Chronic Inflammation 1 Flashcards

1
Q

What is the definition of chronic inflammation?

A

Inflammation in which cell population is especially

lymphocytes
Plasma cells
Macrophages

Features tissue or organ damage, necrosis, loss of function

Healing and repair: Granulation tissue, scarring and fibrosis

May follow from acute inflammation
Also arises as primary pathology

Tends to be long term

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2
Q

What are the clinical presentations of chronic inflammation?

A

No specific sore bit
Malaise and weight loss - tuberculosis - system effect
Loss of function - autoimmune thyroiditis (functional gland destruction) -hypothyroidism
Crohn’s disease (GI tract ulceration and fibrosis) - pain, diarrhoea, gut obstruction
Leprosy (cutaneous nerve destruction) - loss of sensation

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3
Q

When do we see chronic inflammation?

A

Arising from acute inflammation - large volume of damage, poor removal of debris, failure to resolve

rising from a primary lesion

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4
Q

What is characteristic or organisation in acute inflammation?

A

Granulation tissue - healing and repair, leads to fibrosis and formation of a scar

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5
Q

What is the granulation tissue mechanism?

A

Capillaries grow into an inflammatory mass

Access of plasma proteins

Macrophages from blood and tissue

Fibroblasts lay down collagen to repair damaged tissue

Collagen replaces inflammatory exudate

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6
Q

What is the function of granulation?

A

Patches tissue defects
Replaces dead or necrotic tissue
Contracts and pulls together

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7
Q

What are the products of granulation tissue?

A

Fibrous tissue - scar

Fibrosis as a problem (adhesion between loops of bowel following peritonitis)

Can progress to chronic inflammation

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8
Q

What is the most likely cause of primary chronic inflammation?

A

Autoimmune disease

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9
Q

How does Autoimmune disease result in chronic inflammation?

A

Autoantibodies directed against own cell and tissue components - autoantigens

They damage or destroy organs, tissues, cells, cel components

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10
Q

What types of cells does primary chronic inflammation use?

A

lymphocytes, plasma cells, macrophages, fibrosis

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11
Q

What are the other common methods of triggering a chronic inflammatory response?

A

Material resistant to digestion : mycobacteria, Brucella, viruses, this is because their cell wall is resistant to enzymes

Exogenous substances:
sutures, metal and plastic eg joint replacements, mineral crystals, glass

Endogenous substances: Necrotic tissue, keratin, hair, none of which can easily be phagocytosed

Granulomatous inflammation is common

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12
Q

What are lymphocytes responsible for?

A

B cells and T cells

Immune response
Immune memory

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13
Q

What is a plasma cell?

A

Differentiated B cells, differentiated to produce antibodies

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14
Q

What are the B cell mechanisms?

A

Antibody production by plasma cels

Facilitate the immune response

Act with macrophages - present antigens

Immune memory

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15
Q

What are the T cell mechanisms?

A

Produce cytokines - attract and hold macrophages, also activate them
Attract and activate other lymphocytes and immune cells
Alter permeability

Produce Interferons - Antiviral effects, attract and stimulate other cells

Damage and lyse other cells and destroy antigen - chemical mechanisms, granule proteins

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16
Q

What do NK cells do?

A

Destroy antigens and cells, granule proteins like T cells

17
Q

What do macrophages do?

A

Remove debris, antigen presenting cells in immune role, they are made in the bone marrow, move around blood (monocyte) move to tissue, mobile phagocyte, therefore contain enzymes eglysozome

They are also known as
monocyte, histiocyte, activated macrophage, epithelioid cell, giant cell

18
Q

Which is longer lived, macrophages or neutrophils?

A

Macrophages, they take over from neutrophils

19
Q

What might macrophages produce?

A

Interferons and other chemicals, used to destroy

20
Q

What are fibroblasts?

A

Motile cells which are metabollically active, they make and assemble structural proteins, including collagens

21
Q

What is the outcome of chronic inflammation?

A

Ongoing tissue damage and destruction,

insidious loss of function

Granulation tissue, angiogenesis

Scarring and fibrosis

Granuloma formation