Inflammation: Acute and Chronic Processes
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Questions and Answers

Which cells are primarily responsible for the emigration of leukocytes during acute inflammation?

  • Basophils
  • Neutrophils (correct)
  • Eosinophils
  • B lymphocytes

What is the key difference between acute and chronic inflammation regarding the duration and type of cellular response?

  • Chronic inflammation begins immediately after injury with edema.
  • Acute inflammation lasts for weeks with a predominance of lymphocytes.
  • Chronic inflammation is characterized by a rapid onset and significant leukocyte emigration.
  • Acute inflammation shows a short duration with neutrophil predominance. (correct)

Which cytokine is directly involved in the activation of the inflammasome during acute inflammation?

  • IL-1 (correct)
  • TNF
  • IL-2
  • IL-10

Which of the following conditions may arise from excessive or defective inflammatory responses?

<p>Rheumatoid arthritis (A)</p> Signup and view all the answers

What is the primary outcome of acute inflammation when the process is effective?

<p>Resolution of inflammation and tissue repair (C)</p> Signup and view all the answers

What is the function of neutrophils in acute inflammation?

<p>Engage in recognition and phagocytosis of offending agents (A)</p> Signup and view all the answers

Which mediator is involved in the termination of the inflammatory response?

<p>Transforming growth factor-β (TGF-β) (A)</p> Signup and view all the answers

What outcome occurs when there is substantial damage to connective tissue?

<p>Granulation tissue formation leading to scar formation (C)</p> Signup and view all the answers

Which of the following is a characteristic of chronic inflammation?

<p>Coexistence of inflammation, injury, and repair attempts (D)</p> Signup and view all the answers

What is a major cause of chronic inflammation?

<p>Persistent infection by microorganisms that are difficult to eradicate (C)</p> Signup and view all the answers

Which plasma protein is an acute phase reactant involved in the inflammatory response?

<p>Fibrinogen (D)</p> Signup and view all the answers

Which of these is an example of an outcome of complete resolution in acute inflammation?

<p>Re-growth of alveolar lining cells after pneumonia (A)</p> Signup and view all the answers

What initiates the process of leukocyte migration during inflammation?

<p>Chemical signals emitted from damaged tissue (B)</p> Signup and view all the answers

What is the primary role of neutrophils during acute inflammation?

<p>To be the first responders and remove dead cells (B)</p> Signup and view all the answers

Which cytokines are primarily released by resident macrophages and dendritic cells during the inflammatory response?

<p>IL-1 and TNF-α (D)</p> Signup and view all the answers

What physiological change does histamine secretion by mast cells primarily cause?

<p>Vasodilation and increased permeability (A)</p> Signup and view all the answers

What are the characteristic signs of acute inflammation?

<p>Redness, swelling, heat, and pain (A)</p> Signup and view all the answers

Which cells are primarily responsible for the early phase of the acute inflammatory response?

<p>Neutrophils (A)</p> Signup and view all the answers

How do cytokines influence the recruitment of inflammatory cells?

<p>They signal leukocytes to exit the bloodstream. (D)</p> Signup and view all the answers

What occurs during the repair phase of acute inflammation?

<p>Intracellular signaling decreases inflammatory response. (D)</p> Signup and view all the answers

Which process describes the removal of microbes and dead cells during acute inflammation?

<p>Phagocytosis (B)</p> Signup and view all the answers

Flashcards

Acute inflammation resolution

Tissue repair process where neutrophils and necrotic tissue are removed, allowing for tissue regeneration.

Resolution with scar formation

Tissue repair that occurs when substantial damage impedes full regeneration, forming a fibrous scar.

Acute inflammatory exudate

Fluid containing neutrophils and liquified debris, a hallmark of localized pus formation.

Granulation tissue

Pink, soft, granular tissue that fills defects during tissue repair, eventually replaced by collagen.

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Chronic inflammation causes

Persistent infections, hypersensitivity reactions, and autoimmune diseases can result in chronic inflammation.

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Termination of acute inflammation

Process of ending the acute inflammatory response where mediators stop, neutrophils die and macrophages help resolve.

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Outcomes of acute inflammation

Complete resolution, resolution with scar formation or progression to chronic inflammation, dependant on severity and tissue type.

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Abscess

A localized collection of pus, a sign of purulent inflammation.

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Pyrogens

Substances that induce fever by triggering the release of prostaglandin E2 (PGE2) from the hypothalamus, resetting the body's thermostat.

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Acute-phase proteins

Plasma proteins produced by the liver in response to inflammation, including fibrinogen, C-reactive protein (CRP), and serum amyloid A (SAA).

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Leukocytosis

An increase in white blood cell count, particularly neutrophils, during inflammation caused by cytokines like IL-1 and TNF.

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Acute inflammation: Key features

Characterized by a rapid onset, short duration, swelling, redness, pain, and migration of neutrophils.

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Chronic inflammation

Prolonged inflammatory response lasting weeks or months, involving macrophages, lymphocytes, and tissue destruction.

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What are the two main mechanisms of the inflammatory response?

The inflammatory response is initiated by two main mechanisms: extracellular and intracellular recognition of microbes or damage. Extracellular recognition occurs on cell membranes, endosomes, and the cytosol, while intracellular recognition involves cytosolic receptors (NOD-like) recognizing DAMPs.

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What are DAMPs?

DAMPs, or Damage-Associated Molecular Patterns, are molecules released or altered due to cell damage. They signal the presence of injury and activate the inflammatory response.

