Flashcards in Chronic Inflammation (7) Deck (51):
A protective response involving host cells, blood vessels and proteins
Purpose of inflammation is
Remove the cause of injury, remove necrosis and initiate repair
Problem with inflammation
Can be inappropriate and damage nearby tissues and be destructive
Onset of acute inflammation
Fast onset - mins-hours
Onset of chronic inflammation
Slow onset - days
Which cells primarily involved in acute inflammation?
Which cells primarily involved in chronic inflammation?
Macrophages, plasma cells and lymphocytes
Are the signs of acute or chronic inflammation more prominent?
How severe is acute inflammation?
Mild, self-limiting tissue injury
How severe is chronic inflammation?
Infections that cause chronic inflammation
TB and leprosy
Endogenous materials that cause chronic inflammation
Have an internal original e.g. necrotic adipose tissue, uric acid crystals
Exogenous materials that cause chronic inflammation
External origin e.g. asbestos fibres, sutures, implanted prostheses
Autoimmune disease that cause chronic inflammation
RA, SLE, pernicious anaemia
Primary granulomatous diseases that cause chronic inflammation
Acute > Chronic
Most common in supportive (pus forming) acute inflammation, if deep enough walls thicken, granulation and fibrous tissue and recurrent acute
Gall bladder inflammation - due to stones
Infiltration with mononuclear cells (macrophages, lymphocytes, plasma cells), tissue destruction, healing by fibrosis
Macroscopical features - chronic peptic ulcer
Mucosal breach, granulation tissue base, fibrous tissue extends through wall
Chronic abscess cavity, granulomatous, fibrosis
When is fibrosis prominent?
Once inflammatory infiltrate has stopped
Chronic inflammation with non-caseating granulomas, Diarrhoea, mucus, blood, weight loss, pain
What does caseating mean?
Necrosis with conversion of damaged tissue into a soft substance
Cellular infiltrate of lymphocytes, plasma cells and macrophages, production of new fibrous tissue from granulation, exudation of fluid not prominent
Release histamine - increases permeability of blood vessels to WBCs and proteins
(Neutrophils, Basophils, Eosinophils, Mast cells) Eliminate microbes and dead tissues (acute)
Found in blood stream, most abundant phagocyte
Don't phagocytose, good antigen presenting cells
Release prostaglandins - increase blood flow to infection site
Increase inflammation, already at site of damage release cytokines signal to monocytes, monocytes enter damaged tissue from endothelium of blood vessel (leukocyte extravasion), proliferate locally in damaged tissue, immobilisation
What is released from phagocytosis?
What are proteases stimulated by?
Low oxygen content > induce angiogenesis and cells to re-epitheliase the wound and create granulation tissue
New connective tissue and blood vessels that form on surface of wound during healing, grows from base up (light red/pink due to capillaries)
Repair by replacement of injured tissues by fibrous tissues - granulation tissue, angiogenesis, fibroblasts deposit collagen and inflammatory cells
Formation of excess fibrous connective during repair, scarring, macrophage induced laying down of connective tissue (collagen)
If fibrous tissue arises from 1 cell line
Aggregate/nodule of epithelioid histiocytes, lymphocytes, histolytic giant cells
Large vesicular nuclei and eosinophilic cytoplasm, in clusters, secrete angiotensin converting enzyme
Histiocytic giant cells
Form where material is indigestible to macrophages, multinucleate (>100) giant cells, not phagocytic
Example of when histolytic giant cells form
Tubercle bacilli - cell walls resistant to macrophages
Can be considered collection of macrophages
Langhans giant cells
Horseshoe arrangement of peripheral nuclei (TB)
Foreign body giant cells
Large cells, randomly scattered nuclei
Examples of granulomatous inflammation
Bacterial - TB, leprosy
Parasitic - Schistosomiasis
Fungal - Cryptococcus
Synthetic materials - Silicosis
Night sweats, weight loss, haemoptysis, cough, caseous (cheese-like) necrosis, TNFa and INF-y important information and function of granuloma
Granulomas of nerve, respiratory tract, skin and eyes > loss of pain sensation, weakness, poor eyesight
Occupational lung disease from inhailing silica dust, forms scarring and granulomas in upper lobes of lungs
Granulomas form in multiple organs (lungs and lymph nodes), fatigue, weight loss, joint aches and pains, cough, bilateral hilar lymphadenopathy
Inflammation in common diseases
MI, atheroma formation, MS (plasma cells and T seen in white matter where macrophages break down myelin)