kuliah inflamasi
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Transcript of kuliah inflamasi
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Inflammation/peradangan
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Definitions
Inflammation is essentially a protective
response intended to eliminate both theinitial cause of cell injury (e.g., microbes ortoxin) and the necrotic cells and tissuesarising as a consequence of such injury.
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Acute/Chronic Inflammation
Acut Inflammation: relatively short duration, lastingfrom a few minutes up to a few days, and ischaracterized by fluid and plasma protein exudation,
and by a predominatly neutrophil accumulation.
Chronic Inflammation: longer duration (weeks toyears), is manifested histologically by influx of
macrophages, lymphocytes and plasma cells,and bytissue destruction and repair, the later is associatedwith vascular proliferation and fibrosis.
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Acute inflammation
There are 3 major
components :
1. Vasodilatation
2. Structural changes in
the microvasculaturethat permit plasmaprotein to leave thecirculation
3. Neutrophil emigration
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Heat Red Swelling Pain Loss Of
Func.
5 Cardinal Signs
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Classic Signs of Inflammation
Rubor: erythema due to capillary dilation
Calor: warmth due to increased blood flow
Tumor: edema and accumulation of fluid in theextravascular space and cells migrating intothe tissue
Dolor: pain due to local pressure andstimulation of nerve endings
Functio laesa: alteration in function Due tothe physical swelling and the pain present
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Mouth Aphthous ulcer
Calor, Rubor, Dolor, Tumor, Loss of function
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Mediators in vivo of acute inflammation
*Vasodilatation
prostaglandins, nitric oxide (NO)
* Increased vascular permeability
vasoactive amines, C3a and C5a, bradykinin, Leukotiene, PAF
Chemotaxis, leucocyte activation
C5a, Bacterial product, chemokines (IL-8)
Fever
IL-1, IL-6, TNF alfa
Pain
prostaglandin, bradykinin
Tissue damage
Neutrophil & macrophage lysosomal enzymes
Oxygen metabolites, NO
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Migration of Leucocytes
Leucocytes attracted to the area (especially Neutrophils)
These leave the blood vessel and enter the damaged
area. This is called DIAPEDESIS
Leucocytes attracted by CHEMOTAXIS,chemicalsreleased from the damaged tissues
Leucocytes phagocytose the invading bacteria and dead
tissue. Antibodies help with this job.
Fibrin walls the damaged area off preventing further
damage or extending the infected area
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These are usually firstto inflammation Bothin serum and mucosal,will function much asmacrophages
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Granulocytes
Neutrophils
Eosinophils
Basophils
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Neutrophils
Polymorphonuclear neutrophils (PMNs)
First to arrive at the inflamed site
Phagocytize bacteria, dead cells, cellulardebris.
Kill living cells
Digest foreign material
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Eosinophils
Functions
respond to chemical messengers
phagocytosis
kill certain microorganisms
Special functions
parasite infections
allergic reactions
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Basophils
Functions
respond to chemical messengers
release granules containing chemical into the
injured site
have functions similar to mast cells
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Agranulocytes
Monocytes
Lymphocytes
T lymphocytes
B lymphocytes
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Monocytes
Attracted to the area by PMNs
Blood: Monocytes
Exudate and RES: Macrophages Skin: Histiocytes
Respond to the lymphocytes
produce monokines, interferons, TNF more effective phagocytosis
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Lymphocytes
Important in immunity
Less important in inflammation
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Mast Cells
Basophils
The most important activator of the
inflammatory response
Mast cells are cellular bags of granules located
in loose connective tissue near blood vessels.
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Outcomes of acute inflammation
Complete resolution
little tissue destruction and capable ofregeneration
Scarring of fibrosis
do not regenerate
Abscess formation
in the setting of certain bacterial or
fungal infections Progression to chronic inflammation
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Chronic Inflammation
Persistent infections
Tubercle bacilli, Treponema pallidum Prolonged exposure to potentially toxic agents
inhaled silica, chronically elevated plasma lipid
Autoimmune diseases
immune response to self antigens
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Systemic effects of inflammation
Fever
Higher erythrocyte sedimentation rate
Leukocytosis/leukopenia Neutrophilia, eosinophilia, lymphocytosis
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Inflammation Cancer
Arthritis
Atherosclerosis
Colitis
Psoriasis
Infection
Diabetes
Chronic inflammation plays a role inmany disease conditions
Eczema