Chronic Inflammation, Systemic Effects and Scar Formation (3) Flashcards
3 causes of Chronic Inflammation
- Persistent Infection
- Hypersensitivity Disease
- Prolonged exposure to toxic agents
ex. of a hypersensitivity disease that can cause chronic inflammation
Autoimmune
Asthma
ex. of a toxic agent that with prolonged exposure can cause chronic inflammation
Silica
What cells infiltrate with chronic inflammation?
Monocytes/Macrophages and Lymphocytes
Dominant cell with chronic inflammation?
MACROPHAGES
Where are macrophages derived from?
Hematopoietic stem cells of bone marrow postnatally
Macrophages circulating in blood are called?
Monocytes
Liver macrophages are called?
Kupffer cells
CNS macrophages are called?
Microglia
Skin macrophages are called?
Langerhans cells
2 pathways for macrophage activation?
M1 - classical
M2 - alternative
What stimulates the M1 activation pathway?
IFNgamma
What stimulates the M2 activation pathway?
IL-13 and IL-4
What do M1 macrophages release?
ROS, NO, lysosomal enzymes
IL-1, IL-12, chemokines
What do M1 macrophages cause to happen?
Phagocytosis
Inflammation
What do M2 macrophages release?
IL-10
TGF-beta
What do M2 macrophages cause to happen?
Anti-inflammatory effects
Tissue repair
What cells amplify chronic inflammation due to generation of memory cells?
T and B Lymphocytes
In what reactions are eosinophils abundant?
IgE and Parasitic
Eosinophilic granules release a major basic protein. List 1 good and 1 bad effect.
Good = kills parasites Bad = damages epithelial cells
Granulomatous Inflammation is a type of _____ inflammation
Chronic
Granulomatous Inflammation is characterized by collections of what 2 cell types?
Macrophages
T lymphocytes
Granulomatous Inflammation has a central area of?
Necrosis
What is an example of a Granulomatous Inflammation?
Tuberculosis
3 things involved in the Acute Phase Response (systemic effects of inflammation)?
Fever
Acute Phase Reactants
Leukocytosis
What is Leukocytosis?
Increased production of leukocytes
- Can see more immature neutrophils “left shift”
- Seen in an Acute Phase response (systemic effects of inflammation)
What are 3 Acute Phase Reactants?
- C reactive protein
- Fibrinogen
- Serum Amyloid Associated Protein (AA)
C reactive protein and AA are both aid in clearing?
Clearing necrotic debris
C reactive protein and fibrinogen are both stimulated by?
IL-6
Increased Fibrinogen causes what to form?
Rouleaux = RBC stacking
Increased Fibrinogen increases RBC stacking which increases?
ESR - sedimentation rate
A normal ESR is usually below?
20 for men
30 for women
Bacterial infections have increased?
Neutrophils
Viral infections have increased?
Lymphocytes
Allergies and parasites have increased?
Eosinophils
Tissue repair occurs by what 2 processes?
- Regeneration of new cells - normal
2. Deposition of connective tissue - scar
What molecule stimulates cell proliferation for tissue repair?
TGFbeta
Labile tissues
Continuously dividing
ex. Surface epithelia
Stable tissues
Arrested in G0 stage
ex. Liver, kidney, pancreas
Permanent tissues
Terminally differentiated
ex. CNS neurons and heart
Main steps in scar formation?
Inflammation
Cell proliferation - 10 days
Formation of Granulation tissue
Deposition of Connective Tissue
Cell proliferation during scar formation includes what cell types?
Epithelial, Endothelial and Fibroblasts
What do fibroblasts produce at the wound site for scar formation?
Collagen
Granulation tissue includes?
Fibroblasts, Loose CT and mononuclear leukocytes
What molecule stimulates the deposition of connective tissue for scar formation?
TGFbeta
What provides growth factors for proliferating tissues and stimulates fibroblasts proliferation during scar formation?
Macrophages
What remodel scar via collagen and ECM degradation after its formed?
Matrix Metalloproteinases
Hypertrophic scar
Excessive collagen accumulation
Keloid
Scar tissue continues to grow and does NOT regress
Keloids are more common in what race?
African Americans
Ulcers are found with defects in?
Wound healing
