Inflammatory responses

Different tests can be applied to assess the inflammatory response. In cell culture systems, inflammatory response is expressed by the appearance of cytokines or monokines such as interleukin-1, prostaglandin E2, leukotriene B4 (LTB4), and other compounds deriving from the peroxidation cascade (Shirali et al. 1994 Johnson and Organ 1997) or - as we have observed - by the appearance of multinucleated giant cells (Hornez et al. 2002). 

Multinucleated giant cells (MGC) normally appear in cultures of macrophages through the fusion of individual cells. Established cell lines generally exhibit a low percentage of 2-5% of binucleated or multinucleated cells. MGC may not only appear in cellular or organotypic cultures (Ziats et al. 1988), 

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LTC may enhance the survival of mice partially via physiological changes such as induction of hypoxia (217). However, LTC mediates a number of physiological changes, including inflammatory responses and cardiovascular changes, that may also be important. 

Human bodies are constantly exposed to a plethora of bacteria, viruses, and other inflammatory substances. To combat these infections and toxic agents, the body has developed a carefully regulated inflammatory response system. Part of that response is the orderly migration of leukocytes to sites of inflammation. Leukocytes literally roll along the vascular wall and into the tissue site of inflammation. This rolling movement is mediated by reversible adhesive interactions between the leukocytes and the vascular surface. 

Lasky, L. A., 1995. Selectin-carbohydrate interactions and the initiation of die inflammatory response. Annual Review of Biochemistry 64 113-139. 

Histamine. A diamine found in plant and animal tissues. It is involved in inflammatory responses. 

The wide range of inflammation-related factors that adipocytes secrete is linked to the inflammatory response that the tissue exhibits in obesity [1]. Obesity in general, like an increasing number of other diseases, is characterised by a state of mild chronic inflammation, and adipose tissue plays a central role in this. The production of most inflammation-related adipokines increases markedly in obesity and there is an elevated circulating level of a number of these factors as well as of other inflammatory markers such as C-reactive protein (CRP). The increased production of inflammatory adipokines (and decreased production of adiponectin with its anti-inflammatory action) in the obese is considered to play a critical role in the development of the obesity-associated pathologies, particularly type 2 diabetes and the metabolic syndrome [1]. 

Inhaled steroids (commonly used are beclomethasone, budesonide, triamcinolone, fluticasone, flunisolide) appear to attenuate the inflammatory response, to reduce bronchial hyperreactivity, to decrease exacerbations and to improve health status they may also reduce the risk of myocar dial infar ction, but they do not modify the longterm decline in lung function. Whether- steroids affect mortality remains unclear. Many patients appear to be resistant to steroids and large, long-term trials have shown only limited effectiveness of inhaled corticosteroid ther apy. Certainly, the benefit from steroids is smaller in COPD than in asthma. Topical side-effects of inhaled steroids are oropharyngeal candidiasis and hoarse voice. At the normal doses systemic side-effects of inhaled steroids have not been firmly established. The current recommendation is that the addition of inhaled gluco-coiticosteroids to bronchodilator treatment is appropriate for patients with severe to veiy sever e COPD. 

The migration of phagocytic cells to the site of damage is one of the most fundamental components of the acute inflammatory response, and the key players in this process will be presented next. 

In the very early phases of the acute inflammatory response most of the cells invading the damaged area are polymorphonuclear neutrophils, also denoted as PMNs, which serve as initial line of defense and source of proinflammatory cytokines. These cells, which usually live for 4-5 days, circulate in the blood until they are attracted by chemokines into injured tissues. Whereas physical injury does not recruit many neutrophils, infections with bacteria or fungi elicit a striking neutrophil response. The characteristic pus of a bacterial abscess is composed mainly of apoptotic (apoptosis) and necrotic PMNs. Emigration of neutrophils from the blood starts with a process denoted as margination where neutrophils come to lie at the periphery of flowing blood cells and adhere to endothelial cells (Fig. 1). L-Selectin is expressed... 

The very early peak of neutrophil invasion into an inflamed area is followed several hours later by a wave of a second class of phagocytic cells, the macrophages. This biphasic pattern of inflammatory cell movement and accumulation is observed in most acute inflammatory responses. The mononuclear phagocyte in the blood is known as the monocyte and differentiates... 

The objectives of the inflammatory response can be viewed as a hierarchical ordered panel of events. The most successful consequence of an inflammatory response is the complete restoration of function and structure of the affected tissue, also denoted as resolution. If this is not possible, inflammation aims for healing by repair and replacement of lost tissue by scar tissue. 

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