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Systemic effects of acute inflammation and granuloma


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Systemic effects of acute inflammation and granuloma

  2. 2.  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.
  3. 3.  Reaction of a tissue & its microcirculation to a pathogenic insult.  A complex reaction in vascularized connective tissue.  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.
  4. 4. • HeatCALOR • RednessRUBOR • SwellingTUMOR • PainDOLAR • Loss Of FunctionFUNCTIO LAESA
  5. 5.  They are collectively called the acute-phase reaction, or the systemic inflammatory response syndrome.  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.
  6. 6.  temperature > 37.8oC or >100 F  Increased pulse & blood pressure  Chills  Anorexia
  7. 7. Neutrophilia: Increased number of neutrophils, indicating bacterial infection. Lymphocytosis: Increased number of lymphocytes, indicating viral infection. Eosinophilia: in allergy or parasitic infection
  8. 8.  Fibrinogen  CRP  SAA leads to increased ESR
  9. 9.  Increased erythrocyte sedimentation rate due to increased production of acute phase proteins and reactants.  In the presence of acute phase reactants (fibrinogen) erythrocytes aggregate due to loss of their negative charge resulting in increased sedimentation.
  10. 10. Complete resolution Abscess formation (encapsulation and pus) Chronic inflammation Healing with scar formation
  11. 11.  If the condition causing acute inflammation is not resolved, the inflammation may pass to a longer term chronic phase.  Chronic inflammation is from days to years.  Mainly macrophages and lymphocytes are present.  Proliferation of blood vessels, fibrosis and necrosis takes place.
  12. 12.  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.
  13. 13.  A granuloma is a microscopic aggregation of macrophages that are transformed into epithelium-like cells(epitheloid cells) surrounded by a collar of mononuclear leukocytes.  Principally lymphocytes and occasionally plasma cells are present.  Fibrous connective tissue often surrounds granulomas.
  14. 14.  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 cell.  These giant cells can be found either at the periphery or the center of the granuloma.
  15. 15. 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
  16. 16. Foreign Body Granuloma Form when material such as talc, sutures, or other fibers are large enough to preclude phagocytosis by a single macrophage. Immune Granuloma 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.
  17. 17. 1. Bacteria Tuberculosis Leprosy 2. Parasites Schistosomiasis 3. Fungi Histoplasmosis Blastomycosis 4.Metal/Dust Berylliosis Silicosis