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POM (Principles of Medicine) > Inflammation > Flashcards

Inflammation Flashcards

1
Q

What is inflammation?

A

A non-specific immune response to cellular injury designed to remove the cause & consequences of injury

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2
Q

What are the conical features of inflammation?

A 
Redness (Rubor)
Heat (Calor)
Swelling (Tumor)
Pain (Dolor)
Loss of function (Functio laesa)
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3
Q

What are the causes of inflammation?

A

Pathogens, allergens, autoantigens, physical damage, extreme temperatures, non-apoptotic cell death

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4
Q

What is acute inflammation?

A

Short term rapid response non-specific to cellular injury
Instantaneous changes to blood flow
recruitment of immune cells

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5
Q

What occurs to vasculature during acute inflammation?

A

Structural alterations to the microvasculature
Transient vasoconstriction of arterioles following vasodilation of arterioles and capillaries
Results in increased blood flow to the tissue, presenting rubor and callor

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6
Q

What cells are resident in the interstitium?

A

Resident macrophages, dendritic cells, mast cells

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7
Q

Where is the interstitium located?

A

The intermediate layer between the epithelium and the vascular endothelium

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8
Q

What generates inflammatory signals?

A

Non-apoptotic cell death (Damage-associated molecular patterns)
Pathogen-associated molecular patterns - lipopolysaccharides
Vasodilator release

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9
Q

Name the two main vasodilators:

A

Nitric oxide and histamine

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10
Q

How are vasodilators released from mast cells?

A

Mast cell degranulation

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11
Q

What is mast-cell degranulation?

A

The fusion of lysosomes and secretory vesicles to exocytose compounds

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12
Q

What effect does increased blood flow have in the local area of inflammation?

A

Locally raised temperature reduces the effectiveness of pathogen reproduction

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13
Q

What effect does histamine exert?

A

Increased permeability of vascular endothelium, resulting in an exudate forming within tissues,
Cells in walls withdraw from each other (diapedesis), leaky capillaries, the formation of tissue fluid

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14
Q

What is exudate?

A

Protein-rich fluid

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15
Q

What does exudation and increased blood flow result?

A

Stasis of circulation in area

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16
Q

Which cells release histamine?

A

Mast cells, basophils and platelets

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17
Q

What are the benefits of increased vascular permeability?

A

Increased antibody and leukocyte presence, increased availability of protein and formation of the barrier.

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18
Q

What is the cytokine network?

A

Interaction between macrophages and CD4 t cells

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19
Q

What inflammatory factor is released from macrophages?

A

Interleukin-1

GM-CSF

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20
Q

What is the function of IL-1?

A

Generates chemotactic signal of chemokines, activates T-cells

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21
Q

What is the role performed by IL-12?

A

Activates Th1, and NK cells

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22
Q

How is chemotaxis achieved?

A

Chemokines diffuse out to establish a chemical gradient, leukocytes expressing complimentary chemokine receptors migrate towards to chemokine source

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23
Q

What is CXCL8?

A

IL-8

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24
Q

Which cell secrete CXCL8?

