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Immunopathology > Lecture 5 > Flashcards

Lecture 5 Flashcards

1
Q

What is the aetiology of chronic inflammation?

A
  1. Inability to resolve an episode of acute inflammation
  2. Persistent low-grade infection
  3. Recurrent episodes of acute inflammation
  4. Prolonged exposure to potentially toxic agents
  5. Autoimmune diseases
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2
Q

What can cause the inability to resolve acute inflammation?

A
  • Compromised host immunity (impaired immune system)
  • Interruption to the healing process (extensive tissue
    destruction)
  • Any factors that can delay healing e.g underlying
    diseases, poor nutritional status etc
  • Persistence of injury e.g retained foreign material
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3
Q

Histological characteristics of chronic inflammation

A
  1. Infiltration of affected tissue
  2. Tissue damage
  3. Ingrowth of granulation tissue
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4
Q

What do lymphocytes do?

A
  • Involved in specific immunity and non-immune mediated inflammation
  • Interact with APC
  • When activated produce cytokines
  • Form wall of granuloma
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5
Q

What do macrophages do?

A
  • Main cells in chronic inflammation
  • Scattered in connective tissues or some organs (e.g. liver)
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6
Q

What do macrophages do once activated?

A
  • Increase cell size
  • Increase content of lysosomal enzymes
  • more active metabolism
  • Greater ability to kill ingested organisms
  • Secrete various cytokines and growth factors
  • Join with other macrophages to form giant cells
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7
Q

What can macrophages differentiate into?

A
  • Epithelioid cells
  • Microglia in the central
    nervous system
  • Kupffer cells in the liver
  • Alveolar macrophages in
    the lungs
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8
Q

What do epithelioid cells do?

A
  • Take up debris and small particles
  • Contribute to the formation of the centre granuloma
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9
Q

What do giant cells do?

A
  • Engulf very large particles
  • Contribute to the formation of the centre granuloma
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10
Q

What do eosinophils do?

A
  • Found in areas with parasites or allergies (IgE response)
  • Common in allergic reactions
  • Release enzymes like histaminase to reduce histamine effects
  • Can eat allergen-antibody complexes
  • Strong at killing parasites
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11
Q

What are the 2 forms of chronic inflammation?

A
  1. Non-specific proliferative chronic inflammation
  2. Granulomatous inflammation
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12
Q

Non-specific proliferative chronic inflammation

A
  • Characterised by granulation tissue
  • Infiltration by fibroblasts which lay down fibrin and new blood vessels.
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13
Q

Granulomatous inflammation

A
  • Characterised by distinct nodules called granulomas.
  • Have a centre of macrophages,
    epithelioid cells and giant cells
  • The centre is surrounded by a band of lymphocytes, fibroblasts and plasma cells.
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14
Q

What are the types of granulomas?

A
  1. Foreign body granulomas
  2. immune Granuloma
  3. Suppurating granuloma
  4. Granuloma of unknown aetiology
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15
Q

Foreign body granulomas

A
  • Comprise relatively inert material
  • No inflammatory or immune response (glass, silica, suture material)
  • Too large to be phagocytosed by a single macrophage
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16
Q

Immune granuloma

A
  • These involve insoluble or
    poorly soluble particles that
    induce a cell mediated
    immune response

May be:
* Caseating e.g tuberculosis or
* Non-caseating e.g sarcoidosis

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17
Q

Suppurating granuloma

A
  • Necrotic material is present
    and pus is produced e.g cat
    scratch disease
  • The causative agent is Bartonella henselae
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18
Q

Granuloma of unknown aetiology

A
  • Chron’s disease
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19
Q

What are some risk factors for chronic inflammation?

A
  • Increasing age
  • Obesity
  • Diet rich in saturated fat, trans-fats, or refined sugar
  • Cigarette smoking
  • Low levels of sex hormones
  • Stress
  • Sleep disorders
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20
Q

Outcomes of chronic inflammation

A
  • Significant scarring
  • Ulcers
  • Strictures and subsequent obstructions
  • Fistulas
  • Deformations
  • Pain
  • Impaired function of the structures affected
    e.g joints
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21
Q

What is Chronic Inflammation?

