Chronic Inflammation PDF

chronic inflammation chronic inflammation prolonged duration (weeks or months) inflammation and tissue destruction, healing and repair proceeds at the same time causes of chronic inflammation following on acute inflammation persistence of inciting stimulus inter...

chronic inflammation chronic inflammation prolonged duration (weeks or months) inflammation and tissue destruction, healing and repair proceeds at the same time causes of chronic inflammation following on acute inflammation persistence of inciting stimulus interference of normal healing process repeated bouts of acyte inflamation examples of chronic inflammation unresolved aculte inflammation (chronic suppurative inflammation) chronic osteomyelitis chronic abcess repeated episodes of acute inflammation chronic pyelonephritis (pelvic helical system, collecting duct, repeated UTIs)  chronic cholecytitis distinct process drom the outset brief and minimal acute phase low grade smoldering response chronic inflammation important in pathogenesis of disease non conventionally thought of as inflammatory disorders alzheimer's disease metabolic syndrome T2 diabetes mellitus certain cancers histological hallmarks of chronic inflammation mononuclear inflammatory cell infiltrate macrophages recruitment from circulating monocytes transformation into macrophages  activation of macrophages local proliferation and immobilization of macrophages lymphocytes recruited in anti-body mediated immune reactions cell-mediated immune reactions  plasma cells - synthesis of immunoglobulin CLOCK FACED NUCLEUS, eccentric nuclei, cytoplasm is bluish pink other cells in chronic inflammation eosinophils - abundant in immune reations mediated by IgE and in parasitic infections mast cells - response in allergic reactions neutrophils - induced by persistent microbes or by mediatorrs produced by activated macrophages and T lymphocytes granulation tissue in growth of vascular tissue from surrounding connective tissue contains thin walled capillaries, fibroblasts and inflammatory cells tissue destruction and fibrosis (the replacement of functional tissue architecture with excess fibrous connective tissue) tissue destruction is one of the hallmarks of chronic inflammation fibrosis and scarring, e.g valvular stenosis, narrowing of hollow organs adhesions, e.g serous cavities, joint deformity  regeneration regen of destroyed tissue (e.g epithelial overgrowth or invagination) endarteritis oblietrans (narrowing of small artery lumen ) general effect of chronic inflammation fever, acute-phase proteins leukocytosis hyperplasia of lymphoid system immune response w antibody production reactive systemic amyloidosis w formation fo AA protein granulomatous inflammation distinctive pattern of chronic inflammation predominant cell type is activated macrophages showing epithelial like (epitheloid) arrangement CLUSTER MAKES GRANULOMA!!! granuloma collection of modified macrophages may be surrounded by rim of lymphocytes central necrosis may be present tyoes foreign body granuloma incited by inert foreign bodies e.g talc (clover shaped) , sutures, lipid/cholesterol (paraffin gets dissolved, crystal shaped), collagen immunologic granuloma incited by insoluble particles capable of inducting cell mediated immune response infective e.g TB, leprosy, fungal, parasite ova tumors (seminoma) tuberculosis tubercle - aggregate of epitheloid cells and langhan's multinucleated giant cells caseous necrosis - big cavities, lots of tissue destruction acid fast bacilli - rods cell mediated hypersensitivity (type IV) primary TB - infection of individual lacking prev contact w tubercle bacilli secondary TB or post-primary TB arises in prev sensitized individuals most cases represent reactivation of asymptomatic primary disease calcification of apexes of lungs miliary TB when mycobacterium gains access to lymphatic and blod to send distant organs multinucleated giant cells langhans giant cells foreign body giant cells touton giant cells