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Health, Contribute to chronic inflammation, Blood flow is increased to…

- - - - 2. Complement system Second layer of defense when pathogens avoid immune cells
        
        Acute inflammation short term process that protects and heals body from infection
        
        PMNs are first leukocyte to arrive at injured site
        
        PMNs release cytokines including IL and TNF
        
        In response, liver produces CRP, a type of acute phase reactant protein. Periodontitis is associated with high levels of CRP.
        
        PMNs are short lived and are involved in teh early stages of inflammation
        
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        Chronic inflammation
        
        long lived out of control process; no symptoms. Tissue damage is the hallmark of chronic inflammation
        
        The accumulation of macrophages characterizes chronic inflammation
        
        Macrophages engulf and digest microorganisms
        
        Leukocytes release several different inflammatory mediators(IL-1 TNF-alpha and prostaglandins). TNF-alpha contributes to tissue destruction
        
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        Symptoms: Pain, redness, swelling, heat, loss of function
        
        2a. Destroy pathogens by creating protein called membrane attack complex (lysis)
        
        2b. Opsonization- engulfment and destruction of microorganisms by phagocytosis. most important process
        
        2c. Recruitment of phagocytes
        
        2d. Immune clearance
      - Cellular defenders
        
        Leukocytes
        
        Macrophages-slower to arrive than PMNs, most present in chronic inflammation
        
        Release Cytokines
        
        Antigen to t-cells
        
        Release lysosomes
        
        PMNs
        first to the site of infection then phagocytose and kill invading microorganisms
        
        PGE2
        
        Stimulate MMP secretion. Play important role in bone destruction seen in periodontitis
        
        From arachadonic acid cascade, alerts pain to start
        
        MMPs
        
        Extensive collagen destruction occurs in periodontal tissues and alveolar bone
        
        PMNs are short lived
        
        Produce Cytokines
        
        Transendothelial process
        Leukocytes travel through the blood stream and push between the endothelial cells lining the blood vessels
        
        Leukocytes enter the connective tissue and travel to the site of infection through chemotaxis
        
        lysosome enzymes are released and cause damage to tissue cells in the same manner that they destroy bacteria
        
        Lymphocytes
        
        B-cells- once B-cells are activated, they manufactures millions of antibodies
        
        Antibodies neutralizes and coats bacteria to make them more susceptible to phagocytosis. Activate the complement system
        
        T-cells-Intensify the response of other immune cells
        
        Produce cytokines
      - Leukocytes travel through capillary walls into the tissue through transendothelial migration
        
        Phagocytosis occurs from leukocytes and inflammatory mediators are released
        
        Periodontitis