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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 ?

acute 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?

T does


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)


an example of what happens in autoimmune disease due to chronic inflammation

rheumatoid arthritis