Tissue injury in neutrophilic inflammation

The exudation of neutrophils is the hallmark of a form of inflammatory response occurring after tissue colonization by invading bacteria or as an expression of various non-infectious diseases. All these diseases are characterized by a high risk of developing irreversible tissue injury. Neutrophil-endothelium interactions, activation-induced functional and structural changes of responding neutrophils, regulatory systems of neutrophil function, and oxidative-proteolytic pathways responsible for histotoxicity are reviewed here. Finally, perspectives for rational approaches to handle the development of tissue injury during neutrophilic inflammation are considered. In the last two decades major advances have been achieved in understanding the mechanisms of neutrophil-mediated tissue damage during neutrophilic inflammation. In spite of the progress of knowledge, effective therapeutic approaches to controlling tissue injury in neutrophilic inflammation in humans are still lacking. The present review focuses on the events crucial for the development of neutrophilic inflammatory responses, in order to identify the major pathogenic steps which might be therapeutic targets.