Acute and Chronic Inflammation

Question 1

is inflammation a cellular or vascular response or both?

Answer 1

both

Question 2

what are some examples of possible tissue damage from inflammation?

Answer 2

atherosclerosis
allergic reactions
rheumatoid arthritis

Question 3

what are the five R’s in inflammation?

Answer 3

recognition of injurious agent
recruitment of leukocytes
removal of agent
regulation of immune response
resolution or repair

Question 4

what things do white blood cells have receptors for?

Answer 4

microbes
Fc portion of antibodies
complement proteins

Question 5

what does opsonization c do?

Answer 5

coats microbe with antibody or complement
promotes phagocytosis
promotes inflammation

Question 6

what are some circulating proteins that help recognize microbes and damaged cells?

Answer 6

complement
mannose-binding lectin
collectins

Question 7

what does binding of toll-like receptors on epithelial, dendritic/macrophage, and lymphocyte cells cause?

Answer 7

release of inflammatory molecules

Question 8

what are the general features of acute inflammation?

Answer 8

short time course
fluid and plasma leakage
neutrophils

Question 9

what are the general features of chronic inflammation?

Answer 9

long time course
lymphocytes and macrophages
vascular proliferation
fibrous tissue proliferation

Question 10

what are the two major components of acute inflammation?

Answer 10

vascular changes
cellular events

Question 11

what vascular changes happen in acute inflammation?

Answer 11

vasodilation
vascular permability

Question 12

what cellular events happen in acute inflammation?

Answer 12

leukocyte recruitment and activation

Question 13

where does the majority of fluid leakage, leukocyte transmigration, and hemorrhage occur?

Answer 13

capillaries and postcapillary venules

Question 14

loss of fluid and dilation of blood vessels leads to__________________ which leads to __________________

Answer 14

slowing of blood flow
congestion and white blood cells adhering to walls

Question 15

what causes vascular permeability specifically?

Answer 15

nitric oxide and histamine and prostaglandins

Question 16

what is transudate and what is exudate?

Answer 16

transudate has low protein content and few cells
exudate has high protein content and maybe some red and white cells: inflammation

Question 17

what are the mechanisms of increased vascular permeability?

Answer 17

retraction of endothelial cells (histamine, nitric oxide, rapid and short-lived)
endothelial injury (burns, rapid and can be long-lived)

Question 18

what is chemotaxis?

Answer 18

movement along chemical gradient

Question 19

what are the endogenous sources of a chemotactic stimulus for migrating leukocytes?

Answer 19

cytokines/chemokines (IL-8)
C5a
LTB4

Question 20

what receptor does endothelial molecule ICAM-1 have and what is its major role?

Answer 20

CD11/CD18 (integrins)
adhesion, arrest, transmigration

Question 21

what receptor does endothelial molecule PECAM have and what is its major role?

Answer 21

CD31
leukocyte migration through endothelium

Question 22

what mediates firm adhesion and what mediates rolling?

Answer 22

integrins mediate firm adhesion
selectins mediate rolling

Question 23

what do IL-1 and TNF induce expression of?

Answer 23

P-selectin
E-selectin
integrin ligands ICAM-1 and VCAM-1

Question 24

in leukocyte activation, what receptors are present?

Answer 24

toll-like receptors
G protein-coupled receptors
receptors for opsonins
receptors for cytokines

Question 25

what do G protein-coupled receptors recognize?

Answer 25

bacterial peptides containing N-formylmethionyl, chemokines, lipid mediators

Question 26

what is the major macrophage-activating cytokine?

Answer 26

interferon-gamma

Question 27

what is the most efficient bacteriocidal system in neutrophils?

Answer 27

H2O2-myeloperoxidase-halide system

Question 28

what does nitric oxide do to microbials and host cells?

Answer 28

reacts with superoxide to produce free radicals that damage lipids, proteins, and DNA of these cells

Question 29

what controls lysosomal enzymes?

Answer 29

antiproteases such as alpha-1-antitrypsin which inhibits elastase

Question 30

what are the principle sources of histamine?

Answer 30

mast cells basophils platelets

Question 31

can complement stimulate histamine to be released? If so what specifically?

Answer 31

yes- anaphylatoxins C3a and C5a

Question 32

what does histamine cause?

Answer 32

dilation arterioles increased venule permeability constriction of large arteries and airways

Question 33

what metabolites are associated with vasodilation?

Answer 33

PGI2, PGE1, PGE2, PGD2

Question 34

what are the three most important cytokines in acute inflammation?

Answer 34

TNF IL-1 IL-6

Question 35

what are the systemic protective effects of TNF, IL-1, and IL-6?

Answer 35

hypothalamus: fever liver: acute phase proteins (IL-1 and IL-6) bone marrow: leukocyte production

Question 36

what are the main cells that participate in chronic inflammation?

