Flashcards in MOD 7 - Chronic Inflammation Deck (39):
what is inflammation
a protective response involving host cells, blood vessels and proteins
what is the purpose of inflammation?
remove the cause of injury, remove necrosis, initiate repair
what is the difference in cellular response in acute and chronic inflammation
acute - neutrophils, chronic - lymphocytes, plasma cells and macrophages
is granulation & scar tissue more abundant in acute or chronic inflammation ?
what is the common cause of primary chronic inflammation?
sequential from acute inflammation
what are the 5 common causes for primary chronic inflammation?
infections, primary granulomatous diseases, endogenous materials (have an internal origin eg necrotic adipose tissue) , autoimmune, exogenous materials (external origin, asbestos fibres, suture)
what is the most common outcome for acute inflammation?
supporative acute inflammation
what is suppurative acute inflammation?
it is pus forming acute inflammation
what happen if the suppurative acute inflammation goes deep enough in the tissue?
it will cause the wall of tissue to thicken and then it will be filled with granulomas and fibrous tissue
what happen after recurrent acute inflammation?
it will then become chronic inflammation
what is the main cellular morphological features of chronic inflammation?
chronic inflammation will have infiltration of mononuclear cells (macrophages, lymphocytes, plasma cells) along with tissue destruction and healing by fibrosis
what is granulation tissue?
new connective tissue and microscopic blood vessels that form on the surfaces of a wound during the healing process.
what will granulation tissue form in the later stage of chronic inflammation?
production of new fibrosis tissue
what are the 2 types of lymphocytes in chronic inflammation ?
B & T lymphocytes
which B & T lymphocytes produce cytokines?
what does cytokines d o in chronic inflammation?
- attract macrophages leading to activation and so phagocytoseis
- attract neurophils (chemotaxis) and factor eg histamine that increase vascular permeability - like in acute inflammation
- cause perforins - kill invading cells by causing perforation on invading cells
- produce interferons that activate natural killer cells and macrophages - useful for attacking viruses
what does macrophages do in chronic inflammation?
increase inflammation, stimulate immune system, carry out recruitment via cytokines
what happen next after macrophages send out cytokines for recruitment?
monocytes are attracted and enter damaged tissue from blood vessel (this is recruitment)
what do macrophages do local in the damaged tissue?
they release cytokines, proliferate and become immobilised within tissue
what is granulation tissue?
new connective tissue and blood vessels
what is the process of would healing
by forming granulation tissue which grows from the base of the wound upward - angiogenesis is required for the continuation of cells to be delivered, fibroblasts deposit collagen - repair by replacing with fibrosis, inflammatory cells - needed for healing process
what is the main aim of wound healing in chronic inflammation?
repair by replacement of injured tissue by fibrosis tissues
what is fibrosis?
formation of excess fibrosu connective tissue during repair of damaged tissue
what is the name given for fibrosis raised from 1 cell line?
fibroma - 1 cell line of fibrosis tissue
what is the role of macrophages in fibrosis?
macrophage induced laying down of connective tissue inc collagen
what is a granuloma
a granuloma = nodule of epithelioid histiocytes & other cells eg lymphocytes & histiocytice giant cells
what are epithelioid histiocytes?
they are large vesicular nuclei and eosinophilic cytoplasm (eosinophilic stain pink or purple)
what are histiocytic giant cells
they are cells which are formed when materials is indigestible to macrophages eg tubercle bacilli (have cell walls resistance to macrophages), histiocytic giant cells are multinucleate giant cells
what are macrophages known as while in tissue?
what are some example for granulomatous inflammation?
Bacterial = TB, leprosy
Parasitic = schistosomiasis (worm lives in fresh water in tropical area)
Fungal = cryptococcus (hidden sphere in greek)
Synthetic materials = silicosis
Unknown = Sarcoidosis (granuloma develop in the organs of the body. It usually affects the lungs and skin), crohn’s disease.
outline the layers of early granuloma
macrophages - lymphocytes
outline layer of non-caseous epithelioid granuloma
macrophages (Langhans-type giant cells present) - lymphocytes & plasm cells - fibroblasts producing collagens
outline the layers of caseous epithelioid granuloma
caseous necrosis - macrophage (Langhans-type giant cells present) - lymphocytes & plasm cells - fibroblasts producing collagen
what particular condition does chronic inflammation involved in cardiovascular system
myocardial fibrosis (post MI), formation of atheroma
how is atheroma formed?
macrophages adhere to epithelium and recruit other cells process lipids that accumulate in plaques
what are the clinical outcome of chronic inflammation
persistence of infection, prolonged exposure to toxic agents, autoimmune disease
an example of persistent of infection due to chronic inflammation?
H.Polyri - produces proteases - damage intestinal lining - gastritis - loss of protective layer, enzymes can access stomach wall and cause perforation. (life threatening)
An example of what happens in prolonged exposure to toxic agents due to chronic inflammation
prolong exposure of toxic in liver can cause cirrhosis (macrophages cause fibrosis)