Exam 1 -- Inflammation Flashcards
What cell types are associated with acute inflammation?
Neutrophils
What cell types are associated with chronic inflammation?
Lymphocytes and macrophages
What type of inflammation is associated with new vessel growth and fibrosis?
Chronic
What type of adhesion molecule causes slowing of WBC movement along the vessel wall?
Selectin
What type of adhesion molecule causes the WBC to stop along the vessel wall?
Integrin
What substance does the WBC release in order to pass through the basement membrane?
Collegenase
What substances contribute to the chemotaxis that pulls WBCs toward the damaged area?
Bacterial products, C5a, LTB4, IL-8
What substances act as opsonins during an inflammatory response?
IgG and C3b (among others)
Although histamine is predominantly found in mast cells, where else might it be found?
Basophils and platelets
True or false: serotonin is found in mast cells
False; it is found primarily in platelets
What is the result of serotonin release during the inflammatory response?
Vasodilation and easier clot formation
Prostaglandins and leukotrienes are metabolites of what molecule?
Arachidonic acid
The cyclooxygenase pathway results in the production of what products?
Prostaglandins, prostacyclins, and thromboxanes
The lipoxygenase pathway results in the production of what products?
Leukotrienes (5-LO) and lipoxins (5-LO then 12-LO)
The end products of the COX pathway depends on the enzymes present in a particular type of cell. What cell type results in protacyclin (PGI2)?
Endothelial cells
What is the action of prostacyclin?
Vasodilation and inhibition of platelet aggregation
The end products of the COX pathway depends on the enzymes present in a particular type of cell. What cell type results in thromboxane A2 (TXA2)?
Platelets
What is the action of thromboxane?
Vasoconstriction and platelet aggregation
Which leukotriene(s) is/are responsible for neutrophil chemotaxis?
LTB4
Which leukotriene(s) is/are responsible for bronchospasm?
LTC4, D4, and E4
Which leukotriene(s) is/are responsible for vasoconstriction?
LTC4, D4, and E4
What is the action of lipoxin?
Vasodilation, inhibition of neutrophil chemotaxis, stimulation of monocyte adhesion
What is/are the actions of platelet activating factor?
Platelet aggregation/adhesion, vasodilation, increased permeability, stimulates synthesis of AA metabolites, chemotaxis
Cytokines are produced mostly by what types of cells?
Lymphocytes and macrophages
What is/are the major actions of cytokines?
They cause WBC adherence to the vessel endothelium (activate, aggregate, and aggravate)
Interleukin-1 (IL-1) is produced by what type of cell?
Activated macrophages
What is/are the actions of IL-1?
Activates vessel endothelium to increase WBC adhesion (activates selectins and integrins), enhances the production of AA and NO (?)
What are some symptoms caused by expression of IL-1?
Fever, lethargy, and decreased appetite
What is/are the actions of IL-8?
Chemo-attractant; activates PMNs (polymorphonuclear leukocytes), setting the stage for phagocytosis
Tumor necrosis factor (TNF) is produced by what type of cell?
Activated macrophages
What is/are the actions of TNF?
Causes aggregation and activation of neutrophils, activates vessel endothelium to increase WBC adhesion (activates selectins and integrins), increases thrombogenicity of endothelium (activates fibroblasts and increases collagen synthesis)
What are some symptoms caused by expression of TNF?
Fever, lethargy, and decreased appetite
<p>What is/are the actions of interferon-gamma (IFN)?</p>
<p>Limits spread of inflammatory process, activates macrophages and neutrophils, stimulates synthesis of NO, protects against viral infection (inhibits viral replication), induces production of IgG from plasma cells</p>
<p>What is/are the actions of NO?</p>
<p>Vasodilation (most potent vasodilator), microbiocide, antagonizes platelet activation, decreases leukocyte achesion</p>
Which complement molecules form the MAC?
C5b, C6-C9
Which complement molecules act as chemoattractants?
C5a and C5-C7 complex
Which complement molecules are important in opsonization?
C3b
Which complement molecules increase vascular permeability by mast cell degranulation?
C3a, C5a
What actions are the end result of the kinin cascade?
Vasodilation, increased vascular permeability, bronchial constriction, PGI2 and NO release
After fibrin has formed a clot, which molecule has the potential to break it down?
Plasmin; its precursor, plasminogen, entered the area with the fibrinogen and is activated by the endothelium once this has healed
Describe transudate in terms of protein and cellular content.
Low protein content and few cells
Describe exudate in terms of protein and cellular content.
High protein content and some WBC and RBC
Which cytokine activates immature macrophages?
Interferon gamma
Mast cells release what types of molecules?
Histamine and AA metabolites
What type of modified macrophage is found in gramulomatous inflammation?
