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POM 2 Cell biology > 2.13 Inflammation > Flashcards

2.13 Inflammation Flashcards

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1
Q

What are the four cardinal features of inflammation?

A

Rubor - redness
Calor - heat
Tumor - swelling
Dolor - pain

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2
Q

What causes rubor at a site of inflammation?

A

Vascular leakage leads to an accumulation of blood contents, including red blood cells which causes the redness

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3
Q

What causes calor at a site of inflammation?

A

High metabolism of infiltrating immune cells generates heat

Increased presence of fluid at core body temperature in areas with usually limited exposure

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4
Q

What causes pain at a site of inflammation?

A

Some mediators that signal to immune and endothelial cells during inflammation also signal to local nerve cells

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5
Q

What is inflammation?

A

A non specific immune response to cellular injury which is designed to remove damaged cells and clear threats such as infections and pathogens

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6
Q

What are the causes of inflammation?

A

Pathogens, allergens, physical damage, extreme temperatures, autoantigens

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7
Q

Where can inflammation occur?

A

Any vascularised tissue

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8
Q

When is inflammation initiated?

A

When cellular damage leads to release of damage associated molecular patterns

Or body detects pathogen associated molecular patterns

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9
Q

What causes swelling at a site of inflammation?

A

Vascular leakage increases blood flow into the inflamed tissue, leading to tissue buildup

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10
Q

What causes pain in an inflamed area?

A

Many of the mediators that signal to endothelial and immune cells during inflammation also signal on local nerve cells

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11
Q

What is meant by acute inflammation?

A

A short term process occuring in response to tissue injury, normally associated with rapid onset and resolution

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12
Q

What is acute inflammation characterised by?

A

Neutrophil recruitment

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13
Q

What triggers the release of DAMPs and PAMPs?

A

Non-apoptotic cell death (e.g. a wound)

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14
Q

What vasodilators do mast cells release?

A

Nitric oxide and histamine

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15
Q

What are the vascular changes associated with the release of histamine and nitric oxide?

A
  • Increase permeability of blood vessel wall
  • Dilation
  • Plasma leakage
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16
Q

Outline what happens when cell damage occurs

A
  1. Non-apoptotic cell death occurs, foreign material is detected
  2. Immune cells are activated by DAMPs or PAMPs, and mast cells release histamine and nitric oxide (vasodilators)
  3. Rapid vasculature changes occur (permeability, leakage, vasodilation)
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17
Q

What 4 benefits does increased vascular permeability and leakage into a site of inflammation bring? BALP

A

forms a BARRIER
more ANTIBODIES
more LEUKOCYTE migration
more PROTEINS to the site

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18
Q

Why do we experience pain during inflammation?

A

Due to the release of prostaglandins

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19
Q

How do neutrophils move to areas of damage?

A

Via chemotaxis, following a concentration gradient of chemotoxins including C5a, LTB4 and bacterial peptides

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20
Q

What is exudate?

A

Fluid, protein and cells that have seeped out a blood vessel

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21
Q

What does the exudate form?

A

Physical barrier between healthy and inflamed tissue

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22
Q

How are neutrophils able to migrate towards the chemokine source?

A

They express complementary chemokine receptors which allow them to migrate to the site of damage where chemokines are produced

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23
Q

What receptors bind to the chemokine CXCL8 (interleukin-8)?

A

CXCR1 and CXCR2 (g-coupled membrane proteins)

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24
Q

Which cell type prominently expresses receptors that bind to CXCL8 (IL-8) and what does this mean?

A

Neutrophils, thus they are the first cell type to be recruited to the site of inflammation

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25
Q

What is meant by neutrophil extravasation?

A

The movement of neutrophils from the vasculature into the surrounding tissue to reach the site of inflammation

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26
Q

What are the four steps of neutrophil extravasation?

A
  1. Chemo-attraction
  2. Rolling adhesion
  3. Tight adhesion
  4. Transmigration
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27
Q

What are the two adhesion molecules which are upregulated by cytokines?

A

P-selectin and E-selectin

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28
Q

How do neutrophils recognise selectin molecules on the endothelium?

A

They have complementary carbohydrate ligands which bind to the selectin molecules

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29
Q

What is chemo-attraction?

A

Cytokines (e.g. TNF-a) act on the endothelial layer to promote upregulation of adhesion molecules (e.g. selectins)

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30
Q

What is rolling adhesion?

A

Ligands (e.g. PSGL1) in a low affinity state on neutrophils bind selectin molecules, causing the neutrophil to roll along the endothelium

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31
Q

What is the name of the P selectin ligand?

A

PSGL1

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32
Q

What promotes the low to high affinity switch in integrins in tight adhesion and what does this do?

A

Chemokines

This enhances binding to ligands (e.g. ICAM-1)

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33
Q

What is transmigration?

A

The movement of the neutrophil through the endothelial wall which involves the rearrangement of the cytoskeleton

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34
Q

What molecule mediates the transmigration of the neutrophil molecule?

A

PECAM

35
Q

What are the three functions of neutrophils at the site of inflamation?

A
  1. Pathogen recognition
  2. Pathogen clearance
  3. Cytokine secretion
36
Q

How do neutrophils recognise gram negative bacteria?

A

They use TLR4 and CD14 receptors to identify lipopolysaccharides that are present in gram negative bacteria

37
Q

How do neutrophils clear pathogens?

A

By phagocytosis

38
Q

Describe the process of phagocytosis?

A
  1. Pathogen is engulfed into phagosome
  2. Phagosome fuses with enzyme containing vesicles forming a phagolysosome
  3. This is degraded by enzymes through acidifcation
39
Q

What is released during phagocytosis which causes oxidative damage?

