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Aging and Inflammation

By: Peter T. Pugliese, MD
Posted: November 24, 2009, from the December 2009 issue of Skin Inc. magazine.

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Swelling. Swelling is due to fluid in the tissues. It is a combination of interstitial fluid, plasma and white blood cells.

Heat. Heat is a combination of increased blood flow and tissue temperature due to fever-producing proteins.

Pain. Pain is due to the activation of the unmyelinated nerve endings in the skin. It can be mild or intense.

Processes of inflammation

Inflammation is the result of the body’s defense against a pathogenic antigen. There are two defense mechanisms the body uses to mount a response against these antigens. First is a rapid response known as the innate immune system. This system is able to detect many molecular patterns found on pathogenic organisms, but lacks specificity of recognition. The macrophage is a key cell in the initial response, along with other white blood cells such as neutrophils, basophils and eosinophils. Complement is a complex protein system that either destroys cells directly or marks them for destruction by other white blood cells. Phagocytosis is a major means of destroying cells by engulfing the bacteria and destroying it with enzymes (lysozymes). White blood cells release powerful proteins called cytokines that can coordinate and amplify the response.

The second response is launched by the adaptive immune system, which has a finely tuned antigen- recognition mechanism in lymphocytes known as T cells and B cells. These cells can produce massive amounts of antibodies, and T cells can differentiate into at least two subtypes of T helper (TH) cells.