Inflammation 5: Chronic inflammation Flashcards
Compare vascular changes between Acute & chronic inflammation
- Acute: Marked change
- Chronic: mild
compare fluid exudate of Acute & chronic inflammation
Acute has more exudate
Compare inflammatory cells of Acute & chronic inflammation
Acute: POLYMPORH NUCLEAR
* Neutrophils (key cell)
* Macrophages
Chronic: MONONUCLEAR
* Macrophage (key cell)
* Plasma cells
* Giant cells
* Lymphocytes
compare fibrosis of Acute & chronic inflammation
Chronic has Marked fibrosis, Acute has mild fibrosis
which type of inflammation shows more signs of inflammation (red, hot, tender, swelling, etc)
Acute inflammation
Compare between injuries of Acute & chronic inflammation
- Acute: Mild self- limited
- Chronic: Severe progressive (heals by scar tissue destruction)
Compare between specific & Non sepcific chronic inflammation
Nonspecific Chronic inflammation:
* Caused by different irritants
* usually comes after acute inflammation, such as abscess that developed into chronic abscess
* It shows Thickened arterioles (End Arteritis Obliterans) (EAO)
Specific:
* Caused by multiple irritants
* Starts as chronic right away, such as Bilharziasis
* It shows Granuloma
Define chronic inflammation
Inflammation of prolonged duration which heals by fibrosis
Causes of Chronic inflmmation
- Presistant infection difficult to get rid of
- Hypersensitivity/ autoimmune disease
- Prolonged exposure to exogenous undegradable agents/ foreign bodies
role of Macrophage in chronic inflammation
Key cell:
1. Monocytes migrate from blood into tissue by Chemokines to become MACROPHAGES
2. They are activated by Bacterial endotoxins or Cytokines derived from the T cells
3. They immobilize bacteria & produce proteolytic enzymes to cause Intacellular killing + degenration of Extracellular matrix & tissue damage
4. Secrete growth factors for repair
5. After inflammation, they either die, wander into lymphatics or under the effect of INF gamma from T lymphocytes, they become Multinucleated giant cells in granulomas
Monocytes migrate from blood to tissue by ____ & become ____
chemokines, Macrophages
Macrophages are activated by:
- Endotoxins
- Cytokines derived from T cells
Explain how macrophages eradicate bacteria
- Immobilization of bacteria
- Produce proteolytic enzymes for:
* Intracellular killing
* degenration of ECM
* tissue damage
Fate of macrophages after inflammation
- Die
- Wander in lymphocytes
- under the effect of INFgamma, become multinucleated giant cells in Granuloma
Role of B lymphocytes in chronic inflammation
production of Antiboides
Function of T lymphocytes in chronic inflammation
(Along with CD4) secrete cytokines (especially INFgamma)
Eosinophils are mediated by
Ig E
In Parasitic & Allergic chronic inflammations
When are neutrophils present in Chronic inflammation
in Acute-on-top-of-chronic inflammation
Granuloma is what type of reaction
Type 4 (IV) hypersensitivity reaction
In specific chronic inflmmation (granuloma), macrophages are aggregated & activated into _____
Epithelioid cells
epithelioid cells are surrounded by
- T & B lymphocytes
- Plasma cells
Epithelioid cells & Macrophages fuse together to form ____
Giant cells (cells of Langerhans)
Compare between giant cells in TB granuloma & in foreign body granuloma
TB granuloma: horse shoe peripheral aggregated nuclei
FB granuloma: central aggregated nuclei
When does granuloma become suppurative granuloma
when neutrophils are present
Granuloma heals by ___
Fibrosis
Appearance of granuloma & cause of appearance
has central Caseous necrosis
* due to Hypoxia & free radicals
Types of Infective Granuloma
- Bacterial: Tuberculosis (TB)
- Parasitic: Bilharziasis
- Fungal: cryptococcosis
- Madura foot
Types of FB granuloma
- Silicosis
- Asbestosis
- Catgut
Granulomas of unknown cause/auto immune
- Crohn’s disease
- Sarcoidosis
Compilcations of Granulomas
- Destruction
- Fibrosis
- malignancy
2 types of granuloma formation mechanism
- Immune mediated (type IV hypersensitivty)
- Foreign Body mediated