Answer 36

macrophages plasma cells lymphocytes

Question 37

what are the most common causes of chronic inflammation?

Answer 37

persistent infections prolonged exposure to toxic/injurious agents immune-mediated inflammatory disease leukocyte defects (more common in humans)

Question 38

what are the histologic features of chronic inflammation?

Answer 38

infiltration mononuclear cells tissue destruction healing by connective tissue replacement

Question 39

what do alternatively activated macrophages do?

Answer 39

tissue repair, anti-inflammatory effects

Question 40

what cytokines lead to alternatively activated macrophages?

Answer 40

IL-13 IL-4

Question 41

what cytokines from activated macrophages promote leukocyte recruitment?

Answer 41

mainly TNF and IL-1

Question 42

what does production of TNF by activated T lymphocytes stimulate?

Answer 42

inflammation

Question 43

what are the three subsets of CD4+ lymphocytes?

Answer 43

Th1 Th2 Th17

Question 44

in what inflammatory diseases do plasma cells predominate in?

Answer 44

inflammatory bowel disease in dogs and cats lymphoplasmacytic stomatitis and pododermatitis in cats chronic dermatitis interstitial nephritis in dogs and cats

Question 45

what recruits eosinophils to chronic inflammation sites?

Answer 45

IL-5 eotaxin

Question 46

what secretes eotaxin?

Answer 46

endothelial cells epithelial cells eosinophils macrophages

Question 47

what are the five patterns/categories of chronic inflammation?

Answer 47

lymphoplasmacytic fibrosing chronic inflammation chronic-active (purulent) inflammation granulomatous/pyogranulomatous inflammation abscesses

Question 48

what are the predominant cells in lymphoplasmacytic inflammation?

Answer 48

lymphocytes and plasma cells

Question 49

where is lymphoplasmacytic inflammation predominant?

Answer 49

mucosal regions with extending exposure to antigens CNS around vessels

Question 50

what is chronic fibrosing inflammation predominantly composed of?

Answer 50

fibrous connective tissue

Question 51

when does chronic-active inflammation occur?

Answer 51

when stimulus has not been removed and continues to elicit acute inflammation

Question 52

what are the two patterns of granulomatous inflammation?

Answer 52

diffuse/haphazard nodular granulomas/pyogranulomas

Question 53

what is the difference between granulomas and pyogranulomas?

Answer 53

pyogranulomas also have neutrophils

Question 54

what is a granuloma attempting to do?

Answer 54

contain an offending antigen that is difficult to eradicate

Question 55

what are the two types of granulomatous inflammation?

Answer 55

foreign body immune

Question 56

what response does an immune granuloma induce?

Answer 56

specific immune response activation of T cells IL-2 release macrophage responses

Question 57

are neutrophils characteristic of chronic inflammation?

Answer 57

yes, as well as acute

Question 58

in what type(s) of inflammation are mast cells important in?

Answer 58

chronic and acute

Question 59

what are the predominant cell types in granulomatous inflammation?

Answer 59

activated macrophages with an epithelioid appearance can form giant cells

Question 60

what does mannose-binding lectin specifically recognize?

Answer 60

microbial sugars

Question 61

what do collectins bind to?

Answer 61

microbes

Question 62

typically, _______________ predominate in the first 24 hours, but are short-lived and replaced by ____________________

Answer 62

neutrophils monocytes/macrophages

Question 63

what do toll-like receptors recognize?

Answer 63

LPS (endotoxin), bacterial proteoglycans, lipids

Question 64

what secrete interferon-gamma?

Answer 64

natural killer cells and T cells

Question 65

what are Th1 and Th17 cells important against?

Answer 65

many types bacteria and viruses and autoimmune diseases

Question 66

what are Th2 cells important against?

Answer 66

helminthic parasites and allergic inflammation

Question 67

what is proliferation of mast cells regulated by?

Answer 67

self-secreted C-Kit

Question 68

what produces nitric oxide?

Answer 68

macrophages and neutrophils after activated

Question 69

what stimulates mast cells and basophils to release histamine?

Answer 69

trauma cold/heat Ab binding to mast cells (immune reactions) complement anaphylatoxins (C3a and C5a) neuropeptides cytokines

Question 70

what produces IL-1 and TNF?

Answer 70

activated macrophages

Question 71

what chemokines stimulate a macrophage to go into the alternatively activated macrophage line?

Answer 71

IL-13 IL-4

Question 72

what do alternatively activated macrophages release?

Answer 72

IL-10 TGF-beta growth factors

Question 73

what cells are characteristic of granulomatous inflammation?

Answer 73

shift from neutrophils to: epithelioid macrophages lymphocytes +/- multinucleated giant cells

Question 74

what is required for multinucleated giant cells?

Answer 74

macrophages present and bathed in cytokines pathogen factors express fusionogenic molecules like CD44 and macrophage fusion receptor