Abstract

Dr. Rinkal Nakawala*

ABSTRACT

Chronic inflammation is a persistent inflammatory response characterized by prolonged activation of innate and adaptive immune mechanisms, ongoing tissue injury, and simultaneous attempts at repair. Unlike acute inflammation, which is typically short-lived and dominated by neutrophilic infiltration, chronic inflammation may persist for weeks, months or years and is characterized histologically by mononuclear cell infiltration, including macrophages, lymphocytes, and plasma cells, together with tissue destruction, angiogenesis, fibrosis, and remodeling. Chronic inflammation is central to the pathogenesis of numerous infectious, autoimmune, metabolic, degenerative, and neoplastic diseases. The mechanisms underlying chronic inflammation are complex and involve interactions between immune cells, stromal cells, endothelial cells, extracellular matrix components, and a wide range of inflammatory mediators. Macrophages occupy a central position in this process, T lymphocyte and B lymphocytes further regulate the inflammatory response through cytokine production and antibody-mediated mechanisms. Recent evidence has established chronic inflammation as a major biological link between infection, obesity, metabolic syndrome, cardiovascular disease, neurodegeneration, IBD, Chronic pulmonary disorders, and cancer. From a pathological perspective, recognizing the morphological patterns and underlying mechanisms of chronic inflammation is essential for diagnosis, prognosis, and therapeutic decision-making. This critical review discusses the cellular and molecular mechanisms of chronic inflammation, its morphological characteristics, major pathological patterns, mechanisms of tissue injury and repair, relationship with fibrosis and carcinogenesis, and emerging therapeutic approaches. A better understanding of chronic inflammation may facilitate the development of targeted strategies to control persistent inflammation while preserving beneficial host defence and tissue repair.