Acute Inflammation - Zhejiang University急性炎症u2014u2014浙江大学.pdfVIP

Acute Inflammation Acute inflammation is a rapid response to an injurious agent that serves to deliver mediators of host defense—leukocytes and plasma proteins—to the site of injury. Acute inflammation has three major components: (1) alterations in vascular caliber that lead to an increase in blood flow; (2) structural changes in the microvasculature that permit plasma proteins and leukocytes to leave the circulation; and (3) emigration of the leukocytes from the microcirculation, their accumulation in the focus of injury, and their activation to eliminate the offending agent ( Fig. 2-2 ). Figure 2-2 The major local manifestations of acute inflammation, compared to normal. (1) Vascular dilation and increased blood flow (causing erythema and warmth), (2) extravasation and deposition of plasma fluid and proteins (edema), and (3) leukocyte emigration and accumulation in the site of injury. Certain terms must be defined before specific features of inflammation are described. The escape of fluid, proteins, and blood cells from the vascular system into the interstitial tissue or body cavities is known as exudation. An exudate is an inflammatory extravascular fluid that has a high protein concentration, cellular debris, and a specific gravity above 1.020. It implies significant alteration in the normal permeability of small blood vessels in the area of injury. In contrast, a transudate is a fluid with low protein content (most of which is albumin) and a specific gravity of less than 1.012. It is essentially an ultrafiltrate of blood plasma that results from osmotic or hydrostatic imbalance across the vessel wall without an increase in vascular permeability. Edema denotes an excess of fluid in the interstitial or serous cavities; it can be either an exudate or a transudate. Pus, a purulent exudate, is an inflammatory exudate rich in leukocytes (mostly neutrophils), the debr