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Chronic Inflammatory Diseases Flashcards

1
Q

What is inflammation?

A

The biological process in which the immune system respond to an insult.

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2
Q

What are the characteristics of inflammation?

A

Redness
Heat
Swelling
Pain
Dysfunction

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3
Q

What is acute inflammation?

A

Transient as the insult is cleared and tissues heal

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4
Q

What is chronic inflammation?

A

Gets worse leading to loss of tissue, fibrosis and comorbidities.

Chronic pain and behavioural disorders

Reduce quality of life

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5
Q

What simulates innate immune cells?

A

Pathogen (PAMP) or Damage (DMAP) associated molecular patterns.

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6
Q

What are Pattern Recognition Receptors (PRR)?

A

Expressed by immune cells.

Recognise PAMP and DAMP

Mediate inflammatory signalling

Early warning system

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7
Q

What are cytokines?

A

Critical factors mediating inflammatory responses.

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8
Q

Where does early inflammation begin?

A

insults induce Langerhans cells migration to draining lymph nodes.

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9
Q

What is the function of cytokines and growth/differentiation factors in inflammation?

A

Activate skin resident immune cells.

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10
Q

What is the role of chemokines (CCL) in inflammation?

A

Attract macrophage, monocytes, neutrophils and T cells from the blood.

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11
Q

Briefly describe the process of innate immune sensing and signalling?

A

Sensors detect signals inside and outside

Sensors activate signalling pathways (adaptor)

These then stimulate transcription of cytokine gene infernos (IFNs).

They have an effect through IFN stimulated genes (ISGs).

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12
Q

Outline he assembly of the inflammasome.

A
  1. Signal is detected (PAMP) or (DMAP).
  2. PRR, known as NOD-like receptors undergo a conformational change exposing a binding site.
  3. NLRs recruit an adaptor protein called Apoptosis- related ASC which contains CARD, caspase recruitment domain.
  4. Form the ASC filament, scaffolding for the assembly of the inflammasome.
  5. Procaspase-1 undergoes self cleavage leading to caspase-1.
  6. It then cleaves proinflammatory cytokines.
  7. Active cytokines are released from the cell triggering an inflammatory response which recruits immune cells to the site.
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13
Q

What is a mast cell?

A

Immune cells which have a role in allergic reactions.

Allergen binds to antibodies on the surface of mast cells which release inflammatory substances.

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14
Q

What kinds of things are mast cell activators?

A

Receptor-binding agonists

Physical activators

Cell-cell contact

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15
Q

What kinds of things are mast cell molecules?

A

Preformed mediators

T and B cells

Newly synthesized mediators

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16
Q

What is the role of adjuvants?

A

Induce innate immune cells to mature and make cytokines artificially by mimicking PAMP and DAMP.

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17
Q

Why are adjuvants used?

A

Adjuvants are used in vaccines to enhance the body’s immune response.

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18
Q

What are dendric cells (DCs)?

A

Specialized to provide critical signals that activate naïve (resting) T cells.

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19
Q

How do DCs and T cells interact?

A

Form innate cell-cell associations

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20
Q

DCs provide 3 key signals. What are they?

A

Antigen

Co-stimulation

Cytokines

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21
Q

What is the antigen signal?

A

Presented as peptides bound to MHC recognized by the T cell receptor (TCR).

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22
Q

What is the co-stimulation signal?

A

CD80/86 recognized by CD28 on T cells

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23
Q

What is the cytokines signal?

A

Activating cytokines such as IL-12

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24
Q

What is CD28?

A

CD28 is like a key on the surface of T cells that helps activate them when they encounter invaders, boosting the immune response.

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25
Q

What is IL-12?

A

Promotes the differentiation of T cells.

Stimulates the production of cytokines

Enhances natural killer cells.

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26
Q

What happens to T cells once they are activated?

A

Once activated, T cells proliferate rapidly & differentiate to become cytotoxic (CTL) or helper (TH) T cells (effector T cells)

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27
Q

What are the key features of Antigen Presenting Cells (APCs)?

A

The ability to capture antigens.

They can express the MHC

They express co-stimulatory molecules

Initiate the adaptive immune response

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28
Q

Why are APC:T cell interactions selective?

A

Specific antigen recognition

Co-stimulatory signals

Regulatory mechanisms

Tissue microenvironment

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29
Q

What is the MHC?

A

The Major Histocompatibility Complex (MHC) is a set of genes that encode proteins responsible for presenting antigens to T cells, crucial for the immune system’s recognition of foreign substances.

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30
Q

Why are DCs called ‘Nature’s
adjuvants’?

A

They have the unique ability to efficiently capture, process, and present antigens to T cells, effectively enhancing and modulating the immune response.

31
Q

What is antigen presentation?

A

T cells only recognize antigens associated with MHC, thus the antigen has to be presented by MHC.

32
Q

What kind of antigens do MHC class I present?

A

Antigens made in the same cell.

33
Q

What kind of antigens do MHC class II present?

A

Antigens picked up from the environment

34
Q

Outline the process of innate immunity.

