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Chronic_inflammation pathology presentation .ppt
- 1. Chronic Inflammation Chronic Inflammation Dr.Changkel Banak Dr. Changkel Banak General Pathology
- 2. Definition Definition Inflammation of Inflammation ofprolonged prolonged duration duration in which active inflammation, tissue in which active inflammation, tissue destruction destruction and and repair repair go hand in hand. go hand in hand.
- 3. Causes of chronic Causesof chronic inflammation inflammation Acute inflammation Acute inflammation: : – Progressive: osteomyelitis Progressive: osteomyelitis – Recurrent: cholycystitis, gastritis. Recurrent: cholycystitis, gastritis. Primary: (abinitio Primary: (abinitio) ) – TB, fungal inf. TB, fungal inf. – HSR. HSR. Persistent factor Persistent factor : foreign bodies : foreign bodies Autoimmunity: Autoimmunity:
- 4. Mechanism of chronicinf Mechanism of chronic inf Macrophages Cytokines Free radicals Enzymes NO TGF-B FGE GCSF Tissue dam age + EGF Angiogenesis Fibrosis Granulation tissue Healing Activation TH
- 5. Role Role of of Macrophages Macrophages Events of macrophages:- Events of macrophages:- – Chemotaxis: C5a,(PDGF), TGF- Chemotaxis: C5a,(PDGF), TGF-β β. . – Local proliferation. Local proliferation. – Immobilization :by Macrophage Inhibitory Immobilization :by Macrophage Inhibitory Factor and oxidized lipids Factor and oxidized lipids Activated by:- Activated by:- – Immune Immune: IFN- : IFN-γ γ secreted by T secreted by T lymphocytes lymphocytes – Non-immune Non-immune: Endotoxin, fibronectin, : Endotoxin, fibronectin, chemical mediators. chemical mediators.
- 6. Role Role of of Macrophages Macrophages Functions: Functions: –Phagocytosis. Phagocytosis. –Microbial killing. Microbial killing. –Cytokines production. Cytokines production. –Antigen presentation Antigen presentation
- 7. Mononuclear Phagocyte Mononuclear Phagocyte System System - - Circulatingblood monocytes Circulating blood monocytes - - Tissue macrophage Tissue macrophage 1 1 - - Kupffer cells (liver) Kupffer cells (liver) 2 2 - - Sinus Histiocytes (spleen) Sinus Histiocytes (spleen) 3 3 - - Microglia (CNS) Microglia (CNS) 4 4 - - Alveolar Macrophages (lung) Alveolar Macrophages (lung)
- 8. Products secreted byactivated Products secreted by activated macrophages macrophages Neutral proteases Neutral proteases Elastase Elastase Collagenase Collagenase Plasminogen activator Plasminogen activator Acid hydrolases Acid hydrolases Phosphatases Phosphatases Lipases Lipases Plasma proteins Plasma proteins
- 9. Products secreted byactivated Products secreted by activated macrophages macrophages Complement components Complement components Coagulation factors Coagulation factors Reactive oxygen metabolites Reactive oxygen metabolites Eicosanoids Eicosanoids IL-1, TNF-IL-8 IL-1, TNF-IL-8 PDGF, EGF, FGF, TGF- PDGF, EGF, FGF, TGF-β β Nitric oxide Nitric oxide
- 10. Histological features Histological features Mononuclear cells Mononuclear cells: : –Macrophages Macrophages –Lymphocytes/plasma cells Lymphocytes/plasma cells –Fibroblasts Fibroblasts Tissue destruction Tissue destruction. . Evidence of repair Evidence of repair: : Granulation Granulation tissue and tissue and fibrosis fibrosis
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- 12. Morphological patterns of Morphologicalpatterns of chronic inflammation chronic inflammation : : 1 1 . . chronic suppurative inflammation chronic suppurative inflammation . . 2 2 . . chronic granulomatous chronic granulomatous inflammation inflammation : : A. caseous granulomatous A. caseous granulomatous inflammation (TB) inflammation (TB) B. non – caseous granulomatous B. non – caseous granulomatous inflammation, sarcoidosis, leprosy inflammation, sarcoidosis, leprosy . .
- 13. Types of chronicinf Types of chronic inf . . Non specific. Non specific. Specific: Specific: – Granulomatous. Granulomatous. – Chronic ulcers. Chronic ulcers. – Thickening of wall: Gall bladder. Thickening of wall: Gall bladder. – Sinuses and fistula Sinuses and fistula
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- 15. Granulomatous inflammation Granulomatous inflammation Granuloma: Granuloma: collectionof collection of macrophage macrophage/ / epithelioid epithelioid cells & cells & giant cells giant cells ; ; surrounded by l surrounded by lymphocytes ymphocytes and and plasma cells plasma cells with f with fibroblasts ibroblasts and and collagen. collagen.
- 16. Granulomatous Inflammation Granulomatous Inflammation - - Aggregationsof macrophages having Aggregations of macrophages having an enlarged, squamous cell-like an enlarged, squamous cell-like appearance (called epithelioid appearance (called epithelioid macrophages) macrophages) - - Granuloma = Nodular collection of Granuloma = Nodular collection of epithelioid macrophages surrounded epithelioid macrophages surrounded by a rim of lymphocytes by a rim of lymphocytes
- 17. Mechanism of granuloma Mechanismof granuloma PMN failure macro fuse PMN failure macro fuse epithelioid cell giant cells inf epithelioid cell giant cells inf mediators chemotaxis other cells mediators chemotaxis other cells
- 18. Morphology of granuloma Morphologyof granuloma Granuloma Langhans Foreign body
- 19. Examples of granulomas Examplesof granulomas Tuberculosis Tuberculosis Syphilis Syphilis Sarcoid Sarcoid Tuberculoid leprosy Tuberculoid leprosy Aspergillus granuloma. Aspergillus granuloma. Foreign body granulomas Foreign body granulomas Schistosomiasis Schistosomiasis
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