Chronic Inflammation

Question 1

3 examples of chronic inflammation

Answer 1

Orofacial granulomatosis
Periodontal disease
Rheumatoid arthritis / autoimmune diseases

Question 2

In chronic inflammation, which immune system is involved? Innate or adaptive

Answer 2

Both

Question 3

What immune cells are found most commonly in the chronic inflammatory infiltrate

Answer 3

Macrophages
B cells T cells
Not neutrophils

Question 4

3 types of chronic inflammation

Answer 4

Non specific chronic
Specific chronic (non granulomatous)
Chronic Granulomatous

Question 5

Difference between specific and non specific chronic

Answer 5

Non specific - eg periodontal diseases
- repeated acute phases and chronic phases with ongoing repair
Non identifiable cause

Specific
- localised
Specific cause

Question 6

How does autoimmune diseases come about?

Answer 6

Breach in tolerance , immune cells attack self cells, do not recognise self peptides
Sustained immune responses

Question 7

Explain how rheumatoid arthritis links to the oral cavity

Answer 7

Periodontal disease caused by P. gingivalis
This bacteria produces PAD enzyme
PAD enzyme causes peptide citrullination
Human body doesn’t recognise citrulline as a self peptide so produces antibodies against citrullinated proteins

Question 8

What is PAD enzyme

Answer 8

The peptidylarginine deiminases (PADs) are a family of posttranslational modification enzymes that catalyze the conversion of positively charged protein-bound arginine and methylarginine residues to the uncharged, nonstandard amino acid citrulline.

Question 9

Non-granulomatous (ie specific chronic )
has excessively activated macrophages or modified activated macrophages?

Answer 9

Non - excessively activated macrophages
Granulomatous- modified activated macrophages

Question 10

Fibrosis is related to which macrophage? m1 or m2

Answer 10

M2 because anti inflammatory

Tissue repair all M2 - fibrosis growth factors angiogenesis , remodelling

Question 11

Structure of epithelioid macrophages

Answer 11

Large , multi nucleus, fused mass

Question 12

How do granulomas form?

Answer 12

Sometimes, some microbes cannot be removed by macrophages. There is a chronic activation of macrophages by T cells; produces cytokines that induces formation of epithelioid macrophages that contridubute further to giant cell formation

Question 13

Function of granulomas

Answer 13

A granuloma is the body’s way:

to contain an area of bacterial, viral or fungal infection so it can try to keep it from spreading; or

to isolate irritants or foreign objects

Question 14

What destroys soft tissues and hard tissues

Answer 14

Soft - MMPs
Hard - RANKL

Question 15

What produces RANKL

Answer 15

Osteoblasts

Question 16

What else does osteoblasts produce

Answer 16

OPG=osteoprotegerin

Question 17

Function of OPG And RANKL

Answer 17

RANKL by osteoblasts activates RANK on osteoclasts, increase in bone resorption

OPG by osteoblasts inhibits RANKL, controlling bone resorption

Question 18

More RANKL = more bone resorption

Question 19

RANKL and periodontal diseases relation n

Answer 19

P. Gingivalis causes transcription and translation of RANKL in osteoblasts , increasing secretion of RANKL, leading to more bone resorption and bone loss