A
  1. Recognition of the pathogen by innate immune cells.
  2. Phagocytosis and destruction
  3. Inflammatory response
  4. Activation of the complement system.
  5. Inferon response
  6. Barrier defences
35
Q

Outline the process of adaptive immunity

A
  1. Antigen Recognition by APCs.
  2. T cell activation and differentiation.
  3. Helper T cells direct immune
    response.
  4. Cytotoxic T cells kill infected cells.
  5. B cells produce antibodies.
  6. Memory cells provide long-term immunity.
36
Q

What do Th1 CD4 T cell in disease prevention?

A

Delayed-type hypersensitivity and cytotoxic T lymphocytes.

37
Q

What do Th2 CD4 T cell in disease prevention?

A

Antibody production

38
Q

What do Th17 CD4 T cell in disease prevention?

A

Inflammation

39
Q

What do Treg CD4 T cell in disease prevention?

A

Regulate immune responses

40
Q

What do Th1 CD4 T cell do in disease causing?

A

Autoimmunity and transplant rejection

41
Q

What do Th2 CD4 T cell do in disease causing?

42
Q

What do Th17 CD4 T cell do in disease causing?

A

Autoimmunity

43
Q

What do Treg CD4 T cell do in disease causing?

A

Tumour immunity

44
Q

Which immune cells interact with Th1 CD4 T cells?

A

Macrophages

45
Q

Which immune cells interact with Th2 CD4 T cells?

A

Eosinophils

Mast cells

46
Q

Which immune cells interact with Th17 CD4 T cells?

A

Neutrophils

47
Q

Which immune cells interact with Treg CD4 T cells?

A

Suppression of DCs and effector T cells

48
Q

What are CD4 T cells?

A

Recognise antigens and coordinate immune response.

49
Q

What are the 3 phases of wound healing?

A

The inflammation phase

The proliferation phase

The remodelling phase

50
Q

What happens during the inflammation phase of wound healing?

A

Blood vessels constrict to minimize blood loss.

Blood vessels then dilate to give more blood to the wound.

Neutrophils and macrophages recruited to the wound site.

Inflammatory cytokines are released promoting the migration and activation of immune cells

51
Q

What happens during the proliferation phase of wound healing?

A

Fibroblasts migrate to the wound and produce collagen forming granulation tissue.

New blood vessel grow into the wound bed supplying oxygen and nutrients.

Epithelial cells migrate across the wound surface to cover the wound.

52
Q

What happens during the remodelling phase of wound healing?

A

Collagen fibres reorganise and realign along lines of tension, increasing tensile strength.

Excess collagen is gradually broken down leading to scar formation.

Scar tissue matures and becomes less vascular and cellular over time.

53
Q

What are hypo-immune syndromes?

A

Too little immunity and/or too much tolerance

54
Q

What are chronic infections?

A

Pathogens persist in immunocompetent individuals

55
Q

What is cancer?

A

Malignant cells are tolerated, despite expressing tumour antigens

56
Q

What are hyper-immune syndromes?

A

Too much immunity and/or too little tolerance

57
Q

What are autoimmune and allergic diseases?

A

The immune system destroys healthy tissues

58
Q

What is transplant rejection?

A

The immune system destroys life saving healthy donor organs and tissues

59
Q

What are allergies caused by?

A

Immune cells that recognize and respond to harmless environmental factors

60
Q

Outline the process of an allergic reaction?

A

Sensitization
Activation
Immediate Response
Late-Phase Response
Resolution
Memory

61
Q

What is sensitization phase of allergic reaction process?

A

First exposure activates immune response, producing IgE antibodies.

62
Q

What is activation phase of allergic reaction process?

A

Subsequent exposure triggers mast cell and basophil degranulation.

63
Q

What is immediate response phase of allergic reaction process?

A

Rapid release of inflammatory mediators causing symptoms.

64
Q

What is late phase response of allergic reaction process?

A

Optional delayed inflammatory response.

65
Q

What is Resolution of allergic reaction process?

A

Symptoms subside as inflammation resolves.

66
Q

What is memory of allergic reaction process?

A

Formation of memory cells for faster response upon re-exposure.

67
Q

What are chronic infections?

A

Pathogens persist in immunocompetent individuals

Pathogen persistence causes progressive disease and co-
morbidities

68
Q

What is autoimmunity?

A

Caused by immune cells that recognize and respond to tissue-specific self-antigens

69
Q

What are the features of autoimmunity?

A

Develops slowly and progresses (gets worse) leading to loss of tissue function and co-morbidities including pain and neurologic depression

70
Q

What is hyperacute rejection?

A

Rejection within the first few minutes of engraftment

71
Q

What is donor specific immunity?

A

Immunity towards transplanted organs and tissues is a major barrier to transplant success

72
Q

What is the reason for bone marrow transplantation?

A

potentially life-saving treatments for immunodeficiency and leukemia/lymphoma patients.

73
Q

What are immunosuppressant drugs?

A

Essential to prevent graft rejection.

Chronic Disease (15 decks)

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