Inflammation: Acute vs Chronic
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Inflammation: Acute vs Chronic

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Questions and Answers

What are the main components involved in the inflammatory response?

  • Vascular reaction and cellular response (correct)
  • Neuronal response and vascular reaction
  • Cellular reaction and systemic reaction
  • Neuronal response and immune response

    • Which of the following is NOT a feature of acute inflammation?

  • Increased blood flow
  • Prominent local and systemic signs
  • Fast onset within minutes
  • Cellular infiltrate of monocytes (correct)

    • What characterizes the outcome of acute inflammation when the noxious stimulus is eliminated?

  • Repair of damaged tissue and decline of reaction (correct)
  • Progression to chronic inflammation
  • Permanent alteration of tissue architecture
  • Continuous tissue damage

    • Which mediators are primarily responsible for inducing vasodilation in acute inflammation?

    <p>Histamine and kinins</p> Signup and view all the answers

    What is the typical onset duration of chronic inflammation compared to acute inflammation?

    <p>Days</p> Signup and view all the answers

    Which feature is commonly associated with the local effects of acute inflammation?

    <p>Mild and self-limited tissue injury</p> Signup and view all the answers

    What primarily causes the leakage of plasma proteins during an acute inflammatory response?

    <p>Microvascular structural changes</p> Signup and view all the answers

    Which of the following is a common perception of the signs associated with acute inflammation?

    <p>Heat, redness, swelling, and loss of function</p> Signup and view all the answers

    What is primarily responsible for the chemotactic movement of leukocytes during inflammation?

    <p>Complement proteins</p> Signup and view all the answers

    Which of the following is NOT a beneficial effect of acute inflammation?

    <p>Promotion of immune memory</p> Signup and view all the answers

    What characterizes the progression from acute inflammation to chronic inflammation?

    <p>An influx of mononuclear cells</p> Signup and view all the answers

    Which of the following outcomes indicates the least severe consequence of acute inflammation?

    <p>Complete resolution to histologic normality</p> Signup and view all the answers

    What is the role of kinins in the inflammatory response?

    <p>Mediating vascular reactions and pain</p> Signup and view all the answers

    Which factor initiates the clotting and kinin cascades in inflammation?

    <p>Activated factor XII</p> Signup and view all the answers

    Which of the following is NOT a typical outcome of chronic inflammation?

    <p>Abscess formation</p> Signup and view all the answers

    What change occurs in the vasculature during the acute inflammatory response?

    <p>Increased vascular permeability</p> Signup and view all the answers

    What is the primary role of cytokines in the process of leukocyte recruitment during inflammation?

    <p>To promote the expression of selectins and integrin ligands</p> Signup and view all the answers

    Which type of leukocyte is predominantly found in the early inflammatory infiltrate?

    <p>Neutrophils</p> Signup and view all the answers

    Which mechanism primarily initiates the migration of leukocytes through interendothelial spaces?

    <p>Integrins</p> Signup and view all the answers

    What detrimental effect can the mechanisms of inflammation have on normal tissues?

    <p>Pathologic tissue damage</p> Signup and view all the answers

    What is the main effect of the vasoactive amine histamine during the inflammatory response?

    <p>Increased vascular permeability</p> Signup and view all the answers

    Which process involves the degradation of microbes and dead cells in leukocytes?

    <p>Phagocytosis</p> Signup and view all the answers

    Which of the following is NOT a major cell-derived mediator of inflammation?

    <p>Erythropoietin</p> Signup and view all the answers

    What role does reactive oxygen species (ROS) play during inflammation?

    <p>Kills microbes and causes tissue injury</p> Signup and view all the answers

    What type of cells can adult tissues primarily generate?

    <p>Multiple cell lineages</p> Signup and view all the answers

    Which of the following best describes induced pluripotent stem cells (iPS cells)?

    <p>They are created by introducing specific genes into mature cells.</p> Signup and view all the answers

    Which component of the extracellular matrix (ECM) is crucial for mechanical support to tissues?

    <p>Collagens</p> Signup and view all the answers

    What is the outcome of damaged extracellular matrix (ECM) during tissue repair?

    <p>Formation of a scar</p> Signup and view all the answers

    Which type of inflammation is characterized by the presence of pus and necrotic cells?

