[MUSIC] The next part of my talk would predominantly pathocybernetical. We shall discuss inflammation as a typical pathological process which is controlled predominantly with local mechanism, a process under predominant local control. And in order to interpret inflammation from of the point of view of informatics or cybernetics, probably we shall remind the ways of chemical signaling in the body. The first way is endocrine, hormones, organic signalling molecules of distant wireless action. Distant wireless means like radio without any physical wire connection through the radio wave. Hormone is organic signalling molecule acting distantly and wireless via blood. The next member of this regulatory family is neurotransmitter. It is what we have in synapses. Neurotransmitters are also organic, also signaling the molecules. They are also of distant action, but it is wire mediated like a telegraph. If you have wire from one city to another city, you can send through this wire a telegram. If wire is broken, connection is broken. Neurotransmitters, and the most important thing for regulation within inflammatory foci are so-called autocoids. Autocoids goes from Greek words auto, self and acos, drug, self-drugs. Drugs produced by organism. And as every drug, the drug produced by organism also can be poison in certain dose. So autocoids are organic, signaling molecules of local autocrine, juxtacrine or paracrine action. It means they act locally and they spread information locally like a paper pinned somewhere on a post or on the wall only for those persons who will approach, and lead not for those sitting in next room. These are autocoids are inflammatory mediators. These are cytokines, eukosanoids, biogenic amines and the also various inflammatory peptides. The first person who understood that inflammation predominantly is a local process was the founder of battle surgery. Famous British surgeon of 18th century, John Hunter. John Hunter wrote the brilliant phrase, inflammation can be only into the organ, but never of an organ. What does it mean? It means that if you have pneumonia, it looks like in this picture right side lower lob pneumonia. The lower lobe in right lung is involved, but the remaining area of lungs is not involved. If you have brain abscesses which is pockets of inflammation, there is inflammation in the abscesses and around in close vicinity. But the remote parts of brain look absolutely normal, even for an atomic pathology. Or for example, if you have lung abscesses as forci of inflammation, it means that every zone of abscesses in involved in local inflammatory mediators control. But not involved parts, they are not under the influence of that paracrine, juxtacrine, autocrine signals. So there is no inflammation of the whole organ, it is all these into the organ, but never of an organ. Barrier mechanisms limit the spread of autocoid signals and phlogogenic agents like bacteria beyond the borders of this foci. That's why the most important function of inflammation is barrier l function. Systemic neuroendocrine regulation is not necessary for driving of inflammation. Cell behavior within this zone of emergency is controlled by local signals, yet in normoergic typical inflammation. Small amounts of inflammatory autocoids are able to spread due to systemic circulation and they are able to influence the organs removed from the foci of inflammation. They will cause in parallel with local inflammation systemic typical pathological processes, which involve the endocrine system as a whole. These are stress, fever, acute phase response and so on and so forth. These are topics of our next lectures. In turn, systemic neuroendocrine responses help to delineate, to border inflamed area with the barriers. And in case of excessive hyperergic systemic action of inflammation mediators on non-damaged organs, the organ as a whole may experience acute circulatory failure and shock.
