UTILITY OF A GRANULOMA?

Utility of a granuloma? 

The granuloma has a significant protective function. The replicating or inanimate agents cause chronic tissue irritations and evoke a programmed tissue inflammatory response that isolates and walls off the offender. 

This is especially useful in the case of replicating intracellular invaders (Mycobacteria, Listeria) that can disseminate throughout the body. The macrophages that converge at the site of bacterial invasion ingest the bacteria and intracellularly kill them. The compact structure of the granuloma and the efficient intracellular bactericidal activity successfully prevent the dissemination of the microorganisms. This is well illustrated by miliary tuberculosis (TB) where deficient granuloma formation allows the systemic spread of the bacilli. A negative facet of the granuloma is that the lesion may harbor within its burnt-out or calcified structure residual viable Mycobacteria, Histoplasma.

 These latent organisms may cause the flare-up of the disease decades later. In the helminthic infection schistosomiasis the liver granulomas that form around the parasite eggs shield the liver parenchyma cells against the secreted toxic substances.

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