Chronic inflammation 1&2 Flashcards
What is the majority of the cell population?
Lymphocytes
Macrophages
Plasma cells
What does chronic inflammation feature?
Loss of function or necrosis
How can chronic inflammation arise?
Follow on from acute inflammation if there is a large amount of damage or can be primary
Healing and repair includes
Granulation tissue
Scarring and fibrosis
Granulation tissue
Patches tissue defects and replaces dead tissue
Contracts and pulls together
Succession of events of organisation
Capillaries => inflammatory mass => access of plasma protein => Macrophage from blood and tissue => fibroblast lay down collagen => Collagen replaces exudate
Products of granulation tissue
Fibrous tissue - scar
Fibrosis - less movement
Can lead to chronic inflammation
Primary chronic inflammation
- Autoimmune disease eg rheumatoid arthritis
- Material resistant to digestion eg mycobacteria
- Exogenous substance - suture, hip replacement
- Endogenous substance - in wrong place eg keratin
What is a plasma cell?
Undifferentiated B cell ==> antibody
b cell presents antigen to Macrophage
What do T cells produce?
Cytokines to attract macrophages
Interferons that are antiviral
Kill cells
NK cells
Destroy antigens and cells
What do macrophages do? (2)
Remove debris
Antigen presentation
What is a macrophage?
A motile phagocyte
Takes over from neutrophils
Contains enzyme eg lysosome and can produce interferon
Fibroblasts are…
Motile
Make collagen
Metabolically active
Granulomatous infection
Granuloma in tissues and cause serious infection
Aggregation if macrophage in epithelium cells and look like epithelium
What is a granuloma?
Lump of macrophages
Granulomas
May contain giant cells, neutrophil, eosinophil
Type 4 hypersensitivity
Surrounded by lymphocytes
Giant cell
Fusion of macrophage to from larger cells
Large cytoplasm and multiple nuclei
Langhans giant cells
TB - peripheral rim of nuclei with a large eosinophilic nuclei
Infectious granulomatous infection
TB - mycobacterium TB
Leprosy - mycobacterium leprae
Syphilis - Treponema pallidum
Non infective granulomas
Rheumatoid arthritis
Sarcoidosis
Crohns disease
Wound healing
Repair by granulation tissue formation
Phase of acute inflammation and angiogenesis
Fibrosis and scar formation
Surgical scar
Primary intention
Small and linear with a small amount of granulation tissue
Larger defect scar
Secondary intention
Lots of granulation tissue and contract and scar
What are some examples that favour wound healing
Nutrition
Metabolic stability
Cleanliness
Apposition of edges
What are some examples that impair wound healing
Poorly nourished
Inhibition of angiogenesis
Abnormal CHO metabolism
Fracture healing
Situation in bone ossification
Callus around broken bone and soft tissue
Granulation tissue in fracture healing
Osteoblast and fibroblast
VEGF
Released by hypoxic cells and stimulates proliferation
Angiogenesis and organisation in thrombosis
Limits thrombus propagation
Angiogenesis in malignant tumour
Tumour grows
