Inflammation: Acute vs. Chronic

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Questions and Answers

In chronic inflammation, which cellular infiltrate is most commonly observed?

  • Neutrophils
  • Basophils
  • Eosinophils
  • Monocytes/macrophages and lymphocytes (correct)

Which of the following is NOT a typical characteristic of acute inflammation?

  • Fast onset
  • Predominance of neutrophils
  • Prominent local and systemic signs
  • Significant fibrosis and angiogenesis (correct)

Long-term exposure to a stimulus is most likely to result in which type of inflammation?

  • Chronic inflammation (correct)
  • Subacute inflammation
  • Transient inflammation
  • Acute inflammation

Which of the following is NOT considered a cardinal sign of acute inflammation?

<p>Pallor (paleness) (C)</p> Signup and view all the answers

Increased hydrostatic pressure in blood vessels during acute inflammation directly leads to what event?

<p>Transudation of fluid into the extracellular space (A)</p> Signup and view all the answers

What is the primary effect of persistent vasodilation in the context of acute inflammation?

<p>Increased delivery of immune cells and mediators (A)</p> Signup and view all the answers

Endothelial cell contraction leads to increased vascular permeability by which mechanism?

<p>Creating gaps between endothelial cells (C)</p> Signup and view all the answers

Which of the following scenarios would most likely lead to chronic inflammation rather than acute inflammation?

<p>Ongoing exposure to inhaled pollutants (C)</p> Signup and view all the answers

Which of the following is the MOST comprehensive definition of inflammation, incorporating its underlying purpose?

<p>The body's protective response to injury or infection, involving a complex cascade of cellular and molecular events aimed at restoring tissue homeostasis. (C)</p> Signup and view all the answers

Consider a scenario where a patient presents with a localized inflammatory response following a minor skin abrasion. Which sequence of events BEST describes the formation of a cellular exudate at the site of injury?

<p>Vasodilation → increased vascular permeability → leukocyte emigration → exudate accumulation (D)</p> Signup and view all the answers

A researcher is investigating the effects of a novel anti-inflammatory compound. Which of the following mechanisms of action would BEST indicate the compound's potential to resolve acute inflammation?

<p>Promoting the resolution of inflammation by enhancing leukocyte apoptosis and removal of debris. (B)</p> Signup and view all the answers

A patient has recurrent inflammation caused by exposure to an allergen. Which initial event is MOST likely responsible for triggering the inflammatory response?

<p>Antibody-mediated activation of mast cells, leading to the release of inflammatory mediators. (A)</p> Signup and view all the answers

During phagocytosis, a macrophage engulfs a bacterium. Which process is MOST crucial for the intracellular killing of the ingested bacterium?

<p>Fusion of the phagosome with a lysosome, leading to enzymatic degradation of the bacterium. (C)</p> Signup and view all the answers

Which of the following best describes the role of histamine in the inflammatory response?

<p>Causes vasodilation of arterioles and increases vascular permeability. (A)</p> Signup and view all the answers

Leukotrienes are known to perform which of the following functions during inflammation?

<p>Chemotaxis for neutrophils and lysosomal enzyme release. (C)</p> Signup and view all the answers

How do chemokines contribute to the inflammatory response?

<p>By acting as chemoattractants for specific types of leukocytes. (A)</p> Signup and view all the answers

What is the primary function of Tumor Necrosis Factor (TNF) in the context of inflammation?

<p>To induce fever and mediate immune cell recruitment. (C)</p> Signup and view all the answers

Which of the following is a characteristic action of prostaglandins during inflammation?

<p>Vasodilation, fever, and pain. (C)</p> Signup and view all the answers

How do osteoblasts modulate the inflammatory response?

<p>By mediating and regulating immune and inflammatory reactions. (C)</p> Signup and view all the answers

Which of the following mediators is most directly involved in the recruitment of neutrophils to the site of inflammation?

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

What is the primary role of opsonization in the process of phagocytosis?