A

ROS - reactive oxygen species

40
Q

Give 3 reasons why the release of exudate is helpful?

A

Increases lymphatic drainage

Allow direct delivery of plasma proteins (e.g. fibrin) to inflammation site

Forms physical barrier between healthy and inflamed tissue

41
Q

Why are histamine molecules turned over rapidly?

A

They are small molecules and therefore are rapidly degraded

42
Q

What produces anti-inflammatory mediators to resolve acute inflammation?

A

Macrophages

43
Q

How can acute inflammation be resolved through repair?

A

Infiltrating WBCs clear the wound of dead cells and pathogens

They also release growth factors which stimulate tissue repair via ECM deposition

44
Q

How do macrophages clear apoptotic cells?

A

They engulf them

45
Q

When does chronic inflammation occur?

A

When the acute response cannot clear the stimuli

46
Q

What does chronic inflammation result in?

A

Scarring and loss of tissue function

47
Q

What drive continual inflammation in chronic inflammation?

A

Antigens

48
Q

Why is persistent neutrophil activation bad?

A

It is highly toxic and leads to rapid tissue destruction

49
Q

What is a foreign antigen?

A

An antigen derived from molecules not found in the body

50
Q

What is a self antigen?

A

An antigen derived from molecules produced by our bodies

51
Q

What is an immunogen?

A

An antigen indepedently capable of driving an immune response in the absence of additional substances

52
Q

What is a hapten?

A

A small molecule that alone does not act as an antigen but when bound to a larger molecule it can create an antigen

53
Q

What is granulomatous inflammation?

A

Chronic inflammation with distinct patterns of granuloma formation

54
Q

Name some diseases characterised by chronic inflammation?

A

Rhuematoid Arthritis
Asthma
Inflammatory Bowel Disease
Hepatitis
Psoriasis

55
Q

Name some diseases associated with granulomatous inflammation?

A

TB
Leprosy
Tumour reactions
Crohn’s Disease

56
Q

What are some persistent inflammatory stimuli found in chronic inflammation? TUPS

A

Toxic stimuli (e.g. allergens and pollutants)

Unclearable particulates

Persistent/prolonged infection

Self-antigens

57
Q

What does the distinct immune cell infiltrate found in chronic inflammation consist of?

A

Inflammatory macrophages
T cells
Plasma cells

58
Q

How are macrophages recruited to the site of inflammation?

A

As monocytes

59
Q

What are the benefits of macrophages being recruited to the site of inflammation? PCAR

A

Phagocytosis
Cytotoxic effect
Anti-inflammatory
Repair wound by building ECM

60
Q

What are the bad things associated with macrophages being recruited to the area? DIP

A

Damage healthy surrounding tissue
Inflammatory
Pro-fibrotic, deposit excess collagen

61
Q

What pro-inflammatory signals do T cells release?

A

TNF, IL-17 and IFN-gamma

62
Q

How do T cells promote remodelling and suppression of the immune system?

A

TGF-beta

63
Q

How do T cells act in a cytotoxic manner?

A

Through the release of perforin and granzymes

64
Q

What do B cells do in an chronic inflammatory response?

A

Generate antibodies that help to clear infection

65
Q

Which white blood cell can act remotely during chronic inflammation?

A

B cells

66
Q

What are granulomas?

A

Aggregations of activated macrophages

67
Q

What triggers granuloma formation?

A

Strong T cell responses

68
Q

What is the job of the granulomas?

A

To form a physical barrier to prevent pathogenic material from leaking out, thus allowing macrophages to clear the material

69
Q

Compare acute and chronic inflammation in terms of onset

A

Acute is rapid, lasts a few days
Chronic is delayed, lasts up to years

70
Q

What type of cell dominates during acute vs chronic inflammation?

A

Acute – neutrophils
Chronic – monocytes/macrophages

71
Q

What is continually released during acute vs chronic inflammation?

A

Acute – histamines
Chronic – cytokines

72
Q

What happens as a result of acute vs chronic inflammation?

A

Acute – vasodilation, vascular permeability, leukocyte response
Chronic – persistent inflammation, ongoing injury, attempts at healing

73
Q

What are the long term consequences of inflammation called?

A

The sequelae

74
Q

What are the three possible outcomes of injury?

A
  1. Regeneration
  2. Repair/scar formation
  3. Tissue scarring categorized by chronic inflammation
75
Q

What does resolution after injury involve?

A

The clearance of injurious stimuli and inflammatory mediators

Replacing injured cells

Returning to normal function

76
Q

What does fibrosis involve as an sequalae of inflammation?

A

the deposition of collagen leading to excess tissue scarring and therefore the inability of the tissue to carry out its function

77
Q

What is deposited when wounds heal?

A

ECM deposited

78
Q

How do scars form?

A

When the collagen is unable to be removed from the site of endothelial repair

79
Q

What are the positive outcomes of inflammation?

A

Clear inflammatory agent
Remove damaged cells
Restore normal tissue function

80
Q

What are the negative outcomes of inflammation?

A

Excess tissue damage
Scarring
Loss of organ function -> organ failure

81
Q

Describe how neutrophils are able to migrate through the blood vessel walls?

A

Through the relaxation of inter-endothelial cell junctions and digestion of vascular basement membrane

82
Q

Which chemokines released by macrophages cause chemo-attraction of neutrophils to the site of injury?

A

TNF and IL-1

83
Q

Which epithelial ligand mediates transmigration of neutrophils to into the site of damage?

A

PECAM

84
Q

Which chemokines cause the switch from low affinity ligands to high affinity ligands?

A

LFA-1 and MAC-1

POM 2 Cell biology (15 decks)

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