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What is chronic inflammation?

-Inflammation in which the cell population is especially lymphocytes, plasma cells and macrophages.
-It features tissue/organ damage and loss of function


How can chronic inflammation arise?

-It may follow form ongoing acute inflammation
-It may arise as primary pathology


What are the clinical presentations of chronic inflammation/?

-no specific area of pain
-malaise and weight loss (i.e tuberculosis which has a systemic effect)
-loss of function


Name 3 conditions in which there is loss of function.

-Autoimmune thyroiditis (functional gland destruction)=
-Crohn's disease (GI tract ulceration and fibrosis)= pain, diarrhoea, gut obstruction
-Leprosy (cutaneous nerve destruction) =loss of sensation


When does acute inflammation become chronic?

When there is a large volume of damage with the inability to remove debris which leads to the failure of resolution


When does chronic inflammation arise as a primary lesion?

When there is not preceding acute phase and chronic changes are only seen.


What is organisation ?

-An outcome of acute inflammation
-granulation tissue is characteristic of organisation
-results in healing and repair
-leads to fibrosis and formation of a scar


What is the mechanism and function of granulation tissue?

-Capillaries grow into the inflammatory mass and allow access of plasma proteins and macrophages from the blood and tissue.
-fibroblasts lay down collagen to repair the damage tissue and to replace the inflammatory exudate
-this patches the tissue defect, replaces the dead/necrotic tissue and allows or contraction/pulling together


What are the products of granulation tissue?

-fibrous tissue in the form of a scar
-fibrosis which is adhesions between loops of bowel following peritonitis
- can cause progression to chronic inflammation


ask Michael/Ben about slide 18 and 19



What cells are involved in chronic inflammation?

-plasma cells


What tissue components are involved in chronic inflammation?

-granulation tissue


What are lymphocytes?

-cells in the immune system
-small round cells with lots of subtypes and functions
-main types are T-cell
and B-cell
-main functions are immune response and immune memory


What are plasma cells?

-differentiated B-cell of intermediate size
-responsible for antibody production


What are the mechanisms of B-cells?

-they differentiate to plasma cells for antibody production
-facilitate immune response
-act with macrophages = antigen presenting capacity
-immune memory


What are the mechanisms of T-cells?

-produce cytokines
-produce interferons
-damage and kill other cells and destroy antigen


What do cytokines do?

They attract and hold macrophages activating them and other cells such as lymphocytes altering permeability


What do interferons do?

They have antiviral effects and they attract and stimulate other cells


What are the mechanisms of NK cells?

NK cells destroy antigens and cells using granule proteins


What do macrophages do?

-The remove debris and act as antigen presenting cells


What are the mechanisms of macrophages?

-Move from the blood and take over from neutrophils.
-They contain enzymes such as lysozyme and produce interferons and other chemicals


What are fibroblasts?

-Motile cells that are metabolically active
-They make and assemble structural proteins such as collagen