Chronic Inflammation Flashcards
List the cell types involved in chronic inflammation.
Lymphocytes
Plasma cells
Macrophages
Fibroblasts
List the major causes of chronic inflammation.
Arising from acute inflammation – Large volume of damage – Inability to remove debris – Fails to resolve Arising as a primary lesion – No preceding acute phase – Only see chronic changes
Describe the effects of chronic inflammation.
- Granulation tissue is characteristic of organisation
- Results in healing and repair
- Leads to fibrosis and formation of a scar
List factors involved in promoting healing and repair.
- Cleanliness
- Apposition of edges (no haematoma)- abrasion of edges to remove debris
- Sound nutrition
- Metabolic stability and normality
- Normal inflammatory and coagulation mechanisms
Define the role of angiogenesis in healing and repair.
Promotes wound healing, though must remain checked
List the factors that impair healing and repair.
- Dirty, gaping wound, large haematoma
- Poorly nourished, lack of vitamins C, A
- Abnormal CHO metabolism, diabetes, corticosteroid therapy
- Inhibition of angiogenesis
What are some triggers of primary chronic inflammation
Autoimmune disease - Autoantibodies directed against own cell and tissue components – autoantigens which damage or destroy organs, tissues, cells, cell components e.g. Thyroiditis, rheumatoid disease, pernicious anaemia (chief/parietal cells), systemic lupus erythematosis (nuclear antigen), autoimmune thyroiditis
Lymphocytes, plasma cells, macrophages, fibrosis
•
Material resistant to digestion e.g. Mycobacteria, Brucella, viruses with cell wall resistant to enzymes
Exogenous substances
– Sutures, metal and plastic e.g. joint replacements, mineral crystals, glass, which do not provoke immune response
Endogenous substances - Necrotic tissue, keratin, hair which cannot easily be phagocytosed
What are some tissue components of chronic inflammation?
Granulation tissue
Collagen
What are granulomas?
- Aggregates of epithelioid macrophages in tissue
- May contain giant cells
- May surround dead material
- May be surrounded by lymphocytes
- Contain neutrophils, eosinophils
- Response to indigestible antigen
- Many are type IV hypersensitivity reactions
Describe giant cells
- Granulomas comprise epithelioid histioytes (macrophages)
- ? fusion of macrophages to form larger cells
- Large cytoplasm; multiple nuclei
Name 4 different types of giant cell
Langhans type - rim of nuclei on the periphery of the cell
Foreign body type - pigmented, random nuclei, pus
Silicone associated - vacuoles contain leaked silicone
Warthin-Finkeldy type - central cluster of nuclei
When are longhand type cells common?
TB patients
When are warthin-finkeldy giant cells usually seen?
Measles
Name some infectious granulomatous diseases and what causes them
- Tuberculosis – Mycobacterium tuberculosis
- Leprosy – Mycobacterium leprae
- Syphilis – Treponema pallidum
What drug combination is used to treat leprosy?
• Dapsone, rifampicin and clofazimine
