Chronic Inflammation

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Chronic Inflammation

• Dr. Raid Jastania

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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)

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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.

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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)

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Cellular Events in Chronic Inflammation

• Lymphocytes and Plasma cells
• Other cells
• Mast cells
• Eosinophils

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Granulomatous Inflammation

• Collection of activated macrophages with or
  without giant cells
• Rimmed by lymphocytes
• May be surrounded by fibrosis

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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

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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.)

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Lymphatic and Lymph Nodes
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What are the Causes of Acute Inflammation? And,
What are the Causes of Chronic Inflammation?
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