Chronic Inflammation

Question 1

Chronic characterization

Answer 1

Lymphocytes (B and T cells) and macrophages
Proliferating blood vessels
Formation of connective tissue

Question 2

Signature cell of chronic inflammation

Answer 2

M1 macrophages: associated with high levels of pro-inflammatory cytokines
Activated by INF-gamma and microbes

Question 3

Hepcidin

Answer 3

Increases iron accumulation in macrophages and decreases iron absorption in the gut
Decreases the amount of iron in the blood so invading bugs cannot use it

Question 4

M2 macrophages

Answer 4

Activated by IL-13 and IL-4

Shut down immune response, start healing (tissue repair, fibrosis)

Question 5

Granulomatous inflammation

Answer 5

Associated with persistent T-cell activation
IL-2 feedback loop
“Frustrated macrophages” wall off the invader
Common with persistent microbial intracellular infection
Caseous, necrotizing granuloma (cheesy appearance)
Activated macrophages and mutinucleated giant cells in the periphery

Question 6

Biochemical changes in inflammation

Answer 6

Increased hepatic production: fibrinogen (coagulation cascade), ceruloplasmin (copper regulation), complement components (C3)
Decreased albumin synthesis
Increased hepcidin (causing anemia)
Growth factors (stimulating marrow)

Question 7

C-reactive protein (CRP)

Answer 7

Stimulated by inflammation, linked to IL-6 levels
Used in quantification fashion for determining level of inflammation
Obesity can cause a false elevation of CRP

Question 8

Erythrocyte sedimentation rate (ESR)

Answer 8

Chronic inflammation causes increase in IgG and fibrinogen, which coat RBCs
The RBCs will fall more rapidly through column