Systemic effects of acute inflammation and granuloma
BY: MASOOMA SHAHZADI
Inflammation is a protective tissue response
to injury or destruction of tissues, which
serves to destroy, dilute, or wall off both the
injurious agent and the injured tissues.
Reaction of a tissue & its microcirculation to a
A complex reaction in vascularized
Characterized by movement of fluid and
neutrophils from blood into extra vascular
tissues by generation of chemical mediators.
It occurs over seconds, minutes, hours, and
days, of the tissue injury and end when the
injurious stimulus has been removed.
• Loss Of FunctionFUNCTIO LAESA
They are collectively called the acute-phase
reaction, or the systemic inflammatory
The cytokines produced by leukocytes TNF,
IL-1, and IL-6 are the most important
mediators, leading to systemic effects.
IL-6 stimulates the hepatic synthesis of a
number of plasma proteins.
temperature > 37.8oC or >100 F
Increased pulse & blood pressure
Neutrophilia: Increased number of
neutrophils, indicating bacterial infection.
Lymphocytosis: Increased number of
lymphocytes, indicating viral infection.
Eosinophilia: in allergy or parasitic
SAA leads to increased ESR
sedimentation rate due to
increased production of acute
phase proteins and reactants.
In the presence of acute phase
erythrocytes aggregate due to
loss of their negative charge
resulting in increased
(encapsulation and pus)
Healing with scar
If the condition causing acute
inflammation is not resolved, the
inflammation may pass to a longer
term chronic phase.
Chronic inflammation is from days
Mainly macrophages and
lymphocytes are present.
Proliferation of blood vessels,
fibrosis and necrosis takes place.
Granulomatous inflammation is a distinctive
pattern of chronic inflammatory reaction.
It is a protective response to chronic infection
or foreign material, preventing dissemination
and restricting inflammation.
Some autoimmune diseases such as
rheumatoid arthritis and Crohns disease are
also associated with granulomas.
A granuloma is a microscopic aggregation of
macrophages that are transformed into
epithelium-like cells(epitheloid cells)
surrounded by a collar of mononuclear
Principally lymphocytes and occasionally
plasma cells are present.
Fibrous connective tissue often surrounds
Epithelioid cells fuse to form giant cells
containing 20 or more nuclei.
The nuclei arranged either peripherally (or in
horse shoe shape), called Langhans-type
giant cell or
haphazardly called foreign body-type giant
These giant cells can be found either at the
periphery or the center of the granuloma.
Centrally placed necrosis
Surrounded by epitheliod cells
An outer layer of lymphocytes
Plasma cells may be present
Few Giant cells present
Surrounded by fibrin and connective tissue
Foreign Body Granuloma
Form when material such as talc, sutures,
or other fibers are large enough to
preclude phagocytosis by a single
Caused by insoluble particles that are
capable of inducing a cell-mediated
response. This type of immune response
produces granulomas when the inciting
agent is poorly soluble or particulate.