Patient was educated on mechanism of inflammation as follows:
- Every tissue in the body has some cells that play an important role in inflammation. These cells are native to that tissue and initiate the inflammatory process.
- Mast cells and macrophages available locally in the tissues are the major groups of cells that initiate the inflammatory response.
- Injury to the tissue results in activation of these mast cells and macrophages, which lead to production of enzymes called cyclooxygenases.
- Injured tissues, through the mediation of these cyclooxygenase enzymes, produce chemical mediators of inflammation called prostaglandins.
- Prostaglandins result in swelling of the injured tissues and amplify the sensitivity to pain.
- Mast cells upon activation release other chemical inflammatory mediators, histamine and bradykinin.
- Prostaglandins, histamine, and bradykinin increase the pain sensitivity and the individual experiences increased pain in the tissue involved, which is one of the most important symptom of inflammation.
- Also, bradykinin and histamine cause vascular smooth muscle relaxation and contribute to local vasodilation in the tissue injured. Vasodilation results in increased blood flow to the tissue, resulting in local redness and warmth in the tissue involved.
- Local vasodilation also results in increased permeability of the blood vessels, which results in leaking of plasma proteins, such as, immunoglobulins or antibodies into the tissue injured. These immunoglobulins are protective in nature.
- Proteins such as, fibrin, also leak through the blood vessels into the tissues. Fibrin helps with healing of the injured tissue.
- Water always follows movement of plasma proteins and consequently, leaks and accumulates in the tissue, contributing to the swelling.
- Chemical mediators also induce chemotaxis, whereby neutrophils are attracted to the site of injury, along the chemotactic gradient.
- Neutrophils help in the further release of chemical mediators called cytokines, which amplify the inflammatory response further.
- Also, neutrophils along with macrophages in the tissues help by engulfing the attacking agent at the site of injury.
