Systemic inflammation: theoretical and methodological approaches to description of general pathological process model. Part IV. A dynamics of the process.

Abstract

Systemic inflammation (SI) as a general pathological process is considered as a development of cellular stress in response to systemic action of damage factors. An Acute SI is characterized by wavelike course (a changing of activation and inhibition phases); a chronic SI is characterized by successive changing of stages of its progressive development. SI may be classified into three variants which are dependened on intensity of systemic alteration as well as on condition of anti-inflammatory systems: 1) a «break» is a fulminating process (e.g. fulminating sepsis), 2) a «caving» is a relatively gradual conversion of classical inflammation to systemic one; 3) a «sticking» is a typical chronic SI. An evolution of the acute SI is characterized by the 5 following phases: a development, hyperergic phases of the primary and the secondary phlogogenic impact, a resolution, and depressive phase. The last phase is a typical for the «break» variant and characterized by a tolerance, but not a resistance strategy to action of factors of systemic alteration. It is advisable to estimate SI with Integral Criteria (Scales), which reflect both of the development of a systemic inflammatory response and the following other particular processes of SI: the systemic alteration, the micro thrombosis and other microcirculatory disorders, multiple organ dysfunction, and a distress of the neuroendocrine system.