Week 6 - Chronic Inflammation

Front 1

Describe serous, fibrinous, purulent, and ulcer patterns of inflammation

Back 1

Serous inflammation includes a blister, thin fluid (few proteins), and few inflammatory cells
Fibrinous is rich in proteins, forms a fibrin clot, and induces scarring
Purulent or suppurative has pus
Ulcer is a crater in the epithelia by necrosis

Front 2

Describe serous vs ulcer inflammation histologically

Back 2

Serous is a blister, so you can see space under the epithelium. Ulcer has an actual crater in the epithelia

Front 3

How do neutrophils die once they are done? How are they removed from the ECM?

Back 3

They undergo apoptosis, and have "eat me" signals to get phagocytosed. Macrophages then travel through the lymphatic system to remove them from the ECM

Front 4

IMPORTANT: What is the key cell type involved in chronic inflammation?

Back 4

Macrophages.

Lymphocytes are involved to a lesser degree. Eosinophils sometimes, but rarely neutrophils.

Front 5

What are the processes that occur during chronic inflammation that are ongoing attempts at repair?

Back 5

Fibrosis and angiogenesis

Front 6

What are two general causes of chronic inflammation?

Back 6

The presence of the injurious agent despite acute inflammation (sharp stick is still in you), or sub clinical disease (low level infalmmation over years, such as athersclerosis, pulmonary fibrosis). Sub clinical inflammation is associated with obesity

Front 7

What is a granuloma?

Back 7

A granuloma is a mass of immune cells, mostly macrophages, that may appear as a nodule. This is a hallmark of chronic inflammation. It is associated with IFN-gamma, and IL-12

Front 8

What are less ordered patterns of chronic infalmmation

Back 8

Mononuclear cells and eosinophilic (the latter is associated with IL 4,5,6)

Front 9

What are common diseases associated with chronic inflammation?

Back 9

Infections with persistent microbes (TB)
Autoimmune disorders (rheumatoid arthritis)
Occupational lung disease
Impaired acute inflammation (chronic granulomatous disease)

Front 10

What are some signs of TB?

Back 10

A nodule with a cheesy center, and that contains acid fast bacteria (TB is a mycobacteria)
Positive TB skin test

Front 11

How is chronic inflammation associated with tuberculosis?

Back 11

TB is very resistant to the human immune system. Therefore, chronic inflammation only confines the TB. However, this inflammation can destroy tissue and impair function

Front 12

What do macrophages develop from? Are they long lived or short lived? Are they freely mobile or fixed in tissue?

Back 12

They develop from monocytes. They are long lived. There are both freely mobile macrophage and resident macrophage that reside in specific tissues

Front 13

How does the nucleus change when a non activated monocyte becomes activated? What causes activation? What are macrophages resident in the lungs called?

Back 13

The nucleus of a non activated macrophage is horse shoe shaped, but it loses this feature. It is activated by interferon gamma. The resident lung macrophages are called alveolar macrophages

Front 14

Can macrophages be parasitized?

Back 14

Yes, microbes such as mycobacteria may live inside macrophages and avoid immune recognition

Front 15

What are macrophages role in inflammation besides phagocytosis?

Back 15

They secrete cytokines and chemokines, growth factors, and regulate the immune response

Front 16

What cytokines ado NK cells produce?

Back 16

They produce IFN-gamma

Front 17

What can Th0 cell turn into? How does it do this, and what microbe mediates it? What they ultimately form?

Back 17

Th0 cells can become Th1 via IL-12, which is associated with intracellular bacteria. They go on to form granulomas.
Th0 cels can also become Th2, which is associate dwth Helminths (parasites) and IL-4. Th2 cells are then associated with eosinophils

Front 18

What does caseating granuloma look like histologically?

Back 18

It has a necrotic central area (different color, more pink sometimes). This is probably not nucleated

Front 19

What does noncaseating granuloma look like histologically?

Back 19

It looks like a cicle of cels, surrounding abnormal cells. They DO have nucleated cells in the middle

Front 20

What do eosinophils look like in histo? What repair process are they associated with?

Back 20

They look pink granuled cells with dark blue nucei. They are associated with fibrosis

Front 21

What is the main function of eosinophils?

Back 21

Their main function is allergic and anti parasitic

Front 22

How do eosinophils kill parasites?

Back 22

Respiratory burst and granule proteins

Front 23

How does the adaptive immune system educate the innate immune system, in regard to eosinophils.

Back 23

Eosinophils accompany the IgE-mediated response. Without the IgE, you wouldn't have the eosinophils, so the adaptive is educating the innate

Front 24

Important: Chronic inflammation is associated with persistent injury. What type of cell is it associated with mostly? How does it do walling off? What processes do repair?

Back 24

It is associated with macrophages. They wall off by forming granulomas, and they do ongoing repair by fibrosis and angiogenesis

Front 25

What is the best way to treat chronic inflammation?

Back 25

Establish the cause and remove it

Front 26

TNFalpha is associated with an autoimmune disease. What was found to happen when scientists blocked TNF alpha? What does this indicate about TNFalphas role and that of chronic inflammation?

Back 26

When TNFalpha was blocked, patients developed tuberculosis. The chronic inflammation seemed to be containing the TB infection, and without it, the TB spread