<p>To enhance the adherence and engulfment of particles by phagocytic cells. (B)</p> Signup and view all the answers

Interleukins (IL-1, IL-6, IL-8) are primarily involved in which aspect of the inflammatory process?

<p>Activating and differentiating immune cells, and recruiting neutrophils. (A)</p> Signup and view all the answers

In an inflamed tissue site, which of the following enzymes released by neutrophils and macrophages directly contributes to tissue breakdown?

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

What is the primary function of chemotaxis in the context of leucocyte recruitment during inflammation?

<p>To guide the movement of leucocytes towards the site of inflammation. (D)</p> Signup and view all the answers

Which of the following is NOT a typical outcome observed in patterns of acute inflammation?

<p>Atrophy of the affected tissue due to decreased cellular activity. (D)</p> Signup and view all the answers

Which of the following cell types is NOT a recognized source of endogenous chemical mediators involved in inflammation?

<p>Adipocytes (C)</p> Signup and view all the answers

What is the role of increased transcytosis in the context of inflammation?

<p>To facilitate the transport of fluids and proteins across the endothelium. (B)</p> Signup and view all the answers

Why is leakage from newly formed blood vessels a key characteristic of inflammation?

<p>To facilitate the entry of plasma proteins and immune cells into the affected tissue. (D)</p> Signup and view all the answers

Which of the following cell types is NOT known to produce cytokines during an inflammatory response?

<p>Erythrocytes (C)</p> Signup and view all the answers

Flashcards

Inflammation Definition

Local tissue response to injury.

Inflammation Stimuli

Microbial, immunological, physical, and chemical agents.

Inflammation: Friend or Foe?

Defense mechanism that can sometimes cause damage.

Exudate Formation Significance

Accumulation of fluid and cells at the site of injury

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Exudate Types

Cellular: movement of cells; Fluid: accumulation of fluid

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Acute Inflammation

Rapid onset inflammation, mainly involving neutrophils.

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Chronic Inflammation

Slow onset inflammation, involving monocytes/macrophages and lymphocytes.

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Cellular Infiltrate in Acute Inflammation

Neutrophils are the main cellular infiltrate.

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Cellular Infiltrate in Chronic Inflammation

The cellular infiltrate consists of Monocytes/macrophages & lymphocytes.

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Rubor (Redness)

Redness of the skin due to increased blood flow.

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Calor (Heat)

Heat due to increased blood flow.

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Tumor (Swelling)

Swelling caused by fluid accumulation.

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Vascular Event in Acute Inflammation

Persistent vasodilation

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Chemotaxis

Recruitment of leucocytes to an injury site, guided by chemical signals.

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Phagocytosis

The process where cells engulf and digest particles or debris.

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PMNs

Polymorphonuclear neutrophils - crucial in the early stages of inflammation.

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Monocytes & Macrophages

Monocytes mature into macrophages, which are phagocytic cells.

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Opsonisation

Coating a particle to enhance phagocytosis.

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Proteolytic Enzymes

Enzymes released by neutrophils and macrophages which can break down tissue components.

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Chemical Mediator

A chemical messenger that induces an inflammatory response.

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Cytokines

Chemical messenger proteins produced by immune and other cells.

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Osteoblasts

Bone-forming cells that also regulate immune and inflammatory responses.

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Interleukins (IL-1, IL-6, IL-8)

Small proteins produced by leukocytes and other cells; regulate immune cell activity and neutrophil recruitment.

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Tumor Necrosis Factor (TNF)

Cytokine produced by macrophages; induces fever and mediates immune responses.

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Histamine

Vasoactive amine released from mast cells; causes dilation of arterioles and increased permeability.

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Prostaglandins

Lipid compounds produced by cells; involved in inflammation, causing vasodilation, fever, and pain.

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Leukotrienes

Produced by leukocytes. Act as chemotactic agents for neutrophils, cause vasoconstriction, and release lysosomal enzymes.

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Chemokines

Small proteins that attract specific types of leukocytes, enhancing chemotaxis.

