GOVT. AUTONOMOUS AYURVEDA COLLEGE
AND HOSPITAL NIPANIYA REWA(M.P.)
• NAME – NAVEEN PARIHAR
• TOPIC – INFLAMMATION
• BATCH 2019
🔆 INFLAMMATION
🛑 INTRODUCTION
• INFLAMMATION IS DEFINED AS THE LOCAL RESPONSE OF LIVING
MAMMALIAN TISSUES TO INJURY DUE TO ANY AGENT.
BODY DEFENSE REACTION ELIMINATE OR LIMIT THE SPREAD OF
INJURIOUS AGENT.
CAUSE OF INFLAMMATION
1. INFECTIVE AGENTS :- BACTERIA, VIRUSES AND THEIR TOXINS,
FUNGI, PARASITES.
2. IMMUNOLOGICAL AGENTS :- CELL-MEDIATED AND ANTIGEN
ANTIBODY REACTIONS.
3.PHYSICAL AGENTS :- HEAT, COLD, RADIATION, MECHANICAL
TRAUMA.
4. CHEMICAL AGENTS :- ORGANIC AND INORGANIC POISONS.
5. INERT MATERIALS :- SUCH AS FOREIGN BODIES
SIGNS OF INFLAMMATION
4 CARDINAL SIGNS(CELSUS)
• - RUBOR (REDNESS);
• - TUMOR (SWELLING);
• - CALOR (HEAT);
• - DOLOR (PAIN)
• 5TH SIGN FUNCTION - LAESA (LOSS OF FUNCTION) R
VIRCHOW
Types of
inflammation
1. ACUTE INFLAMMATION-
- SHORT DURATION
- REPRESENTS THE EARLY BODY
REACTION
- FOLLOWED BY HEALING
- EDEMA
- MAINLY NUTROPHILS
• 2. CHRONIC
INFLAMMATION
- LONGER DURATION
- LYMPHOCYTES AND MACROPHAGES
PREDOMINATE
- FIBROSIS
ACUTE INFLAMMATION
• THE MAIN FEATURES OF ACUTE INFLAMMATION ARE:-
- ACCUMULATION OF FLUID AND PLASMA AT THE
AFFECTED SITE.
- INTRAVASCULAR ACTIVATION OF PLATELETS;
- POLYMORPHONUCLEAR NEUTROPHILS AS
INFLAMMATORY CELLS.
THESE INFLAMMATORY CHANGES INVOLVE
TWO MAIN COMPONENT –
Vascular Reaction
Cellular Reaction
Changes in Blood
vessels
Changes in
Leucocytes (blood
cells)
Changes in blood vessels involve following
steps
1. Vasodilation
2. Change in
vascular
permeability
3. Change in
vascular Flow
VASODILATION
• VASODILATION IS THE ONE OF THE EARLIEST MANIFESTATION OF ACUTE INFLAMMATION.
SOMETIME IT FOLLOWS TRANSIENT CONSTRICTION OF ARTERIOLE. THIS VASOCONSTRICTION
LASTING FOR A FEW SECONDS.
• VASODILATION FIRST INVOLVE ARTERIOLE AND THEN RESULTS IN OPENING OF NEW
CAPILLARY BEDS IN THE AREA.
CHANGE IN VASCULAR PERMEABILITY
• INCREASED VASCULAR PERMEABILITY IS THE HALLMARK OF ACUTE
INFLAMMATION.
• DUE TO VASCULAR PERMEABILITY ESCAPE OF PROTEIN RICH FLUID [EXUDATE]
AND LEUKOCYTE INTO EXTRA VASCULAR SPACE.INTRAVASCULAR OSMOTIC
PRESSURE REDUCES DUE TO EXUDATION OF PROTEIN AND OSMOTIC PRESSURE
OF INTERSTITIAL FLUID IS INCREASED.
• TOGETHER WITH INCREASED HYDROSTATIC PRESSURE AND DECREASED
INTRAVASCULAR OSMOTIC PRESSURE LEADS TO FURTHER OUTFLOW OF FLUID
AND ACCUMULATE IN THE INTERSTITIAL FLUID.
CHANGE IN VASCULAR FLOW
• THE LOSS OF FLUID RESULTS IN CONCENTRATION OF RED
CELLS AND INCREASED VISCOSITY OF BLOOD. WHICH
SLOW THE BLOOD FLOW CALLED AS STASIS.
