Pathology in rhythm and rhyme

Vascular and cellular response: foot soldiers of our first line of defense

Any injury to body tissues quickly causes local blood vessels to dilate (vascular response of inflammation). The slower flow brings in the required elements to remove the offending agent and overcome the damage. Key players are pre-existing proteins and white blood cells (cellular response of inflammation) carried by the flowing blood that leak out of the opened gaps of thin-walled vessels. Soon other activated protein systems and phagocytes follow, followed by growth factors. Finally, regeneration and repair restore tissue architecture and function.

Insights and Impact

• Whether on the body surface or in deep tissues the injury-inflammation sequence is predictable and guaranteed
• Cardinal signs of inflammation cause clinical symptoms -redness, swelling, pain, raised temperature and loss of function- and urge the patient to seek medical attention
• A physician always alert to the cardinal signs of inflammation – local or systemic – will never neglect or delay diagnosis, investigation and treatment
• Communicating to the patient the protective nature of the inflammatory response, its likely duration and mitigating the more severe symptoms will ensure patient’s compliance with treatment and patience with recovery
• Caution: underlying diseases like malnutrition, diabetes or immunosuppression that prevent an effective inflammatory response must be recognized, and patients alerted to unfavorable outcomes while instituting a modified treatment plan

Inflammatory response: Action and reaction
Nature has endowed us with unique tools to survive
Blood vessels the conduit, many immune cells that help us thrive;
When injury strikes from within or without, the twain promptly step in:
At first local vessels dilate, the pressure builds and transudates are thin;
Blood proteins and immune cells sense they have an opportunity to escape
Exudates then develop in the ECM as endothelial junctions gape;
Leucocytes’ cytoskeleton makes them move with unidirectional purpose
Cytokines from bacteria, dead cells, phagocytes provide the chemotactic stimulus;
Scavengers vigorously mop the cesspool of inflammation
Injured tissues regenerate or repair to return to animation;
The sequence of inflammatory events manifest as clinical signs:
Calor, rubor, tumor, dolor, functio laesa are very much by design.

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Vascular and Cellular components of Inflammation

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