Inflammation: Course Teacher: Imon Rahman

Inflammation
Course Teacher: Imon Rahman

Inflammation
Inflammation is a complex
reaction to injurious agents
such as microbes and
damaged, usually necrotic cells
that consists of vascular
response, migration and
activation of leukocytes and
systemic reaction.
Or
Inflammation is the complex
reaction of the living
vascularized connective tissue
towards an injury.
Types
Acute inflammation:
Acute inflammation is the inflammation of short

duration (few mins to few days) by exudation of fluid
and plasma protein and the emigration of leukocytes,
predominantly neutrophils.
Cardinal Signs
1. Rubor (Redness)
2. Tumor (Swelling)
3. Calor (heat)
4. Dolor (Pain)
5. Functio Laesa (loss of
function)
Chronic inflammation
It is defined as an
inflammation of prolonged
duration (weeks or months)
in which active
inflammation, tissue
destruction and attempts at
repair are proceeding
simultaneously.
Eg: Tuberculosis, Rheumatoid

arthritis, atherosclerosis and
chronic lung disease.
Histological features
1. Infiltration with mononuclear cells, which include
macrophages, lymphocytes and plasma cells.
2. Tissue destruction, induced by persistent offending
agent or by inflammatory cells.
3. Attempts at healing by connective tissue
replacement of damaged tissue, accomplished by
proliferation of small blood vessels (angiogenesis)
and in particular, fibrosis.
Causes of acute inflammation
1. Infection (bacteria and viral parasites) and microbial
toxin.
2. Trauma (blunt and penetrating)
3. Physical and chemical agents, thermal injury, e.g
burns or frostbite, some environmental chemicals.
4. Tissue necrosis (from any cause)
5. Foreign bodies (splinters).
6. Immune reaction (also called hypersensitivity
reaction)
Causes of Chronic Inflammation
1. Persistent infection: by certain
microorganism, tubercle bacilli,
treponema pallidum and certain
viruses, lung and parasites.
These organism causes delayed
hypersensitivity. Some time a
granulomatous reaction occurs.
2. Prolonged exposure to
potentially toxic agent:
 Exogenous: particulate silica-
causes silicosis
 Endogenous: causes
atherosclerasis.
3. Autoimmunity:
Immune reaction develops
against the individual’s
own tissues, leading to
autoimmune diseases,
such as rheumatoid
arthritis and lupus
erythematosus.
Exudation
The escape of proteins rich
fluid and blood cells
(predominantly
leukocytes) from the
vascular system to
interstitial tissue or body
cavities is known as
exudation.
Exudates
It is an inflammatory extra vascular fluid that has a
high protein concentration, much cellular debris and
specific gravity above 1.020. it is due to normal
permeability of small blood vessels in the area of
injury.
Benefits of Exudates
Fluid exudates:
1. Dilution of irritant substances.
2. Exudates carry inflammatory cells & natural anti-bacterial substances like
complement, specific immunoglobulin.
3. Drugs & antibiotics appear at the site of action from the circulation through the
exudates.
4. It contain fibrin which has 3 main functions
 It forms an union between the cut/damaged tissue
 It may form a barrier against bacterial invasion
 It aids phagocytosis
5. Nutrition to the greatly increased cells
6. Low of pH due to lactic acid formation (by injured cells & nerves). So inhibits
bacterial growth.
7. Promotion of immunity: by carrying Ag to local lymphnode and including immune
response
Tissue exudates
1. neutrophils, macrophages- ingest foreign particles,
bacteria &cell debris.
2. B lymphocytes- secrets Ig
Function of exudates in Inflammation
1. Dilution of irritant substances.
2. Exudates carry inflammatory cells & natural anti-bacterial
substances like complement, specific immunoglobulin.
3. Drugs & antibiotics appear at the site of action from the
circulation through the exudates.
4. It contain fibrin which has 3 main functions-
 It forms an union between the cut/ damaged tissue.
 It may form a barrier against bacterial invasion.
 It aids phagocytosis.
5, 6 and 7 are same.
8. Pain production by increasing the tension/ pressure on nerve
endings.
Acute Inflammation
Fate of acute inflammation:
1. Complete resolution: Resolution means the complete return
to normal of a tissue following acute inflammation. Usually it
occurs-
 When the injury is limited and short lived.
 When there has been a little tissue damage.
2. Healing by connective tissue replacement:

 There is a substantial tissue destruction
 Inflammation occurs in the tissue that do not regenerate.
 There is abundant fibrin exudation
Chronic Inflammation
If causative agent persists of there is
interference of repair.
Clinical Manifestation:
Tissue Destruction: induced by
persistent offending agent or
inflammatory cells. Necrosis of the
tissue takes place. Necrotic tissue
can perpetuate the inflammatory
cascade through the activation of
kinin, coagulation complement,
dying cells also liberate uric acid.
Fibrosis is another
manifestation: it takes
and whole of the tissue
become fibrotic leading
to disfiguring of scar,
intestinal obstruction,
decrease motility of
joints.
Systemic effects of inflammation
1. Fever
2. Increasing acute phase protein
3. Leukocytosis
4. Manifestation of acute phase response-
 Increase BP and pulse
 Decrease sweting
 Chills, anorexia
5. Sepsis
Beneficiary effects of inflammation
1. Without inflammation, infection would remain

unchanged
2. Without inflammation wound would never heal
3. Injured tissue and organ might remain as permanent
defect.
Harmful effects
1. It may lead to disfiguring scar
2. Formation of fibrous bands may limit the mobility of
a joint.
3. Formation of large scar tissue in an organ, may
impair the function of a organ.
4. Immune mediated hypersensitivity reaction may
cause generalized inflammation leading to massive
exudation and shock.
5. Leukocyte products released causes endothelial cell
injury and tissue damage.
Pus
It is inflammatory exudates
consisting of leukocytes
(mostly neutrophils),
necrotic cells and edema
fluid.
Composition of Pus:
1. Dead and dying leukocyte
2. Inflammatory exudates:
edema fluid and fibrin
3. Living or dead organism.

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Inflammation

Course Teacher: Imon Rahman

Acute inflammation is the inflammation of short

Eg: Tuberculosis, Rheumatoid

2. Healing by connective tissue replacement:

1. Without inflammation, infection would remain

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