5 - Chronic Inflammation Flashcards
What is chronic inflammation?
Chronic response to injury with associated fibrosis. Destruction and repair occuring at same time
- De novo e.g autoimmune and TB
- Take over from acute inflammation if damage too severe
- Alongside acute in repeated irritation
![](https://s3.amazonaws.com/brainscape-prod/system/cm/379/746/335/a_image_thumb.jpeg?1549033729)
What are the main cells involved in chronic inflammation?
- Macrophages: phagocytosis, presentation of antigens, synthesis of proteins and enzymes and cytokines and free radicals, control other cells
- Lymphocytes: B make antibodies, T in control and cytotoxic
- Eosinophils: allergies and parasites
- Fibroblasts/Myofibroblasts: make collagen
How do monocytes get from blood to tissue?
Same process as with neutrophils. Once in tissue they differentiate into macrophage and they can live for weeks/months
How do you spot a macrophage histologically?
Foamy cytoplasm with slipper nuclei
![](https://s3.amazonaws.com/brainscape-prod/system/cm/379/746/349/a_image_thumb.png?1549034014)
Why are lymphocytes involved in chronic inflammation and what do they look like?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/379/746/353/q_image_thumb.png?1549034137)
- Macrophages release cytokines, e.g TNF, IL-1 to recruit lymphocytes
- They can secrete cytokines for more recruitment of inflammatory cells
- Hyperchromatic, larger nucleus than cytoplasm, 1-2 times the size of RBC
![](https://s3.amazonaws.com/brainscape-prod/system/cm/379/746/353/a_image_thumb.png?1549034116)
What do plasma cells look like histologically?
- Usually nucleus with tail of cytoplasm
- Clock face nucleus as chromatin around the outside
- From B-cells and produce antibodies against persistent antigens
![](https://s3.amazonaws.com/brainscape-prod/system/cm/379/746/361/a_image_thumb.png?1549034299)
What do eosinophils look like histologically and when are they seen?
- Tomato with sunglasses
- Recruited by eotoxin as they contain proteins that are toxic to parasites but toxins damage human
- Seen in parasitic infections and allergies with mast cells
![](https://s3.amazonaws.com/brainscape-prod/system/cm/379/746/363/a_image_thumb.png?1549034437)
What makes the macrophage different to neutrophils
- They are involved in chronic inflammation
- They can live for months and replicate
- Can stimulate fibrosis, angiogenesis, fever, acute phase reaction
Why are fibroblasts involved in chronic inflammation?
- They respond to chemokines and move to where they are needed where they secrete GAG’s, collagen and elastin
- They can differentiate into myofibroblasts for wound healing
![](https://s3.amazonaws.com/brainscape-prod/system/cm/379/746/371/a_image_thumb.png?1549034747)
What are giant cells?
- Fused macrophages with lots of nuclei
- Occur when certain foreign bodies and bacteria are present
- Involved in granulomatous inflammation
![](https://s3.amazonaws.com/brainscape-prod/system/cm/379/746/374/a_image_thumb.png?1549034889)
What are Langhans giant cells?
Nuclei arrange around periphery of cell in horse-shoe shape.
![](https://s3.amazonaws.com/brainscape-prod/system/cm/379/746/377/a_image_thumb.png?1549034916)
Seen mainly in TB
What are foreign body type giant cells?
- Nuclei arranged randomly
- Seen with foreign bodies
- If small body then giant cell will have phagocytosed it, if large the body will stick to it’s surface
![](https://s3.amazonaws.com/brainscape-prod/system/cm/379/746/380/a_image_thumb.png?1549035044)
What are touton giant cells?
- Nuclei in ring towards centre of the circle
- Form in lesions where there is high lipid content, e.g xanthomas
- Foam cells
- Occurs in breast tissue and associated with fat necrosis
![](https://s3.amazonaws.com/brainscape-prod/system/cm/379/746/383/a_image_thumb.png?1549035132)
What are some situations where chronic inflammation occurs?
- Autoimmune
- Chronic persistent infections
- After or alongside acute inflammations
- Prolonged exposure to toxic tissues
What sre some of the possible complications of chronic inflammation?
- Atropy e.g gastric mucosa
- Impaired function e.g chronic IBS
- Excessive fibrosis e.g chronic cholecystitis, chronic peptide ulcers
- Tissue destruction
- Stimulation of immune response