Role of Inflammation

Acute inflammation is the protective tissue response to injury or destruction of tissues, of sudden onset marked by the classical signs of inflammation (4). The vascular and exudative processes predominate and set up a campaign against infiltrating foreign agents. Its beneficial roles have been outlined in the literature for many years; however, in recent times the acute inflammatory response has been identified as also having detrimental effects and outcomes. The balance of positive and negative effects and outcomes will be scrutinized in this essay and the demonstrative evidence will be delineated.

The acute inflammatory response is the initial tissue reaction to a variety of agents that cause injury. The causative agents can range from microbial infections to tissue necrosis (3, 7). Three components are attributable to the acute inflammatory response, namely: alterations in vascular flow, structural changes in the microvasculature permitting exudation, and mass movement of leukocytes from the vascular areas to the focus of tissue injury (3). Clinically, the integration of these phases manifests to characteristic macroscopic appearances such as: redness, heat, swelling, pain, and loss of function (7).

The early stages of acute inflammation involve vascular changes leading to leakage of protein rich fluid into the extravascular space. Vasodilation occurs, after a brief period of vasoconstriction as a direct response to tissue injury (3). Symptomatically, this manifests as heat and redness, due to increased blood flow. The active hyperaemic response usually is ensued by circulatory changes. The slowing of the circulation leads to stasis of the blood, and peripheral orientation of leukocytes, principally neutrophil polymorphs, becomes apparent – a process known as leukocytic margination (6). Initially, the adhesion of leukocytes to the endothelium is frail, however the increased avidity leading to ‘rolling’ and consequently ‘pavementing’ results in the...