AM L2 Inflammation & ATS Flashcards
ROS - reactive oxygen species NO - nitric oxide TF - tissue factor
Plaques that are likely to rupture are termed
Unstable
Rupture of plaques may result in (2)
Thrombosis or arterial occulsion
Total/partial occlusion of the coronary artery can cause (2)
Angina or frank MI
ATS is recognised as an ….. process rather than a passive process of …….. and …..
Inflammatory process
rather than passive process of lipid infiltration and endothelial injury
ATS occurs via interplay between …. and …..
hypercholesterolemia
and
inflammatory cascades
What initiates ATS?`
Endothelial dyhsfuntion/damage
One of the first signs of endothelial dysfunction/damage…
Decreased production/activity of NO (nitric oxide)
Endothelial damage causes: (4)
1 Decreased production/activity of NO
2 Chemokine and cytokine release
3 ROS production
4 Upregulation of endothelial adhesion receptors such as VCAM-1
Where does LDL accumulate?
Subendothelially
LDL is a complex containing
apolipoprotein B100 (ApoB100)
ApoB100 binds to….
negatively charged extra cellular matrix proteoglycans
What causes retention of LDL particles in the subendothelial layer?
ApoB100 binding to negatively charged extracellular matrix proteoglcans
What binds to negatively charged extracellular matrix proteoglycans?
ApoB100 in LDLs
ApoB100 binding to negatively charged extracellular matrix proteoglcans causes…
retention of LDLs in the subendothelial layer
LDLs that are retained in the subendothelial layer are suceptable to…. (2)
oxidative modification by ROS or enzymes
Enzymes that might cause oxidative modicication of LDLs retained in subendothelial layer? (2)
myleperoxidases or lipoxygenases
secreted from inflammatory cells
Diapedesis is
attachment and migration of monocytes through the endothelial layer
Modified lipids alter the expression of…. by…..
adhesion receptors by endothelial cells
Altered expression of adhesion receptors by endothelial cells promotes…… of …. cells
intimal immune cell infiltration
Monocytes adhere to …. and migrate….
adhere to endothelial cells and migrate into the arterial wall
Monocytes that are resident in the cell wall then…
differentiate into macrophages (via MCSF)
MCSF is
macrophage colony stimulating factor
MCSF causes
differentiation of monocytes (in the arterial wall) into macrophages
Macrophages are present at what stages of ATS
all
How are foam cells formed
Tissue phagocytosis engulfing lipophoteins
‘fatty streak legions’ produced by …(2)… cells?
T cells and monocyte-derived macrophage like foam cells
which scavenging cells ingest LDL?
macrophages
Macrophages can produce ….(3)… that amplify local inflammation and promote thrombotic complications
Pro-inflammatory mediators
ROS
TF procoagulants
Pro-inflammatory mediators
ROS
TF procoagulants
are produced by …. and cause (2)
Produced by macrophages
…amplify local inflammation and promote thrombotic complications
What two receptors are highly regulated in monocytes/macrophages during differentiation?
SR-A (scavenger receptor A) CD36 (class B scavengers receptor)
SR-A and CD36 are highly regulated in ….cells during….
macrophages/monocytes during differentiation
Scavenger receptors are found on what cells and do what?
found on macrophages/monocytesd duting differentiation
bind and internalise oxidised LDL, helping to form foam cells
Atherosclerotic legions have high expression of what receptor?
CD36 (class B scavenger receptor)
Accumulation of …(3)… forms necrotic core
Apoptotic cells, debris and cholesterol crystals
‘shoulder regions’ are heavily infiltrated by… (2)… which produce…. (2)
T cells and mast cells
Enzymes and proinflammatory cytokines… this contributes to adventitial inflammation of advanced plaques
Modified LDLs form a core surrounded by cap of ….(2)…
smooth muscle cells and collagen rich matrix
What are the central effector cells in ATS? (2)
Monocytes and macrophages
