An abscess on the skin, showing the redness and swelling characteristic of inflammation (presents as darkening in people with dark skin). An abscess (abscessus is a collection of Pus (dead Neutrophils) that has accumulated in a cavity formed by the tissue on the basis of an infectious process Black rings of necrotic tissue surround central areas of pus

Inflammation (Latin, inflammatio, to set on fire) is the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Necrosis (in Greek Νεκρός = "dead" is the name given to unnatural Death of cells and living tissue. Pus is a whitish-yellow yellow or yellow-brown substance produced during Inflammatory responses of the body that can be found in regions of Pyogenic bacterial Latin ( lingua Latīna, laˈtiːna is an Italic language, historically spoken in Latium and Ancient Rome. The blood vessels are part of the Circulatory system and function to transport Blood throughout the body A pathogen (from Greek πάθος pathos "suffering passion" and γἰγνομαι (γεν- gignomai (gen- "I give birth to" infectious It is a protective attempt by the organism to remove the injurious stimuli as well as initiate the healing process for the tissue. Inflammation is not a synonym for infection. An infection is the detrimental Colonization of a host Organism by a foreign Species. Even in cases where inflammation is caused by infection it is incorrect to use the terms as synonyms: infection is caused by an exogenous pathogen, while inflammation is the response of the organism to the pathogen.

In the absence of inflammation, wounds and infections would never heal and progressive destruction of the tissue would compromise the survival of the organism. However, inflammation which runs unchecked can also lead to a host of diseases, such as hay fever, atherosclerosis, and rheumatoid arthritis. Hay Fever is a comic play written by Noel Coward in 1924 and first produced in 1925 with Marie Tempest as the first Judith Bliss Atherosclerosis is a Disease affecting arterial Blood vessels It is a chronic inflammatory response in the walls of arteries in large part due to the accumulation Rheumatoid arthritis ( RA) is a chronic systemic autoimmune disorder that causes the Immune system to attack the Joints, where It is for this reason that inflammation is normally tightly regulated by the body.

Inflammation can be classified as either acute or chronic. Acute inflammation is the initial response of the body to harmful stimuli and is achieved by the increased movement of plasma and leukocytes from the blood into the injured tissues. Blood plasma is the Liquid component of Blood, in which the Blood cells are suspended A cascade of biochemical events propagates and matures the inflammatory response, involving the local vascular system, the immune system, and various cells within the injured tissue. This is an article about the rock music band "Circulatory System" An immune system is a collection of mechanisms within an Organism that protects against Disease by identifying and killing Pathogens and Tumor Prolonged inflammation, known as chronic inflammation, leads to a progressive shift in the type of cells which are present at the site of inflammation and is characterised by simultaneous destruction and healing of the tissue from the inflammatory process.

Causes

• Burns
• Chemical irritants
• Frostbite
• Toxins
• Infection by pathogens
• Necrosis
• Physical injury, blunt or penetrating
• Immune reactions due to hypersensitivity
• Ionizing radiation
• Foreign bodies, including splinters and dirt

Types

Acute inflammation

Infected ingrown toenail showing the characteristic redness and swelling associated with acute inflammation

Acute inflammation is a short-term process which is characterized by the classic signs of inflammation - swelling, redness, pain, heat, and loss of function - due to the infiltration of the tissues by plasma and leukocytes. It occurs as long as the injurious stimulus is present and ceases once the stimulus has been removed, broken down, or walled off by scarring (fibrosis). Fibrosis is the formation or development of excess fibrous Connective tissue in an organ or tissue as a reparative or reactive process as opposed to a formation of Fibrous The first four characteristics have been known since ancient times and are attributed to Celsus. Aulus Cornelius Celsus (ca 25 BC—ca 50 was a Roman encyclopedist and Physician. Loss of function was added to the definition of inflammation by Virchow in the 19th century (1870). Rudolf Ludwig Karl Virchow ( 13 October 1821 &ndash 5 September 1902) was a German doctor, anthropologist, public health ^[3]

The process of acute inflammation is initiated by the blood vessels local to the injured tissue, which alter to allow the exudation of plasma proteins and leukocytes into the surrounding tissue. Blood plasma is the Liquid component of Blood, in which the Blood cells are suspended The increased flow of fluid into the tissue causes the characteristic swelling associated with inflammation since the lymphatic system doesn't have the capacity to compensate for it, and the increased blood flow to the area causes the reddened colour and increased heat. The lymphatic system in Vertebrates is a network of conduits that carry a clear fluid called Lymph. The blood vessels also alter to permit the extravasation of leukocytes through the endothelium and basement membrane constituting the blood vessel. The endothelium is the thin layer of cells that line the interior surface of Blood vessels forming an interface between circulating Blood in the The basement membrane is a structure that supports overlying Epithelial or Endothelial cells. Once in the tissue, the cells migrate along a chemotactic gradient to reach the site of injury, where they can attempt to remove the stimulus and repair the tissue. Chemotaxis, a kind of Taxis, is the phenomenon in which bodily cells bacteria, and other single-cell or Multicellular organisms direct their movements

