What are examples of the inflammatory process?

From the Guidelines

The inflammatory process is characterized by several key examples, including acute inflammation, chronic inflammation, allergic reactions, and atherosclerosis, which are all mediated by immune cells and chemical messengers like cytokines, as seen in conditions such as rheumatoid arthritis, where inflammation is the basis of the disease process, leading to signs and symptoms like joint swelling, pain, and stiffness 1.

Key Examples of Inflammatory Process

• Acute inflammation: involves redness, swelling, heat, pain, and loss of function in the affected area, as seen in conditions like sunburn, infected cuts, or sprained ankles.
• Chronic inflammation: occurs in diseases like rheumatoid arthritis, where joints become persistently swollen and painful, or in inflammatory bowel diseases like Crohn's disease and ulcerative colitis, which cause digestive tract inflammation.
• Allergic reactions: represent another inflammatory response where the immune system overreacts to harmless substances, causing symptoms like hives or anaphylaxis.
• Atherosclerosis: involves inflammation of blood vessel walls leading to plaque buildup.

Mechanism of Inflammatory Process

• Mediated by chemical messengers like cytokines, which are products of immune system cells, as mentioned in the context of rheumatoid arthritis 1.
• Involves immune cells such as neutrophils and macrophages that migrate to damaged areas, release inflammatory mediators, and help clear pathogens and damaged tissue.

Impact of Inflammatory Process

• While inflammation is protective in the short term, persistent inflammation can damage healthy tissues and contribute to chronic disease, as seen in rheumatoid arthritis, where inflammation leads to joint damage and limited function 1.
• The goal of treating conditions like rheumatoid arthritis is to stop the inflammation, thereby reducing damage and disability, and improving health-related quality of life, which is key in the management of the disease 1.

From the FDA Drug Label

2 Rheumatic Disorders As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in: Psoriatic arthritis Rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy) Ankylosing spondylitis Acute and subacute bursitis Acute nonspecific tenosynovitis Acute gouty arthritis Post-traumatic osteoarthritis Synovitis of osteoarthritis Epicondylitis 6 Ophthalmic Diseases Severe acute and chronic allergic and inflammatory processes involving the eye and its adnexa such as: Allergic corneal marginal ulcers Herpes zoster ophthalmicus Anterior segment inflammation Diffuse posterior uveitis and choroiditis Sympathetic ophthalmia Allergic conjunctivitis Keratitis Chorioretinitis Optic neuritis Iritis and iridocyclitis

Some examples of the inflammatory process include:

• Rheumatoid arthritis
• Psoriatic arthritis
• Ankylosing spondylitis
• Acute and subacute bursitis
• Acute nonspecific tenosynovitis
• Acute gouty arthritis
• Anterior segment inflammation
• Diffuse posterior uveitis and choroiditis
• Iritis and iridocyclitis 2

From the Research

Inflammatory Process Examples

• Acute appendicitis is a common example of an inflammatory process, with symptoms including vague periumbilical pain, anorexia/nausea/intermittent vomiting, migration of pain to the right lower quadrant, and low-grade fever 3
• The inflammatory process in acute appendicitis can lead to complications such as perforation, which can result in sepsis and occurs in 17% to 32% of patients with acute appendicitis 4
• Non-steroidal anti-inflammatory drugs (NSAIDs) can affect the inflammatory process, and their concomitant use with low-dose methotrexate has been associated with an increased risk of serious adverse events, including liver toxicity, acute renal failure, and cytopenia 5
• NSAIDs have also been linked to an increased risk of appendicitis in patients over 50 years old, possibly due to an impairment of host defenses leading to failure in the resolution of inflammatory episodes 6
• The diagnosis and treatment of acute appendicitis involve understanding the inflammatory process, with surgical intervention being the gold standard of treatment, although other modalities such as antibiotics and endoscopic retrograde appendicitis therapy (ERAT) are being explored to avoid surgical complications 7

Key Factors in the Inflammatory Process

• Clinical presentation, including symptoms such as pain and fever, plays a crucial role in diagnosing inflammatory processes like acute appendicitis 3, 4
• Imaging modalities, such as CT scans, can help identify the inflammatory process and guide treatment decisions 3, 7
• Laboratory studies, including white blood cell counts, can also aid in diagnosing and monitoring the inflammatory process 6
• The use of medications, such as NSAIDs and antibiotics, can impact the inflammatory process and treatment outcomes 5, 6