Chronic Inflammation 1

Question 1

What is the definition of chronic inflammation?

Answer 1

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

Question 2

What are the clinical presentations of chronic inflammation?

Answer 2

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

Question 3

When do we see chronic inflammation?

Answer 3

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

rising from a primary lesion

Question 4

What is characteristic or organisation in acute inflammation?

Answer 4

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

Question 5

What is the granulation tissue mechanism?

Answer 5

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

Question 6

What is the function of granulation?

Answer 6

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

Question 7

What are the products of granulation tissue?

Answer 7

Fibrous tissue - scar

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

Can progress to chronic inflammation

Question 8

What is the most likely cause of primary chronic inflammation?

Answer 8

Autoimmune disease

Question 9

How does Autoimmune disease result in chronic inflammation?

Answer 9

Autoantibodies directed against own cell and tissue components - autoantigens

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

Question 10

What types of cells does primary chronic inflammation use?

Answer 10

lymphocytes, plasma cells, macrophages, fibrosis

Question 11

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

Answer 11

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

Question 12

What are lymphocytes responsible for?

Answer 12

B cells and T cells

Immune response
Immune memory

Question 13

What is a plasma cell?

Answer 13

Differentiated B cells, differentiated to produce antibodies

Question 14

What are the B cell mechanisms?

Answer 14

Antibody production by plasma cels

Facilitate the immune response

Act with macrophages - present antigens

Immune memory

Question 15

What are the T cell mechanisms?

Answer 15

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

Question 16

What do NK cells do?

Answer 16

Destroy antigens and cells, granule proteins like T cells

Question 17

What do macrophages do?

Answer 17

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

Question 18

Which is longer lived, macrophages or neutrophils?

Answer 18

Macrophages, they take over from neutrophils

Question 19

What might macrophages produce?

Answer 19

Interferons and other chemicals, used to destroy

Question 20

What are fibroblasts?

Answer 20

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

Question 21

What is the outcome of chronic inflammation?

Answer 21

Ongoing tissue damage and destruction,

insidious loss of function

Granulation tissue, angiogenesis

Scarring and fibrosis

Granuloma formation