Meanwhile, several biochemical cascade systems, consisting of chemicals known as plasma-derived inflammatory mediators, act in parallel to propagate and mature the inflammatory response. These include the complement system, coagulation system and fibrinolysis system. The complement system is a Biochemical cascade that helps clear Pathogens from an organism Coagulation is a complex process by which Blood forms Clots It is an important part of Hemostasis (the cessation of blood loss from a damaged vessel whereby Fibrinolysis is the process wherein a Fibrin clot, the product of Coagulation, is broken down

Finally, down-regulation of the inflammatory response concludes acute inflammation. Removal of the injurious stimuli halts the response of the inflammatory mechanisms, which require constant stimulation to propagate the process. Additionally, many inflammatory mediators have short half lives and are quickly degraded in the tissue, helping to quickly cease the inflammatory response once the stimulus has been removed. ^[3]

Chronic inflammation

Chronic inflammation is a pathological condition characterised by concurrent active inflammation, tissue destruction, and attempts at repair. Chronic inflammation is not characterised by the classic signs of acute inflammation listed above. Instead, chronically inflamed tissue is characterised by the infiltration of mononuclear immune cells (monocytes, macrophages, lymphocytes, and plasma cells), tissue destruction, and attempts at healing, which include angiogenesis and fibrosis. Monocyte is a type of Leukocyte, part of the Human body 's Immune system. Macrophages ( Greek: "big eaters" from makros "large" + phagein "eat" ( Mø) are cells within the tissues that A lymphocyte is a type of White blood cell in the Vertebrate Immune system. Plasma cells (also called plasma B cells or plasmocytes) are cells of the Immune system that secrete large amounts of antibodies. Angiogenesis is a physiological process involving the growth of new Blood vessels from pre-existing vessels Fibrosis is the formation or development of excess fibrous Connective tissue in an organ or tissue as a reparative or reactive process as opposed to a formation of Fibrous

Endogenous causes include persistent acute inflammation. Exogenous causes are varied and include bacterial infection, especially by Mycobacterium tuberculosis, prolonged exposure to chemical agents such as silica, tobacco smoke, or autoimmune reactions such as rheumatoid arthritis. Mycobacterium tuberculosis is the Bacterium that causes most cases of Tuberculosis. The Chemical compound silicon dioxide, also known as silica or silox (from the Latin " Silex " is an Oxide Autoimmunity is the failure of an organism to recognize its own constituent parts as self, which results in an immune response against its own cells and tissues Rheumatoid arthritis ( RA) is a chronic systemic autoimmune disorder that causes the Immune system to attack the Joints, where

In acute inflammation, removal of the stimulus halts the recruitment of monocytes (which become macrophages under appropriate activation) into the inflamed tissue, and existing macrophages exit the tissue via lymphatics. However in chronically inflamed tissue the stimulus is persistent, and therefore recruitment of monocytes is maintained, existing macrophages are tethered in place, and proliferation of macrophages is stimulated (especially in atheromatous plaques). In Pathology, an atheroma (plural atheromata is an accumulation and swelling (-oma in Artery walls that is made up of cells (mostly Macrophage cells ^[3]

Exudative component

The exudative component involves the movement of plasma fluid, containing important proteins such as fibrin and immunoglobulins (antibodies), into inflamed tissue. Proteins are large Organic compounds made of Amino acids arranged in a linear chain and joined together by Peptide bonds between the Carboxyl Fibrin (also called Factor Ia) is a Protein involved in the clotting of blood Antibodies (also known as immunoglobulins, abbreviated Ig) are Gamma globulin Proteins that are found in Blood or other Bodily This movement is achieved via the chemically-induced dilation and increased permeability of blood vessels, which results in a net loss of blood plasma. The blood vessels are part of the Circulatory system and function to transport Blood throughout the body Blood plasma is the Liquid component of Blood, in which the Blood cells are suspended The increased collection of fluid into the tissue causes it to swell (edema). Oedema (or Edema in American English formerly known as dropsy or hydropsy, is the increase of Interstitial fluid in any organ &mdash swelling

