Case 1: Acute immunology

Question 1

What are the three phases of wound healing?

Answer 1

• inflammatory
• proliferative
• remodelling

Question 2

what happens in the inflammatory phase?

Answer 2

wound sterilisation and clearance:

• phagocytosis
• removal of infection and damaged tissue

Question 3

what happens in the proliferative phase?

Answer 3

wound closure:

• early epithelialisation
• angiogenesis
• ECM reorganisation
• fibroblast proliferation - collagen

Question 4

what happens in the remodelling phase?

Answer 4

return tissue to normal functioning state:

• full epithelialisation
• ECM remodelling
• increase in tensile strength of wound
• apoptosis and removal of proliferated cells
• scar maturation

Question 5

what are the cardinal signs of inflammation?

Answer 5

• redness
• swelling
• heat
• pain
• loss of function

Question 6

what are the three themes of immunity?

Answer 6

detection
communication
disposal

Question 7

what happens in detection?

Answer 7

recognition of non-self - PAMPs

recognition of altered self - DAMPs

Question 8

what happens in communication?

Answer 8

pathogen bound to macrophage leads to relase of cytokines which co-ordinate an inflammatory response

Question 9

describe general effect of release of cytokines

Answer 9

increased vasodilation and vascular permeability - leadsto swelling and pain due to impingement on nerves and attraction of prostaglandins as well as chemotaxis of whit blood cells to site of infection

Question 10

what are the two types of immunological response of cytokines?

Answer 10

• inflammation

- movement

Question 11

describe the effect of TNF- alpha

Answer 11

• cell recruitment: activates endothelial cells to allow entry of leukocytes
• induces acute phase response: increase body temperature (kill pathogen)/ diffusion to liver to upregulate complement expression
• clotting of small damaged blood vessel to prevent systemic spread
• angiogenesis- via release of VEGF

Question 12

describe the effect of CXC8

Answer 12

chemokine - IL-8
- induced by recognition of PAMPs to site of infection and recruits neutrophils to site of infection by directing the,m using chemotactic gradient

Question 13

how is acute inflammtion resolved?

Answer 13

pathogen clearance
early apoptosis
phagocytosis
increased release of VEGF and TGF-B 
decreased inflammation and increased tissue repair