About the book
Edema formation is a hemodynamic disturbance mediated by an increase of fluids in the interstitial space. This process occurs by balancing liquid flow deregulation in the interstitial space and consequent accumulation in body regions, such as members, abdomen, and organs. The liquid retention becomes harmful, affecting cellular metabolism performance due to restricting the exchange of nutrients. In specific organs, the impaired function becomes deleterious to the homeostasis, leading to severe damage. Several factors lead to this phenomenon, such as inflammatory mediators, hormones, plasma proteins, and infectious diseases. Some diseases develop local and generalized edema, as in liver diseases, nephrotic syndrome, lymphedema, and pulmonary edema.
Edema formation and inflammation are directly connected since it is one of the five cardinal signs of the inflammatory process. The inflammatory process is the body's response to pathogens or agents that mediates stress in tissues or organs. During the inflammatory process, cytokines and inflammatory mediators are released, such as IL-1β, TNF-α, IL-6, the vasoactive amines serotonin and histamine, arachidonic acid metabolites, and complement fragments. The edema formation process causes an increase in the permeability of fluids in blood vessels in response to inflammatory mediators activity and subsequent volume increase affecting the tissue, causing pain and swelling. Paw edema assay in murine is standard in vivo assay in trials involving tests of molecules that induce the inflammatory process or inhibition. Mediators as collagen, carrageenan, and ATP are molecules used to promote a pro-inflammatory response. The Miles Assay technique involves edema formation related to the measurement of vascular permeability and cellular mediators. Thus, several intracellular systems are targets for studies involving inflammation, such as the cholinergic system, purinergic system, and intracellular factors, among others. Concerning the studies in this area, they could be investigated in the inflammatory response through the edema analysis.
In clinical practice, the edema condition is still an obstacle related to its pathophysiology and associated diseases. The conventional therapeutic ways for treating edema are generally based on diuretic and anti-inflammatory drugs or in combination with another medicament. However, prolonged use of these drugs may cause side effects on the organism. Diuretic drugs may be harmful to renal homeostasis, and there are cases of patients with resistance to this treatment. These drugs are an aggravating factor in combination with nonsteroidal anti-inflammatory drugs. Nonsteroidal anti-inflammatory drugs prolonged treatment mediates harmful effects to organs, such as the gastrointestinal system, kidney, and heart. Thus, this book intends to provide the reader with a comprehensive overview of the current search for the most effective anti-edema treatment, avoiding the side effects and possible organ overload.