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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
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.
• HeatCALOR
• RednessRUBOR
• SwellingTUMOR
• PainDOLAR
• Loss Of FunctionFUNCTIO LAESA
 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.
 temperature > 37.8oC or >100 F
 Increased pulse & blood pressure
 Chills
 Anorexia
Neutrophilia: Increased number of
neutrophils, indicating bacterial infection.
Lymphocytosis: Increased number of
lymphocytes, indicating viral infection.
Eosinophilia: in allergy or parasitic
infection
 Fibrinogen
 CRP
 SAA leads to increased ESR
 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.
Complete resolution
Abscess formation
(encapsulation and pus)
Chronic inflammation
Healing with scar
formation
 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.
 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
leukocytes.
 Principally lymphocytes and occasionally
plasma cells are present.
 Fibrous connective tissue often surrounds
granulomas.
 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.
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
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.
1. Bacteria
Tuberculosis
Leprosy
2. Parasites
Schistosomiasis
3. Fungi
Histoplasmosis
Blastomycosis
4.Metal/Dust
Berylliosis
Silicosis
Systemic effects of acute inflammation and granuloma
Systemic effects of acute inflammation and granuloma
Systemic effects of acute inflammation and granuloma
Systemic effects of acute inflammation and granuloma
Systemic effects of acute inflammation and granuloma
Systemic effects of acute inflammation and granuloma

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Systemic effects of acute inflammation and granuloma

  • 1.
  • 3.  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.
  • 4.
  • 5.  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.
  • 6. • HeatCALOR • RednessRUBOR • SwellingTUMOR • PainDOLAR • Loss Of FunctionFUNCTIO LAESA
  • 7.
  • 8.
  • 9.  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.
  • 10.  temperature > 37.8oC or >100 F  Increased pulse & blood pressure  Chills  Anorexia
  • 11. Neutrophilia: Increased number of neutrophils, indicating bacterial infection. Lymphocytosis: Increased number of lymphocytes, indicating viral infection. Eosinophilia: in allergy or parasitic infection
  • 12.  Fibrinogen  CRP  SAA leads to increased ESR
  • 13.  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.
  • 14. Complete resolution Abscess formation (encapsulation and pus) Chronic inflammation Healing with scar formation
  • 15.
  • 16.
  • 17.  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.
  • 18.
  • 19.  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.
  • 20.
  • 21.  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.
  • 22.  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.
  • 23.
  • 24. 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
  • 25.
  • 26.
  • 27. 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.
  • 28.
  • 29. 1. Bacteria Tuberculosis Leprosy 2. Parasites Schistosomiasis 3. Fungi Histoplasmosis Blastomycosis 4.Metal/Dust Berylliosis Silicosis