaction
10	Inflammation - 10 Regulation of inflammatory reactions: eAs the level of antigen decreases inflammation subsides eFormed or released mediators assist in the regulation: Ženzymes Žcomplement Žfibrinolytic products Žkinin system products Žvarious amines Acute Phase response: ea rapid response to inflammation due to release of: ŽC-reactive proteins (CRP) Ž"-2 macroglobulins Žfibrinogen (Factor I) Žserum amyloid A protein (SAA)
11	Inflammation - 11 Laboratory Diagnosis of Inflammation: eMeasure the level of the following products: ŽErythrocytic Sedimentation Rate (ESR) ŽC-reactive protein (CRP) ŽInterleukin-6 (IL-6) Žfibrinogen (Factor I) Žserum amyloid A protein (SAA)
12	Inflammation - 12