Inflammation

Inflammatory cytokines Plasma derived Bradykinin C3 C5a Factor XII (Hageman Factor). Membrane attack complex Plasmin Thrombin Cell derived Lysosome granules Histamine IFN-γ Leukotriene B4 Nitric oxide Prostaglandins TNF-α and IL-1

Yacoubian S and Serhan CN (2007) New endogenous anti-inflammatory and proresolving lipid mediators: implications for rheumatic diseases Nat Clin Pract Rheumatol 3: 570–579 doi:10.1038/ncprheum0616

Albini and Sporn Nature Reviews Cancer 7, 139–147 (February 2007) | doi:10.1038/nrc2067

Wound healing Functional aspect Structural aspect Three phases stop blood loss restore function prevent infection Structural aspect restoring both cells and their protein matrix Three phases Inflammatory phase proliferative/repair pahse remodeling/maturation phase

Inflammatory phase

Proliferative phase

Remodeling phase

Chronic inflammation - Granuloma

Foreign body reaction begins as wound healing accumulation of exudate infiltration of inflammatory cells formation of granulation tissue persistent presence of a biomedical implant inhibits full healing Histological findings formation of foreign body giant cells encapsulation of the foreign object chronic inflammation Nonspecific immune reaction

Foreign body reaction Giant cell Encapsulation Products of macrophage fusion Hallmark of the foreign body reaction Secrete degradative agents: superoxides and free radicals Encapsulation Firm, avascular collagen shell deposited around a foreign body Isolating foreign body from the host tissues

Artificial Skin

Immune privilege

Take home message Four symptoms and signs of inflammation Three stages of wound healing and foreign body reaction Immune privilege