Infection, Inflammation, Innate & Specific Immune Responses Flashcards
Does bacteria go into a cell nucleus?
no
Do viruses go into a cell nucleus?
yes
What does the intestinal flora help do for the body?
Synthesize vit K
Non-specific inflammatory response example
fever & Inflammation
Specific inflammatory response example
Antigen-Antibody response
How fast does a Non-specific inflammatory response occur?
Immediate
How fast does a specific inflammatory response occur
develops slowly
What type of cells are involved in a specific inflammatory response
specific cells to combat a particular pathogen
antibody (immunoglobulin)
protein that neutralizes pathogens to get them out of the body
Antigen
A toxin
Non-specific mechanical first line of defense examples
skin, mucus membranes, urine, pooping, vomiting
non-specific: chemical factors: first line of defense examples
acid pH of skin, Lysozymes, gastric juice, unsaturated fatty acids
Lysozymes
an enzyme that catalyzes the destruction of the cell walls of certain bacteria
Non-specific: internal defenses: second line defense
antimicrobial proteins, natural killer cells, phagocytes, inflammation, fever
Phagocytes
WBC that can ingest & destroy microorganisms
Complement system
group of 20 proteins circulating in the blood looking for invaders
Interferons
WBC communicators, proteins produced by WBC when the immune response is triggered
Function of lymph nodes
proliferation (increase) of immune cells, filter lymph fluid & remove bacteria/toxins from circulation
Thymus function & location
produces t-lymphocytes, located in mediastinum
spleen function
reservoir for blood, largest lymph organ, carries platelets
tonsils function
produce lymphocytes, gaurd against airborne & ingested pathogens
red bone marrow function
houses stem cells that develop into lymphocytes
B cell function and where they are made
split into plasma cells that make antibodies and memory b cells; made in the bone marrow
where are T cells made
Made in the thymus
Tissue macrophages function
clean up blood
examples of tissue mactophages
Lung: alveolar macrophages, Liver: Kupffer’s cells, spleen, lymph node, intestine: Peyer patches, CNS: microglial cells
Granulocytes examples
Neutrophils, Basophils, Eosinophils
“polys” or “segs”
Neutrophils
fight infection by phagocytosis (engulfing miccroorganisms), most common type of WBC,
Phagocytosis
the process of engulfing and destroying microorganisms and other foriegn materal
The 3 Phagocytes
Neutrophils, monocytes and macrophages
What do granulocytes release?
Heparin and histimine
Bands
baby neutophils
Basophils & Eosinophils respond to what kind of infections?
respond to parasitic & allergic infections
Agranulocytes examples
Monocytes, lymphocytes
Lymphocyte examples
B-cells and T-cells
Lymphocytes respond to which type of diseases?
viral
Monocytes function and respond to which type of infections?
take over for neutrophils, respond to severe infections
Relative WBC
percentage
Absolute WBC
actual number
Aboslute value equals what?
Absolute value = % x WBC
Relative WBC values will always equal what?
100% (If one type of cell increases then the other types must decrease
Which count is more important? Relative of absolute?
Absolute
Terminology: Increased value of WBC
“cytosis” except & “philia”
Terminology: Decreased value of WBC
“penia”
What can cause a low WBC count?
Attack on bone marrow
dietary deficiencies
autoimmune diseases
What does it mean if there is a drastic decrease in WBC count?
bone marrow failure & risk for infection
Do newborns & infants have a high or low WBC count?
high
How are the elderly affected by WBC count?
They may not have an increase in WBC with a severe infection
Erythrocyte Sedimentation Rate (ESR)
rate that RBC’s settle out of anticoagulated blood in 1 hour
C-Reactive protein (CRP)
an abnormal protein made in the liver, it occurs rapidly
What kind of cell wall does Gram + cocci have?
a THICK peptidoglycan cell wall, soak up purple stain
Gram + Cocci examples
Staph aureus, staph epidermidisstrep pna, Group A beta-hemolytic streptococcus
Where are Staph aureus & Staph epidermidis found?
wounds, surgical sites, indwelling catheters
Where is strep pna found?
community acquired pna, adult bacterial meningitis
Example of Group A beta-hemolytic streptococcus
rheumatic fever
What kind of a cell wall do a Gram - pathogens have? and what are they impermeable to?