A

Chronic inflammation is also referred to as slow, long-term inflammation lasting for prolonged periods of several months to years. The extent and effects vary with the cause of the injury and the ability of the body to repair and overcome the damage.

N/A

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22
Q

What can cause an inability to resolve an episode of acute inflammation?

A

Causes include:
* Compromised host immunity
* Interruption to the healing process
* Factors that delay healing (e.g., underlying diseases, poor nutritional status)
* Persistence of injury

N/A

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23
Q

What are some examples of agents that can persist and cause chronic inflammation?

A

Examples include:
* Mycobacterium tuberculosis
* Treponema pallidum
* Certain fungi and protozoa

N/A

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24
Q

What is one potential cause of chronic inflammation related to infection?

A

Persistent low-grade infection by agents such as Mycobacteria sp

N/A

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25
What can lead to recurrent episodes of acute inflammation?
Recurrent episodes of acute inflammation can lead to chronic inflammation. ## Footnote N/A
26
What are examples of potentially toxic agents that can induce chronic inflammation?
Examples include: * Non-degradable exogenous material (e.g., inhaled particles of silica, asbestos, or coal) ## Footnote These substances tend to resist enzymatic breakdown or phagocytosis.
27
What is an autoimmune disease?
An autoimmune disease occurs when an individual develops an immune response to self-antigens and tissues. ## Footnote Chronic inflammation is seen in conditions like rheumatoid arthritis and systemic lupus erythematosus.
28
Fill in the blank: Chronic inflammation is also referred to as _______.
[slow, long-term inflammation] ## Footnote N/A
29
True or False: Chronic inflammation can last for several weeks.
False ## Footnote Chronic inflammation lasts for months to years.
30
What role does compromised host immunity play in chronic inflammation?
It can lead to the inability to resolve an episode of acute inflammation. ## Footnote N/A
31
What are the typical histological characteristics of chronic inflammation?
Affected tissue infiltrated with predominantly mononuclear cells, tissue damage caused by inflammatory cytokines, and ingrowth of granulation tissue ## Footnote Granulation tissue contains fibroblasts and can lead to fibrosis and granuloma formation.
32
Which cells are primarily involved in chronic inflammation?
Lymphocytes, plasma cells, and macrophages ## Footnote Each cell type has specific roles in the inflammatory process.
33
What role do lymphocytes play in chronic inflammation?
Involved in specific immunity and non-immune mediated inflammation, activated by antigen presenting cells, and contribute to granuloma formation ## Footnote Activated lymphocytes produce various cytokines that stimulate monocytes and macrophages.
34
What are plasma cells derived from?
B lymphocytes ## Footnote Plasma cells produce antibodies against persistent antigens.
35
What is the origin of macrophages?
Derived from a common precursor stem cell that forms monocytes ## Footnote Monocytes enter tissues to become macrophages.
36
What happens to macrophages upon activation?
Increase in cell size, lysosomal enzymes, metabolism, and ability to kill organisms ## Footnote Activated macrophages secrete biologically active products important in immune response and tissue destruction.
37
What are the types of cells that macrophages can differentiate into?
* Epithelioid cells * Microglia * Kupffer cells * Alveolar macrophages * Osteoclasts ## Footnote Each type has specific functions in different tissues.
38
What is the function of epithelioid cells?
Take up debris and small particles, contribute to granuloma formation ## Footnote Epithelioid cells are activated macrophages with specialized functions.
39
What is the role of giant cells in chronic inflammation?
Engulf very large particles and contribute to granuloma formation ## Footnote Giant cells are formed from the fusion of activated macrophages.
40
In which situations are eosinophils characteristically found?
Inflammatory sites around parasitic infections and in immune reactions mediated by IgE ## Footnote Eosinophils are associated with allergies, such as asthma.
41
What enzymes do eosinophils release, and what is their purpose?
Histaminase, which combats the effects of histamine in allergic reactions ## Footnote Eosinophils can also phagocytose antigen-antibody complexes.
