Revista Habanera de Ciencias Médicas (Jan 2019)
Inflammation from an immunologic perspective: a challenge to medicine in the 21st century
Abstract
Introduction: Inflammation is a homeostatic response of the body. It is one of the main reasons for consultation in Cuba and throughout world. There is a misperception that it is an isolated and always pathological entity. It is a dynamic, complex, systemic, and multifactorial process. Therefore, it is a challenge to elucidate the elements and the tissue changes that it causes to establish the best way to improve the clinical practice related to an inflammatory process.Objective: To describe inflammation, its classification, elements involved, and systemic changes from an immunological perspective.Material and Methods: A review of the topic was made using the updated bibliography. Free-access articles were consulted in Pubmed and Scielo databases in the period from January 2013 to December 2018.Development: Inflammation can be classified according to the damage, time or effectors involved. The main molecules are the cytokines like TNF-α, IFN-γ, IL-1β, IL-10, IL-6, TGF-β. Some cells participate such as neutrophils, mastocytes, macrophages, T-lymphocyes, and the vascular endothelium. During the inflammatory process, the functions of almost all organ systems are modified. It produces systemic changes that are observed in physiological processes such as pregnancy or aging. Sometimes inflammation triggers diseases such as cardiovascular and neurological ones, and cancer. The pathophysiological mechanisms have not been clarified.Conclusions: Currently, the events that trigger chronic inflammation and how tissue damage occurs are unknown. The biggest challenge is to elucidate the causes and immunological mechanisms that lead to inflammatory manifestations that are expressed as systemic neurological, cardiovascular and autoimmune diseases, among others.Keywords: Acute inflammation, chronic inflammation, proinflammatory mediators, sepsis.