A protective outer coat (lipopolysaccharide + transmembrane protein pores) that are impermeable to penicillin’s & cephalosporins
Gram - examples
Escherichia, Neisseria, Pseudomonas, most noscomial infections
Anaerobes are made from which gram? + or -?
both
Anaerobe examples
Bactericides fragilis, CDIFF
“itis”
inflammation
Does colonization (presence of microorganisms) cause inflammation?
No
What initiates the inflammatory process?
cell injury
can you be hypoxic without having ischemia?
yes
Can you have ischemia without being hypoxic?
no
signs of inflammation
rubor (red), calor (heat, Dolor (pain), Tumor (swelling), Functio laesa
rubor
red
calor
heat
Dolor
pain
Tumor
swelling
Functio laesa
Loss of function
Leukocyte emigration
the passage of leukocytes through the endothelial gap junctions of blood vessels
Leukocyte Margination
increases expression of adhesion of molecules so they can get to where they need to go to
Chemotaxis
The process by which leukocytes (WBC, phagocytes)wander through the bloodstream and our attracted to chemical signals brought on by an inflammatory response
During inflammation, what happens on a vascular level?
arteriolar vasoconstriction followed by vasodilation (brings back O2) which produces swelling & erythema & hyperemia
What happens to the capillary permeability during an inflammatory response?
It increases causing swelling and dilutes toxins
Who are the first responders in an inflammatory response?
Neutrohils (24 hr life)
When do macrophages respond in an inflammatory response
after 48 hours, they do more work than neutrphils
Mast cell function
release heparin to maintain blood flow to area
5 steps in the phagocytosis process
1) Attachment
2) Ingestion
3) Fusion of the lysosome & phagosome
4) Digestion
5) Release of digested products
Histamine is released by
Basophils, platelets & mast cells
What else does Histamine stimulate?
Bronchoconstriction (H1 receptors) & Gastric acid secretion (H2 receptors)
What is the purpose of vasodilation in an inflammatory response?
to increase blood flow and increase capillary permeability
Kinins function
an inflammatory mediator that:
1) increases capillary permeability
2) induces vasodilation
3) act as chemotatic agents for phagocytes
Kinin example
Bradykinin —> increases capillary permeability & causes pain
How are Kinins formed?
from inactive precursors (proteins that are inactive and can be turned on), kininogens, in blood
What do Prostaglandins do? what are they?
- Inflammatory Mediator made from lipids -They cause fever in response to infection,
- stimulate pain receptors, increase effects of histamine & Kinins
What are prostaglandins blocked by?
NSAIDs
What are prostaglandins produced by
arachodonic acid found in cell membranes
what are Leukotrienes produced by?
basophils & mast cells during breakdown of membrane phospholipds
What is the key role in bonchoconstriction in asthma? Its associated with leukotrienes
SRSA- slow Reacting Substance of Anaphylaxis
What are Leukotrienes at their function
They are Inflammatory Mediators
- increase vascular permeability
- increase adhesion of WBC to capillary during injury/infection
- Acts as chemo-attractants
What are complements?
Inflammatory Mediators
-consist of 20 circulating proteins
What is the function of complements?
Increase:
- Vascular permeability
- Chemostasis
- Phagocytosis
- Lysis of foreign cells
Where do Platelet Activating Factors come from and what are they?
