Chronic inflammation GPPE

Chronic inflammation

• Prolonged duration (weeks/months)

• Coexist with repair

• Pattern:

1. Chronic nonspecific inflammation

2. Granulomatous inflammation

Characteristics (Histological) features

• Infiltration with MONONUCLEAR CELLS; macrophages, lymphocytes & plasma cells

• Tissue destruction; persistent offending agent/inflammatory cells

• Attempt healing by connective tissue replacement of damage tissue by proliferation of small blood vessels (angiogenesis) & fibrosis

Causes of chronic inflammation

Primary chronic inflammation

• Inflammatory response has all Histological features of chronic inflammation from onset& no initial phase of acute Inflammation

Progression from acute Inflammation

• Acute Inflammation progress to chronic inflammation is supportive type

• Osteomyelitis (abscess in bone marrow cavity)

Recurrent episodes of acute inflammation

• Recurrent cycle of acute inflammation & healing

• Chronic cholecystitis with gall stones

Pattern of chronic inflammation

• Chronic nonspecific inflammation

• Granulomatous inflammation

Chronic nonspecific inflammation

Characteristics:

• Cellular reaction with preponderance of mononuclear cells(macrophages, lymphocytes and plasma cells)

• Proliferation of fibroblast & new vessels

• Scaring & distortion of tissue

Cytokines derived from monocytes-macrophages active lymphocytes

Lymphocyte activation by macrophage : presented antigen results in formation of antibody by producing plasma cells

Granulomatous inflammation

• Characteristics by granulomas: nodular collection of specialized macrophages (Epithelioid cells) & granulomas are usually surrounded by rim of lymphocytes

• Caseous necrosis is often Characteristics (tuberculosis), resulting from killing of mycobacteria-laden macrophages by T lymphocytes & possibly by cytokines/sensitive macrophages

• Langhans giant cell: has nuclei arranged in horse-shaped pattern

• Tuberculosis

Conclusion