chronic inflammation


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inflammation

 [in″flah-ma´shun]
a localized protective response elicited by injury or destruction of tissues, which serves to destroy, dilute, or wall off both the injurious agent and the injured tissue. adj., adj inflam´matory.  

The inflammatory response can be provoked by physical, chemical, and biologic agents, including mechanical trauma, exposure to excessive amounts of sunlight, x-rays and radioactive materials, corrosive chemicals, extremes of heat and cold, or by infectious agents such as bacteria, viruses, and other pathogenic microorganisms. Although these infectious agents can produce inflammation, infection and inflammation are not synonymous.

The classic signs of inflammation are heat, redness, swelling, pain, and loss of function. These are manifestations of the physiologic changes that occur during the inflammatory process. The three major components of this process are (1) changes in the caliber of blood vessels and the rate of blood flow through them (hemodynamic changes); (2) increased capillary permeability; and (3) leukocytic exudation.

Hemodynamic changes begin soon after injury and progress at varying rates, according to the extent of injury. They start with dilation of the arterioles and the opening of new capillaries and venular beds in the area. This causes an accelerated flow of blood, accounting for the signs of heat and redness. Next follows increased permeability of the microcirculation, which permits leakage of protein-rich fluid out of small blood vessels and into the extravascular fluid compartment, accounting for the inflammatory edema.

Leukocytic exudation occurs in the following sequence. First, the leukocytes move to the endothelial lining of the small blood vessels (margination) and line the endothelium in a tightly packed formation (pavementing). Eventually, these leukocytes move through the endothelial spaces and escape into the extravascular space (emigration). Once they are outside the blood vessels they are free to move and, by chemotaxis, are drawn to the site of injury. Accumulations of neutrophils and macrophages at the area of inflammation act to neutralize foreign particles by phagocytosis.

Chemical mediators of the inflammatory process include a variety of substances originating in the plasma and the cells of uninjured tissue, and possibly from the damaged tissue. The major kinds of mediators are (1) vasoactive amines, such as histamine and serotonin; (2) plasma endopeptidases that comprise three interrelated systems, the kinin system that produces bradykinin, the complement system that produces proteins that interact with antigen--antibody complexes and mediate immunologic injury and inflammation, and the clotting system that increases vascular permeability and chemotactic activity for the leukocytes; (3) prostaglandins, which can reproduce several aspects of the inflammatory process; (4) neutrophil products; (5) lymphocyte factors; and (6) other mediators, such as slow-reacting substance of anaphylaxis and endogenous pyrogen.

Hormonal Response. Some hormones, such as cortisol, have an antiinflammatory action that limits inflammation to a local reaction while others are proinflammatory. Thus, the endocrine system has a regulatory effect on the process of inflammation so that it can be balanced and beneficial in the body's attempts to recover from injury.
Cellular changes in inflammation. 1, Margination of neutrophils brings these inflammatory cells in close contact with the endothelium. 2, Adhesion of platelets results in the release of mediators of inflammation and coagulation. Fibrin strands are the first signs of clot formation. 3, Pavementing of leukocytes is mediated by adhesion molecules activated by the mediators of inflammation released from platelets and leukocytes. RBC, red blood cells. From Damjanov, 2000.
acute inflammation inflammation, usually of sudden onset, marked by the classical signs of heat, redness, swelling, pain, and loss of function, and in which vascular and exudative processes predominate.
catarrhal inflammation a form affecting mainly a mucous surface, marked by a copious discharge of mucus and epithelial debris.
chronic inflammation prolonged and persistent inflammation marked chiefly by new connective tissue formation; it may be a continuation of an acute form or a prolonged low-grade form.
exudative inflammation one in which the prominent feature is an exudate.
fibrinous inflammation one marked by an exudate of coagulated fibrin.
granulomatous inflammation a form, usually chronic, attended by formation of granulomas.
interstitial inflammation inflammation affecting chiefly the stroma of an organ.
parenchymatous inflammation inflammation affecting chiefly the essential tissue elements of an organ.
productive inflammation (proliferative inflammation) one leading to the production of new connective tissue fibers.
pseudomembranous inflammation an acute inflammatory response to a powerful necrotizing toxin (such asdiphtheria toxin), characterized by formation on a mucosal surface of a false membrane composed of precipitated fibrin, necrotic epithelium, and inflammatory leukocytes.
purulent inflammation suppurative inflammation.
serous inflammation one producing a serous exudate.
subacute inflammation a condition intermediate between chronic and acute inflammation, exhibiting some of the characteristics of each.
suppurative inflammation one marked by pus formation.
toxic inflammation one due to a poison, e.g., a bacterial product.
traumatic inflammation one that follows a wound or injury.
ulcerative inflammation that in which necrosis on or near the surface leads to loss of tissue and creation of a local defect (ulcer).

chron·ic in·flam·ma·tion

an inflammation that may begin with a relatively rapid onset or in a slow, insidious, and even unnoticed manner, and that tends to persist for several weeks, months, or years and has a vague and indefinite termination; occurs when the injuring agent (or products resulting from its presence) persists in the lesion, and the host's tissues respond in a manner (or to a degree) that is not sufficient to overcome completely the continuing effects of the injuring agent; characterized histopathologically by infiltrates of lymphocytes, plasma cells, and histiocytes; fibrosis; and granuloma formation.

chron·ic in·flam·ma·tion

(kron'ik in'flă-mā'shŭn)
An inflammation that may begin with a relatively rapid onset or in a slow, insidious, and even unnoticed manner; tends to persist for several weeks, months, or years; and has a vague and indefinite termination; characterized histopathologically by infiltrates of small round cells (lymphocytes), fibrosis, and granuloma formation.