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What are the key phases of inflammation?

The inflammatory response has four main phases: recruitment, removal, regulation, and repair. Recruitment brings immune cells to the affected area, removal clears out pathogens and debris, regulation controls the intensity and duration of the response, and repair restores damaged tissues.

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What are inflammatory mediators?

Inflammatory mediators are chemicals released by cells during inflammation, such as cytokines and chemokines. They play crucial roles in attracting immune cells, causing vasodilation, and increasing vascular permeability.

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What are the cardinal signs of inflammation?

The cardinal signs of inflammation are redness, swelling, heat, pain, and loss of function. They reflect the physiological changes occurring during the inflammatory process.

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What are resident macrophages and dendritic cells?

They are sentinel cells residing in tissues, acting as the first line of defense. They detect injury, initiate the inflammatory response by releasing IL-1 and TNF-α, and recruit other immune cells.

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What are neutrophils?

Neutrophils are the 'first responders' of the immune system, rapidly migrating to the site of inflammation. They phagocytose bacteria and pathogens, playing a crucial role in the early stages of the response.

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What are circulating monocytes?

Monocytes are the 'heavy artillery' of the immune system. They enter tissues after neutrophils, becoming macrophages. They remove debris, promote tissue repair, and can remain in the tissue for days.

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Study Notes

Systemic Ramifications

  • Cytokines released into the bloodstream
  • Fever induced by pyrogens (e.g., bacterial products, cytokines IL-1, TNF)
  • Pyrogens trigger PGE2 release from hypothalamus, resetting body's thermostat
  • Elevated acute-phase proteins (e.g., fibrinogen, CRP, SAA) produced in the liver
  • Leukocytosis (increased white blood cells) due to IL-1 and TNF

Types of Inflammation

Acute Inflammation

  • Rapid onset (minutes to days)
  • Short duration
  • Characterized by edema, redness, pain, neutrophil emigration
  • Triggered by immediate response to stimuli

Chronic Inflammation

  • Persistent stimulus
  • Long duration (weeks to months)
  • Characterized by macrophages, lymphocytes, blood vessel proliferation and tissue destruction
  • May follow acute inflammation if stimulus persists

Acute Inflammatory Steps

  • Recognition: Inflammasome activation, release of IL-1 by resident cells (macrophages, dendritic cells, mast cells) induced by pathogen recognition.
  • Recruitment: Inflammatory cells and plasma proteins enter affected tissue in response to released cytokines.
  • Removal: Phagocytic cells eliminate microbes and dead cells.

Regulation and Repair

  • Inflammation ends when its purpose is achieved; anti-inflammatory mediators are secreted.
  • Resident macrophages and dendritic cells detect injury trigger release of IL-1 and TNF- α.
  • Mast cells secrete histamine and serotonin causing vasodilation and increased vascular permeability.
  • Neutrophils arrive within 6 hours and continue responding up to 24 hours.
  • Additional cells and contributions (e.g. Pseudomonas bacteria, viral infections, allergic reactions).

Vascular Changes

  • Vasodilation increases blood flow, causing redness and heat.
  • Increased permeability allows fluid and proteins to leak into tissues, causing swelling.
  • Transudate and exudate - differing characteristics based on composition and presence of cellular debris.

Leukocyte Recruitment and Migration

  • Leukocytes migrate in response to cytokines and chemokines.
  • Adhesion to the endothelium is necessary, leading to the movement inside tissues.

Morphological Types of Acute Inflammation

  • Serous: Fluid with low protein and cell content (e.g., blisters, pleural effusion).
  • Fibrinous: High protein content, fibrin threads form a mat (e.g., pericarditis, pleuritis).
  • Suppurative/Purulent: Pus is present, rich in neutrophils and pathogens).
  • Abscess: Purulent exudate localized in circumscribed area.

Termination of Response

  • Mediators stop being released.
  • Short half-lives of mediators (e.g., neutrophils).
  • Anti-inflammatory cytokines released.

Outcomes of Acute Inflammation

  • Complete resolution: tissue regeneration possible.
  • Scar formation: Occurs with substantial tissue damage; granulation tissue replaces the damaged tissue.
  • Factors determining outcomes: severity of damage, ability of cells to regenerate, and type of agent.

Chronic Inflammation

  • Ongoing inflammation
  • Long duration, possibly leading to tissue damage and fibrosis.
  • Contributing factors are persistent infection or irritation.

Causes of Chronic Inflammation

  • Persistent infection (e.g., mycobacteria, viruses, fungi,parasites).
  • Hypersensitivity reactions.
  • Autoimmune diseases (e.g., rheumatoid arthritis, multiple sclerosis).
  • Prolonged exposure to toxins (e.g., silicosis, atherosclerosis).

Cells Involved

  • Macrophages: Initiate and regulate inflammation.
  • Lymphocytes: Immune responses and activation of specific cells via various pathways.
  • Plasma cells: produce antibodies.
  • Eosinophils: Response to parasitic infections and allergic reactions.
  • Mast cells: Release histamine and other mediators causing vasodilation and increased vascular permeability.
  • Neutrophils: Phagocyte cells that play a major role in the initial stages of inflammation.

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Description

This quiz covers the systemic ramifications of inflammation, detailing cytokine responses, types of inflammation, and the steps involved in acute inflammation. Understand the differences between acute and chronic inflammation and their implications on the body’s response to pathogens.

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