Chronic Inflammation Flashcards
What factors favour resolution
- minimal cell death and tissue damage
- occurrence in an organ or tissue with regenerative capacity
- rapid destruction of the casual agent (the thing causing the response)
- rapid removal of fluid and debris by good local vascular drainage (drainage of oedema)
What is Organisation
replacement of destroyed tissue by granulation tissue
What factors favour organisation
Large amounts of fibrin
substantial necrosis
Exudate and debris cannot be removed or discharged
If the skin is completely destroyed what kind of granulation tissue replaces it
vascular granulation tissue
Inflammatory exudate replaced by:
– Capillaries
– Macrophages
– Fibroblasts
– Collagen
What is the replacement of inflammatory exudate regulated by
TNF, EGF, FGF
What is chronic inflammation
primary
progression from acute
recurrent episodes of accute
What causes TB and leprosy
Resistance of infective agent to phagocytosis and intracellular killing
What causes gout
Foreign body reactions to endogenous materials
What causes the reaction to asbestos
Foreign body reactions to exogenous materials
What is rheumatoid arthritis caused by
an autoimmune disease
Give me an example of a primary chronic inflammation that has an unknown aetiology
ulcerative colitis
What is an example of primary granulomatous disease
sarcoidosis
What factors favour progression from acute to chronic
- foreign body reaction (indigestible substances)
- deep seated suppurative inflammation where drainage is delayed or inadequate
- Thick abscess wall
- Fibrous/granulation tissue
- pus becomes organised
- forms a fibrous scar
What is osteomyelitis
A chronic abscess which is extremely difficult to eradicate (in the bone)
What happens in the case of clinicopathological entity of chronic inflammation
chronic cholecystitis - replacement of wall by fibrous tissue Lymphocytes rather than neutrophils predominate
What does chronic inflammation look like
chronic ulcer -mucosa breached -base lined by granulation tissue -fibrous tissue throughout muscle layers chronic abscess cavity thickening of the wall of a hollow viscus granulomatous inflammation fibrosis
Define inflammatory response
an inflammatory process in which lymphocytes, plasma cells and macrophages predominate
this is usually accompanied by the formation of granulation tissue resulting in fibrosis
Tell me about macrophages
•Considerable phagocytic capabilities
• Can ingest a wide range of materials
• Relatively large cells
• Can harbour viable organisms resistant to lysosomal enzymes
Produce a range of important cytokines
• Activated on migration to an area of inflammation
What are the two factors which effect macrophages
macrophage activation factor MAF
migration inhibition factor MIF
How do you differentiate between acute and chronic
macrophages = chronic acute = neutrophils
What is a granuloma
an aggregate (collection) of epithelioid histiocytes
What is a histiocyte
a macrophage in connective tissue
tell me more about granulomatous inflammation
Little phagocytic activity
secretory function
Tell me about a typical granuloma
central Giant cells
surrounded by epithelioid histiocytes
peripheral rim of activated lymphocytes
What are the causes of granulomatous disease
• Specific infections
• Foreign bodies
– i) endogenous
– ii)exogenous
• Specific chemicals
- Drugs
- Unknown
What can happen during granulomatous inflammation
may develop:
caseous necrosis (soft white dead cells like cheese)
Giant cells
