Sensitization of Individual Vascular Territories to the Antiphlogistic Effect of Hydrocortisone An Example of "Selective Conditioning"

Experimental interference with the circulation in a circumscribed tissue area, too slight to produce any manifest disturbance in itself, can strikingly alter topical reactivity to irritants and to the antiphlogistic effect of hydrocortisone. Thus, certain vascular territories can be "selectively condi-tioned " to the anti-inflammatory actions of blood-borne corticoids. Conversely, when tissue dam-age is severe, such "selective conditioning " may induce a seemingly paradoxic reversal of the hydrocortisone effect, so that the hormone enhances inflammation. Here, impairment of circulation and hydrocortisone facilitate the production by irritants of necrosis, more than of inflammation. The resulting wide-spread necrosis induces an even greater inflammatory response, despite hydro-cortisone, than would have been observed without hormone treatment. IT has been amply substantiated, both byexperimental and by clinical observations,that the so-called "gluco-corticoids " or "antiphlogistic corticoids, " such as hydrocor-tisone, can inhibit inflammatory responses to a great variety of irritants. It has also been demonstrated that during stress, the endog-enous production of antiphlogistic corticoids