chronic inflammation Flashcards
how does chronic inflammation differ from acute?
- greater tissue destruction
- reaction more productive rather than exudative
- macrophages, lymphocytes and plasma cells prominent
what are the 2 classes based on how chronic inflammation arises?
- non-specific chronic inflammation
- specific chronic inflammation
name a subset of specific chronic inflammation
granulomatous chronic inflammation
how does non-specific chronic inflammation occur ?
failure to resolve acute inflammation, persistent bouts of acute inflammation
how does specific (primary) chronic inflammation occur ?
arises from the beginning due to persistent exposure to agent
what is granulomatous chronic inflammation ?
subset of specific chronic inflammation characterised by the presence granulomas
non-specific chronic inflammation infiltrate is dominated by which cells?
t cells, macrophages, b cells
specific chronic inflammation is characterised by the excessive activation of what immune cell?
macrophage
specific chronic inflammation can be induced in 2 categorical ways, what are these?
- non immunologically
- immunologically
give examples of non-immunological stimuli which may cause specific chronic inflammation
inert noxious material (silica, asbestos)
give examples of immunological stimuli which may cause specific chronic inflammation
- virus, bacteria, fungi, parasite
- hypersensitivity reaction
- autoimmune reaction
macrophages are the central figure in chronic inflammation, what are the 2 subsets of macrophages?
- M1
- M2
What is the function of M1 macrophages?
- cytotoxicity
- fight disease, phagocytose
- produce proteins which cause tissue damage
What is the function of M2 macrophages?
- immune suppression
- produce molecules which switch off M1 and drive heading
- anti-inflammatory
how does chronic granulomatous inflammation differ from normal chronic inflammation?
predominant cell type of granulomatous is modified activated macrophages (epitheliod macrophages form gaint cells)
give examples of modified activated macrophages
- epitheliod macrophages
- giant cells (multi nucleated)
what may cause chronic granulomatous inflammation?
- delayed hypersensitivity (immunological)
- foreign body in tissue (non-immunological)
oral crohns/orofacial granulomatosis (OFG) is characterised by what?
granulomas in soft tissue and swelling
what is crohns?
autoimmune reacyion to commensal organisms in GIT
give examples of autoimmune diseases
- rheumatoid arthritis
- psoriasis
- sjorens
- MS
- type 1 diabetes
give two symptoms of sjorens?
- xerostomia
- xerophthalmia (dry eyes)
describe periodontal disease
- chronic inflammation, soft and hard tissue destruction
name the complex structure that supports cells in the gingivae?
ECM
what is the ECM made from?
protein fibres (mainly collagen)
the ECM is remodelled by which molecule?
MMPs (matrix metalloproteinases)
what do MMPs do to the ECM once activated?
breakdown matrix
which molecules inhibit MMPs?
Tissue inhibitors TIMPs
why is remodelling of the ECM important?
- path clearing
- ECM proteolysis generates signalling molecules
- angiogenesis (formation new BVs)
which type of immune cell are TIMPs?
cytokines
what does ROS stand for?
reactive oxygen species
what does RNS stand for?
reactive nitrogen species
RNS and NOS are byproducts of which process?
phagocytosis
what may RNS and NOS cause?
- cell membrane damage
- mitochondria damage
- DNA damage
what is the name for the process of bone formation?
osteoblastogenesis
what is the name for the process of bone resorption?
osteoclastogenesis
which molecule drives osteoclastogenesis?
RANKL (receptor activator of nuclear factor kabob B ligand)
what substance inhibits RANKL?
OPG (osteoprotogerin)
what cell produces OPG?
osteoblasts
excessive immune response has what effect on RANKL:OPG?
increased -tipping balance towards bone loss
high RANKL:OPG in gingival crevicular fluid is associated with what disease?
periodontal
