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Introduction
1. Persistence of infections by
organisms:
Autoimmunity
Reaction against the body’s own tissues
Results in chronic tissue damage and inflammation
Rheumatoid arthritis.
Types of Chronic Inflammation:
It is characterized by
Macrophages
Lymphocytes
Plasma cells
Dendritic cells
Eosinophils
Those recruited from affected tissues are:
Fibroblasts
In chronic inflammations
macrophages form groups called
granulomas
Granulomatous inflammation is
seen
when an organism is of low
Mycobacterium tuberculosis
Mycobacterium leprae
Fungus
Virus
Parasite
Granuloma
It involves activation of macrophages by
interactions with T lymphocytes. Poorly
digestible antigen is presented by macrophages
to CD4+ lymphocytes. Interaction with the
antigen-specific T cells receptor of these cells
triggers the release of cytokines(especially
interferon gamma) which mediate the
transformation of monocytes and macrophages
to epithelioid cells and giant cells.
Langhans Giant Cell
Granuloma
Lymphocytic Rim
e c rosis
se ous N
Ca
Epithelioid Macrophage
Granulomatous inflammation
lymphocytes
A granuloma in TB is called a
tubercle
A tubercle is composed of
activated macrophages with
surrounding lymphocytes
and fibroblasts
In TB the granulomas
undergo caseation necrosis
and heal by fibrosis when the
immunity is good
Caseating granulomas are seen commonly in TB
giant cells
Area of caseation
necrosis
Granulomatous inflammation can be a tissue
response to some foreign materials
Noncaseating granuloma in
Granuloma healing by fibrosis Sarcoidosis
Miliary TB
Pulmonary dissemination
Miliary tuberculosis, Spleen
Secondary tuberculosis
Allah Hafiz