Lecture 06 - Chronic Inflammation

Question 1

Causes of Chronic Inflammation

Answer 1

1. resistant organisms: TB, T. pallidum, viruses (hepatitis, HIV, …), fungi
2. diseases caused by hypersensitivity: allergies, autoimmune diseases
3. prolonged exposure

Question 2

Chronic Inflammation Cells

Answer 2

1. Macrophages
2. Monocytes
3. eosinophils

Question 3

1. Macrophage Activation

Answer 3

stem cell –> monobalst –> monocyte –> macrophage

1. classic activation –> IFN-Y, bateria –> ROS, NO, lysosomal enzymes, chemotaxis, IL-1,12,23 –> acute inflammation
2. alternative activation –> IL-4,13 –> GF, collagenase –> remodeling –> more fibroblast –> fibrosis –> IL-10, TGF-B –> anti-inflammation
3. immune –> lymphocyte T by IFN-Y
4. non-immune –> endotoxin, fibronectin, chemical mediators

Question 4

2. Lymphocyte

Answer 4

B cell –> Ab
Th1 –> IFN-Y –> macrophage classic activation
Th2 –> IL-4,5,13 –> macrophage alternative activation
Th17 –> IL-17 –> chemotaxis

Question 5

Granuloma

Answer 5

epitheloid macrophage accumulation

multinucliated giant cell

Question 6

TB

Answer 6

caseous necrosis granulom (or maybe not)

Question 7

Leprosy

Answer 7

non-caseous necrosis granulom

acid-fast mycobacterium inside macrophage

Question 8

Syphilis

Answer 8

Goma with center coagulative necrosis

Question 9

Cat Scratch

Answer 9

gram- basilus

round/star like granulum with abscess and neutrophil

Question 10

Sarcoidosis

Answer 10

non-caseous necrosis granulom with a lot of macrophages

Question 11

Crohn Disease

Answer 11

non-caseous necrosis granulom

mostly in terminal ileum

Question 12

Leishmaniasis

Answer 12

langerhans giant cells

Question 13

Signs of Inflammation

Answer 13

1. local
   - hotness
   - redness
   - pain
   - edema
2. systemic
   - fever: TNF, IL-1 –> PGE2 –> increased cAMP in hypothalamus
   - chills
   - myalgia
   - malaise

Question 14

Acute Phase Reactions

Answer 14

IL-6 –> CRP, fibrinogen
IL-1, TNF –> SAA
- fibrinogen –> rouleau formation –> increased sedimentation rate –> increased ESR

Question 15

Leukocytosis

Answer 15

leukemoid reaction
IL-1, TNF –> release of reserve pods in BM or spleen
stem cell –> myeloblast –> promyelocyte –> myelocyte –> metamyelocyte –> Band form –> segment form

Question 16

Cell Cycle

Answer 16

1. labile tissue
2. stable tissue
3. permanent tissue