Ch2txtinflammation_and_repair - MPET2008-CH2 1 - -...

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MPET2008-CH2 - - 1 INFLAMMATION AND REPAIR – General Aspects Although in essence a protective response of the body, inflammatory reactions nevertheless form a common pathogenetic mechanism in quite a number of diseases. Some examples are: asthma (an allergic inflammatory disease of the bronchi), arthritis (inflammation of the joint), hepatitis (inflammation of the liver), sepsis (generalized or systemic inflammation), inflammatory bowel disease (Crohns disease, colitis ulcerosa). Inflammation is a complex reaction of vascularised tissue to a variety of exogenous and endogenous stimuli. The central characteristic is a change in the activation state of endothelial cells and leukocytes , leading to changes in the permeability of the vascular wall and in the adhesion of leukocytes to the endothelium. Eventually (Nl : uiteindelijk) this results in extravasation of fluid and leukocytes and their accumulation in the extravascular tissue. Inflammatory reactions are closely related to the process of tissue repair . While inflammatory reactions aim at the destruction, the dilution or the encapsulation of the noxe (injurious agent) , at the same time they start a process that will restore the normal tissue as much as possible. This process of repair can follow two different ways: repair by regeneration of the original tissue and parenchymal cells or repair by replacing the original tissue by fibroblastic tissue (= scarring ). This latter process can result in loss of function in organs. Inflammation is fundamentally a beneficial, protective process that serves to get rid the organism both of the initial causes of the injury (e.g. toxins, microbial agents) and the resulting cellular debris (e.g. necrotic cells and tissues). Without inflammation the body would be unable to cope with infections or to heal wounds or restore organ function. Inflammatory processes can however become diseases when they become systemic (= generalized in the body), chronic, exaggerated or based on a « false stimulus ». Also repair can be the cause of problems, e.g. in the bowel in m. Crohn (m. Crohn = morbus Crohn = disease of Crohn) , when liver tissue is replaced by fibrotic tissue (liver cirrhosis with loss of functional liver parenchyma) or in the joints with loss of mobility. The body disposes of a number
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MPET2008-CH2 - - 2 of systems that will limit the effect of the potential harmful mediators and effectors of inflammation and switch of the inflammatory reaction. One should distinguish acute inflammation , lasting from minutes to days, and characterized mainly by extravasation of fluid and plasma proteins ( edema ) and leukocytes, mainly neutrophils, and chronic inflammation , w h i ch i
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This note was uploaded on 05/28/2010 for the course WE BIBI000000 taught by Professor Johangrooten during the Spring '10 term at Ghent University.

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Ch2txtinflammation_and_repair - MPET2008-CH2 1 - -...

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