Vascular changes

Acute inflammation is characterised by marked vascular changes, including vasodilation, increased permeability, and the slowing of blood flow, which are induced by the actions of various inflammatory mediators. Vasodilation occurs first at the arteriole level, progressing to the capillary level, and brings about a net increase in the amount of blood present, causing the redness and heat of inflammation. An arteriole is a small diameter Blood vessel that extends and branches out from an Artery and leads to capillaries. Capillaries are the smallest of a body's Blood vessels measuring 5-10 μm in diameter which connect Arterioles and Venules and enable the interchange Increased permeability of the vessels results in the movement of plasma into the tissues, with resultant stasis due to the increase in the concentration of the cells within blood - a condition characterised by enlarged vessels packed with cells. Blood plasma is the Liquid component of Blood, in which the Blood cells are suspended Stasis allows leukocytes to marginate along the endothelium, a process critical to their recruitment into the tissues. Normal flowing blood prevents this, as the shearing force along the periphery of the vessels moves cells in the blood into the middle of the vessel. A shear stress, denoted \tau\ ( Tau) is defined as a stress which is applied Parallel or tangential to a face of a material

Plasma cascade systems

• The complement system, when activated, results in the increased removal of pathogens via opsonisation and phagocytosis. The complement system is a Biochemical cascade that helps clear Pathogens from an organism An opsonin is any molecule that acts as a binding Enhancer for the process of Phagocytosis, for example by coating the negatively-charged molecules on the membrane Phagocytosis is the cellular process of engulfing solid particles by the Cell membrane to form an internal Phagosome, or "food vacuole
• The kinin system generates proteins capable of sustaining vasodilation and other physical inflammatory effects. The kinin-kallikrein system or simply kinin system is a poorly delineated system of Blood Proteins that plays a role in Inflammation, Blood
• The coagulation system or clotting cascade which forms a protective protein mesh over sites of injury. Coagulation is a complex process by which Blood forms Clots It is an important part of Hemostasis (the cessation of blood loss from a damaged vessel whereby
• The fibrinolysis system, which acts in opposition to the coagulation system, to counterbalance clotting and generate several other inflammatory mediators. Fibrinolysis is the process wherein a Fibrin clot, the product of Coagulation, is broken down

Plasma derived mediators

* non-exhaustive list

Cellular component

The cellular component involves leukocytes, which normally reside in blood and must move into the inflamed tissue via extravasation to aid in inflammation. Some act as phagocytes, ingesting bacteria, viruses, and cellular debris. Phagocytes are cells that are found in the blood bone marrow and other tissues of Vertebrates. The Bacteria ( singular: bacterium) are a large group of unicellular Microorganisms Typically a few Micrometres in length bacteria have Others release enzymatic granules which damage pathogenic invaders. In cell biology, a granule can be any structure barely visible by light microscopy Leukocytes also release inflammatory mediators which develop and maintain the inflammatory response. Generally speaking, acute inflammation is mediated by granulocytes, while chronic inflammation is mediated by mononuclear cells such as monocytes and lymphocytes. Granulocytes are a category of White blood cells characterised by Monocyte is a type of Leukocyte, part of the Human body 's Immune system. A lymphocyte is a type of White blood cell in the Vertebrate Immune system.

Leukocyte extravasation

Neutrophils migrate from blood vessels to the inflamed tissue via chemotaxis, where they remove pathogens through phagocytosis and degranulation

Main article: Leukocyte extravasation

Various leukocytes are critically involved in the initiation and maintenance of inflammation. Leukocyte extravasation is the movement of Leukocytes out of the Circulatory system, towards the site of tissue damage or infection These cells must be able to get to the site of injury from their usual location in the blood, therefore mechanisms exist to recruit and direct leukocytes to the appropriate place. The process of leukocyte movement from the blood to the tissues through the blood vessels is known as extravasation, and can be divided up into a number of broad steps:

