body responds to injury - inflammation Flashcards
What are the 4 classical signs of inflammation?
- calor (heat)
- dolor (pain)
- rubor (redness)
- tumor (swelling)
What is the 5th sign of inflammation and who coined it?
- functio laesa (loss of function)
- Rudolf Virchow
Define inflammation
a complex biological response of body tissues to harmful stimuli involving immune cells, blood vessels and molecular mediators
What is the function of inflammation?
- eliminate the initial cause of injury
- clear out damaged tissues
- initiate tissue repair
Describe acute inflamation
- short duration
- usually severe intensity
- classically neutrophils, antibodies and complements
Describe chronic inflammation
- long
- mild to severe intensity
- other leucocytes that neutrophils
- may cause severe progressive tissue damage over time
What are some types of harmful inflammation?
- autoimmune disease
- allergy
- inadequately controlled
What are the 5 Rs of what happens in the inflammatory process?
- Recognition
- Recruitment (of leukocytes)
- Removal
- Regulation (of inflammatory response)
- Resolution/Repair
What are the 3 steps of acute inflammation?
- vascular dilatation
- increased vascular permeability + extravasation of fluid
- emigration of leukocytes, primarily neutrophils
How is vasodilation triggered in the first step of acute inflammation?
- endothelium produces histamine and nitric oxide
- this relaxes the vascular smooth muscle
What does vasodilaton result in (first step of acute inflammation)?
- results in stasis of the blood
- increase in hydrostatic pressure, leading to oedema
Which classical signs of inflammation happen due to the first step of acute inflammation?
- rubor
- tumor
- calor
How is step 2 of acute inflammation carried out?
histamine and nitric oxide activate endothelial cells themselves and make them retract from each other
What is the other name for oedema in inflammation?
acute inflammatory exudate
What is the difference between exudate and transudate?
- exudate: gap big enough for proteins to leave
- transudate: only fluid really gets through
What are the 3 steps to the leukocytes leaving the vasculature in acute inflammation?
- margination and rolling along vessel wall
- adhesion to activated endothelium
- emigration through vessel wall
Which proteins are involved in the margination of leukocytes along endothelium wall? What are they upregulated by?
- SELECTINS
- upregulated by tumour necrosis factor (TNF) and Interleukin 1 (IL-1)
What mediates the adhesion of leukocytes to the activated endothelium in acute inflammation? What are hey upregulated by?
- INTEGRINS (VCAM-1, ICAM-1)
- upregulated by TNF and IL-1
What mediates the emigration of leukocytes through the vessel wall in acute inflammation?
CD31 and PECAM-1
Which complement factors are involved in acute inflammation, and what do they do?
C3 and C5
- interplay between neutrophils, macrophages and the complement system
How do leukocytes move?
- contractile cytoplasmic microtubules
- changes in cytoplasmic fluidity
What do leukocytes move towards and what is that called?
- towards higher concentration of chemical mediators
- chemotaxis
Which mediators are involved in vasodilation?
- histamine
- nitric oxide
- prostaglandins
Which mediators are involved in increased vascular permeability?
- histamine
- complement C3a and C5a
- bradykinin
- leukotrienes
Which mediators are involved in chemotaxis and leukocyte recruitment?
- TNF
- IL-1
- complement C3a and C5a
Which mediators are involved in fever?
- TNF
- IL-1
- prostaglandins
Which mediators are involved in pain?
- prostaglandins
- bradykinin
Which mediators are involved in tissue and cell damage?
- lysosomal enzymes from leukocytes
- reactive oxygen species
- nitric oxide
What are the 4 main manifestations of acute inflammation?
- serous inflammation and effusion
- fibrinous inflammation
- purulent inflammation and abscess formation
- ulceration
What are the 3 possible outcomes of acute inflammation?
- complete resolution
- abscess healing by scarring (fibrosis)
- progression to chronic inflammation
What is granulomatous inflammation?
- common subtype of chronic inflammation
- collections of activated epithelioid macrophages
What is a naked granuloma?
not surrounded by lymphocytes
What is a necrotizing granuloma?
granuloma that may show central necrosis
