Exam 2: Inflammation & Immunity Flashcards
Acute inflammation
minutes to several days; presence of neutrophils
Phases:
1. Vascular: increase in blood flow and changes in small blood vessels (minimize damages)
- Cellular: migration of leukocytes or white blood cells (WBCs) for tissue repair (Leukocyte activation and phagocytosis)
Chronic inflammation
days to years; presence of lymphocytes, macrophages, fibrosis tissue
Purpose of inflammation
eliminate cause of cell injury, remove damaged tissue, and generate new tissue
Clinical manifestations of inflammation
Cardinal: Redness, warmth, swelling, tenderness/pain, loss of function
Systemic response: Temperature, elevated C-reactive protein (CRP), elevated erythrocyte sedimentation rate (ESR), elevated white blood cells (WBCs), malaise and anorexia, lymphadenitis
Endothelial cells
release platelet and thrombotic cell agents to form a clot, regulates synthesis and release of inflammatory mediators
Platelets
circulating in blood to help form clots and release potent inflammatory mediators
Mast cells
when activated stimulate release of histamine, TNF-α, Interleukins, cytokines, monocytes, macrophages
Histamine 1
released from mast cells
- Vasodilation
- Vascular permeability
- Bronchoconstriction
**Histamine 2 causes increased secretion of gastric acid
Prostaglandins
group of lipids with hormone-like actions that your body makes primarily at sites of tissue damage or infection
- Increased vascular permeability
- Vasodilation
- Fever
- Pain
- Neutrophil chemotaxis (The attractive forces that pull the Phagocytes to the site of injury/infection)
Leukotrienes
Released by mast cells
Think of asthma attack ->
* Increased vascular permeability
* Smooth muscle contraction which promotes bronchoconstriction and airway edema
Promotes slower and more prolonged responses than Histamine
Cytokines
Chemokines: family of small proteins that act primarily as chemoattractant to recruit and direct the migration of immune and inflammatory cells
Interleukins (ILs)
Interferons (IFNs)
Tumor necrosis factor alpha (TNF-α)
Flow chart of inflammation process
Exudate
a mass of cells and fluid that has seeped out of blood vessels or an organ, especially in inflammation.
Ulceration
a site of inflammation that has become necrotic or eroded
Serous
watery fluid, amber/clear
Hemorraghic or sanginous
red blood cells, red/pink
Fibrinous
increased fibrinogen and form a thick sticky meshwork
Purulent
pus, degraded white blood cells, proteins, and tissue debris
yellow/white/green
dendritic cells
innate cells that capture, process, and present antigens to adaptive immune cells and mediate their polarization into effector cells
link b/t innate and adaptive along with cytokines
antigen
a substance that induces the formation of antibodies because it is recognized by the immune system as a threat
Humoral immunity
B cells use antibodies to tag pathogens for destruction
immunoglobulins
substances found in the “humors” (fluid) of the body
Innate immunity:
It is the body’s first and immediate line of defense; includes macrophages, cytokines and natural killer cells. Composed of the body’s natural anatomical barriers, normal flora, white blood cells (WBCs), and protective enzymes and chemicals. Macrophages phagocytose foreign debris and antigens. Interferons, cytokines, and hydrochloric acid are some of the protective enzymes and chemicals.
Adaptive immunity:
after the innate system and more specific protection
developed after exposure to antigens and act rapidly, specifically, destructively, and with memory for every individual antigen it has encountered through human cell surface antigens called major histocompatibility complexes (MHCs), also called human leukocyte antigens (HLAs)
allows the body to distinguish between antigens that belong to the host versus antigens that are from an invader
Active acquired Immunity:
Obtained through exposure to an antigen or through immunization (vaccine). The patient’s body has to synthesize specific immunoglobulins against an antigen
Passive acquired Immunity:
The body merely passively accepts the immunoglobulins and the body DOES NOT have to manufacture them, this is short-term immunity
B lymphocyte or B cells:
Naïve or immature until they encounter an antigen, after exposure to an antigen B cells are stimulated to further mature in plasma cells, then they have the ability to produce specific proteins and immunoglobulins (Igs) also called antibodies which attach an antigen. They mature to an extent in the bone marrow.
