Immunopathology Flashcards
T helper cells are classified as ____ and TH2 cells drive a ____ mediated response
CD4
Antibody
Identify the most likely type of necrosis to occur in the brain after a stroke
Liquefaction necrosis
Thromboxane A2 (TXA2) and prostacuyclin (PGI2) are products of this pathway
Arachidonic acid
Cyclooxygenase
Cardinal signs
Rumor Calor Tumor Dolor Function laesa
Why is PGE2 unique
Primary one for pain
Associated with fever
What makes up the most abundant population of WBCs
Neutrophils
- segs, PMNs
Primary leukocyte in acute infection
Neutrophils
Primary cell players in chronic inflammation
Macrophages and lymphocytes
Where are the neutrophils at
50% in circulating pool, and 50% in amrginating pool, tethered to the side of the blood vessel walls
-doing a blood count gives us the count that is circulating in the blood, not tethered to the wall
Neutrophil distribution is influenced by what
Activating or inactivating neutrophil adhesion molecules
Trauma and WBC
Trauma causes neutrophils to be released from the marginating pool, causing the WBC to shoot up
Steps of acut inflammation
- IL-1 and TNFa released and upregulate the expression of E selecting and P selectin
- Neutrophils weakly bind to endothelial selectins and roll along the surface
- Neutrophils stimulated to express ligand for cellular adhesion molecules
- Neutrophils adhere firmly to cellular adhesion molecules (ICAMs and VCAMs)
- neutrophils then emigrate (via diapedesis), migrate through the tissues (via chemotaxis), phagocytize, degranulate and kill what has been eaten
IL-8 in acute inflammation
Clean up on aisle 8: neutrophils are attracted to site of damage via IL-8
Exudates and acute inflammation
Neutrophils going into an area and killing themselves, producing pus
Where are a vast majority of mast cells
Lungs and skin
Earliest signs and symptoms of reaction
Itching and difficulty breathing because of mast cells in skin and lungs
Cause vasodilation and increased vascular permeability
Histamine
What is histamine produced by
Basophils, platelet, and mast cells– release triggers include iGE mast cell reactions, anaphylatoxins and IL-1
Vasoactive amines
Histamine
Serotonin
Causes vasodilation and increased vascular permeability produced by platelets
Serotonin
Anaphylatoxins
C3a and C5a
Cause degranulation
Neutrophil attractants
IL-8
C5a
What does the kinin system produce
Bradykinin
-causes vasodilation, pain, increased vascular permeability, bronchoconstrition
Factor 12 of coagulation cascade
Causes prekallikrein to kallikren
What produces pain
NOT HISTAMINE. Bradykinin
Bad actor of COX pathway in arachidonic acid
Thromboxane A2
What does aspirin act on
Thromboxane A2
What does aspirin
Irreversibly acetylates platelets
-neutralized
Is aspirin reversible or irreversible
Irreversible, all other NSAIDs are reversible
What is thromboxane A2 produced by
Platelets
Prostacyclin (PGI2)
COX
Dilates vessels
Inhibits stickiness of platelets
PGE2
COX
Pain
Fever
What causes pain
PGE2
bradykinin
LOX pathway
Leukotriene
Plays a huge role in the lungs and asthma
What does arachidonic acid split into
LOX and COX
What does COX split into
PGI2
TXA2
Steroids and arachidonic acid
Hit PAL-2
When you want to shut down inflammation fast what do you do
You want to shut down the arachidonic acid cascade by giving steroid
Cut head off of snake by adding it to the beginning of the arachidonic acid cascade
IL-6
Causes liver to produce acute phase reactants
Activate endothelial cell adhesion molecules; initaties PGE2 synthesis in anterior hypothalamic, leading to production of fever
IL1 and TNFa
Makes RBC sticky
Fibrinogen
ESR
What does fibrinogen do to ESR
Causes it to go up
Primary cytokines that acts on liver to produce ACP: ferritin, fibrinogen, CRP
IL-6
Ferritin
Iron binder
Huge proinflammatory cytokines and initiate PGE2
IL1 and TNFa
PMN chemotaxis
IL-8
4 outcome of acute inflammation
Complete resolution with regeneration
Complete resolution with scarring
Abscess formation
Transition to chronic inflammation
Abscess in brain
Usually with infection, but in brain will be from ischemia, sterile abcsess
Causes of chronic infection
- persistenc infeections
- mycobacteria phagocytized by macrophages and cause a larger inflamed lesion and granuloma
- autoimmune diseases
- response to foreign material
- response to malignant tumors
Monocytes
Macrophages in blood
Macrophages in skin
Histiocytes
Kupffer cels
Macrophages int he liver
Osteoclasts
Macrophages in bone
Microglia
Macrophages in brain
How can macrophages be modified
Into epithelioid cells in granuloma
-NOT EPITHELIAL CELLS. Macrophages have been activated in granulomas
B cells, plasma cels, and T cells
Lymphocytes
Key role in parasitic infections and IgE mediated allergic reactions
Eosinophils
Major basic protein in eosinophils
Toxic to parasites and tissue
High number in lung and skin
Basophils and mast cells
Play key role in IgE mediated reactions and can release histamine
Basophils and mast cells
What kind of response is epitheliof macrophages in a granuloma
TH1 response, cell mediated
What is in the center of granuloma
Central necrosis
Purples high protein filled with neutrophils in the exudate
Caused by necrosis
Irreversible/often uncontrolled death of many cells
Necrosis
Neutrophils and acute
Necrosis
May be aseptic due to blood supply loss
Necrosis
Two processes in necrosis
Enzymatic digestions of the cell
Desaturation of proteins
Four types of necrosis
Coagulative necrosis
Liquefactive
Caseous
Fat
Geletin, dead tissues where cells retain their shape but have lost their organelles, structure boundary is maintained
Coagulative necrosis
Due to ischemia or infarction: heart attack
Coagulative necrosis
When can regeneration occur in coagulative necrosis
If enough viable cells are present around the affected area regeneration may occur
What does ischemia cause in the central nervous system
Liquefactive necrosis because there is little structural framework in neural tissue
Is coagualtive necrosis septic or aseptic
Aseptic because its from loss of blood supply
Usually infectious, forms an abscess, often associated with bacterial or fungal infections
Liquefactive necrosis
Exception of liquefactive necrosis
In the brain, it is due to ischemia and is ASEPTIC here but none where else
When blood supply is cut off somewhere in the body what does it form
A triangular block
Cheesy proteinaceous dead cell mass, smog often observed in TB infections, may be seen in histo, cryptococcosis, and cocciodomycosis
Caseous necrosis
White specks. This is death in adipose tissue-small white lesions are formed, most often due to trauma
Fat necrosis
Programmed cell death
Apoptosis
This is critical in an embryo and fine tuning the developing retina
Apoptosis
How many ganglion cells die in the apoptosis
70%
T helper cells are classified as _____ and TH2 cells drive a ____ mediated response
CD4
Ab
Identify the most likely type of necrosis to occur in the brain after a stroke
Liquefaction necrosis
Thromboxane A2 (TXA2) and the prostacyclin (PGI2) are products of this pathway
- arachidonic acid
- cyclooxygenase