Revision: Chronic inflammation Flashcards
chronic inflammation definition
chronic response to injury w/ associated fibrosis
How can a CIR arise?
1 It can take over from an AIR
-If damage is too severe to be dealt with in a few days
2 It can arise de novo
- some autoimmue conditions eg RA
- some chronic infections eg viral hepatitis
- chronic low level irritation
3 It can develop alongside an AIR
- from persistent/repeated/severe infections
list cells involved in a CIR
lymphocytes, eosinophils, myo/fibroblasts, macrophages (+ giant cells- Langhans, Foreign body type, Touton)
Lymphocytes in a CIR
aka Chronic Inflamm. Cells
Function: Complex, but mainly immunological
- B/Plasma (presence indicates high chronicity): differentiate and produce ABs
- T: Control (CD4/helper), Cytotoxic (CD8/killer)
eosinophils in a CIR
Allergic rxns, parasitic infestations, some tumours
Myo/fibroblasts in a CIR
recruited by macrophages, produce collagen
macrophages in a CIR
varied levels of activation, important in AIRs as well
Functions: -synthesis of clotting factors, cytokines, complement components, proteases
- control of other cells via cytokines
- processing and presentation of AGens to IS
- Phagocytosis and destruction of debris and bacteria
- Also fuse together to form multinucleate Giant Cells
Giant Cells
multinucleate cells formed from fusion of macrophages due to frustrated phagocytosis
Types: Langhans -> indicative of (though not specific to) TB (nuclei are arranged in a horseshoe-like pattern)
Foreign body type -> found especially in implants (nuclei are disorganisd)
Touton -> fat necrosis (ring of nuclei surrounded by foamy cytoplasm)
what is present here?
Langhans Giant Cell - indicative of TB
distinguished by horse-shoe arrangement of nuclei around cytoplasm
What is present here, in the centre?
Touton Giant cell -> indicative of fat necrosis
distinguished by circular arrangement of nuclei around foamy cytoplasm
What is present here?
Foreign body type Giant Cell -> usually from an implant, IS recognises it as foreign and attempts to remove it
Distinguished by disorganised nuclei in pockets, not in a pattern, unlike touton and langhans
Chronic colecystitis
Cause: repeated obstruction of gall bladder w/ gallstones
-> repeated AIR -> CIR & fibrosis of gall bladder wall
Treatment: surgical removal of gall bladder
Gastric Ulceration
Cause: Acute - alcohol, drugs Chronic - Helicobacter Pylori
-> ulceration due to an imbalance between acid production and mucosal defence - the acid eats into the lining of the GI tracts
Treatment - ‘triple therapy/treatment’:
- PPI (proton pump inhibitor) - inhibits the secretion of protons into the gastric lumen, attempting to increase the pH eg Omeprazole
- 2 antibiotics to combat the H. pylori eg clarithromycin, amoxicillin
Inflammatory Bowel Disease
Affects S and L intestine, presents w. diarrhoea, rectal bleeding and other symptoms
Ulcerative collitis: No known direct cause, combo. of factors, superficial
-Treatment: immunnosuppresants, colectomy (surgical removal of large intestine)
Chron’s Disease: Thought to be caused by a combo. of genetic and environmental factors
- Transmural (affects entire thickness of wall), Stricture (stenosis/narrowing), fistulae (abnormal connectons made between to epith. line organs)
- Treatment: lifestyle mod.s eg diet, hydration, immunosuppresants
Liver cirrhosis
cause: alcohol, HBV/HCV (hep. B/C), drugs eg paracetamol, toxins, immunological, fatty liver disease
CIR w/ fibrosis - disorganised architecture leading to an attempted regeneration - nodules of hepatocytes surrounded by bands of collagen -> cirrhosis
Cannot be reversed, treatment is either a lifestyle change to prevent further damage, or a liver transplant
