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Acute Inflammation
• Cardinal signs– Red (rubor)– Swelling (tumor)– Warm (calor)– Tender (dolor)– Loss of function (functio laesa)
NeutrophilsPolymorphonuclear Lekocytes (PMN)
• Margination– Pavementing
• Adhesion– Complementary adhesion molecules on
leukocytes and endothelial cells
Emigration & Chemotaxis Mediators
• Bacterial products - LPS• Complement derivatives - C5a• Arachidonic acid derivatives
– leukotriene B4• Cytokines - IL-8
Emigration & Chemotaxis Mediators
Neutrophil Chemotaxis in vitro
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
Phagocytosis & Degranulation
• Phagocytosis requires three distinct steps– Recognition– Attachment– Engulfment
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
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
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
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
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