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This book covers the physiological processes relevant to inflammation. It centers on the recruitment of leukocytes to sites of injury and infection, their function in the tissue and the eventual resolution of inflammation.
Chronic diseases are increasingly recognized as involving low grade inflammation, that is, a self-perpetuating tissue response to stress caused by exogenous or endogenous triggers, that progressively evokes danger-associated molecular pattern release, ultimately driving tissue damage and loss of function. This response is frequently unapparent clinically, thus the designation "low grade". This eBook comprises nineteen reviews and original articles that provide the most updated knowledge on the causes and roles of this inflammatory response in a variety of diseases and conditions. The editorial that precedes these articles not only summarizes each one, but provides a broader interpretation of the role of inflammation in health and a variety of disease conditions, the underlying mechanisms and the targets more promising for therapy. Finally, it also highlights the most relevant and emerging research topics that are already shaping future directions for the development of more fine-tuned and innovative therapies.
The microcirculation is highly responsive to, and a vital participant in, the inflammatory response. All segments of the microvasculature (arterioles, capillaries, and venules) exhibit characteristic phenotypic changes during inflammation that appear to be directed toward enhancing the delivery of inflammatory cells to the injured/infected tissue, isolating the region from healthy tissue and the systemic circulation, and setting the stage for tissue repair and regeneration. The best characterized responses of the microcirculation to inflammation include impaired vasomotor function, reduced capillary perfusion, adhesion of leukocytes and platelets, activation of the coagulation cascade, and enhanced thrombosis, increased vascular permeability, and an increase in the rate of proliferation of blood and lymphatic vessels. A variety of cells that normally circulate in blood (leukocytes, platelets) or reside within the vessel wall (endothelial cells, pericytes) or in the perivascular space (mast cells, macrophages) are activated in response to inflammation. The activation products and chemical mediators released from these cells act through different well-characterized signaling pathways to induce the phenotypic changes in microvessel function that accompany inflammation. Drugs that target a specific microvascular response to inflammation, such as leukocyte-endothelial cell adhesion or angiogenesis, have shown promise in both the preclinical and clinical studies of inflammatory disease. Future research efforts in this area will likely identify new avenues for therapeutic intervention in inflammation. Table of Contents: Introduction / Historical Perspectives / Anatomical Considerations / Impaired Vasomotor Responses / Capillary Perfusion / Angiogenesis / Leukocyte-Endothelial Cell Adhesion / Platelet-Vessel Wall Interactions / Coagulation and Thrombosis / Endothelial Barrier Dysfunction / Epilogue / References
The acute inflammatory response is the body's first system of alarm signals that are directed toward containment and elimination of microbial invaders. Uncontrolled inflammation has emerged as a pathophysiologic basis for many widely occurring diseases in the general population that were not initially known to be linked to the inflammatory response, including cardiovascular disease, asthma, arthritis, and cancer. To better manage treatment, diagnosis, and prevention of these wide-ranging diseases, multidisciplinary research efforts are underway in both academic and industry settings. This book provides an introduction to the cell types, chemical mediators, and general mechanisms of the host's first response to invasion. World-class experts from institutions around the world have written chapters for this introductory text. The text is presented as an introductory springboard for graduate students, medical scientists, and researchers from other disciplines wishing to gain an appreciation and working knowledge of current cellular and molecular mechanisms fundamental to inflammation.
The partition of fluid between the vascular and interstitial compartments is regulated by forces (hydrostatic and oncotic) operating across the microvascular walls and the surface areas of permeable structures comprising the endothelial barrier to fluid and solute exchange, as well as within the extracellular matrix and lymphatics. In addition to its role in the regulation of vascular volume, transcapillary fluid filtration also allows for continuous turnover of water bathing tissue cells, providing the medium for diffusional flux of oxygen and nutrients required for cellular metabolism and removal of metabolic byproducts. Transendothelial volume flow has also been shown to influence vascular smooth muscle tone in arterioles, hydraulic conductivity in capillaries, and neutrophil transmigration across postcapillary venules, while the flow of this filtrate through the interstitial spaces functions to modify the activities of parenchymal, resident tissue, and metastasizing tumor cells. Likewise, the flow of lymph, which is driven by capillary filtration, is important for the transport of immune and tumor cells, antigen delivery to lymph nodes, and for return of filtered fluid and extravasated proteins to the blood. Given this background, the aims of this treatise are to summarize our current understanding of the factors involved in the regulation of transcapillary fluid movement, how fluid movements across the endothelial barrier and through the interstitium and lymphatic vessels influence cell function and behavior, and the pathophysiology of edema formation. Table of Contents: Fluid Movement Across the Endothelial Barrier / The Interstitium / The Lymphatic Vasculature / Pathophysiology of Edema Formation
The Inflammatory Process focuses on the approaches, methodologies, and technologies involved in the study of the inflammatory process, including capillary structure, tissue injury, and inflammatory response. The selection first offers information on the experimental approach to inflammation, ultrastructural and biochemical consequences of cell injury, and ultrastructural basis of capillary permeability. Discussions focus on permeability of capillaries, cytoplasm, nucleus, gross pathology of inflammation, light microscope and the study of inflammation, and the physiologic approach to problems of inflammation. The text then elaborates on the microvascular aspects of tissue injury and the sticking and emigration of white blood cells in inflammation. The book examines neutrophil and eosinophil leucocytes, "life history" and functions of lymphocytes, and metabolism and physiology of mononuclear phagocytes. Topics include inflammatory response, biochemistry and metabolism, special relationships to bacteria and viruses, and origins and early development of lymphocytes. The text also ponders on the role of lysosomes in tissue injury, hemostatic mechanisms in tissue injury, and anti-inflammatory agents. The selection is a vital source of data for researchers interested in the inflammatory process.
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This book provides readers with an up-to-date and comprehensive view on the resolution of inflammation and on new developments in this area, including pro-resolution mediators, apoptosis, macrophage clearance of apoptotic cells, possible novel drug developments.
Although acute inflammation is a healthy physiological response indicative of wound healing, chronic inflammation has been directly implicated in a wide range of degenerative human health disorders encompassing almost all present day non-communicable diseases including autoimmune diseases, obesity, diabetes and atherosclerosis. Chronic Inflammation