Chronic Inflammation Flashcards
What are the factors affecting Resolution in tissues?
- Amount Cell Death
- Regeneration Capacity of the Organ
- How quickly the casual agent is removed
- How quickly the fluid/Debris is removed
What does Resolution mean?
Resolutions means the complete restoration of the tissue to normal after an episode of acute inflammation
What is Suppuration?
Suppuration is the formation of Pus
What is pus composed of?
Living Cells, Dying Cells, Neutrophils Cellular Debris Bacteria
What is Organisation of Tissues?
This is replacement of tissues by formation of Granulation tissue
What factors favour the Organisation of tissues?
Large amounts of Fibrin Formed
Substantial Necrosis
Exudate/Debris cannot be removed
What is granulation Tissue?
Granulation tissue is classified by:
Capillaries
Macrophages
Fibroblasts proliferation
Collagen synthesis
What are the cells of chronic Inflammation ?
Plasma Cells
Lymphocytes
Macrophages
(Neutrophil polymorphs if it originated from acute inflammation)
How does Acute inflammation become chronic inflammation?
When the agent causing acute inflammation is not removed
What favours the change from Acute inflammation to Chronic?
- Indigestible Substances
- Deep seated Suppurative Inflammation
- Recurrent episodes of acute inflammation
What are the Macroscopic appearances of Chronic Inflammation?
Chronic Ulcer Chronic Abscess Cavity Thickening of Fibrous Tissue Granulomatous Inflammation (Caseous necrosis) Fibrosis
How does monocyte becomes a macrophage?
Stem cell produces Promoncyte
Promoncyte matures into monocyte
Monocyte stays in the blood
When a monocyte moves into the tissues, it is a macrophage
What are the uses of a Macrophage?
Phagocytic Cells
Produce a range of important cytokines
Activated on migration to an area of inflammation
Macrophage activation Faction - recruits
Migration Inhibition Factor - Prevents action.
What is Granuloma?
A granuloma is aggregate of epitheliod histiocytes
Formed from Granulomatous Inflammation
What is a Histiocyte?
A Histiocyte is a macrophage present in connective tissue. They have little phagocytic activity, but a secretory function.
What feature of the stimuli generally causes granulomatous inflammation?
Their indigestibility
What histocytic giant cells are there?
Langhan’s Giant Cell
Foreign Body Type Giant Cell
What causes Granulomatous Disease?
Specific Infections - Myobacteria, Shistosomiasis
Foreign Bodies - Endogenous or Exogenous
Specific Chemicals
Drugs
What is the reservoir for M. Tuberculosis?
Humans
How is TB spread?
Acquired through Inhalation
What is the disease mechanism of TB?
Can cause necrosis of organs - caseous
M Bovis TB initially affects the intestinal/tonsillar lesions
What do Mycobacteria induce?
They induce Granulomatous reactions in tissue
How can you test for Mycobacteria?
Acid/Alcohol fast at microscopic staining
How do Mycobacteria survive?
Mycobacteria can survive and replicated within neutrophils and macrophages
What is MAF?
It is Macrophage Activation Factor
What is MIF
This is Migration Inhibition Factor - It affects Macrophages
What manages the granulation tissue process?
Growth Factors - This stimulates cell regeneration by angiogenesis
What can Fibrosis lead to?
Fibrosis can lead to distortion or stricture formation
When does Organisation of Tissue occur?
When much of the skin is completely destroyed and underlying tissue is undergoing repair
Damage area is being replaced by vascular granulation
What is angiogenesis?
Process through which new blood vessel form from pre-existing vessels
What is oesteomyelitis?
Inflammation of the bone
How does Suppurative Inflammation lead to Chronic Inflammation?
Drainage delayed/inadequate
Results in thick wall composed of granulation tissue
Rigid walls fail to come together after drainage
Pus within cavity becomes organised
Results in a fibrous scar
What causes Granulomatous Inflammation ?
Sarcoidosis Caseous Necrosis Crohn's Disease Mycobacteria Schistosomiasis Foreign Bodes