RADANG AKUT

Dr. NK SUNGOWATI, SpPA

RADANG AKUT
Perubahan vaskuler
a. Perubahan aliran dan ukuran
pembuluh darah
b. Peningkatan permeabilitas vaskuler
Peristiwa seluler: ekstravasasi leukosit
dan fagositosis
a. Adhesi dan transmigrasi
b. Kemotaksis dan aktivasi leukosit


Outline

c. Fagositosis (pengenalan, perlekatan,
pelahapan dan degradasi)
d. Pengeluaran produk leukosit
e. Defek fungsi leukosit

Jejas pada sel
RADANG AKUT
Merupakan respon langsung dan
dini terhadap jejas
Ditandai perubahan sirkulasi mikro,
eksudasi cairan dan transmigrasi
leukosit dari pembuluh darah ke
tempat jejas
CARDINAL SIGN
Rubor
Calor
Tumor
Dolor
Functio laesa

ISTILAH-ISTILAH
Eksudasi
Eksudat
Transudat
Edema
Pus
PERUBAHAN VASKULER
Perubahan kaliber pembuluh darah
dan aliran darah
a. Vasodilatasi
b. Perlambatan sirkulasi
c. Stasis
Peningkatan permiabilitas vaskuler
(vascular leakage)
Mekanisme
terjadinya
vascular leakage
Kontraksi endotel
(histamin,bradikinin,
lekotrin)
Reorganisasi
sitoskeleton
(sitokin)
Jejas langsung
Leakage diperantarai
leukosit
Leakage dari endotel
regeneratif
PERISTIWA SEL DARAH PUTIH
Marginasi, rolling, adhesi
Transmigrasi (diapedesis)
Migrasi menuju stimulus
kemotaktik
Peristiwa sel darah putih
Adhesi leukosit
pada endotel
Interaksi endotel neutrofil
TRANSMIGRASI
Terjadi sepanjang interseluler junction
Tergantung umur lesi dan tipe stimulus
Neutrofil (6-24 jam)
Monosit (24-48 jam)
Pseudomonas (neutrofil ~ 2-4 hari)
Virus ~ limfosit
Hipersensitivitas ~ eosinofil
Reaksi radang akut
Peristiwa Sel Darah Putih
Ikatan ligan-reseptor
Ikatan ligan-reseptor
FAGOSITOSIS
Pengenalan dan perlekatan
Pelahapan
Pembunuhan atau degradasi
Fagositosis
Fc
C3
NADPH
NADP+
Oksidase aktif
SITOPLASMA VAKUOLA FAGOSITIK
Oksidase sitoplasmik
Oksidase membran
Granula spesifik
PENGELUARAN PRODUK
LEUKOSIT
Terdiri dari : E. lisosom,
metabolit aktif O2, prostalglandin
dan lekotrin.
DEFEK FUNGSI LEUKOSIT
Lebih rentan terhadap infeksi
Genetik :
a. LAD tipe1,2 (defisiensi molekul
adhesi)
b. CGD (defisiensi NADPH oksidase)
c. Chediak-Higashi S. (neutrofenia,
defektif degranulasi, perlambatan
pembunuhan bakteri)
Didapat :
a. Kemotaksis : febris, diabetes ,
sepsis, immunodefisiensi
b. Adhesi : hemodialisis, DM
c. Fagositosis, aktivitas mikrobisidal :
leukemia, anemia, sepsis, diabetes,
neonatus, malnutrisi
MANIFESTASI KLINIK
(SISTEMIK)
Febris : pirogen dan prostalglandin
Perubahan hitung sel darah putih perifer
- Neutrofil leukositosis
- Neutropenia, limfositosis
Perubahan protein plasma
C-reactive protein, antitrypsin, fibrinogen,
haptoglobin, ceruloplasmin
RINGKASAN
Reaksi radang akut :
Aliran darah meningkat (dilatasi
arteriol)
Permeabilitas meningkat
(interendotel junction melebar, jejas
langsung endotel)

Neutrofil (adhesi, transmigrasi,
migrasi ke tempat jejas)
Fagositosis
Produk leukosit
Acute Inflammation. A capillary
surrounded by PMN leucocyte in are of
inflammation.
Purulent exudate in some alveoli of the lung
(left). Alveoli to the right are dilated as
compensatory measure for the obstruction of
alveoli on the left.
Alveolar exudate. Leucocytes in the alveoli together
with strands of fibrin. Venules in the alveolar walls
are dilated as part of the inflammatory response.
Fibrinous exudate. Pink staining threads of
fibrin with leucocytes in alveoli. The vessels
are dilated.
Pus. Section of skin showing an accumulation of the pus
(pustule) in the epidermis. This is often seen in impetigo
which superficial infection caused by coccal bacteria.
Purulent exudate. The edge of an ulcer in the
colon. Damaged colonic epithelium is seen on
the left and purulent exudate in the base of the
ulcer on the right.
Fibrinopurulent
exudate. The wall
of an ulcer showing
fibrinopurulent
exudate on the
surface (top) and
newly formed
vessels (granulation
tissue) deeper down.
Acute inflammation.
Section of heart muscle
an visceral pericardium
showing pink layer of
fibrin on the surface.
Inflammatory cells and
dilated vessels are
present in the
underlying connective
tissue.
Acute inflammation. Visceral pericardium.
Movement of the heart in pericardial sac causes
strands of fibrin to project into the lumen of the
pericardial sac.
Plasma cells and mast cells
Mast cells with fibroblast on the right.
The mast cell granules have stain bright
red with solachrome cyanin.
Mast cell granules also stain bright blue with
toluidine blue.
Eosinofil leucocyte.
Dr.NK Sungowati