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Inflammation Mediators

Chemical mediators like histamine, prostaglandins, and leukotrienes.

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Study Notes

  • Intended learning outcomes include being able to describe the classical signs of acute inflammation, explain the significance of cellular and fluid exudate formation, discuss ways inflammation can be generated, explain phagocytosis and bacterial killing, and to recognize effects and action of chemical mediators

Inflammation Overview

  • Inflammation can be both a friend and foe
  • It's relevant to dentistry

Defining Inflammation

  • Local response of tissue to injury
  • Stimuli for inflammation can be microbial, immunological, physical or caused by chemical agents

Types of Inflammation

  • Acute inflammation
  • Chronic inflammation

Acute vs. Chronic Inflammation

  • Acute onset is fast, chronic onset is slow
  • Acute cellular infiltrate is mainly neutrophils, chronic involves monocytes, macrophages, and lymphocytes
  • Acute tissue injury is mild and self-limited
  • Acute inflammation has prominent local and systemic factors
  • Cardinal signs present in acute inflammation, absent in chronic
  • Acute stimulus short, chronic stimulus long acting
  • Acute response clears stimulus, chronic response involves fibrosis and angiogenesis

Causes

  • Infections can cause inflammation via bacteria, viruses, fungi and parasites
  • Tissue necrosis from physical/chemical injuries and heart attacks
  • Trauma can cause inflammation
  • Foreign bodies like splinters, sutures, bones and fingernails lead to an inflammatory response
  • Immune hypersensitivity reactions, triggered by environmental factors or autoimmune diseases cause inflammation

Cardinal Signs of Inflammation

  • Rubor (redness)
  • Calor (heat)
  • Tumor(swelling)
  • Dolor (pain)
  • Loss of function

Vascular Events

  • Persistent vasodilation
  • There is an elevation of hydrostatic pressure
  • Increase in vascular permeability
  • Transudation of fluid into extracellular space
  • Slowing or stasis of microcirculation.

Causes of Increased Vascular Permeability

  • Endothelial cell contraction
  • Endothelial injury may be direct or leukocyte induced
  • Increased transcytosis fluid
  • Leakage from new blood vessels

Cellular Events

  • Leukocyte recruitment (chemotaxis)
  • Phagocytosis of particles

Phagocytosis

  • Two types of phagocytic cells exist
  • Polymorphonuclear leukocytes (PMNs) are part of the early inflammatory response
  • Monocytes and macrophages
  • Opsonization is a marker by which neutrophils and macrophages release proteolytic enzymes

Patterns of Inflammation

  • Serous
  • Fibrinous
  • Suppurative (purulent)
  • Ulcerative

Chemical Mediators

  • These are chemical messengers act on blood vessels, inflammatory cells to cause an inflammatory response
  • Can be exogenous or endogenous
  • Exogenous mediators are endotoxins
  • Endogenous mediators can originate from plasma, leukocytes, endothelial cells, or fibroblasts

Cytokines

  • These are chemical proteins produced by many cells e.g. PMN's, macrophages, B lymphocytes, epithelial cells, gingival fibroblasts and osteoblasts
  • Mediate & regulate immune & inflammatory reactions
  • Interleukins are pro-inflammatory & anti-inflammatory compounds, such as IL-1, IL-6 & IL-8

Histamine

  • Vasoactive amine produced by mast cells
  • Acts on blood vessels
  • Cause dilation of arterioles & increased permeability

Prostaglandins

  • Produced by mast cells, macrophages & endothelial cells
  • These are lipid compounds
  • Involved in vascular & systemic inflammation, cause vasodilation, fever and pain

Leukotrienes

  • Produced by leucocytes and mast cells through lipoxygenase action
  • Act as chemotactic agents for neutrophils
  • Usually accompanied by histamine & prostaglandins
  • Releases lysosomal enzymes
  • Cause vasoconstriction

Chemokines

  • Family of small proteins act as chemo-attractants for leukocytes and enhance chemotaxis

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