42
True or False: Macrophages are the main cells involved in chronic inflammation.
True ## Footnote Macrophages play a central role in sustaining the inflammatory response.
43
What are the two main forms of chronic inflammation?
1. Non-specific proliferative chronic inflammation 2. Granulomatous inflammation ## Footnote Non-specific proliferative chronic inflammation is characterized by granulation tissue, while granulomatous inflammation is characterized by distinct nodules called granulomas.
44
What characterizes non-specific proliferative chronic inflammation?
Infiltration by mononuclear cells, fibroblasts, and new blood vessels. ## Footnote Fibroblasts lay down fibrin in this type of inflammation.
45
What are granulomas?
Distinct nodules formed in granulomatous inflammation, consisting of macrophages, epithelioid cells, and giant cells surrounded by lymphocytes, fibroblasts, and plasma cells. ## Footnote Granulomas can vary in type and cause.
46
What is a foreign body granuloma?
Granulomas that comprise relatively inert material, do not cause an inflammatory or immune reaction, and are too large to be phagocytosed by a single macrophage. ## Footnote Examples include glass, silica, and suture material.
47
What characterizes an immune granuloma?
Involves insoluble or poorly soluble particles that induce a cell-mediated immune response and may be caseating or non-caseating. ## Footnote Caseating examples include tuberculosis; non-caseating examples include sarcoidosis.
48
What is a suppurating granuloma?
A type of granuloma where necrotic material is present and pus is produced, e.g., in cat scratch disease. ## Footnote This type of granuloma indicates ongoing inflammation and infection.
49
What are some risk factors for chronic inflammation?
* Increasing age * Obesity * Diet rich in saturated fat, trans-fats, or refined sugar * Cigarette smoking * Low levels of sex hormones * Stress * Sleep disorders ## Footnote These factors can contribute to the onset and persistence of chronic inflammation.
50
What can localized chronic inflammation cause?
* Significant scarring * Ulcers * Strictures and subsequent obstructions * Fistulas * Deformations * Pain * Impaired function of the structures affected ## Footnote The specific outcomes depend on the tissue involved.
51
True or False: Chronic inflammation can play a role in diseases such as rheumatoid arthritis and cancer.
True ## Footnote Chronic inflammation is linked to various serious diseases, including heart disease, diabetes, asthma, and Alzheimer’s.
52
Fill in the blank: Chronic inflammation may lead to _______ and impaired function of the affected structures.
significant scarring ## Footnote This is one of the local outcomes of chronic inflammation.
53
What is healing?
The process by which the object (to be healed) is made whole, sound or well again.
54
Define regeneration in the context of tissue repair.
Replacement of damaged tissue with healthy tissue, with complete return to normal structure and function.
55
What is repair in tissue healing?
When damaged tissue is replaced by scar tissue.
56
What is scar tissue predominantly made up of?
Collagen fibres.
57
What does wound healing aim to achieve?
Fill in, seal and shrink the wound.
58
What are the two types of wound healing?
Primary intention and secondary intention.
59
What is the best possible outcome of the repair process?
Regeneration.
60
In which types of cells can regeneration occur?
In tissues composed of labile and stable cells.
61
What factors influence cell growth and division in regeneration?
Polypeptide growth factors and other mechanisms.
62
What leads to repair instead of regeneration?
Severe or persistent tissue injury and inflammation.
63
How many stages are in the wound healing process?
Three stages.
64
What is the first stage of wound healing?
Inflammatory phase.
65
What occurs during the inflammatory phase?
Haemostasis, cellular and vascular phases of inflammation, increased cell division and fibroblast migration.
66
What is angiogenesis?
New blood vessel formation.
67
What happens during the proliferative phase?
Formation of granulation tissue and coverage of the defect.
68
What is the final phase of wound healing?
Maturation or Remodelling phase.
69
What occurs during the maturation phase?
Realigning of collagen, increasing tensile strength, scar maturation, and contraction.
70
What characterizes healing by first intention?
Healing of a clean, uninfected surgical incision with minimal tissue destruction.
