Djumadi Achmad

BEBERAPA GOLONGAN Mediator :

1. Amine vasoaktif : histamin, serotonin 2. Protease plasma : komplemen, kinin,

sistem pembekuan 3. Metabolit asam arakhidonik : Prostaglandin, leukotrien

4. Platelet Activating Factor (PAF ) 5. Sitokin : IL-1, IL-8, TNF 6. Nitric oxide (NO) 7. Enzim lisosomal dari lekosit 8. Radikal bebas dari oksigen

Cell-derived mediators
Diproduksi oleh : Platelet Mast cells / basophils Polymorphonuclear leukocytes Endothelial cells Monocytes / macrophages Injured tissue

Cell-derived mediators
Pembentukannya : 1. Preformed dan disimpan dalam granula sitoplasma (histamin, serotonin, enzim lisosomal) 2. Berasal dari metabolisme asam arakhidonik (prostaglandin,
leukotrien, tromboxan, platelet activating factor)

3. Produk lain dari vascular regulator (NO)

Mast cell / basofil, Platelet

Jejas fisik Rx imun : Ab-mast cell Komplemen : C3a, C5a

Histamine-releasing protein dari lekosit Neuropeptide : substasi P Sitokin : IL-1, IL-8

Vasodilatasi Hiperpermeabilitas

Platelet

Kontak : kollagen, trombin, ADP, kompl Ag-Ab PAF <- mast cell

Vasodilatasi Hiperpermeabilitas

Figure 2-16 Generation of arachidonic acid metabolites and their roles in inflammation. The molecular targets of action of some anti-inflammatory drugs are indicated by a red X. COX, cyclooxygenase; HETE, hydroxyeicosatetraenoic acid; HPETE, hydroperoxyeicosatetraenoic acid.

Metabolit Asam Arakhidonik

Metabolit
TXA2, LTC4, LTD4, LTE4 PGI2, PGE1, PGE2, PGD2

Efek
Vasokonstriksi Vasodilatasi Khemotaktik

LTC4, LTD4, LTE4

LB4, HETE

Hiperpermeabilitas Nyeri, demam

PGE2

IgE mediated rx
Mast cell / basofil, netrofil, monosit, endotel,
Membran fosfolipid
PLA2

Vasokonstriksi, spasme bronkhus Vasodilatasi Adhesi lekosit Khemotaksis Degranulasi Radikal bebas O-

Hiperpermeabilitas

PAF

Figure 2-18 Major effects of interleukin-1 (IL-1) and tumor necrosis factor (TNF) in inflammation.

Figure 2-19 Functions of nitric oxide (NO) in blood vessels and macrophages, produced by two NO synthase enzymes. NO causes vasodilation, and NO free radicals are toxic to microbial and mammalian cells. NOS, nitric oxide synthase.

Plasma-derived mediators
1. Sistem komplemen 2. Faktor Hageman (faktor XII)

Figure 2-14 The activation and functions of the complement system. Activation of complement by different pathways leads to cleavage of C3. The functions of the complement system are mediated by breakdown products of C3 and other complement proteins, and by the membrane attack complex (MAC).

Figure 2-15 Interrelationships between the four plasma mediator systems triggered by activation of factor XII (Hageman factor). Note that thrombin induces inflammation by binding to protease-activated receptors (principally PAR-1) on platelets, endothelium, smooth muscle cells, and other cells.

Sistem KININ

Efek :

1. Hiperpermeabilitas
2. Kontraksi otot polos 3. Vasodilatasi 4. Nyeri

Diinaktifkan oleh : Kininase