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Chronic inflammation
Chronic inflammation is inflammation that lasts for weeks or months. It can be caused by persistent infections, immune-mediated diseases, or toxic agents. The key features are infiltration by mononuclear cells like macrophages and lymphocytes, ongoing tissue destruction, and attempts at healing through fibrosis and new blood vessel formation. Activated macrophages play a major role by releasing factors that cause further tissue injury and scar formation. Granulomatous inflammation is a pattern of chronic inflammation seen in some infectious and noninfectious conditions. It involves the formation of granulomas, which are microscopic aggregations of macrophages that form giant cells and are surrounded by lymphocytes in an attempt to contain hard to eliminate agents.
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Chronic inflammation
- 1. Chronic Inflammation M Dr Mohammad Manzoor Mashwani
- 2. Chronic Inflammation Chronic inflammationis inflammation of prolonged duration (weeks or months) in which inflammation, tissue injury, and attempts at repair coexist, in varying combinations.
- 3. CAUSES OF CHRONICINFLAMMATION 1.Persistent Infection 2. Immune-mediated inflammatory diseases 3. Toxic Agents
- 4. Causes of chronicinflammation • Acute inflammation: – Progressive: osteomyelitis – Recurrent: cholycystitis, gastritis. • Primary: (abinitio) abinitio means "from the beginning“ • Contents – TB, fungal inf. – HSR. • Persistent factor : foreign bodies
- 5. Primary Chronic Inflammation Itis the cause of tissue damage in some of the most common and disabling human diseases, such as rheumatoid arthritis, atherosclerosis, tuberculosis, and pulmonary fibrosis. It has also been implicated in the progression of cancer and in diseases once thought to be purely degenerative, such as Alzheimer disease.
- 6. Mechanism of chronicinf Macrophages TH Activation Free TGF-B EGF radicals Enzymes Cytokines FGE + NO GCSF e Fibrosis Angiogenesis s u ge Tis ma da Healing Granulation tissue © Dr.yasir 2oo7
- 7. MORPHOLOGIC FEATURES Chronic inflammationis characterized by: 1. Infiltration with mononuclear cells, which include macrophages, lymphocytes, and plasma cells 2. Tissue destruction, induced by the persistent offending agent or by the inflammatory cells 3. Attempts at healing by connective tissue replacement of damaged tissue, accomplished by proliferation of small blood vessels (angiogenesis) and, in particular, fibrosis.
- 8. A, Chronic inflammationin the lung, showing all three characteristic histologic features: (1) collection of chronic inflammatory cells (*), (2) destruction of parenchyma (normal alveoli are replaced by spaces lined by cuboidal epithelium, arrowheads), and (3) replacement by
- 13. The roles ofactivated macrophages in chronic inflammation. Macrophages are activated by nonimmunologic stimuli such as endotoxin or by cytokines from immune-activated T cells (particularly IFN-γ). The products made by activated macrophages that cause tissue injury and fibrosis are indicated. AA, arachidonic acid; PDGF, platelet-derived growth factor; FGF, fibroblast growth factor; TGFβ, transforming growth factor β.
- 21. GRANULOMATOUS INFLAMMATION Granulomatous inflammationis a distinctive pattern of chronic inflammation that is encountered in a limited number of infectious and some noninfectious conditions. Immune reactions are usually involved in the development of granulomas. A granuloma is a cellular attempt to contain an offending agent that is difficult to eradicate. In this attempt there is often strong activation of T lymphocytes leading to macrophage activation, which can cause injury to normal tissues.
- 23. A granuloma isa focus of chronic inflammation consisting of a microscopic aggregation of macrophages that are transformed into epithelium- like cells, surrounded by a collar of mononuclear leukocytes, principally lymphocytes and occasionally plasma cells.
- 26. Giant Cells Older granulomasdevelop an enclosing rim of fibroblasts and connective tissue. Frequently, epithelioid cells fuse to form giant cells in the periphery or sometimes in the center of granulomas. These giant cells may attain diameters of 40 to 50 μm. They have a large mass of cytoplasm containing 20 or more small nuclei arranged either peripherally (Langhans-type giant cell) or haphazardly (foreign body–type giant cell).
- 27. Types of Granulomas I.Foreign body granulomas II. Immune granulomas
- 28. Foreign body granulomas Incitedby relatively inert foreign bodies. Typically, foreign body granulomas form around material that are large enough to preclude phagocytosis by a single macrophage and do not incite any specific inflammatory or immune response. The foreign material can usually be identified in the center of the granuloma, particularly if viewed with polarized light, in which it appears refractile.
- 29. Immune granulomas Caused byagents that are capable of inducing an immune response which produces granulomas usually when the inciting agent is poorly degradable or particulate.
- 31. Methods of identificationof Specific etiologic agent in Granulomatous diseases 1. Special stains for organisms (e.g., acid-fast stains for tubercle bacilli), 2. Culture methods (e.g., in tuberculosis and fungal diseases), 3. Molecular techniques (e.g., the polymerase chain reaction in tuberculosis), 4. Serologic studies (e.g., in syphilis).