1. Leukocyte localisation and recruitment to the endothelium local to the site of inflammation – involving margination and adhesion to the endothelial cells: Recruitment of leukocytes is receptor-mediated. In Biochemistry, a receptor is a Protein molecule embedded in either the Plasma membrane or Cytoplasm of a cell to which a mobile signaling The products of inflammation, such as histamine, promote the immediate expression of P-selectin on endothelial cell surfaces. Histamine is a Biogenic amine involved in local immune responses as well as regulating physiological function in the gut and acting as a Neurotransmitter P-selectin is a Cell adhesion molecule ( CAM) found in granules in Endothelial cells (cells lining blood vessels and activated Platelets. This receptor binds weakly to carbohydrate ligands on leukocyte surfaces and causes them to "roll" along the endothelial surface as bonds are made and broken. Cytokines from injured cells induce the expression of E-selectin on endothelial cells, which functions similarly to P-selectin. E-selectin, also known as CD62E, is a Cell adhesion molecule expressed only on Endothelial cells activated by Cytokines Like other Selectins Cytokines also induce the expression of integrin ligands on endothelial cells, which further slow leukocytes down. Integrins are Cell surface receptors that interact with the Extracellular matrix (ECM and mediate various intracellular signals. These weakly bound leukocytes are free to detach if not activated by chemokines produced in injured tissue. Activation increases the affinity of bound integrin receptors for ligands on the endothelial cell surface, firmly binding the leukocytes to the endothelium.
2. Migration across the endothelium, known as transmigration, via the process of diapedesis: Chemokine gradients stimulate the adhered leukocytes to move between endothelial cells and pass the basement membrane into the tissues.
3. Movement of leukocytes within the tissue via chemotaxis: Leukocytes reaching the tissue interstitium bind to extracellular matrix proteins via expressed integrins and CD44 to prevent their loss from the site. Chemotaxis, a kind of Taxis, is the phenomenon in which bodily cells bacteria, and other single-cell or Multicellular organisms direct their movements In Biology, the extracellular matrix ( ECM) is the Extracellular part of animal tissue that usually provides structural support to the cells The CD44 Protein is a cell -surface Glycoprotein involved in cell-cell interactions cell adhesion and migration Chemoattractants cause the leukocytes to move along a chemotactic gradient towards the source of inflammation. Inorganic or organic substances possessing Chemotaxis inducer effect in motile cells

Cell derived mediators

* non-exhaustive list

Morphologic patterns

Specific patterns of acute and chronic inflammation are seen during particular situations that arise in the body, such as when inflammation occurs on an epithelial surface, or pyogenic bacteria are involved. In biology and medicine epithelium is a tissue composed of cells that line the cavities and surfaces of structures throughout the body Pyogenic refers to Bacterial Infections that make Pus or form Abscesses The pus is mostly composed of dead Neutrophils that are

• Granulomatous inflammation: characterised by the formation of granulomas, they are the result of a limited but diverse number of diseases, which include among others tuberculosis, leprosy, and syphilis. In Medicine ( Anatomical pathology) a granuloma (classical Latin plural granulomata; modern anglicized plural granulomas, also accepted Tuberculosis (abbreviated as TB for tubercle bacillus or T u' b' erculosis Bacillus --> is a common Leprosy (from the Greek lepi (λέπι meaning scales on a fish or Hansen's disease, is a chronic disease caused by the bacterium Syphilis is a Sexually transmitted disease caused by the spirochetal Bacterium Treponema pallidum pallidum.
• Fibrinous inflammation: Inflammation resulting in a large increase in vascular permeability allows the blood vessels to pass through fibrin. Fibrin (also called Factor Ia) is a Protein involved in the clotting of blood If an appropriate procoagulative stimulus is present, such as cancer cells,^[3] a fibrinous exudate is deposited. This is commonly seen in serous cavities, where the conversion of fibrinous exudate into a scar can occur between serous membranes, limiting their function. In Anatomy, a serous membrane (or serosa) is a smooth membrane consisting of a thin layer of cells which excrete Serous fluid
• Purulent inflammation: Inflammation resulting in large amount of pus, which consists of neutrophils, dead cells, and fluid. Pus is a whitish-yellow yellow or yellow-brown substance produced during Inflammatory responses of the body that can be found in regions of Pyogenic bacterial Infection by pyogenic bacteria such as staphylococci is characteristic of this kind of inflammation. Staphylococcus (in Greek σταφυλη staphyle means bunch of grapes and κοκκος coccos means granule is a genus of Gram-positive Large, localised collections of pus enclosed by surrounding tissues are called abscesses. An abscess (abscessus is a collection of Pus (dead Neutrophils) that has accumulated in a cavity formed by the tissue on the basis of an infectious process
• Serous inflammation: Characterised by the copious effusion of non-viscous serous fluid, commonly produced by mesothelial cells of serous membranes, but may which also be derived from blood plasma. The mesothelium is a membrane that forms the lining of several body cavities the Pleura (thoracal cavity Peritoneum (abdominal cavity including the mesentery and In Anatomy, a serous membrane (or serosa) is a smooth membrane consisting of a thin layer of cells which excrete Serous fluid Skin blisters exemplify this pattern of inflammation. A blister is a small pocket of fluid within the upper layers of the skin
• Ulcerative inflammation: Inflammation occurring near an epithelium can result in the necrotic loss of tissue from the surface, exposing lower layers. Necrosis (in Greek Νεκρός = "dead" is the name given to unnatural Death of cells and living tissue. The subsequent excavation in the epithelium is known as an ulcer. Ulcers are healing wounds that develop on the skin mucous membranes or eye

