Cases Flashcards
SIRS
mediated by massive release of pro inflammatory cytokines
Causes of SIRS
gram negative LPS, gram positive polysaccharides, F-met-leu-phe, 5’mCPG, or superantigens, binding to PAMP R
Vitals of someone in septic shock or SIRS
increased temp, HR, RR, and serum creatinine
decreased BP and urinary output
physical findings: edema
PRR example
TLR4 binding the LPS:CD14 complex
What is sepsis?
SIRS + confirmed infectious etiology
What is severe sepsis?
sepsis + > 1 sign of organ failure (CV, renal, hepatic, respiratory, hematological, CNS, acidosis)
what pro inflammatory signals are released to start SIRS
TNF-alpha, IL-1, IL-6, prostaglandins
effects of proinflammatory signals
fever, acute phase protein release, cap leakage, DIC, hemorrhagic necrosis
If SIRS is caused by LPS endotoxin and patient survives would he be immune?
NO, endotoxin LPS is highly variable in its polysaccharide types and therefore no cross immunity would be generated
Cytokines derived from APC or macrophages
IL-1 and TNF-alpha: fever, acute phase protein release, increased capillary permeability, DIC, hemorrhagic necrosis
IL-6: fever, acute phase protein release, vascular effects, platelet and lymphocyte production
T cell cytokines
IL-2: T cell activation and GF
IFN-gamma: macrophage activation
In TSS
all T cells possessing a receptor V-beta become activated
If SIRS is caused by superantigen exotoxin and patient survives would he be immune?
No, many cytokines but T cell anergy and no memory
What is the role of CD4+ Th1 cells in controlling intracellular infections?
produce cytokines:
IFN-gamma: macrophage activation
granuloma formation
IL-2: CTL lysis of infected cells
Reduction of CD4 due to AIDS affects other immune cell populations
ineffective or abnormal responses ensue, because cytokines released by Th1 cells should regulate their function