    <p>Suppurative (Purulent) inflammation</p> Signup and view all the answers

    In which type of inflammation might you find a meshwork of fibrin threads?

    <p>Fibrinous inflammation</p> Signup and view all the answers

    What typically occurs in an abscess related to suppurative inflammation?

    <p>A focal collection of pus</p> Signup and view all the answers

    Which of the following best describes ulceration?

    <p>Erosion of an epithelial surface due to necrosis</p> Signup and view all the answers

    Which of the following best describes the primary characteristic of chronic inflammation?

    <p>Persistent inflammation with associated tissue injury</p> Signup and view all the answers

    What role do cytokines produced by macrophages and lymphocytes play in chronic inflammation?

    <p>They contribute to an amplified and prolonged inflammatory response</p> Signup and view all the answers

    Which of the following conditions is NOT typically associated with granulomatous inflammation?

    <p>Acute viral infection</p> Signup and view all the answers

    What is the main effect of pro-inflammatory cytokines like TNF and IL-1 on the hypothalamus during inflammation?

    <p>Stimulation of prostaglandin production leading to fever</p> Signup and view all the answers

    In chronic inflammation, which type of cellular infiltrate is predominantly found?

    <p>Activated macrophages, lymphocytes, and plasma cells</p> Signup and view all the answers

    What activation signal do macrophages respond to during chronic inflammation?

    <p>Interferon-gamma (IFN-γ)</p> Signup and view all the answers

    What defines tissues as stable in the context of cell proliferation?

    <p>They proliferate slowly and can regenerate under certain conditions</p> Signup and view all the answers

    Which process is primarily stimulated by cytokines during systemic inflammation?

    <p>Production of acute-phase proteins</p> Signup and view all the answers

    Study Notes

    Inflammation

    • Host response to foreign invaders and necrotic tissue, but can also cause tissue damage
    • A protective response to remove the initial cause of cell injury, necrotic cells and tissues
    • Harmful effects include anaphylactic shock, rheumatoid arthritis, and atherosclerosis

    Components of Inflammation

    • Vascular reaction
    • Cellular response

    Steps of Inflammatory Response

    • Recognition of the injurious agent
    • Recruitment of leukocytes
    • Removal of the agent
    • Regulation of the response
    • Resolution (repair)

    Features of Acute and Chronic Inflammation

    Acute Inflammation

    • Fast onset (minutes to hours)
    • Cellular infiltrate mainly neutrophils
    • Usually mild and self-limited tissue injury
    • Prominent local and systemic signs

    Chronic Inflammation

    • Slow onset (days)
    • Cellular infiltrate mainly monocytes/macrophages and lymphocytes
    • Often severe and progressive tissue injury
    • Less prominent local and systemic signs, may be subtle

    Acute Inflammation

    • Short duration (few minutes to few days)
    • Characterized by:
      • Increased blood flow (hyperemia)
      • Microvascular structural changes leading to plasma protein leakage (exudation)
      • Emigration of neutrophils towards the site of injury
    • Outcome:
      • Elimination of the noxious stimulus, followed by repair
      • Persistent injury resulting in chronic inflammation
    • Classical signs:
      • Heat (calor)
      • Redness (rubor)
      • Swelling (tumor)
      • Pain (dolor)
      • Loss of function (functio laesa)

    Reaction of Acute Inflammation

    • Vasodilation: induced by histamine, causing erythema and blood flow stasis
    • Increased vascular permeability: induced by histamine, kinins, and other mediators, resulting in edema
    • Leukocyte recruitment: leukocytes are recruited from blood to extravascular tissue to remove pathogens or damaged tissue

    Leukocyte Recruitment

    • Multi-step process:
      • Loose attachment and rolling on endothelium (selectins)
      • Firm attachment to endothelium (integrins)
      • Migration through interendothelial spaces
    • Cytokines (TNF, IL-1, chemokines) regulate expression of selectins, integrin ligands, and promote leukocyte migration

    Leukocyte Effector Mechanisms

    • Phagocytosis: engulfment and destruction of microbes and dead cells in phagolysosomes
    • Destruction: caused by free radicals (ROS, NO) and lysosomal enzymes
    • Extracellular release: enzymes and ROS can damage normal tissue