made from a complex lipid in cell membranes. They are inflammatory mediators
Platelet activating factors function
- Induces PLT aggregation (put together)
- Activates neutrophils
- Potent eosinophil chemo-attractant
Non-inflammatory cells
fibroblasts & endothelial cells
Cytokines function
proteins produced by different cell types to bind to receptors to remove
another name for Interleukin
Cytokines
non-inflammatory cells
fibroblasts & endothelial cells
Cytokines: ILs
activates t-cells and induces fever
Cytokines: IF-y
induces MHC 1 and 2, activates macrophages & endothelial cells
Cytokines: TNF
cytokine for tumor cells
Cytokines: CSF
promotes neutrophilic, eosinophilic and macrophage bone marrow colonies, activates mature granulocytes
chemical mediator for Leukocytosis
TNF and IL-8
chemical mediator for Fever
IL-1 and IL-6
chemical mediator for Pain
prostaglandins & bradykinin
chemical mediator for chemotaxis
complement fragments
chemical mediator for Tissue damage
lysosomal enzymes & products released from neutrophils, & macrophages
chemical mediator for swelling, redness & tissue warmth
histamine, prostaglandins, leukotrienes, bradykinin, platelet-activating factor
what does an Abscess look like?
inflammation with purulent exudate
what does an ulceration look like?
inflammation where epithelial surface has become necrotic &eroded
what happens in an acute inflammation response is unsuccessful at riding the body of invading foreign particles?
chronic inflammation & granuloma formation
Granuloma formation examples
- ) 1-2mm lesions
- ) foreign bodies such as splinters
- ) giant cells engulf large foreign particles
- ) “cheesy” necrotic center from TB
What happens in the acute phase inflammatory response when WBC proteins are broken down?
negative nitrogen balance
During an acute inflammatory response during bacterial infections, what is increased?
of leukocytes, neutrophilia (shift to left)
Lymphadenopathy
increase in size of lymph nodes
Lymphadenitis
tender lymph nodes/inflammed
non-painful lymph nodes=what
neoplasms
what will patients temp be like after surgery
low grade for first 48-72 hours
Fever coming from outside
hyperthermia
pyrogens
fever producers
Endogenous pyrogens stimulate the release of PgE (prostaglandin E) from where?
hypothalmus
Endogenous pyrogens are produced where? examples
from within the the cell; malignancies, graft rejections
Exogenous pyrogens are produced where? examples
from outside the cell; fungus, endotoxins, gram +/- bacteria
stages of fever: prodromal
before fever; malaise, feeling achy
stages of fever: stage 1
cold or shaking stage, occurs 10-40 min w/ rapid steady rise of temp b/c of shaking
stages of fever: stage 2
flush; thermostat reset, skin warm and flushed—> cellular dehydration occurs
stages of fever: stage 3
defervescence (heat loss), sweating occurs-fever breaks
patterns of fever: intermittent
returns to normal at least q24hr
patterns of fever: remittent
varies a few degrees in either direction
Fever of unknown origin
temp >101 present for ?3 weeks
what are causes of fevers of unknown origin
malignancies, infections & cirrhosis
apoptosis
ability to program cell dealth for the good of the person
Hapten &Hapten-carrier complex
penicillin binding to plasma protein example
Major Histocompatibility complex (MHC) 1:
it can differentiate self from non self, on all nucleated cells in body
Major Histocompatibility complex (MHC) 2
They present the antigen to helper t-cells- “here it it-take it away!”
AKA Human Leukocyte Antigens (HLA)
4 linked groups of genes on chromosome 6
Who gets AKA Human Leukocyte Antigens (HLA)
receive a set (haplotype)from each parent
who has issues with Major Histocompatibility Complex (MHC)?
patients with transplants
processing of antigens
ingestion digestion fusion binding insertion
main responders to viral infections
lymphocytes (B & T-cells)
regulatory lymphocytes
coordinate & organize calling to battle
effector lymphocytes
final stage in immune response, raise alarm by releasing cytokines
B-lymphocytes (10-20%)mature where and occur when?
mature in bone marrow, found in humoral or antibody-mediated immunity
T-lymphocytes (60-70%)mature where and occur when?
