4 - Chronic Inflammation and Healing

Question 1

What are the local effects of acute inflammation?

Answer 1

• redness (rubor - due to hyperaemia)
• swelling (tumor - due to oedema)
• heat (calor - due to hyperaemia)
• pain (dolor - pain receptors activated)
• loss of function (due to damage to cells)

Question 2

What are the systemic effects of acute inflammation?

Answer 2

Pyrexia (fever - mediated by inflammatory mediators IL-1 TNF released by endo and macrophages
Leukocytosis (^ WBC from BM)
Acute Phase Proteins (proteins involved in the inflam response from liver)
Endocrine Changes (increased release of glucocorticoid steroid hormones due to stress)

Question 3

What do inappropriate immune reactions underlie

Answer 3

• rheumatoid arthritis, atherosclerosis, hypersensitivity, hyperimmune response/cytokine storm
• fibrosis due to repair can lead to scars/fibrous bands that cause obstruction or limit joint mobility
• anti-inflam drugs try to control the harmful consequences of inflammation without interfering with the benefits

Question 4

What releases TNF and IL1 and what 4 things do they affect

Answer 4

Macrophages actiavted by bacterial products, toxins, immune complexes, cytokines, injury
Act on endothelial cells, leukocytes (to secrete more cytokines), fibroblasts, acute phase rxs (i.e. causing fever, apatite loss, etc)

Question 5

What occurs at the same time as chronic inflammation

Answer 5

chronic inflam is a complex process in which active inflammation, tissue destruction and attempts to repair occur at the same time

Question 6

What is a granuloma and when does it occur

Answer 6

• important in chronic inflam but also TB and sarcoidosis
• a granuloma has a core of necrosis, microscopic aggregations of macrophages that are transformed into epithelium like cells to assist in their function (epithelioid macrophages) with a collar of lymphocytes
• often the epithelioid macrophages fuse together into giant cells with >20 nuclei