    Major Cell-Derived Mediators of Inflammation

    • Vasoactive amines: histamine, serotonin - vasodilation and increased vascular permeability
    • Arachidonic acid metabolites: prostaglandins and leukotrienes - vascular reaction, leukocyte chemotaxis, and other inflammatory reactions
    • Cytokines: TNF, IL-1, IL-6, chemokines - leukocyte recruitment and migration
    • ROS: microbial killing and tissue injury
    • NO: vasodilation and microbial killing
    • Lysosomal enzymes: microbial killing and tissue injury

    Plasma Protein-Derived Mediators of Inflammation

    • Complement proteins: activation leads to chemotaxis, opsonization, and cell killing
    • Coagulation proteins: activated factor XII triggers clotting, kinin, complement, and fibrinolytic systems
    • Kinins: mediate vascular reaction and pain

    Sequence of Events in Acute Inflammation

    • Vasodilation: increased blood flow, erythema, and warmth
    • Increased vascular permeability: fluid leakage, tissue edema
    • Leukocyte adhesion and migration: neutrophils adhere to endothelium and migrate to the site of injury
    • Phagocytosis: removal of the offending agent
    • Outcome: resolution, chronic inflammation, scarring

    Beneficial Effects of Acute Inflammation

    • Dilution of toxins
    • Exudation of protective antibodies
    • Fibrin formation, delaying bacterial spread
    • Exudation of plasma mediators (complement, coagulation, fibrinolytic, and kinin)
    • Exudation of nutrient materials
    • Promotion of immunity

    Outcomes of Acute Inflammation

    • Complete resolution
    • Fibrosis: occurs when inflammation involves non-regenerative tissues, substantial tissue destruction, or extensive fibrinous exudates
    • Abscess formation: focal collection of pus caused by deep seeding of pyogenic bacteria
    • Progression to chronic inflammation

    Chronic Inflammation

    • Longer duration (days to years)
    • Characterized by:
      • Infiltration by mononuclear cells (monocytes, lymphocytes, macrophages)
      • Tissue destruction
      • Tissue repair (vascular proliferation and fibrosis)
    • Causes:
      • Persistent infections (tuberculosis, syphilis)
      • Prolonged exposure to toxic agents
      • Autoimmune disorders

    Features of Chronic Inflammation

    • Prolonged host response to persistent stimuli, often underlies many diseases
    • Characterized by:
      • Persistent inflammation
      • Tissue injury
      • Attempted repair by scarring
      • Immune response
    • Cellular infiltrate: activated macrophages, lymphocytes, and plasma cells, with fibrosis

    Mediators of Chronic Inflammation

    • Cytokines produced by macrophages and lymphocytes (notably T lymphocytes), leading to amplified and prolonged inflammation

    Cells in Chronic Inflammation

    • Macrophages: derived from monocytes, increase in size, with more lysosomes and active metabolism
    • Lymphocytes: T lymphocytes secrete IFN-γ, stimulating macrophages
    • Plasma cells: produce antibodies
    • Eosinophils: involved in allergic reactions and parasitic infections

    Macrophage Secretions

    • Acid and neutral proteases
    • Complement components
    • Oxygen-free radicals and nitric oxide
    • Cytokines: IL-1, TNF

    Granulomatous Inflammation

    • Aggregation of activated macrophages (epithelioid appearance)
    • Causes:
      • Bacterial infection (tuberculosis, leprosy, syphilis)
      • Parasitic infection (bilharziasis)
      • Fungal infection (histoplasmosis)
      • Inorganic metals (silica, berylliosis)
      • Foreign body
      • Unknown (sarcoidosis)

    Systemic Effects of Inflammation

    • Fever: cytokines stimulate prostaglandin production in hypothalamus
    • Production of acute-phase proteins: C-reactive protein stimulated by cytokines
    • Leukocytosis: cytokines stimulate leukocyte production from bone marrow precursors
    • Septic shock: severe infections leading to low blood pressure, disseminated intravascular coagulation, metabolic abnormalities, induced by high levels of TNF

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    Description

    Explore the differences between acute and chronic inflammation in this quiz. Understand the host's response to injury, the components involved, and the steps in the inflammatory response. Test your knowledge on the effects and characteristics of each type of inflammation.

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