Chronic Inflammation PDF

CHRONIC INFLAMMATION BY DR.MUHAMMAD ALI SOOMRO  WHAT IS CHRONIC INFLAMMATION? Occurs owing to persistent or recurrent inciting stimulus or when the inflammatory reaction is insufficient to completely degrade the agent ( bacteria, tissue debris and foreign b...

CHRONIC INFLAMMATION BY DR.MUHAMMAD ALI SOOMRO  WHAT IS CHRONIC INFLAMMATION? Occurs owing to persistent or recurrent inciting stimulus or when the inflammatory reaction is insufficient to completely degrade the agent ( bacteria, tissue debris and foreign bodies) that incites the inflammatory reaction. Occurs in two major patterns: – CHRONIC NON-SPECIFIC INFLAMMATION. – GRANULAMATOUS INFLAMMATION. WHAT IS CHRONIC INFLAMMATION?  CHRONIC NON-SPECIFIC INFLAMMATION A cellular reaction with predominance of mono-nuclear blast cells- macrophages, lymphocytes and plasma cells- often with proliferation of fibroblasts and new vessels. Scarring and distortion of tissue architecture is characteristic. Monocytes are recruited from circulation by various chemo-tactic factors. CHRONIC NON-SPECIFIC INFLAMMATION  CHRONIC NON-SPECIFIC INFLAMMATION Cytokines derived from monocytes and macrophages deposited activate lymphocytes, which further activate the other monocytes and macrophages. B-Lymphocytes activation by macrophage –presented antigen results in formation of antibody producing plasma cells. CHRONIC NON-SPECIFIC INFLAMMATION  GRANULAMATOUS INFLAMMATION This type of inflammation is characterized by focal accumulation of specialized activated macrophages known as epitheloid cells leading to formation of granulomas. Activation of macrophages by interaction with T Cells is involved. Poorly digested antigen is presented by macrophages to CD4+ GRANULAMATOUS INFLAMMATION  GRANULAMATOUS INFLAMMATION Interaction with the antigen specific T Cell receptor of these cells trigger the cytokine release (interferon-gamma) that mediates transformation of monocytes and macrophages to epitheliod cells and giant cells. Caseous Necrosis is often characterstic ( especially in TB). It occurs due to killing of bacteria engulfed non functional macrophages by T Cells. GRANULAMATOUS INFLAMMATION  GRANULAMATOUS INFLAMMATION Presence of multi-nucleated giant cells are witnessed due to merging of multiple bacterial contaminated macrophages giving specific pattern of the cell. – LANGERHAN’S GIANT CELLS: Nuclei in horse shoe pattern. – FOREIGN BODY GIANT CELLS: Scattered nuclei.  GRANULAMATOUS INFLAMMATION CAUSES: – INFECTIOUS: M.LEPRAE AND M.TUBERCULOSIS. BLASTOMYCES DERMATITIDIS. TREPENOMA PALLIDUM. BARTONELLA HENSELAE. – FOREIGN BODIES – UNKNOWN THANKS THE END!