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Chronic Inflammation. Dr. Raid Jastania. Chronic Inflammation:. Chronic inflammation is a prolonged inflammation with continuous: Cell injury Active inflammation Ongoing healing (repair) process It is characterized by: Mononulcear cells (lymphocytes, macrophages, plasma cells)
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Chronic Inflammation Dr. Raid Jastania
Chronic Inflammation: • Chronic inflammation is a prolonged inflammation with continuous: • Cell injury • Active inflammation • Ongoing healing (repair) process • It is characterized by: • Mononulcear cells (lymphocytes, macrophages, plasma cells) • Tissue destruction • Repair process (including new vessel formation and fibrosis)
Cellular Events in Chronic Inflammation: • Monocyte – histiocyte – macrophage – giant mutincleated cell • Tissue macrophages: eg. Kupffer cell in liver, alveolar macrophage in lung… • Macrophage is responsible for: • Mononuclear phagocytic system, and hence • Alert the Immune system.
Cellular Events in Chronic Inflammation: • Macrophages also produce: • Acid and neutral proteases to break down extracellular components • Complement components and coagulation factors. • Oxygen-free radicals and NO • AA metabolites • Cytokines (eg. IL-1, TNF)
Cellular Events in Chronic Inflammation: • Lymphocytes and Plasma cells: • Other cells: • Mast cells • Eosinophils
Granulomatous Inflammation • Collection of activated macrophages with or without giant cells • Rimmed by lymphocytes • May be surrounded by fibrosis
Granulomatous Inflammation • Granuloma can be divided (morphologically) into Necrotizing granuloma and Non-necrotizing granuloma. • Necrotizing granuloma is seen in infections. • In tuberculosis the granuloma shows central necrosis “Caseating Necrosis”
Granulomatous Inflammation • Causes: • The causes of granuloma can be divided in: • Infectious • mycobacterium (like tuberculosis), and syphilis. • Fungal infections commonly result in granuloma (candida, aspergillous, mucor, histoplasma, blastomycosis….) • Parasitic infections may result in granuloma (Schistosomiasis). • Non-infectious • immune mediated (like sarcoidosis) • foreign body granuloma ( like suture material, pigments….)
What are the Causes of Acute Inflammation? And, What are the Causes of Chronic Inflammation?