Lecture 5- Chronic Inflammation

Question 1

What is chronic inflammation?

Answer 1

Chronic response to injury with associated fibrosis

Question 2

How can chronic inflammation arise?

Answer 2

Either it takes over from acute inflammation after a few days if the damage is severe enough or else it starts itself from the beginning. It will lead to repair and scarring.

Question 3

What can cause chronic nflammation from the beginning?

Answer 3

Some autoimmune disease eg rheumatoid arthritis

Some chronic infections like viral hepatitis

Question 4

What does chronic inflammation look like?

Answer 4

Much more variable than acute. Most important identifier is the cell type which is macrophages (acute is neutrophils)

Question 5

What is a blood monocyte?

Answer 5

A macrophage when present in the blood

Question 6

Macrophage function?

Answer 6

Phagocytosis

Antigen presentation

Synthesis of cytokines etc

Control of other cells through cytokine release

Question 7

Role of lymphocytes in chronic inflammation?

Answer 7

B lymphocytes for antibodies and T lymphocytes for cytotoxic functions.

Question 8

Chronic inflammation and plasma cells?

Answer 8

Plasma cells are differentiated B lymphocytes.They synthesise ad secrete antibodies and have clock face like appearance. Takes a few weeks before these will be seen

Question 9

Eosinophils and chronic inflammation?

Answer 9

Tomato with sunglasses appearance.

Granulocytes that play a role in allergy and parasitic infections. They are therefore involved in hypersensitivity reactions.

Question 10

Fibroblasts/ myoblasts and chronic inflammation?

Answer 10

Recruited by macrophages and make collagen. Responsible for fibrosis

Question 11

What are myofibroblasts?

Answer 11

Half way between a fibroblast and a smooth muscle cell. responsible for closing wounds

Question 12

What are giant cells seen?

Answer 12

During frustrated phagocytosis meaning that macrophages come together to make giant cells to deal with things that they cant deal with individually

Question 13

What types of giant cells do you see when?

Answer 13

Touton cells- fat necrosis

Langhans cells- tuberculosis

Foreign body type- presence of foreign bodies

See lecture for images

Question 14

What are the effects of chronic inflammation?

Answer 14

Fibrosis (cirrhosis)

Atrophy- tissues lose cells eg gastric mucosa

Immune response- macrophage lymphocyte interaction

Impaired function- chronic inflammatory bowel disease

Question 15

Does chronic inflammation ever increase function?

Answer 15

Very rarely eg increased mucus secretion with chest infection

Question 16

Why can ulcerative colitis be dangerous?

Answer 16

They’re open sores which have failed to heal. Can lead to contents entering peritoneum

Question 17

What are the two conditions that encompass inflammatory bowel disease?

Answer 17

Crohn’s disease and ulcerative colitis.

Present with diarrhoea, rectal bleeding etc

Question 18

What is a stricture and who’s does Crohn’s disease cause it?

Answer 18

Narrowing of a passage of the body. Caused by scar formation

Question 19

What is cirrhosis?

Answer 19

Fibrosis and associated impaired function

Question 20

Why is cirrhosis so serious if the liver regenerates so well?

Answer 20

Cells regenerate but original architecture will not be restored. Must treat chronic inflammation to avoid cirrhosis

Question 21

How are immunity and inflammation relegated?

Answer 21

Immune responses cause chronic inflammation which damages body and chronic inflammation can trigger immune responses

Question 22

What is granulomatous inflammation?

Answer 22

Chronic inflammation with granulomas

Question 23

What is a granuloma?

Answer 23

Localised group of chronic inflammatory cells (macrophages and lymphocytes)

Question 24

When does granulomatous inflammation arise?

Answer 24

Persistent low grade antigenic stimulation

Hypersensitivity

Mildly irritant foreign material

Certain infections that are from mycobacterium like tuberculosis

If immune system struggles to deal with something a granuloma will form there

Question 25

What are mycobacterium?

Answer 25

Type of bacteria that the body struggles to remove

Question 26

Tuberculosis?

Answer 26

Disease caused by mycobacterium that is hard to combat. Leads to chronic inflammation that does more damage that the organism itself. Often presents in lungs and coughing of blood etc can be blamed on inflammation.

Indicated by Langhans giant cells

Question 27

What will a tb granuloma look like?

Answer 27

Caseous necrosis with macrophages, lymphocytes and Langhans cells

Question 28

Wh other diseases can be found with granulomas?

Answer 28

Sarcoidosis

Crohns

Wegeners granulomatosis