Epithelioid cells
<p>What is the name for the mass of modified macrophages that accumulates during granulomatous inflammation?</p>
<p>Giant cell (made from epitheloid cells, which are modified macrophages)</p>
Granulomatous inflammation is characteristic of what type of hypersensitivity?
Type IV hypersensitivity
What types of agents may cause a granulomatous inflammation?
Bacteria, fungi, inorganic materials
What types of granulomas are there?
Foreign body and immune
What is another term for acute phase reaction?
Systemic inflammatory response syndrome
Which cytokines are the most important in acute phase reaction?
TNF, IL-1, IL-6
What are common features of the acute phase reaction (APR)?
Fever, fatigue, malaise, elevated WBC, elevated HR and BP, anorexia
Which proteins have elevated levels during acute phase reaction?
C-reactive protein (CRP), fibrinogen, serum amyloid A (SAA)
Erythrocyte sedimentation rate is used to measure levels of what protein?
Fibrinogen
What is a normal ESR result for a male?
Half of the age in years (in mm/hr)
What is a normal ESR result for a female?
Half of (the age in years plus 10) (in mm/hr)
What is the role of CRP?
Binds to cell wall of bacteria and fungi as opsonin and activates complement
What is a normal value for CRP?
0-0.5 mg/dL
<p>What is the role of SAA?</p>
<p>Recruits immune cells to inflammatory sites; induces enzymes that degrade ECM; is also associated with cancer (especially breast) and RA</p>
What is a normal value for SAA?
0
What four classes of drugs are important for ODs in terms of inflammation?
Antihistamines, mast cell stabilizers, NSAIDs, corticosteroids
What is a key difference between hyperplasia and neoplasia?
Hyperplasms continues to respond to regulatory systems; neoplasms do not.
What is metaplasia?
A cell type changing to another cell type to cope with the environmental factors
What is dysplasia?
Disorderly proliferation of cells (but not neoplastic); sometimes called precancer
What is another name for Type I hypersensitivity?
Anaphylactic (also, atopic)
Which Ab is involved in Type I reaction?
IgE
Which leukocytes are involved in Type I reactions?
Mast cells and basophils
Why must care be taken after the immediate anaphylactic crisis is resolved?
Arachidonic acid metabolites are being created and will cause further problems 2-10 hours later
What is another term for Type II hypersensitivities?
Antibody-mediated
What are the three basic mechanisms of Type II reactions?
Opsonization and phagocytosis; inflammation; Ab-mediated cellular dysfunction
Briefly outline opsonization and phagocytosis during a Type II reaction.
Drug on cell surface makes cell look foreign; Ab (IgG or IgM) attaches to cell and activates complement; cell is either destroyed by MAC, or C3a attracts neutrophils and macrophages while C3b serves as opsonin.
What are two examples of Type II reactions involving opsonization and phagocytosis?
Hemolytic anemia; transfusion hemolysis
Briefly outline inflammation during a Type II reaction.
Ab binds to cellular or tissue “Ag;” complement is activated and neutrophils and monocytes are recruited; these release inflammatory mediators which cause tissue damage due to frutrated phagocytosis
What are two examples of Type II reactions involving inflammation?
Acute rheumatic fever, Mooren ulcer
Briefly outline Ab-mediated cellular dysfunction during a Type II reaction.
Ab binds to or blocks a receptor, thus interfering with normal tissue function
What are two examples of Type II reactions involving Ab-mediated cellular dysfunction?
MG and Grave’s disease
What is another name for Type III hypersensitivity?
Immune complex mediated
Briefly outline a Type III reaction.
Ag-Ab complex deposits in tissue and activates complement system; inflammation and tissue damage occur
Which areas of the body are common sites of Type III reactions?
Blood vessels, kidneys, and joints
What are three examples of Type III reactions?
Reaction arthritis (ReA), Systemic lupus erythematosus (SLE), Sjogren’s syndrome
What is another name for Type IV hypersensitivity?
Cell-mediated (or delayed)
True or false: Type IV reactions are a function of T cells, not antibodies
True.
What are the two types of Type IV reactions?
Delayed-type hypersensitivity (DHT); T-cell mediated cytotoxicity
In delayed-type hypersensitivity, which T cell is responsible for the reaction?
CD4+
What are two examples of Type IV delayed-type reactions?
Tuberculin reaction, contact dermatitis
In T-cell mediated cytotoxicity, which T cell is responsible for the reaction?
CD8+
By what method do CD8+ cells cause damage?
They themselves release perforin and granzymes
What are some examples of Type IV T-cell mediated cytotoxicity reactions?
T1DM, MS, Hashimoto thyroiditis
