Session 3 - Chronic inflammation Flashcards
What is the definition of chronic inflammation?
Definition: chronic response to injury with associated fibrosis; may overlap with host immunity
What are macrophages derived from?
monocytes
What is the role of lymphocytes?
Chronic inflammatory cells
What are the three functions of lymphocytes?
o Adaptive immune response
o B lymphocytes > antibodies
o T lymphocytes > control & cytotoxic functions
What are plasma cells derived from?
Terminally differentiated B lymphocytes
What do plasma cells imply?
Chronic inflammation
What do plasma cells do?
Synthesis and secrete antibodies
What do plasma cells look like?
o Clock face chromatin
o Pale around nucleus – lots of golgi
What reactions are Eosinophills involved in?
- Allergic reactions, parasitic infections, some tumours
What do eosinophils look like?
- Appearance: “sunburtn face with sunglasses”`
What are fibroblasts recruited by?
Macrophages
What pathology underlies scarring?
Fibrosis
How do giant cells appear?
Multinucleated and via the fusion of macrophages
What is are the roles of macrophages?
- Phagocytosis of non-pyogenic debris and bacteria
- Anti-gen presentation
- Synthesis of cytokines, complement factors, blood clotting factors and proteases
- Control of other cells via cytokine release
What do macrophages fuse together to form?
o Langhans – TB – horse shoe shaped
o Foreign body type – disorganized
o Touton – fat necrosis
When might chronic inflammation arise?
- May take over from acute inflammation if damage too severe
- May occur De Novo
How does chronic inflammation occur de novo? (4)
- Autoimmune disease e.g. rheumatoid arthritis
- Chronic infections e.g. viral hepatitis
- Chronic low level irritation e.g. suture (considered a foreign body)
- May develop alongside acute inflammation e.g. if severe/repeated inflammation
Give five complications of chronic inflammation
- Fibrosis (scarring) e.g. cirrhosis of the liver
- Impaired function e.g. chronic inflammatory bowel disease > diarrhoea
- Increased function (rare) e.g. thyrotoxicosis
- Atropy e.g. autoimmune destruction of adrenal glands/ gastric mucosa
- Stimulated immune responsep
What is chronic cholecystitis and how is it caused?
Give a treatment
- Repeated obstruction, of cystic duct of gall bladder by gallstones > ischaemia
- Repeated acute inflammation > chronic inflammation
- Fibrosis of bladder wall
- Treated with surgicalremoval
What is gastric ulceration and how is it caused?
- Acute gastritis (alcohol, drugs)
- Helicobacter pylori > chronic gastric ulceration
- Occurs due to imbalance between acid production and mucosal defence
- Fibrosis of stomach mucosa
Give two types of inflammatory bowel disease
Ulcerative colitis
Chron’s disease
What is ulcerative colitis?
Give two treatments
o Superficial
o Diarrhoea > dehydration > malnutrition
o Bleeding
- Treat with immunosupression, surgical removal of the large bowel
What is crohn’s disease?
Give three treatments
o Transmural
o Strictures
o Fistulae: connections between two eipthelia
- Treat with lifestyle modifications, diet/hydration, immunosupression
What is inflammatory bowel disease?
Give two symptoms
- Infllammatory disease affecting the large and small bowel.
Present with diarrhea, rectal bleeding and other symptoms
