Chronic Inflammation Pathology PDF

2) Chronic Inflammation Chronic Lerning Objectives: Define Chronic inflammation. List the possible causes. Recognise the common morphological features. Provide various examples of chronic inflammatory diseases. Discuss the key immune cells involved. Recognise and describe granulomatous inflammation....

2) Chronic Inflammation Chronic Lerning Objectives: Define Chronic inflammation. List the possible causes. Recognise the common morphological features. Provide various examples of chronic inflammatory diseases. Discuss the key immune cells involved. Recognise and describe granulomatous inflammation. Describe the systemic effects of inflammation -itis Inflammation effects vascular connective tissue. 4 phases: Dilute Destroy Isolate Initiate rep Acute & Chronic Acute an excess of blood in the vessels supplying an organ or other part of the body. Too much of everything blood flooding the place Scar tissue Chronic Prolonged - inflammation, tissue injury and healing happen simultaneously. Leads to active inflamm, tissue destruction and fibrosis. Macrophages From monocytes. Travel, arrive, change to macrophages. They proliferate and are then immobilised (by cytokines+ oxidised lipids) Tissue macrophages: kupffer cells in liver, microglial cell in brain, alveolar macrophages in lungs. Long life span Macrophages are activated by immune receptors (TLR) and cytokines (IFN-g) secreted by T- Helper cells and NK cells. Also let the leukocytes know there’s bad guys in town Im here 4 you - to help u IL - 10 → Anti Inflamm Granulomatous Inflammation Predominant cell - macrophages. GRANULOMA = Nodular aggregation of Epithelioid macrophages surrounded by a cuff of Lymphocytes Contain Giant cells = Epitheloid cells that fuse (Langhan’s) Have large mass of cytoplasm Have 20 or more small nuclei arranged in the periphery or haphazardly Types of Granulomatous Inflammation Immune granulomas – Caused by insoluble particles GRANULOMA as explained above. Eg TB (Myco tuberc) Leprosy Syphilis Sarcoidosis Crohn’s disease (autoimmune/intestinal bacteria) Foreign Body Granulomas. Epitheloid cells and giant cells are apposed to the surface and encompass the foreign body. The foreign body is usually found in the center of the granuloma. Examples: Talc/Splinter/Suture Metal/Dust – Silicosis Systemic effects of Inflammation: Fever- elevation of body temp by 1-4 °C Elevated conc of acute-phase proteins Leukocytosis (15-20,000cells/µL) Increased pulse and BP, rigors, chills, malaise Sepsis + Septic Shock Bacteremia or sepsis - pathogens gain access to the vascular circulation - Next line of defense -Tissue-resident macrophages must then prevent overwhelming infection - Phagocytic cells of the liver, spleen, and bone marrow Heart valves, meninges, kidneys, and joints are favored sites of implantation for blood-borne organisms Septic shock 1. Systemic vasodilation - tissue hypoperfusion & hemodynamic shock 2. Disseminated Intravascular Coagulation ( DIC) – Multiple Thrombi in circulation & Fibrin split products. 3. Metabolic abnormalities-insulin resistance and hyperglycemia Multi Organ Failure – Mainly Lung (ARDS), Liver, Kidney & Bowel