Inflammatory disorders

Abnormalities associated with inflammation comprise a large, unrelated group of disorders which underly a variety of human diseases. The immune system is often involved with inflammatory disorders, demonstrated in both allergic reactions and some myopathies, with many immune system disorders resulting in abnormal inflammation. Allergy is a disorder of the Immune system often also referred to as Atopy. In Medicine, a myopathy is a neuromuscular Disease in which the Muscle fibers do not function for any one of many reasons resulting in Muscular weakness Autoimmunity is the failure of an organism to recognize its own constituent parts as self, which results in an immune response against its own cells and tissues Non-immune diseases with aetiological origins in inflammatory processes are thought to include cancer, atherosclerosis, and ischaemic heart disease. Atherosclerosis is a Disease affecting arterial Blood vessels It is a chronic inflammatory response in the walls of arteries in large part due to the accumulation Ischaemic or ischemic heart disease (IHD or myocardial ischaemia, is a Disease characterized by reduced blood supply to the heart muscle ^[3]

A large variety of proteins are involved in inflammation, and any one of them is open to a genetic mutation which impairs or otherwise dysregulates the normal function and expression of that protein.

Examples of disorders associated with inflammation include:

Allergies

An allergic reaction, formally known as type 1 hypersensitivity, is the result of an inappropriate immune response triggering inflammation. Asthma is a chronic Condition involving the Respiratory system in which the airways occasionally constrict become inflamed, and are Autoimmune diseases arise from an overactive Immune response of the body against substances and tissues normally present in the body Inflammation ( Latin, inflamatio, to set on fire is the complex biological response of vascular tissues to harmful stimuli such as Pathogens Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS should be distinguished from other forms of Prostatitis such as Chronic bacterial prostatitis and acute Glomerulonephritis, also known as glomerular nephritis, abbreviated GN, is a renal disease characterized by Inflammation of the glomeruli Hypersensitivity (also called hypersensitivity reaction refers to undesirable (damaging discomfort-producing and sometimes fatal reactions produced by the normal immune system In Medicine, inflammatory bowel disease ( IBD) is a group of inflammatory conditions of the large intestine and Small intestine Pelvic inflammatory disease (or disorder) ( PID) is a generic term for Inflammation of the female Uterus, Fallopian tubes, and/or Reperfusion injury refers to damage to tissue caused when Blood supply returns to the tissue after a period of Ischemia. Rheumatoid arthritis ( RA) is a chronic systemic autoimmune disorder that causes the Immune system to attack the Joints, where Transplant rejection occurs when a transplanted organ or tissue fails to be accepted by the body of the transplant recipient Vasculitis (plural vasculitides) a group of diseases featuring Inflammation of the wall of Blood vessels including veins ( Phlebitis) arteries Allergy is a disorder of the Immune system often also referred to as Atopy. A common example is hay fever, which is caused by a hypersensitive response by skin mast cells to allergens. Hay Fever is a comic play written by Noel Coward in 1924 and first produced in 1925 with Marie Tempest as the first Judith Bliss A mast cell (or mastocyte) is a resident cell of several types of tissues and contains many granules rich in Histamine and Heparin An allergen is a nonparasitic Antigen capable of stimulating a Type-I hypersensitivity reaction in atopic individuals Pre-sensitised mast cells respond by degranulating, releasing vasoactive chemicals such as histamine. Degranulation is a cellular process that releases Antimicrobial Cytotoxic molecules from secretory vesicles called granules found inside A hormone drug or chemical which is capable of eliciting Vasoconstrictive or Vasodilative action on the Vasculature. These chemicals propagate an excessive inflammatory response characterised by blood vessel dilation, production of pro-inflammatory molecules, cytokine release, and recruitment of leukocytes. ^[3] Severe inflammatory response may mature into a systemic response known as anaphylaxis. Anaphylaxis is an acute systemic (multi-system and severe Type I Hypersensitivity allergic reaction in humans and other Mammals