71
What is the outcome of healing by first intention?
Essentially normal epidermis with minor scarring.
72
What is healing by second intention?
Healing process for extensive cell or tissue loss requiring complex reparative processes.
73
What is a characteristic of secondary healing?
Formation of large amounts of granulation tissue and scar tissue.
74
What role do myofibroblasts play in wound healing?
They contribute to wound contraction.
75
Fill in the blank: Healing by first intention is also known as _______.
Primary union.
76
Fill in the blank: Healing by second intention is also known as _______.
Secondary union.
77
What are the local factors that influence wound healing?
Type, size and location of the wound, local wound infection, mechanical factors, foreign bodies, ionizing radiation, insufficient blood flow, type of tissue affected ## Footnote Local factors include specific characteristics of the wound and surrounding area that can enhance or impede the healing process.
78
How does the type of wound affect healing?
Clean, sharp aseptic wounds heal better than wounds caused by blunt trauma; small blunt wounds heal faster than large blunt ones ## Footnote The nature of the wound significantly influences the healing duration and effectiveness.
79
What impact does local wound infection have on healing?
Delays wound healing by causing excessive granulation tissue ## Footnote Local infections are a major factor in hindering the healing process.
80
What are mechanical factors that can retard wound healing?
Early mobility of healing edges before tensile strength is established ## Footnote Movement of the wound edges can disrupt the healing process.
81
What types of foreign bodies can influence wound healing?
Fragments of steel, glass, bone, undissolved sutures or ligatures ## Footnote Retained foreign materials can cause complications and prolong healing.
82
How does ionizing radiation affect wound healing?
Irradiated areas heal slower due to interference with blood supply and blocking of cell proliferation ## Footnote Radiation exposure can significantly slow down the healing process.
83
What is the effect of insufficient blood flow on wound healing?
Reduced supply of substances needed for repair ## Footnote Lack of blood flow can severely limit the body's ability to heal wounds.
84
What are the systemic factors influencing wound healing?
Circulatory status, nutritional status, metabolic status, hormones and medications, age, haematological disorders, immune status, underlying disease states ## Footnote Systemic factors are body-wide conditions that can affect the healing process.
85
How does impaired circulation affect wound healing?
Delays healing due to arteriosclerosis and reduced venous and lymphatic drainage ## Footnote Circulatory issues can significantly hinder the healing process.
86
Which nutritional deficiencies can impair wound healing?
Vitamin C, zinc, methionine ## Footnote Proper nutrition is essential for effective wound healing.
87
What metabolic condition is associated with delayed wound healing?
Poorly controlled diabetes ## Footnote Diabetes can lead to reduced blood flow and increased risk of infection, affecting healing.
88
How do corticosteroids affect wound healing?
Delay wound healing ## Footnote Corticosteroids are known to impair the body's natural healing response.
89
What is keloid scarring?
Excessive formation of collagen in the dermis that extends beyond the wound margins ## Footnote Keloids are a type of abnormal scar formation.
90
What complications can arise from wound healing?
Infection, formation of excess granulation tissue, keloid scarring, contractures, adhesions, dehiscence, ulceration ## Footnote These complications can significantly impact recovery and function.
91
What is contracture in the context of wound healing?
Permanent shortening of tissue resulting in deformities and limitation of movement ## Footnote Contractures can severely affect mobility and function.
92
What is dehiscence?
Separation of layers of a surgical wound ## Footnote Dehiscence is a serious complication that can occur post-surgery.
93
Fill in the blank: A lack of _______ can delay wound healing.
leukocytes ## Footnote Haematological disorders affecting white blood cells can impair the healing process.
94
True or False: Advanced age contributes to increased collagen and faster wound healing.
False ## Footnote Aging typically results in reduced collagen production and slower healing.

Immunopathology (11 decks)

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