What is chronic inflammation?
Inflammation in which the cell population is especially:
What does chronic inflammation feature?
Tissue or organ damage
Loss of function
Healing and repair involving granulation tissue and scarring
What may chronic inflammation arise from?
What are the clinical presentations of chronic inflammation?
No specific 'sore bit'
Loss of function
When does chronic inflammation ocur after acute inflammation?
When there are large volumes of damage
Inability to remove debris
What is the mechanism of granulation tissue?
1) Capillaries grow into inflammatory mass
2) Access of plasma proteins
3) Macrophages travel in from blood and tissue
4) Fibroblasts lay down collagen to repair damaged tissue
5) Collagen replaces inflammatory exudate
6) Contracts and pulls together
What are the outcomes of granulation tissue?
Fibrous tissue (scar)
Fibrosis can cause adhesion between loops of bowel which is a problem
Can progess to chronic inflammation
What may primary chronic inflammation arise due to?
Lymphocytes, plasma cells, macrophages, fibrosis
Material resistant to digestion
What are examples of autoimmune diseases that can cause primary chronic inflammation?
What are autoimmune diseases?
Where antibodies are directed against out owen cell and tissue components, leading to damage or destruction of organs
What are some materials resistant to digestion?
Mycobacteria and viruses who's cell walls are resistant to enzymes
What are some exogenous substances?
Sultures, metal and plastic such as joint replacements or glass
What do exogenous substances not provoke?
What are some endogenous substances?
What can not easily be done to endogenous substances?
They cannot easily be phagacytosed
What are cells involved in chronic inflammation?
What are plasma cells and what do they do?
They are differentiated B cells that produce antibodies
What are the tissue components of chronic inflammation?
What are different B cell mechanisms?
Differentiate into plasma cells and produce antibodies
Facilitate immune response
Act with macrophages (antigen presenting capacity)
What are different T cell mechanisms?
Damage and kill other cells, destroy antigens using granule proteins
What do cytokines released from T cells do?
Attract and hold macrophages
Activates other cells such as lymphocytes
Changes vessel permeability
What do interferons do?
Attract and stimulate other cells
What do natural killer cells do?
Destroy antigens and cells by using granule proteins
What immune system are natural killer cells apart of?
Innate immune system, non-specific
What are mechanisms of macrophages?
Antigen presenting cell for immune system
What are macrophages formed from?
What does the life cycle of macrophages involve?
What are fibroblasts?
Motile cells that make and assemble structural proteins such as different collagens
What are the outcomes of chronic inflammation?
Ongoing tissue damage and destruction
Insidious loss of function
Cellular and stromal response (granulation tissue and angiogenesis)
Scarring and fibrosis
Granuloma formation (mass of granulation tissue)
What is an adverse effect of scaring?
It can lead to loss of cuntion due to not being able to be stretched