Chronic Inflammation Flashcards
what is the difference between acute and chronic inflammation?
acute inflammation occurs rapidly whilst chronic inflammation is persistent and occurs over months, years and possibly forever
what is chronic inflammation associated with?
greater tissue destruction and generally less fluid build up in infected tissue
what is inflammatory infiltrate?
a mixture of macrophages and lymphocytes (neutrophils are not prominent)
what are the three types of chronic inflammation?
non-specific chronic inflammation, specific (primary) chronic inflammation, chronic granulomatous inflammation
what is non-specific chronic inflammation
failure to resolve, acute inflammation, persistent bouts of acute inflammation, excessive suppuration
what is specific (primary) chronic inflammation
arises without prior warning, persistent exposure to agent, autoimmune diseases
what is chronic granulomatous inflammation?
subset of specific chronic inflammation
when does chronic inflammation arise from acute inflammation?
when the immune system is not sufficient enough to eradicate stimulus
what is the infiltrate of non-specific chronic inflammation dominated by?
tissue macrophages, T cells and B cells
what is non-specific chronic inflammation characterised by?
a dynamic balance between tissue destruction and repair
what may disease pathogenesis of non-specific chronic inflammation include?
repeated acute phases and chronic phases with ongoing repair
give an example of non-specific chronic inflammation
periodontitis
is specific chronic inflammation granulomatous or non-granulomatous?
either
what is specific chronic inflammation characterised by?
excessively activated macrophages
what non-immunological agents induce specific chronic inflammation?
foreign body reactions, inert noxious material (silica and asbestos)
what immunological agents induce specific chronic inflammation
infective organisms that grow in cells (viruses, mycobacteria), hypersensitivity reactions, autoimmune reactions, infection by fungi, protozoa or parasites
what is specific chronic inflammation induced by?
non-immunological agents or immunological agents
what is an autoimmune disease?
unwanted response to body’s own cells and tissues or commensal bacteria, loss of tolerance to self antigens or commensal bacteria, sustained immune response that generates cells and molecules that destroy tissues
give an example of an autoimmune disease
rheumatoid arthritis
what is the disease mechanism of rheumatoid arthritis?
autoreactive T cells against antigens of joint synovium
what is the consequence of rheumatoid arthritis?
joint inflammation and destruction causing arthritis
how is periodontal disease associated with rheumatoid arthritis?
periodontal disease - porphyromonas gingivalis infection - local and systemic inflammatory syndrome - rheumatoid arthritis OR porphyromonas gingivalis infection - production of enzymes: PAD and proteases - peptide citrullination - loss of tolerance: production of antibodies to citrullinated proteins - rheumatid arthritis
what are PAD enzymes and where are they produced from?
peptidyl arginine deiminase and are naturally produced by host cells such as neutrophils but also produced by P. gingivalis
what does PAD enzyme do?
citrullinates proteins (arginine conversion to citrulline which is not a normal naturally occurring amino acid)
how does chronic granulomatous inflammation differ from normal chronic inflammation?
the predominant cell types are modified activated macrophages