• किसी भी बाह्य िारि ि
े प्रवेश िरने पर प्रकिकिया स्वरूप में
प्रभाकवि उत्ति ों से किस्टाकमन स्त्राकवि ि िा िै। किससे सबसे पिले
VASODILATION ि िा िै।
• HISTAMIN
SMOOTH MUSCLES ि RELAX िरिा िै, किससे VASODILATION ि िा िै।
RUBOR (RED), COLOR (HEAT) ARTERIOLES व CAPPILARIES में रक्त िा प्रवाि बढ िािा िै।
HYDROSTATIC PRESSURE बढ़ने ि
े िारण TRANSUDATE बािर आिा िै।
(बाह्य िारि ों िी प्रकिकिया स्वरूप) िथा CAPPILARY PERMEABILITY बढ़ने ि
े िारण
ARTERIOLE OR CAPPILARIES से प्र टीन बािर INTERSTITIAL SPACE में आने लगिा िै।
ि कशिाओों से EXUDATE (प्र टीन आकिक्य स्राव बािर आिा िै।
• ि
े कशिाओों में रक्त प्रवाि िम ि ने पररक्त ि कशिाओों में पररवितन प्रारम्भ ि िे िै।
• CELLULAR CHANGES :- A CRITICAL FUNCTION IS TO DELIVER
LEUKOCYTE TO THE SITE OF INJURY AND TO ACTIVATE THE
LEUKOCYTE TO PERFORM THEIR NORMAL FUNCTION IN HOST
DEFENCE
• THE SEQUENCE OF EVENTS IN THE JOURNEY OF LEUKOCYTE FROM
THE VESSEL LUMEN TO INTERSTITIAL TISSUE IS CALLED
EXTRAVASATION.
Cellular reaction involve following
changes
1. In the vessel
2. Diapedesis
3. Chemotaxis
4. Leukocyte
Activation
5. Phagocytosis
A) Migration
B) Rolling
C) Adhesion
D) Pavementing
Extravasatio
n
Extravasation involved following steps.
1. IN THE VESSEL
MIGRATION – AS STASIS DEVELOPS, LEUKOCYTE PRINCIPALLY
NEUTROPHIL ACCUMULATE ALONG THE VASCULAR ENDOTHELIUM. THIS IS
CALLED MIGRATION.
ROLLING – THE ROWS OF LEUKOCYTE MOVE SLOWLY ALONG THE
ENDOTHELIUM A PROCESS CALLED ROLLING.
ADHESION – FINALLY COMING AT REST, LEUKOCYTE ADHERE FIRMLY TO
ENDOTHELIUM THIS MECHANISM CALLED ADHESION.
PAVEMENTING – THE ENDOTHELIUM CAN BE LINED BY WHITE CELLS,
PROCESS CALLED- PAVEMENTING
• IT IS THE PROCESS OF TRANSMIGRATION OF
LEUCOCYTE ACROSS THE ENDOTHELIUM.
• AFTER FIRM ADHESION, LEUKOCYTE MIGRATE
THROUGH INTER ENDOTHELIAL JUNCTION AND ASSUME
A POSITION BETWEEN ENDOTHELIUM CELLS AND THE
BASEMENT MEMBRANE.
• EVENTUALLY THEY PIERCE THE BASEMENT MEMBRANE
BY SECRETING COLLAGENASE AND ESCAPE INTO THE
EXTRAVASCULAR SPACE.
2. Diapedesis
3. CHEMOTAXIS :-
• AFTER EXTRA VASATION, LEUKOCYTE EMIGRATE INTO TISSUE TOWARDS THE
SITE OF INJURY, ALONG A CHEMICAL GRADIENT A PROCESS KNOWN AS
CHEMOTAXIS.THE SUBSTANCE THAT ACT AS A CHEMO ATTRACTANT MAY BE
EXOGENOUS [BACTERIAL PRODUCTS] OR ENDOGENOUS [INTERLEUKINS- 8]
4. Leucocyte Activation :-
• At the site of inflammation, cytokines induce
defensive function of leukocyte and are
referred as leukocyte activation.
5. PHAGOCYTOSIS
• RELEASE OF ENZYME BY NEUTROPHILS AND MACROPHAGES ARE
RESPONSIBLE FOR ELIMINATING THE INJURIOUS AGENTS
• IN PHAGOCYTOSIS, ENGULFMENT AND KILLING AND
DEGRADATION OF INJURIOUS AGENT TAKE PLACE.
• WBC रक्त िा वेग िम ि ने पर नाकिय ों िी किवार िी ओर िाने लगिी िै किसे MIGRATION
िििे िैं।
• WBC उन्ीोंकिवार ों पर घूमने लगिी िै, किसे ROLLING िििे िै
• एि स्थान कवशेष पर किपि िािी िै किसे ADHESION िििे िै।
• ित्पश्चाि् ि कशिायें रक्ति कशिाओों िी किवार ों से बािर कनिलिर INTERSTIAL SPACE में आ
िािी िै विााँ िीवाणु आकि ि
े द्वारा स्त्राकवि कवष (TOXIN) ि
े प्रभाव से रक्त ि कशिायें िीवाणुओों
िी िरफ गकिमान ि िी िै व उन्ें PHAGOCYTS द्वारा भक्षण िर लेिी िै।