2. Inflammation:
Definition:
Inflammation is a protective response intended to remove
injurious stimuli as well as the necrotic cells and tissues
resulting from original insert.
5. PLAYERS OF INFLAMMATION:
CIRCULATING CIRCULATING
CELLS PROTEINS
The inflammatory
responses have
many players.
They include
EXTRA
VASCULAR CELLULAR
WALL CELLS MATRIX
6. PLAYERS OF INFLAMMATION:
1. CIRCULATING CELLS:
Bone marrow derived polymorph nuclear leukocytes e.g.,
Basophils, Esinophils and Neutrophils.
Lymphocytes
Monocytes
Platelets.
9. PLAYERS OF INFLAMMATION:
4. EXTRA CELLULAR MATRIX:
Fibrous structural proteins e.g., Elastin & Fibrinogen
Gel-forming proteoglycans
Adhesive glycoprotein e.g., Fibronectin, that are cell-
ECM and ECM-ECM connectors.
10. PROCESS OF INFLAMMATION:
Inflammatory Chemical
stimulus mediators
When the inflammatory Inflammatory response
stimulus is removed these (until
mediators are then injurious stimulus is
dissipated, catabolized or removed)
removed.
12. CHRONIC INFLAMMATION:
Chronic inflammation is the inflammation with
prolonged duration usually from weeks to months
and sometimes to years in which active
inflammation, tissue injury and healing process
proceed simultaneously.
14. ORIGIN AND PROCESS:
Chronic inflammation arises from acute inflammation.
This transition takes place if the acute responses
cannot be resolved either because of the
persistence e.g., of injurious stimuli or by
interference of the normal healing process e.g.,
peptic ulcer.
Some types of injuries engender responses with chronic
inflammation initially e.g., viral infections.
17. CHRONIC INFLAMMATORY CELLS & MEDIATORS:
1) MACROPHAGES:
Macrophages are white blood cells within tissues, produced by
the division of monocytes.
A majority of macrophages are stationed at strategic points
where microbial invasion or accumulation of dust is likely to
occur. Each type of macrophage, determined by its location,
has a specific name:
In liver Kupffer cells
Spleen and lymph nodes Sinus histocytes
Nervous system Microglial cells
Lungs Alveolar macrophages
18. During chronic inflammation macrophages serve to eliminate injurious agents and
initiate repair- however, they are as well responsible for much of the tissue injury
that occurs
Tissue macrophage
Activated T cell or NK cell
Non Immune activation: IFN-g
Endotoxins,
fibronectin,
chemical mediators
Activated macrophage
Fibrosis (Scaring)
Growth factors involved
in fibroblast proliferation
(PDGF,TGFb,FGF)
Tissue injury Angiogenesis factors
Toxic oxygen metabolites (FGF,VEGF)
Metallo-proteases Collagen deposition
Coagulation factors (IL-13 and TGFb)
AA metabolites and NO
19. CHRONIC INFLAMMATORY CELLS & MEDIATORS:
FUNCTIONS OF MACROPHAGES:
They help to:
Filter the particulate matter
Kill microbes
Alert immune system of the body.
Their life is 1-2 days.
20. CHRONIC INFLAMMATORY CELLS & MEDIATORS:
ACTIVATION OF MACROPHAGES:
Activation of macrophages means:
Increase in size
Increase in lysosomal content
Increase in metabolism
Increase in microbial killing activity
21. CHRONIC INFLAMMATORY CELLS & MEDIATORS:
ACTIVATION SIGNALS:
Different signals required to activate macrophages are:
Cytokines produced by T-lymphocytes
Bacterial endotoxins
Different mediators produced during acute inflammation
Extra cellular matrix proteins e.g., Fibrinogen
When macrophages become activated they produce different
type of biologically active substances that either cause one of
Cell injury
Fibrosis.
24. CHRONIC INFLAMMATORY CELLS & MEDIATORS:
2) LYMPHOCYTES:
Both T- & B-lymphocytes are involved in chronic
inflammation. Their migration is brought about by
specific adhesion molecules and cytokines. The T-
lymphocytes work in reciprocal with B-lymphocytes
in chronic inflammation. The already activated
macrophages release TNF & IL1 and activate the
inactive lymphocytes which then produce different
antibodies that cause destruction of antigens at the
inflammatory site.
25. CHRONIC INFLAMMATORY CELLS & MEDIATORS:
3) ESINOPHILS:
They are usually found in parasitic infections and IgE
mediated allergic reactions. Their migration is
brought about by adhesion molecules produced by
leukocytes and epithelial cells. Esinophils specific
granules contain Major Basic Proteins which is
highly cationic &toxic for parasites.
26. CHRONIC INFLAMMATORY CELLS & MEDIATORS:
4) MAST CELLS:
Mast cells are tissue cells which are like basophils in
shape. They are present in bone marrow and
around blood vessels and do not enter the blood.
They are specifically armed with IgE antibodies
against certain antigens. When these antigens are
encountered, they release histamines and amino
acid metabolites. They cause initial vascular changes
in acute inflammation and also cause anaphylactic
reactions.
28. TYPES OF CHRONIC INFLAMMATION:
1) AGRANULOMATOUS:
Granuloma is not formed,
Inflammation is characterized by all features of chronic
inflammation.
Examples:
Chronic viral infections e.g., Hepatitis
Chronic autoimmune diseases e.g., Rheumatoid arthritis
and Ulcerative colitis
Chronic chemical intoxication e.g., Chronic alcoholic liver
disease
Allergic reactions e.g., Bronchial asthma
29. TYPES OF CHRONIC INFLAMMATION:
2) GRANULOMATOUS INFLAMMATION:
Characterized by aggregates of activated macrophages
that assume a squamous cell like epithelloid
appearance.
GRANULOMA is defined as aggregates of macrophages
formed due persistant response of T-lymphocytes to
particular antigens.
This has a granular cheesy appearance called as
caseous necrosis.