mature in thymus, occur in cell-mediated immunity
cell-mediated immunity
the destruction of target cells through secretion of lymphokines
types of t-cells
killer, helper, suppressor (you have to turn off immune response at some point), memory
Humoral or Immunoglobulin-mediated immunity
B cell mature into plasma cells which produce antibodies, wants to eliminate bacteria & prevent viral infections
cell-mediated immunity chart
- antigen
- macrophage engulf antigen
- antigen MHC expression -release of cytokines
- production of cytotoxic cells
what do lymphocytes activate
T-cels & B-cells
T4 Lymphocyte
regulate & amplify B & T-cell response
Cytotoxic T- cells bond to MHC I or !!? and what is the code for them
MHC I (CD8)
Helper T-cells bond to MHC I or II? and what is the code for them
MHC2 (CD4)
Suppressor t-cells
reduce the humoral response
memory T-cells
remain dormant until 2nd exposure
Natural killer cells
CD15 & CD56, non-specific that kill tumor cells &virusus
How are natural killer cells able to kill cells?
they are inhabited by contact with MHC self molecules, depends on production of perforinsm enzymes & toxic cytokines (they punch holes into cells and destroy it)
what enhances natural killer cells?
IL-2
macrophages
ingest antigen–>present antigen-MHC complex to T-lymphocytes—>activate T-lymphocytes
what do macrophages secrete?
cytokins: tumor necrosis factor (TNF) & interleukin-1 (IL-1) which produces fever
humoral immunity chart
clones of B &T cells occur
basis of humoral immunity
B-lymphocytes
antigen binds with receptor,–>differentiates into plasma cell–>secretes immunoglobulins
B-Lymphocytes
what regulates B-lymphocytes?
T-Lymphocytes & cytokines
Antibody structure: Fab (antigen binding fragment) is specific for what?
each antibody
Antibody structure:Fc (constant fragment)
non-specific, all immunoglobins
What activates constant fragment (Fc) antibody structures?
the binding of a antigen binding fragment (Fab)
IgG (75%)
most common in all body fluids, stays higher during second exposure, crosses placenta—“Its like the grass the field”
IgM (10%)
first responder–too larger to cross membranes, lasts a week, doesn’t get higher during 2nd exposure –“Its like the maple trees in the grass field
IgA (15%)
found in body secretions, saliva, sweat, tears, mucus, bile & colostrum —“Its the Area of wetness in the grass field”
IgD (0.2%)
found in plasma & easily broken down, found on B cells that help B cell grow —“The baby dear that needs to grow up in the grass field”
IgE (0.004%)
found in allergic reactions, RARE, found on Fc region on basophils & mast cells–“Its like the elm trees in the grass field”
natural immunity
innate resistance, age, health, race, sex
active immunity
acquired through immunizations OR having the disease
passive immunity
short term protection
examples: bit by a snake & antidote given, breast milk, gamma globulins, antitoxin
The complement Cascade
20 inactive proteins circulating
how does the complement cascade cause inflammation?
by increasing vascular permeability, cheostasis, phagocytosis & lysis of foreign material
the initial step of the classic pathway in the complement cascade (C1-C10?)
C1
Anaphylaxis
degranulation of mast cells with release of histamine & other chemical mediators
Opsonization
targeting of antigen so it can be easily engulfed & digested by macrophages
cytolysis
destruction of cell membranes
Adherence of immune cells
Adhesion of Ag-Ab complexes to surface of cells
C1-C5
stimulate mast cell degranulation (release of chemical mediators)
C6-10
bacterial cell lysis by making cell wall “leaky”
the initial step of the alternatepathway in the complement cascade
C3
Type 1 hypersensitivity disorder involves what immunoglobin
IgE allergic , IMMEDIATE
ex. anaphylaxis, allergy
Type 2 hypersensitivity disorder
IgM & IgG, cytoxic rxns
ex. blood transfusions
Type 3 hypersensitivity disorder
immune complex rxns
ex. post-strptococal glomerulonephritis
Type 4 hypersensitivity disorders
cell-mediated rxns
ex. contact dermatitis
which type of hypersensitivity disorders involve antibodies?
Type 1-3
goodpasture’s syndrome, erythroblastosis fetalis, autoimmune hemolytic anemia, hemolytic transfusion rxn are examples of which type of hypersensitivity disorder?
Type 2
serum sickness, post-streptococcal glomerulonephritis are examples of which type of hypersensitivity disorder?
Type 3
Contact dermatitis, HVGD and GVHD, allograft rejection are examples of what hypersensitivity disorder?
Type 4