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Inflammation (Mediators (Cytokines + Chemokines (Cytokines (TNF-alpha…

- - - - hay fever
      - allegy
      - skin irritation
    - - increases blood flow
      - increased microvascular permeability
      - itch
      - H1 antagonists
        
        Chlorpheniramine
        
        non-sedating
        
        terfenadine
        
        cetirizine
        
        astemizole
  - - - increase blood flow
      - increase micorvascular permeability
      - nociception
      - broncho-constriction
      - nasal blockage (present in nasal cavity druing allergic rhinitic attakcs
      - B-2 antagonists
        
        inhibit effect of some angioedemas
    - - induced in inflammation
      - mediate pain
  - - - vasodilators
      - increase pain sensation
      - induce fever
      - Cyclo-oxygenase pathway from arachidonic acid
    - - increase oedema formation
      - some are broncho-constrictors
      - lipoxygenase pathway from arachidonic acid
  - - - Interleukin -1
        
        arthritis
        synergistically influence each other
      - TNF-alpha
        
        Tumor necrosis factor
        
        huge role in chronic inflammation
        
        stimulation of emigration of inflammatory cells
        e.g. neutrophils and macrophages
        sectretion of other cytokines
        
        Inhibitors (Antibodies)
      - IL-1
        IL-6
        IL-17
        
        pro-inflammatory
      - IL-2
        
        t-cell acitvation
      - IL-3
        
        bone marrow stimulant
      - IL-5
        
        eosinophil activation
      - IL-10
        IL-4
        
        anti-inflamatory
    - - can be pro- and antiinflammatory
    - - = smaller peptides
      - bind to G-protein coupled receptors
- - - - source: endothelial cells inflammatory cells
        sensory nerves
  - - - due to plasma extravasation
      - = inflammatory swelling
      - oedema producing mediators
        
        neutrophil dependent: agents that stimulate Neutrophil activation
        
        Mediators leading to neutrophil accumulation in tissue
        
        Neutrophil acitvating agents:
        LTB4 (Leukotrien)
        C5a
        IL-8
        
        Endothelial adhesion molecule stimulants:
        TNF and IL-1
        
        Direct acting:
        Histamine
        substance P
        bradykinin
        PAF (platelet activating factor)
        Leukotrienes