Immunoglobulins (Igs):
Antibodies
Proteins made in response to antigens by B cells and plasma cells
There are several types they are involved in the antibody mediated immunity abbreviated (IgM, IgG, IgA, IgE, and IgD)
IgA:
Mainly found within secretions, such as tears, saliva, nasal and respiratory secretions, GI fluid, and breast milk
IgE:
Usually present in very low concentrations in the blood but it rises to high levels in allergic reactions
IgD:
Binds to basophils and mast cells in hypersensitivity reactions, comprises only 1% of immunoglobulins
IgM:
Responds first to infection elevated may indicate a recent or current infection
IgG:
Is a secondary responder, which means that levels rise after a second exposure to an antigen. This indicates exposure and immune competence to a particular antigen
T lymphocyte:
Continue to mature in the thymus gland where they become CD4 and CD8 cells and then move to the lymphoid tissue for proliferation
CD 4 or T helper cells:
Influences all other cells of the immune system including other T cells, B-lymphocytes, macrophages and NK cells. They are involved with cell-mediated immunity and assist in antibody-mediated adaptive immunity
CD8 cells or cytotoxic T cells:
Directly attack an antigen
Major Histocompatibility complexes (MHCs) or human leukocyte antigens (HLAs):
Cell surface antigen that the body can use to distinguish between self-versus invader
Antigen presenting cells (APCs) or dendritic:
Process the antigen first and induce cell-mediated immunity
Anergy panel:
Injected intradermal (just under the skin), no reaction indicates lack of immune responsiveness and immunodeficiency
Antibody titer:
Confirms protection by measuring IgM and IgG
Allergy testing:
Serology test such as ELISA that evaluates the severity of an allergy by how much IgE reacts with the allergen
CBC with differential:
A lab test of the complete blood count that also has all the WBCs broken down. (monocytes, lymphocytes, granulocytes, neutrophils, eosinophils, basophils)
Culture and sensitivity:
The culture determines out the exact organism of infection and the sensitivity determines the medication that will treat the infection
Monocytes:
3-7% WBCs, they leave the circulation and enter tissue, they mature into macrophages, which are found in large quantities in the spleen and other organs. Their primary function is phagocytosis.
Macrophages:
Function within the innate immune system and are the first responders in defense against an antigen
Neutrophils:
Neutrophils make up 60% to 70% of the WBCs in circulation. They are first responders to an infection, stressful event, or inflammatory reaction. Antigens, epinephrine, and corticosteroids stimulate generation and release of neutrophils in the bloodstream. Due to the shape of their nucleus, mature neutrophils are referred to as segs, whereas immature neutrophils are called bands. In severe acute infection or inflammation, the bone marrow cannot keep up with the body’s need for mature neutrophils, so it releases bands. If a laboratory test indicates a high number of bands in circulation, this is referred to as a “shift to the left.”
**break this up
Eosinophils:
WBCs, mainly released during allergy and parasitic infection
Basophils:
Generated and released by the bone marrow in response to many inflammatory reactions, particularly parasitic infection
Leukocytosis:
A rise in WBC count above 11,000/uL
Leukopenia:
A decrease in WBC count below 4,000/uL, which is a general term that describes a decrease in all types of WBCs. Leukopenia increases the risk of infection, decreases signs of infection, and diminishes healing ability
Neutropenia:
Lack of sufficient number of neutrophils in blood. The most frequent kind of leukopenia. It is diagnosed in patients with fewer than 1,500 neutrophils/uL. Neutropenia increases susceptibility to infection and diminishes the external signs of inflammation
Granulocytes:
WBCs with chemical containing granules in their cytoplasm. Their granules contain powerful digestive enzymes capable of killing microorganisms and then catabolizing debris during phagocytosis. There are three types of granulocytes: eosinophils, basophils, and neutrophils
Super infection
Infection caused by broad spectrum antibiotics that disturb the normal flora
Opportunistic infection
Organisms that would not normally cause disease but do so in immunocompromised patients
