chronic inflammation

Question 1

how does chronic inflammation differ from acute?

Answer 1

• greater tissue destruction
• reaction more productive rather than exudative
• macrophages, lymphocytes and plasma cells prominent

Question 2

what are the 2 classes based on how chronic inflammation arises?

Answer 2

• non-specific chronic inflammation

- specific chronic inflammation

Question 3

name a subset of specific chronic inflammation

Answer 3

granulomatous chronic inflammation

Question 4

how does non-specific chronic inflammation occur ?

Answer 4

failure to resolve acute inflammation, persistent bouts of acute inflammation

Question 5

how does specific (primary) chronic inflammation occur ?

Answer 5

arises from the beginning due to persistent exposure to agent

Question 6

what is granulomatous chronic inflammation ?

Answer 6

subset of specific chronic inflammation characterised by the presence granulomas

Question 7

non-specific chronic inflammation infiltrate is dominated by which cells?

Answer 7

t cells, macrophages, b cells

Question 8

specific chronic inflammation is characterised by the excessive activation of what immune cell?

Answer 8

macrophage

Question 9

specific chronic inflammation can be induced in 2 categorical ways, what are these?

Answer 9

• non immunologically

- immunologically

Question 10

give examples of non-immunological stimuli which may cause specific chronic inflammation

Answer 10

inert noxious material (silica, asbestos)

Question 11

give examples of immunological stimuli which may cause specific chronic inflammation

Answer 11

• virus, bacteria, fungi, parasite
• hypersensitivity reaction
• autoimmune reaction

Question 12

macrophages are the central figure in chronic inflammation, what are the 2 subsets of macrophages?

Answer 12

• M1

- M2

Question 13

What is the function of M1 macrophages?

Answer 13

• cytotoxicity
• fight disease, phagocytose
• produce proteins which cause tissue damage

Question 14

What is the function of M2 macrophages?

Answer 14

• immune suppression
• produce molecules which switch off M1 and drive heading
• anti-inflammatory

Question 15

how does chronic granulomatous inflammation differ from normal chronic inflammation?

Answer 15

predominant cell type of granulomatous is modified activated macrophages (epitheliod macrophages form gaint cells)

Question 16

give examples of modified activated macrophages

Answer 16

• epitheliod macrophages

- giant cells (multi nucleated)

Question 17

what may cause chronic granulomatous inflammation?

Answer 17

• delayed hypersensitivity (immunological)

- foreign body in tissue (non-immunological)

Question 18

oral crohns/orofacial granulomatosis (OFG) is characterised by what?

Answer 18

granulomas in soft tissue and swelling

Question 19

what is crohns?

Answer 19

autoimmune reacyion to commensal organisms in GIT

Question 20

give examples of autoimmune diseases

Answer 20

• rheumatoid arthritis
• psoriasis
• sjorens
• MS
• type 1 diabetes

Question 21

give two symptoms of sjorens?

Answer 21

• xerostomia

- xerophthalmia (dry eyes)

Question 22

describe periodontal disease

Answer 22

• chronic inflammation, soft and hard tissue destruction

Question 23

name the complex structure that supports cells in the gingivae?

Answer 23

ECM

Question 24

what is the ECM made from?

Answer 24

protein fibres (mainly collagen)

Question 25

the ECM is remodelled by which molecule?

Answer 25

MMPs (matrix metalloproteinases)

Question 26

what do MMPs do to the ECM once activated?

Answer 26

breakdown matrix

Question 27

which molecules inhibit MMPs?

Answer 27

Tissue inhibitors TIMPs

Question 28

why is remodelling of the ECM important?

Answer 28

- path clearing - ECM proteolysis generates signalling molecules - angiogenesis (formation new BVs)

Question 29

which type of immune cell are TIMPs?

Answer 29

cytokines

Question 30

what does ROS stand for?

Answer 30

reactive oxygen species

Question 31

what does RNS stand for?

Answer 31

reactive nitrogen species

Question 32

RNS and NOS are byproducts of which process?

Answer 32

phagocytosis

Question 33

what may RNS and NOS cause?

Answer 33

- cell membrane damage - mitochondria damage - DNA damage

Question 34

what is the name for the process of bone formation?

Answer 34

osteoblastogenesis

Question 35

what is the name for the process of bone resorption?

Answer 35

osteoclastogenesis

Question 36

which molecule drives osteoclastogenesis?

Answer 36

RANKL (receptor activator of nuclear factor kabob B ligand)

Question 37

what substance inhibits RANKL?

Answer 37

OPG (osteoprotogerin)

Question 38

what cell produces OPG?

Answer 38

osteoblasts

Question 39

excessive immune response has what effect on RANKL:OPG?

Answer 39

increased -tipping balance towards bone loss

Question 40

high RANKL:OPG in gingival crevicular fluid is associated with what disease?

Answer 40

periodontal