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Inflammation & Repair

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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  1. Inflammation & Repair

  2. Chronic Inflammation

  3. Chronic Inflammation

  4. 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

  5. Other Cell Types • Lymphocytes • Plasma cells • Eosinophils • IgE mediated, parasitic infections • Mast Cells

  6. 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.

  7. Granulomatous Inflammation - TB

  8. Granulomatous Inflammation - TB

  9. Granulomatous Inflammation - TB

  10. Granulomatous Inflammation - TB

  11. Granulomatous Inflammation - TB

  12. Healing and Repair

  13. Cell Types with Different Regenerative Capacities

  14. Resolution vs Repair

  15. Granulation Tissue • Proliferation of new blood vessels and fibroblasts • Fibroblasts  myofibroblasts

  16. Granulation Tissue

  17. Granulation Tissue

  18. 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

  19. Healing by First Intention Healing by Second Intention 24 Hours

  20. Healing by First Intention Healing by Second Intention 3 to 7 Days

  21. Healing by First Intention Healing by Second Intention Weeks

  22. Aberrations of Wound Healing • Inadequate granulation tissue/healing • Excessive repair • Hypertrophic scar • Keloid • Contractures

  23. Hypertrophic Scar

  24. Keloid

  25. 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

  26. Extracellular Matrix- Collagen - • Tropocollagen is the basic unit • Intracellular • procollagen • Extracellular • procollagen cleavage & lysine oxidation  cross-linking •  tensile strength

  27. 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)

  28. Outcomes of Acute Inflammation

  29. The End Chronic Inflammation & Repair

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