Inflammation Flashcards
What are 4 characteristic features of inflammation? What does it result in? (from the Roman writer Celsus)
Rubor (redness)
Tumor (swelling)
Calor (heat)
Dolor (pain)
results in functio laesa (loss of function)
Inflammation is a protective response to rid tissues of ____ _____.
cell injury
Inflammation has a dark side. Repair usually does not result in complete ______ of tissue and very likely results in ____.
regeneration, scar
Complete function may or may not return to the tissue
What are the 3 types of inflammation?
acute
chronic
granulomatous (a subset of chronic)
What type of inflammation is characterized by mobilization of fluid and acute inflammatory cells (neutrophils) into tissues?
acute
What are the two steps in the acute inflammatory process?
vascular changes
cellular changes
What are the vascular changes? (4)
- immediate vasoconstriction followed by vasodilation
- increased blood flow to site of injury
- slowing of circulation to the area by increased microvascular permeability, eventually leading to stasis
- margination of WBC’s, especially neutrophils
The two major events that occur on the cellular level are what?
delivery of WBC’s to site of injury AND phagocytosis
How do WBC’s get to the site of injury? (a sequence of 4 events)
- neutrophils marginate
- they then roll along the endothelium
- they migrate across the endothelium (diapedesis)
- they migrate through the interstitium as a result of a chemotactic response
What endothelial molecule and leukocyte molecule go with the rolling of neutrophils, monocytes, T lymphocytes?
Endothelial molecule- P-selectin
Leukocyte molecule- Sialyl-Lewis-X-modified proteins
What endothelial molecule and leukocyte molecule go with rolling and adhesion of neutrophils, monocytes, T lymphocytes?
Endothelial molecule- E-selectin
Leukocyte molecule- Sialyl-Lewis-X-modified proteins
What endothelial molecule and leukocyte molecule go with rolling of neutrophils and monocytes only?
Endothelial molecule- GlyCam-1, CD34
Leukocyte molecule- L-selectin
What endothelial molecule and leukocyte molecule go with adhesion, arrest, and transmigration of neutrophils, monocytes, and lymphocytes?
Endothelial molecule- ICAM-1 (immunoglobin family)
Leukocyte molecule- CD11/CD18(Beta 2) integrins (LFA-1, Mac-1)
What endothelial molecule and leukocyte molecule go with adhesion of eosinophils, monocytes and lymphcytes?
Endothelial molecule- VCAM-1 (immunoglobin family)
Leukocyte molecule- VLA-4 (Beta 1) integrin
LAD1 leads to what?
genetic
defective leukocyte adhesion because of mutations in Beta chain of CD11/CD18 integrins
LAD2 leads to what?
genetic
defective leukocyte adhesion because of mutations in fucosyl transferase required for synthesis of sialylated oligosaccharide (ligand for selectins)
Chronic granulomatous disease leads to? X-linked?
Autosomal recessive?
genetic
- decreased oxidative burst
- phagocyte oxidase (membrane component)
- phagocyte oxidase (cytoplasmic components)
MPO deficiency leads to what? genetic
decreased microbial killing because of defective MPO- H2O2 system
Chediak-Higashi syndrome leads to what? genetic
decreased leukocyte functions because of mutations affecting protein involved in lysosomal membranes traffic
What vasodilates the microvascular system but paradoxically constricts larger arteries?
histamine
What is released from platelets as they aggregate? This acts similar to histamine
serotonin
Inactive components become activated, several help increased vascular permeability; C5a also aids in chemotaxis of neutrophils
complement
What initiates the clotting system?
activated Hageman factor (factor XIIa)
What contributes to pain and fever in the inflammatory response?
Prostaglandins
What modulates a variety of pathways involved with immunity, neutrophil activation, monocyte activation, and stimulate hematopoiesis?
cytokines
What accounts for much of tissue injury in the inflammatory response?
free radicals
What morphologic pattern in inflammation forms effusions?
serous
What morphologic pattern in inflammation forms fibrinous exudates?
fibrinous- duh
What morphologic pattern in inflammation forms pus?
suppurative (purulent)
What are the 4 parts of ulceration?
- necrosis
- acute and/or chronic inflammation
- granulation tissue
- scar
What type of inflammation is characterized by infiltration by mononuclear inflammatory cells (lymphocytes, monocytes, plasma cells) along with MACROPHAGES?
chronic
What is the key player in the chronic inflammatory response?
THE MACROPHAGE!
Neutrophils are more often involved in ______ infections, lymphocytes/monocytes more often in _____ infections.
BACTERIAL
VIRAL
This is a distinctive subtype of chronic inflammation that is characterized by ACTIVATED MACROPHAGES (histiocytes).
granulomatous inflammation
What is in a granuloma? (3)
- ball of histiocytes (may or may not be necrotic)
- multinucleated giant cells
- surrounding cuff of lymphocytes
What causes a granuloma? (2)
immune reaction or foreign body
Who is responsible for a granuloma? (the most common)
- necrotizing (caseating) granulomas
- non-necrotizing (non-caseating) granulomas
Think TB, fugus (esp. Histoplasma) and cat scratch disease
necrotizing (caseating) granulomas
Think foreign body, sarcoid, and don’t forget that diseases that have necrotizing granulomas can also be sprinkled with occasional non-necrotizing granulomas (usually the smaller ones are non-necrotic)
non-necrotizing (non-caseating) granulomas