Other hypersensitivity reactions (type 2 and type 3) are mediated by antibody reactions and induce inflammation by attracting leukocytes which damage surrounding tissue. Hypersensitivity (also called hypersensitivity reaction refers to undesirable (damaging discomfort-producing and sometimes fatal reactions produced by the normal immune system ^[3]

Myopathies

Inflammatory myopathies are caused by the immune system inappropriately attacking components of muscle, leading to signs of muscle inflammation. They may occur in conjunction with other immune disorders, such as systemic sclerosis, and include dermatomyositis, polymyositis, and inclusion body myositis. Scleroderma is a chronic Autoimmune disease characterized by a hardening or Sclerosis in the Skin or other organs Dermatomyositis (DM is a connective-tissue disease related to Polymyositis (PM that is characterized by Inflammation of the muscles and the skin Polymyositis is a type of Inflammatory myopathy, related to Dermatomyositis and Inclusion body myositis. Sporadic inclusion body myositis ( sIBM) is an inflammatory Muscle Disease, characterized by slowly progressive weakness and wasting of the ^[3]

Leukocyte defects

Due to the central role of leukocytes in the development and propagation of inflammation, defects in leukocyte function often result in a decreased capacity for inflammatory defence with subsequent vulnerability to infection. ^[3] Dysfunctional leukocytes may be unable to correctly bind to blood vessels due to surface receptor mutations, digest bacteria (Chediak-Higashi syndrome), or produce microbicides (chronic granulomatous disease). A microbicide is any compound or substance whose purpose is to reduce the infectivity of microbes such as Viruses or bacteria. Chronic granulomatous disease (CGD is a diverse group of hereditary diseases in which certain cells of the Immune system have difficulty forming the reactive Additionally, diseases affecting the bone marrow may result in abnormal or few leukocytes. Bone marrow is the flexible tissue found in the hollow interior of Bones In adults marrow in large bones produces new Blood cells It constitutes 4% of

Pharmacological

Certain drugs or chemical compounds are known to affect inflammation. Vitamin A deficiency causes an increase in inflammatory responses,^[4] and anti-inflammatory drugs work specifically by inhibiting normal inflammatory components. Vitamin A refers to a family of similarly shaped molecules the Retinoids. Anti-inflammatory refers to the property of a substance or treatment that reduces Inflammation.

Cancer

Inflammation orchestrates the microenvironment around tumours, contributing to proliferation, survival and migration. Cancer cells use selectins, chemokines and their receptors for invasion, migration and metastasis. Selectins are a family of cell adhesion Molecules (or CAMs. All selectins are single-chain transmembrane Glycoproteins that share similar properties Chemokines are a family of small Cytokines, or Proteins secreted by cells Proteins are classified as chemokines according to shared structural characteristics ^[5] On the other hand, many cells of the immune system contribute to cancer immunology, suppressing cancer. Cancer immunology is the study of interactions between the Immune system and Cancer cells (also called tumors or malignancies

Termination

The inflammatory response must be actively terminated when no longer needed to prevent unnecessary "bystander" damage to tissues. ^[3] Failure to do so results in chronic inflammation, cellular destruction, and attempts to heal the inflamed tissue. One intrinsic mechanism employed to terminate inflammation is the short half-life of inflammatory mediators in vivo. They have a limited time frame to affect their target before breaking down into non-functional components, therefore constant inflammatory stimulation is needed to propagate their effects.

Active mechanisms which serve to terminate inflammation include^[3]:

• TGF-β from macrophages
• Anti-inflammatory lipoxins
• Inhibition of pro-inflammatory molecules, such as leukotrienes

Systemic effects

An organism can escape the confines of the immediate tissue via the circulatory system or lymphatic system, where it may spread to other parts of the body. This is an article about the rock music band "Circulatory System" The lymphatic system in Vertebrates is a network of conduits that carry a clear fluid called Lymph. If an organism is not contained by the actions of acute inflammation it may gain access to the lymphatic system via nearby lymph vessels. In Anatomy, lymph vessels are thin walled Valved structures that carry Lymph. An infection of the lymph vessels is known as lymphangitis, and infection of a lymph node is known as lymphadenitis. Lymphangitis is an Inflammation of the Lymphatic channels that occurs as a result of infection at a site distal to the channel Lymphadenopathy is a term meaning "disease of the Lymph nodes. A pathogen can gain access to the bloodstream through lymphatic drainage into the circulatory system.

