Inflammation & Repair
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Inflammation & Repair. Chronic Inflammation. Chronic Inflammation. Cell Types in Chronic Inflammation. Macrophages Types of Macrophages (fixed) Kupffer cells - liver Pulmonary alveolar macrophages Histiocytes - connective tissue Microglia - brain Osteoclasts - bone Spleen/lymph nodes

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Inflammation & Repair

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Inflammation & Repair


Chronic Inflammation


Chronic Inflammation


Cell Types in Chronic Inflammation

  • Macrophages

  • Types of Macrophages (fixed)

    • Kupffer cells - liver

    • Pulmonary alveolar macrophages

    • Histiocytes - connective tissue

    • Microglia - brain

    • Osteoclasts - bone

    • Spleen/lymph nodes

    • Langerhans cells - epidermis


Other Cell Types

  • Lymphocytes

  • Plasma cells

  • Eosinophils

    • IgE mediated, parasitic infections

  • Mast Cells


Granulomatous Inflammation

  • Granulomatous inflammation

    • focal accumulations of activated macrophages with an epithelial-like (epithelioid) appearance.

  • Granuloma

    • microscopic aggregation of epitheliod macrophages surrounded by a collar of lymphocytes and occasionally plasma cells.


Granulomatous Inflammation - TB


Granulomatous Inflammation - TB


Granulomatous Inflammation - TB


Granulomatous Inflammation - TB


Granulomatous Inflammation - TB


Healing and Repair


Cell Types with Different Regenerative Capacities


Resolution vs Repair


Granulation Tissue

  • Proliferation of new blood vessels and fibroblasts

  • Fibroblasts  myofibroblasts


Granulation Tissue


Granulation Tissue


Wound Healing

  • Primary union (healing by 1st intention)

    • healing of a clean surgical incision

    • very little tissue damage is present

  • Secondary union (healing by 2nd intention)

    • healing of a large tissue defect


Healing by First Intention

Healing by Second Intention

24 Hours


Healing by First Intention

Healing by Second Intention

3 to 7 Days


Healing by First Intention

Healing by Second Intention

Weeks


Aberrations of Wound Healing

  • Inadequate granulation tissue/healing

  • Excessive repair

    • Hypertrophic scar

    • Keloid

  • Contractures


Hypertrophic Scar


Keloid


Conditions Inhibiting/Delaying Wound Healing

  • Poor local vascular supply

    • Poor oxygenation, decreased bacterial resistance, low temperature, and an acid pH

  • Deficiencies of vitamin C, protein, zinc

  • Infection

  • Tissue necrosis

    • Foreign material delay healing and acts as a nidus for bacterial infection

  • Excessive movement


Extracellular Matrix- Collagen -

  • Tropocollagen is the basic unit

  • Intracellular

    • procollagen

  • Extracellular

    • procollagen cleavage & lysine oxidation  cross-linking

    •  tensile strength


Wound Healing

  • Replacement of Type III collagen by Type I in wound healing will have a maximal tensile strength of 70-80% of normal (takes about 3 months)


Outcomes of Acute Inflammation


The End

Chronic Inflammation

&

Repair


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