Download Differences Between Acute and Chronic Inflammation

Differences Between Acute and Chronic Inflammation
Acute Inflammation
Chronic Inflammation
Features
Onset
Duration of Course
Specificity
Cardinal Signs
Causative Agents
Rapid onset
Short (Days)
Non-specific
 Pain (Dolor)
 Heat (Calor)
 Redness (Rubor)
 Swelling (Tumor)
 Loss of Function (Functio Leasa)
 Physical and Chemical damages
 Pathogen invasion
 Tissue necrosis
 Immune response
 Neutrophils
 Macrophages
Fundamental Cells
Fluid Exudation and Edema
Fibrosis
Angiogenesis
Systemic Manifestation
Peripheral Blood Changes
Primary Mediators
Present
Absent
Absent
 High grade fever
 Other 5 cardinal signs




Neutrophil Leukocytosis (bacterial infection)
Lymphocytosis (viral infection)
Vasoactive amines
o Serotonin
o Histamine
Eicosanoids
o Prostaglandins
o Thromboxane
Insidious/delayed onset
Long (Weeks to Months)
Specific as it involves Acquired Immunity
Absent in any of cardinal signs



Presistent infection
Presence of foreign bodies
Autoimmunity
Lymphocytes
o T cells
o B cells
 Macrophages
 Fibroblasts
Absent
Present
Present
 Low grade fever
 Loss of weight
 Loss of appetite
 Often absent
 Increase in the level of Antibodies
 Interferon Gamma
 TNF alpha
 Growth Factor
 ROS
 Hydrolyzing enzymes

Features
Pathogenesis
Differences Between Acute and Chronic Inflammation
Acute Inflammation
Chronic Inflammation
1. Increased blood flow
1. Infiltration of Mononuclear Phagocyting Cells
a. Transient vasocontriction upon endothelial
a. Macrophages
injury
i. Circulate as monocytes and reach site of
b. Followed by released of cytokines that
injury within 24 – 48 hrs and transform
promotes vasodilation leads to warmness
ii. Activatd by numerous cytokines from the
and redness of injured area
injured site
2. Increased capillary permeability
b. T and B cells
a. Increased volume of blood passes the
i. Recruited and activated by Antigen
capillar; increasing Endothelial permeability
Presenting Cells like macrophages and
b. IVF moves into ICF, leads to increase
dendritic cells
concentration of RBC’s in the blood vessels
ii. B cells will be become Plasma Cells and
(Margination)
produce Antibodies
c. Stasis of blood leads to Exudation
iii. T cells will produce cytokine to activated
3. Migration of neutrophils
the B cells and also macrophages
a. Rolling of Neutrophils
2. Tissue destructions
b. Adhesion
a. Due to massive production of
c. Diapedesis into injured site
i. ROS
4. Chemotaxis
ii. Hydrolytic enzymes
a. Movements of Neutrophils to the injurous
b. Inflammatory resposnes
agents
3. Tissue repair
5. Leukocytes recruitment and activation
a. Angiogenesis at the injured sites
a. Leukocytosis
b. Formation of Granulomas
i. Foreign body Granuloma
ii. Immune Granuloma
c. Fibrosis
Differences Between Acute and Chronic Inflammation
Types of Inflammation
Gross




Redness
Warmth
Tendor
Swollen
Microscopy



Massive infiltration of
o Neutrophils
o PMN’s
Dilation and
congestion of blood
vessles
Exudation of the
affected area
Acute Inflammation
Ulceration
o Eg
 Chronic peptic
ulcer
 Tropical ulcer of the
foot
 Thickening of the wall of
hollow organ
o Eg
 Crohn’s disease
 Cholecystitis
 Changes in tissue
texture
o Necrosis
o Fibrosis

Chronic Inflammation


Granulomatous Inflammation
o
Can be either

Caseating

Non-caseating
o
Characterized by
accumulation of
Macrophages which
appeared like epithelial
cells (epitheloid)
o
Accumulation of
Lymphocytes
Non-granulomatous
Inflammation
o
Scattered accumulation
of

Lymphocytes

Macrophages

Plasma cells
o
Proliferation of

Fibroblasts

Blood vessels