chronic inflammation

low-grade, long-term, non-resolving inflammation; characteristic of soft-tissue injury (the affected area is re-subject to injury during the healing period); chronic inflammatory conditions respond to regular local heat (ultrasound therapy, infrared therapy, low-level laser therapy, wax baths, poultices) and/or rubefacients, together with imposed rest (padding, strapping, walking cast, crutches) and rehabilitation (physiotherapy and orthoses); topical anti-inflammatory agents (e.g. a steroid ± local anaesthetic injection) may be indicated

chron·ic in·flam·ma·tion

(kron'ik in'flă-mā'shŭn)
Inflammation that may begin with relatively rapid onset or in slow, insidious, and even unnoticed manner, and tends to persist for several weeks, months, or years and has a vague and indefinite termination; occurs when the injuring agent persists in the lesion, and the host's tissues respond in a manner insufficient to overcome its continuing effects.

inflammation

a localized protective response elicited by injury or destruction of tissues, which serves to destroy, dilute, or wall off both the injurious agent and the injured tissue.
The inflammatory response can be provoked by physical, chemical and biological agents, including mechanical trauma, exposure to excessive amounts of sunlight, x-rays and radioactive materials, corrosive chemicals, extremes of heat and cold, and infectious agents such as bacteria, viruses and other pathogenic microorganisms. Although these infectious agents can produce inflammation, infection and inflammation are not synonymous.
The classic signs of inflammation are heat, redness, swelling, pain and loss of function. These are manifestations of the physiological changes that occur during the inflammatory process. The three major components of this process are: (1) changes in the caliber of blood vessels and the rate of blood flow through them (hemodynamic changes); (2) increased capillary permeability; and (3) leukocytic exudation.

acute inflammation
inflammation, usually of sudden onset, marked by the classic signs of heat, redness, swelling, pain and loss of function, and in which vascular and exudative processes predominate.
adhesive inflammation
promotes adhesion of adjacent surfaces.
atrophic inflammation
one that causes atrophy and deformity.
catarrhal inflammation
a form affecting mainly a mucous surface, marked by a copious discharge of mucus and epithelial debris.
chronic inflammation
prolonged and persistent inflammation marked chiefly by new connective tissue formation; it may be a continuation of an acute form or a prolonged low-grade form.
chronic inflammation bowel disease of sheep
a syndrome of unknown etiology, manifest with wasting, ill thrift and mortality or culling for poor production. Reported in England and Canada, it affects both housed and pastured sheep, predominantly in their first year of life, but cases up to three years-of-age have been seen. Affected sheep are dull and anorectic with pale mucous membranes and have fecal staining of the perineum. The rumen fill is reduced and the feces are soft and malodorous. Blood examination shows hypoalbuminemia, an elevated blood urea nitrogen and leukocytosis with neutrophilia. On postmortem there is a lymphocytic enteritis with gross thickening of segments or the entire or distal part of the small intestine. There is no evidence for Johne's disease or parasitic gastroenteritis and the syndrome has similarities to the proliferative enteropathies of swine and horses.
croupous inflammation
a homogeneous layer of exudate lying close to but detached from the underlying inflamed tissue, which is comparatively unharmed; may form a fibrinous cast.
diphtheritic inflammation
manifested by the development of a fibrinous exudate which is firmly attached to the underlying tissue, such that it cannot be removed except by tearing off a superficial layer.
exudative inflammation
one in which the prominent feature is an exudate.
fibrinous inflammation
one marked by an exudate of coagulated fibrin.
fibrous inflammation
leads to the development of fibrous tissue.
granulomatous inflammation
a form, usually chronic, attended by formation of granulomas.
hyperplastic inflammation
leads to the development of new connective tissue.
hypertrophic inflammation
leading to the enlargement of the affected tissues.
interstitial inflammation
inflammation affecting chiefly the stroma of an organ.
obliterative inflammation
inflammation within a vessel or viscus leading to occlusion of the lumen.
parenchymatous inflammation
inflammation affecting chiefly the essential tissue elements of an organ.
productive inflammation, proliferative inflammation
one leading to the production of new connective tissue fibers.
pseudomembranous inflammation
an acute inflammatory response to a powerful necrotizing toxin, e.g. Fusobacterium necrophorum toxin, characterized by formation on a mucosal surface of a false membrane composed of precipitated fibrin, necrotic epithelium and inflammatory leukocytes. See also diphtheritic inflammation (above).
purulent inflammation
suppurative inflammation.
serous inflammation
one producing a serous exudate.
specific inflammation
one due to a particular microorganism.
systemic inflammation response syndrome (SIRS)
a generalized inflammatory response with vasodilation of capillaries and postcapillary venules, increased permeability of capillaries, and hypovolemia. Depressed cardiac function and decreased organ perfusion follow. The various initiating stimuli include sepsis and septic shock, hyperthermia, pancreatitis, trauma, snake bite and immune-mediated diseases.
toxic inflammation
one due to a poison, e.g. a bacterial product.
traumatic inflammation
one that follows a wound or injury.
ulcerative inflammation
that in which necrosis on or near the surface leads to loss of tissue and creation of a local defect or ulcer.
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The finding could help in the development of treatments for infections that 'overwhelm' the immune system like HIV as well as conditions that cause chronic inflammation such as rheumatoid arthritis, they said.
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Chronic inflammation is often treated with expensive pharmaceuticals with a long list of potential side effects.
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