When inflammation overwhelms the host, systemic inflammatory response syndrome is diagnosed. In Medicine, systemic inflammatory response syndrome ( SIRS) is an inflammatory state of the whole body (the "system" without a proven source When it is due to infection, the term sepsis is applied, with bacteremia being applied specifically for bacterial sepsis and viremia specifically to viral sepsis. An infection is the detrimental Colonization of a host Organism by a foreign Species. Sepsis is a serious medical condition characterized by a whole-body inflammatory state (called a Systemic inflammatory response syndrome or SIRS caused Bacteremia ( Bacteræmia in British English is the presence of bacteria in the Blood. Viremia (UK viraemia) is a medical condition where Viruses enter the Bloodstream and hence have access to the rest of the body Vasodilation and organ dysfunction are serious problems associated with widespread infection that may lead to septic shock and death. Septic shock is a very serious medical condition caused by decreased tissue perfusion and oxygen delivery as a result of Infection and Sepsis, though the

Acute-phase proteins

Inflammation also induces high systemic levels of acute-phase proteins. In acute inflammation, these proteins prove beneficial, however in chronic inflammation they can contribute to amyloidosis^[3] These proteins include C-reactive protein, serum amyloid A, serum amyloid P, vasopressin, and glucocorticoids, which cause a range of systemic effects including^[3]:

Leukocyte numbers

Inflammation often affects the numbers of leukocytes present in the body:

• Leukocytosis is often seen during inflammation induced by infection, where it results in a large increase in the amount of leukocytes in the blood, especially immature cells. In Medicine, amyloidosis refers to a variety of conditions in which Amyloid Proteins are abnormally deposited in organs and/or tissues C-reactive protein ( CRP) is a Plasma protein, an Acute phase protein produced by the Liver and by Adipocytes. Serum amyloid A (SAA proteins are a family of Apolipoproteins associated with High-density lipoprotein (HDL in plasma Amyloid P component serum (SAP is the identical serum form of amyloid P component (AP a 25kDa pentameric Protein first identified as the pentagonal constituent of in vivo Arginine vasopressin ( AVP) also known as vasopressin, argipressin or antidiuretic hormone ( ADH) is a Hormone found in Glucocorticoids (GC are a class of Steroid hormones characterised by an ability to bind with the glucocorticoid receptor ( GR) and trigger similar effects Fever (also known as pyrexia, from the Greek pyretos meaning fire or a febrile response, from the Latin word Febris Blood pressure is also the title of a short story by Damon Runyan in Guys and Dolls and Other Stories Malaise is a feeling of general discomfort or uneasiness an "out of sorts" feeling often the first indication of an infection or other disease Anorexia (deriving from the Greek "α(ν-" ( a(n-, a prefix that denotes absence + "όρεξη (orexe = appetite is the decreased sensation Somnolence (or " drowsiness " is a state of near- Sleep, a strong desire for sleep or sleeping for unusually long periods (c Leukocytosis is a raised white blood cell count (the Leukocyte count above the normal range Leukocyte numbers usually increase to between 15 000 and 20 000 cells per ml, but extreme cases can see it approach 100 000 cells per ml. The litre or liter (see spelling differences) is a unit of Volume. ^[3] Bacterial infection usually results in an increase of neutrophils, creating neutrophilia, whereas diseases such as asthma, hay fever, and parasite infestation result in an increase in eosinophils, creating eosinophilia. Neutrophil granulocytes, generally referred to as neutrophils, are the most abundant type of White blood cells in humans and form an essential part of the Neutrophilia (or neutrophil leukocytosis) is a condition where a person has a high number of Neutrophil granulocytes in their Blood. Asthma is a chronic Condition involving the Respiratory system in which the airways occasionally constrict become inflamed, and are Hay Fever is a comic play written by Noel Coward in 1924 and first produced in 1925 with Marie Tempest as the first Judith Bliss Eosinophil granulocytes, usually called eosinophils (or less commonly acidophils) are White blood cells that are one of the Immune System components Eosinophilia is the state of having a high concentration of eosinophils ( Eosinophil granulocytes in the Blood. ^[3]
• Leukopenia can be induced by certain infections and diseases, including viral infection, Rickettsia infection, some protozoa, tuberculosis, and some cancers. Leukopenia (or leukocytopenia, or leucopenia, from Greek λευκό -white and πενία -deficiency is a decrease in the number of Rickettsia is a Genus of motile, Gram-negative, non-sporeforming, highly Pleomorphic bacteria that can present Protozoa (in Greek πρῶτον proton "first" and ζῷα zoia "animals" are unicellular Eukaryotes (singular Tuberculosis (abbreviated as TB for tubercle bacillus or T u' b' erculosis Bacillus --> is a common Cancer (medical term Malignant Neoplasm) is a class of Diseases in which a group of cells display uncontrolled ^[3]

