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Immunity and Pathology 1 > Acute Inflammation > Flashcards

Acute Inflammation Flashcards

1
Q

What are the 3 main responses involved in acute inflammation?

A

– Vascular dilation
– Increased vascular permeability
– Neutrophil activation and migration

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2
Q

What are the main causes of inflammation?

A
  • Microbial infection
    – Resulting from microbial recognition
  • Physical agents
    – Physical trauma
    – Ultraviolet or other radiation
    – Heat (burns)
    – Cold (frostbite)
  • Irritant and corrosive chemicals
    – Acids, alkali, oxidizing agents
    – Microbial virulence factors
  • Tissue necrosis
    – Lack of oxygen or nutrients
    – Inadequate blood flow (infarction)
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3
Q

What are the 5 cardinal signs of inflammation?

A
  • Redness (rubor)
    – Dilation of small blood vessels
  • Heat (calor)
    – Increased blood flow (hyperaemia)
  • Swelling (tumor)
    – Accumulation of fluid in extra vascular space (oedema)
  • Pain (dolor)
    – Stretching/distortion of tissues due to oedema. – Chemical mediators induce pain
  • Loss of function
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4
Q

What disease is an example of acute inflammation?

A

gingivitis

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5
Q

What happens if there is no resolution to gingivitis?

A

periodontitis

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6
Q

During amplification, what occurs?

A

recruitment and activation of innate immune cells via chemokine/cytokine activity and vascular dilation

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7
Q

What is exudation?

A

the vessels become ‘leaky’ and allow passage of water, salts and some proteins

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8
Q

What are the vascular responses in inflammation?

A
  • Small blood vessels adjacent to site of damage become dilated
  • Endothelial cells swell and retract
  • Exudation – the vessels become ‘leaky’ and allow passage of water, salts and some proteins
  • Endothelial cells activated to promote immune cells passage to damaged tissues
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9
Q

What does exudation provide to tissues?

A

– Fluids and salts
– Glucose and oxygen
– Complement proteins and antibodies
– Fibrin (long insoluble filamentous protein)

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10
Q

What condition occurs during inflammation and what is it?

A

oedema
* Defined as an excess of watery fluid collecting in the cavities or tissues of the body.
* Increased blood and lymph flow

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11
Q

What are the chemical mediators of inflammation?

A

– Histamine
– Bradykinin
– Leukotrienes
– Serotonin
– Prostaglandins

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12
Q

What are the protein mediators of inflammation?

A

– Cytokines
– Chemokines

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13
Q

What is histamine, how is it stored/released and what is its role?

A
  • Product of breakdown of amino acid histidine
  • Stored in granules of immune cells such as mast cells
  • Degranulation releases histamine
  • Role as a neurotransmitter–itching
  • Causes vascular dilation
  • Many immune cells express histamine receptors
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14
Q

What are prostaglandins, how are they produced and what is their main role?

A
  • Produced by macrophages and neutrophils (with leukotrienes)
  • Product of fatty acid metabolism
  • Most abundant is Prostaglandin E2 (PGE2)
  • Causes vascular dilation
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15
Q

What are the other roles of prostaglandins in acute inflammation?

A

– Regulate cytokine production
– Regulate cell recruitment
– Act on nerve fibres – pain
– Involved in tissue remodelling

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16
Q

What enzyme regulates prostaglandins?

A

Cyclo-oxygenaseII (COXII)

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17
Q

What are the 4 enzymatic cascades of plasma?

A

– Complement
– The kinin system
– Coagulation
– Fibrinolytic system

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18
Q

What are the 3 pathways of complement?

A

(1) Classical pathway – antibody attached to microbe
(2) Alternative pathway – microbial cell wall
(3) Mannose binding lectin pathway (MBL) – carbohydrates on pathogen surface

19
Q

Describe the kinin system

A

Involves a number of plasma proteins/enzymes

Hageman factor (coagulation factor XIIa) generates kallikrein

Kallikrein converts kininogens to kinins (e.g., bradykinin)

20
Q

What are the 3 pathways of coagulation?

A
  • Intrinsic (FXII) – activated when blood comes into contact with sub-endothelial connective tissues (outside blood vessel)
  • Extrinsic – Damaged blood vessel means Human Factor VII (FVII) leaves vessel and encounters tissue factor in surrounding tissue
  • Common – Production of thrombin which in turn produces fibrin from fibrinogen (clot formation)
21
Q

Describe the fibrinolytic system

A
  • Results in activation of plasmin from plasminogen via many activators (tPA, kallikrein, hageman factor)
  • Activates complement (plasmin cleaves C3 – protein part of complement cascade)
  • Indirect role as fibrin degradation products promote vascular permeability
22
Q

What factor is involved in all plasma systems?

A

12 - Hageman Factor

23
Q

What is haemostasis?

A

balance between the coagulation and fibrinolytic system

24
Q

What are examples of congenital coagulation disorders?

A

– Von Willebrand disease (VWD)
– Haemophilia A
– Haemophilia B

25
Q

What drugs are examples of acquired anti- coagulation?

A

– Warfarin
– Heparin

26
Q

What is another outcome of acute inflammation?

A

Abscess formation (suppuration)

27
Q

What is suppuration dependant on?

A
  • Tissue involved
  • Amount of tissue destruction
  • Nature of the harmful agent
28
Q

What are the 3 types of dental abscess?

A
  • Gingival abscess
  • Periodontal abscess
  • Periapical abscess
29
Q

What is suppuration?

A

the formation of pus usually arising from an infection.

30
Q

What is pus?

A

bacteria with dead and dying neutrophils

31
Q

What surrounds pus when it accumulates?

A

pyogenic membrane

32
Q

What is an important part of suppuration?

A

neutrophil infiltration

33
Q

What does complete restoration of tissues after an episode of acute inflammation require?

A

– Minimal cell death and tissue damage
– Occurrence in tissues with regenerative capacity
– Rapid elimination of causative agent
– Rapid removal of fluid and debris by
vascular/lymphatic drainage

34
Q

Where do non-steroidal inflammatory drugs act?

A

COX - cyclo-oxygenase enzyme

35
Q

What does activation of plasma factors include?

A

cleavage
enzymes

36
Q

What is bradykinin similar to?

A

histamine

37
Q

What are the roles of bradykinin?

A

Important role in activating complement

Increase vascular permeability

Stimulate nerves – pain

Induce expression of cytokines and chemokine

Induce production of chemical mediators of inflammation

38
Q

What is the hageman factor?

A

enzyme in plasma

39
Q

What innate immune cell engages in the kinin system?

A

neutrophil

40
Q

What factor is part of both pathways?

A

factor Xa

41
Q

Where is tPA (tissue plasminogen activator) found?

A

endothelial cells

42
Q

What protein activates all plasma systems?

A

hageman factor

43
Q

Swelling (tumor), one of the cardinal signs of acute inflammation is caused by leakage from capillaries of which factors?

A

plasma proteins

Immunity and Pathology 1 (13 decks)

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