Some aspects of the inflammatory process.

The inflammatory process is a nonspecific complex, stereotype, coordinated response of tissues to injury. This process involves vascular permeability, active migration of blood cells, and passage of plasma constituents into the injurious tissue. The molecules that mediate the initial events of inflammation are the adhesion molecules. They are localized on leukocytes and endothelium. The adhesion and cell-cell cooperation appear to be critical for the migration of leukocytes to the abluminal surface of the blood vessels. The emigrating cells initiate the complex reactions that are controlled by a multitude of intercellular messengers called mediators. Prostanoids, that are products of arachidonic acid metabolism in cyclooxygenase pathway are involved in the process of communication between cells. Two isoforms of the cyclooxygenase COX-1 and COX-2 were found. They subserve different physiological function largely because of the striking differences in their tissue expression and regulation. A common feature of chronic inflammation is the persistence of a large number of leukocytes in the tissue; thus, their removal is important for the resolution of the inflammatory process. The mechanism by which they are removed includes the apoptotic recognition system. The new concepts regarding the therapy of the diseases concomitant with inflammatory reaction should include the inhibition of the appropriate isoform of cyclooxygenase and the regulation of apoptotic process in some cells.