Systemic inflammation and obesity

With the discovery of interleukins (IL), the concept of systemic inflammation developed. Interleukins are a group of Cytokines (secreted Signaling molecules) that were first seen to be expressed by White blood cells ( Leukocytes hence Although the processes involved are identical to tissue inflammation, systemic inflammation is not confined to a particular tissue but involves the endothelium and other organ systems. The endothelium is the thin layer of cells that line the interior surface of Blood vessels forming an interface between circulating Blood in the

High levels of several inflammation-related markers such as IL-6, IL-8, and TNF-α are associated with obesity. Interleukin-8 (IL-8 is a Chemokine produced by Macrophages and other cell types such as epithelial cells Tumor necrosis factor ( TNF, cachexin or cachectin and formally known as Tumor necrosis factor-alpha) is a Cytokine involved in systemic Obesity is a condition in which excess Body fat has accumulated to such an extent that health may be negatively affected ^[7][8] During clinical studies, inflammatory-related molecule levels were reduced and increased levels of anti-inflammatory molecules were seen within four weeks after patients began a very low calorie diet. ^[9] The association of systemic inflammation with insulin resistance and atherosclerosis is the subject of intense research. Insulin resistance is the condition in which normal amounts of Insulin are inadequate to produce a normal Insulin response from Fat, Muscle Atherosclerosis is a Disease affecting arterial Blood vessels It is a chronic inflammatory response in the walls of arteries in large part due to the accumulation ^[10]

Outcomes

Scars present on the skin, evidence of fibrosis and healing of a wound

The outcome in a particular circumstance will be determined by the tissue in which the injury has occurred and the injurious agent that is causing it. There are three possible outcomes to inflammation:^[3]

1. Resolution
   The complete restoration of the inflamed tissue back to a normal status. Inflammatory measures such as vasodilation, chemical production, and leukocyte infiltration cease, and damaged parenchymal cells regenerate. Parenchyma is a term used to describe a bulk of a substance It is used in different ways in Animals and in Plants. In situations where limited or short lived inflammation has occurred this is usually the outcome.
2. Fibrosis
   Large amounts of tissue destruction, or damage in tissues unable to regenerate, can not be regenerated completely by the body. Fibrous scarring occurs in these areas of damage, forming a scar composed primarily of collagen. Scars (also called cicatrices) are areas of fibrous tissue that replace normal Skin (or other tissue after injury Collagen is the main Protein of Connective tissue in Animals and the most abundant protein in Mammals making up about 50% of the whole-body protein The scar will not contain any specialized structures, such as parenchymal cells, hence functional impairment may occur. Parenchyma is a term used to describe a bulk of a substance It is used in different ways in Animals and in Plants.
3. Abscess Formation
   A cavity is formed containing pus, an opaque liquid containing dead white blood cells and bacteria with general debris from destroyed cells.
4. Chronic inflammation
   In acute inflammation, if the injurious agent persists then chronic inflammation will ensue. This process, marked by inflammation lasting many days, months or even years, may lead to the formation of a chronic wound. A chronic wound is a Wound that does not heal in an orderly set of stages and in a predictable amount of time the way most wounds do wounds that do not heal within three months Chronic inflammation is characterised by the dominating presence of macrophages in the injured tissue. These cells are powerful defensive agents of the body, but the toxins they release (including reactive oxygen species) are injurious to the organism's own tissues as well as invading agents. A toxin ( Greek:, toxikon, lit (poison for use on arrows is a Poisonous substance produced by living cells or organisms that is active at very low Reactive oxygen species (ROS are ions or very small molecules that include Oxygen Ions free radicals, and Peroxides both inorganic and Consequently, chronic inflammation is almost always accompanied by tissue destruction.

Examples

Inflammation is usually indicated by adding the suffix "-itis", as shown below. However, some conditions such as asthma and pneumonia do not follow this convention. Asthma is a chronic Condition involving the Respiratory system in which the airways occasionally constrict become inflamed, and are Pneumonia is an inflammatory illness of the Lung. Frequently it is described as lung Parenchyma / alveolar inflammation and abnormal More examples are available at list of types of inflammation.

Acute appendicitis

Acute dermatitis

Acute infective meningitis

Acute tonsillitis

See also

• Anaphylatoxin
• Anti-inflammatories
• Healing
• Interleukin
• Lipoxin
• Substance P

References

External links

• What You Need to Know About Inflammation at Cleveland Clinic
• Anti-Inflammatory Diet - Foods and Inflammation at About.com
• MeSH Inflammation