Cell Injury and Inflammation, & Neoplasia

• Cell Injury and Inflammation

  Adaptive Process
• Adaptive Process


  • Hypertrophy
  • Hyperplasia
  • Atrophy
  • Metaplasia
• Cell Injury and Inflammation

  Maladaptive Process
• Maladaptive Process


  • Dysplasia
  • Anaplasia
• First line of defense

  • Skin and Mucous membrane
  • MPS or Mononuclear Phagocyte System
  • Monocytes and Macrophages
  • Precursor cells (Reticuloendothelial cells or RES)
  • Fixed phagocytes or Macrophages
  • Mobile or Wandering phagocytes
• Functions of MPS


  • Recognition and phagocytosis of foreign materials as microorganisms
  • Removal of old or damaged cells from circulation
  • Participation in the immune system
• Distinct Phenomena in the Inflammatory Response

  • Increased Vascular Permeability (Vascular response)
  • Infiltration of Leukocytic cells (Cellular response)
  • Formation of exudate
  • Healing process
• Increased Vascular Permeability (Vascular response)

  • Vasoconstriction
  • Release of histamines / chemicals
  • Vasodilatation
  • Hyperemia
  • Filtration process
• Cell Injury


  1. Momentary local vasoconstriction

  2. Cell death

  3. Release of chemicals (kinins, histamine, prostaglandin)

  4. Local vasodilation

  5. Hyperemia

  6. Capillary permeability

  7. Fluid exudate
• Leukocytes


  • Neutrophils
  • Monocytes
  • Lymphocytes
  • Eosinophils
  • Basophils
• Inflammatory Response


  1. Margination and diapedesis of blood leukocytes

  2. Cell injury

  3. Chemostaxis

  4. Migration of leukocytes to site of injury

  5. Lymphocytes

  6. Monocytes

  7. Macrophages

  8. Phagocytosis

  9. Cellular exudate

  10. Immune response

  11. Tissue macrophages
• Mediators of Inflammation Response

  • Histamine
  • Serotonin
  • Kinins
  • Complement components
  • Fibrinopeptides
  • Prostaglandin
  • Leukotrienes and cytokines
• Histamine


  Vasodilation and increased vascular permeability
• Serotonin


  Vasodilation and increased vascular permeability
• Kinins


  Contraction of smooth muscles and vasodilation
• Complement components


  Stimulate histamine release, chemotaxis
• Fibrinopeptides


  Increase vascular permeability, stimulate chemostaxis – neutrophils and monocytes
• Prostaglandin


  PG1 and PG2 causes vasodilation
• Leukotrienes and cytokines


  LT stimulates chemotaxis
• Types of Exudate


  • Serous
  • Serosanguinous
  • Sanguinous
  • Purulent
  • Catarrhal or Mucoid
• Healing Process


  • Replacement of dead or damaged cells
  • Regeneration – replaced by new cells that are identical
  • Scar formation – formation of collagenous scar
  • Primary healing – Union or first intention
  • Secondary healing – Secondary union or secondary intention
  • Tertiary healing – Tertiary intention
• Systemic Inflammatory Response occurs when bacterial invaders cannot be successfully localized and destroyed
• Clinical Manifestations of Systemic Inflammatory Response

  • Fever
  • Leukocytosis
  • Anorexia
  • Nausea
  • Malaise
  • Increased ESR
• Manifestations of Systemic Inflammatory Response

  • Prodromal (Non-specific complains - mild headache, fatigue, general malaise, muscle ache)
  • Chill (Cutaneous vasoconstriction, pale skin and feeling of being cold, Shivering causing the body to reach new temperature set by the control center in the hypothalamus)
  • Flush (Sensation of warmth throughout the body, warming and flushing of the skin)
  • Defervescence (Sweating, decreased in body temperature)
• Immunity


  State of responsiveness to foreign substances
• Functions of Immunity


  • Defense
  • Homeostasis
  • Surveillance
• Humoral Immunity


  Ability of the body to respond to the presence of an antigens by the formation of antigen and specific antibodies
• Cellular Immunity


  Aspect of the immune process that is instrumental in the formation and sensitization of a certain group of lymphocytes
• Cancer Staging refers to the extent of cancer within the body. It helps doctors understand how serious the cancer is and guides treatment decisions.
• Hypertrophy 


  increase in the size of cells, leading to an enlargement of an organ or tissue
• Hyperplasia


  increase in the number of cells in an organ or tissue, leading to its enlargement
• Atrophy


  opposite of hypertrophy and refers to a decrease in the size or mass of an organ or tissue
• Metaplasia


  reversible change in which one mature cell type is replaced by another mature cell type that is not normally found in that tissue
• Dysplasia


  abnormal development or growth of cells within a tissue or organ
• Anaplasia


   loss of differentiation or specialization of cells
• Neoplasia


  abnormal and uncontrolled growth of cells, leading to the formation of a tumor or mass
• Skin and Mucous membrane


  first line of defense
• MPS or Mononuclear Phagocyte System


  a network of cells involved in the immune response and the clearance of foreign substances or cellular debris from the body
• Monocytes


  • type of white blood cell that circulate in the bloodstream
  • by migrating into tissues and differentiating into macrophages
• Macrophages


  • phagocytosis (engulfing and digesting foreign particles or cellular debris), antigen presentation (displaying antigens to activate immune cells), and cytokine production (regulating immune responses).
  • type of phagocyte that can be found in various tissues throughout the body