Amplification
Chapter: 2
The inflammatory process is dependent upon a number of different processes to rapidly amplify an initial inflammatory response into one that is sufficient to eliminate the inciting stimulus. Some of the main means of amplification are: local activation of precursors of rapidly expanding proinflammatory cascades of plasma proteins (e.g., the complement or Hageman factor-related cascades); autocatalytic feedback loops (e.g., activated Hageman factor leading to the production of kallikrein, which is an activator of more Hageman factor, etc.); rapid, leukocyte-selective, quantitatively dramatic expression of inducible genes, the products of which are proinflammatory (e.g., cyclooxygenase-2, a.k.a. prostaglandin G/H synthase-2); up-regulation by early inflammatory mediators of cell surface molecules that promote the recruitment of leukocytes (e.g., adhesion molecules); local production of precursor proinflammatory molecules by recruited leukocytes (e.g., proinflammatory complement proteins by macrophages); and synergistic augmentation by one cytokine of the proinflammatory effects or production of another (chief among these is interferon-gamma).