A

Macrophages

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25
What is the role of CXCL8?
Chemotactic attract for neutrophils , neutrophil migration to the site of infection
26
What receptors do CXCL8 bind to?
G-coupled 7-TM proteins (CXCR-1/2)
27
Which cells are the initial responders to inflammation?
Neutrophils
28
How do cytokines influence adhesion molecules?
Upregulates endothelial production of adhesion molecules
29
Which cell secretes chemoattract cytokines?
Macrophages
30
What is the main example of an adhesion molecule?
E and P-Selectins
31
What is the first step of neutrophil migration?
Rolling and adhesion
32
Describe the neutrophil binding with the endothelial cell surface:
Establishes reversible binding between selectins induced on the endothelial cell surface and carbohydrate ligands in a low-affinity state
33
Which ligand binds onto P and E-selectins?
PSGL-1 (Selectin-P ligand)
34
Which switch ensures that there is a tight adhesion to the endothelial surface?
Low to high-affinity switch in integrins
35
What are the two integrin ligands?
LFA-1, MAC-1 (high affinity)
36
Which factors promote the low-high affinity switch in neutrophil tight adhesion? (Selectin --> integrin-mediated)
IL-8 C5A Leukotriens LTB4 Formylated peptides and platelet activating factor
37
Which molecule presented on the endothelial surface interacts with the neutrophil integrins, MAC-1, LFA-1?
ICAM-1/2
38
Which chemotaxin gradient do neutrophils migrate across?
IL-8
39
Which molecule secreted by endothelial cells stimulates diapedesis?
CD99
40
How do infiltrating neutrophils pass through the endothelial membrane?
Disrupts the interactions of junction adhesion molecules (JAM) and vascular endothelial cadherins (VE-cadherin)
41
How is the rearrangement of the cytoskeleton of pseudopodia caused during the neutrophil invasion?
PECAM interactions
42
Which cells release prostaglandins?
Mast cells, leukocytes
43
What action do prostaglandins exhibit?
Vasodilation, pain, fever
44
Which cells secrete TNF, and IL-1?
Macrophages, endothelial cells, mast cells
45
What is the role performed by TNF & IL-1?
``` Endothelial activation (adhesion molecules) fever, malaise, pain, and anorexia, shock ```
46
Which cells secrete chemokines?
Macrophages and leukocytes
47
What is the role performed by chemokines?
Chemotaxis | Leukocyte activation
48
Which receptors identify pathogen-associated molecular patterns (PAMPs)?
Toll-like receptors | CD14
49
Give an example of a PAMP?
Lipopolysaccharides present on gram-negative bacteria
50
Which enzymes are secreted by lysosomes?
Lysozyme and elastase
51
What is the role of reactive oxygen species & NADPH oxidase?
Secreted to interfere and disrupt microbial function
52
What is netosis? | Hint: NETs
Neutrophil extracellular traps (NETs) are networks of extracellular fibres composed of neutrophil DNA which bind pathogens
53
How long is the half-life of activated neutrophils?
Short half-life
54
What is the resolution of an acute inflammatory response??
Clearance of apoptotic cells and produce anti inflammatory mediators Repair: ECM & granularof formation
55
What are the sensory stimulatory signals transmitted by nociceptor neurons?
PGEs and histamines
56
What is chronic inflammation?
Arises as a response to injury with associated | Fibrosis occurring over a prolonged period of time in comparison with acute inflammation
57
The formation of which structure characterizes chronic inflammation?
Granulomas
58
Why does chronic inflammation occur?
Persistent exposure to stimuli
59
What are the examples of persistent stimuli?
Infection (TB, Hepatitis) Pollutants and allergens Inclearable particulates Auto-immunity
60
Which cells are involved in chronic inflammation?
Inflammatory macrophages T cells Plasma cells
61
What are the roles performed by macrophages?
Phagocytosis of pathogens & necrotic cells Recognize and engulf apoptotic cells Anti-inflammatory responses through cytokine release Antigen-presenting cells Promotes tissue repair through stimulating angiogenesis and fibrosis
62
Whare are regulatory T cells? (Treg)
Regulate the effector and activation stages of T-cells, secretes IL-10 Downregulates macrophages
63
What is granulomatous inflammation?
Chronic inflammation with a distinct pattern of granuloma formation
64
What are granulomas?
Aggregation of activated macrophages forms when the immune system attempts to form a clearance barrier, surrounding the pathogen Prevents infection spread.
65
Compare the onset of acute and chronic inflammation:
``` Immediate onset (lasts few days) v Delayed onset (Last weeks, months, years) ```
66
Compare the immune cells present in both types of inflammation:
Neutrophils V Macrophages & Monocytes
67
What are the chemical releases in acute and chronic inflammation?
Histamine v Cytokine release
68
What are the outcomes of acute inflammation?
Complete resolution | Progression to chronic
69
What are the outcomes of chronic inflammation?
Scarring | Loss of function

POM (Principles of Medicine) (34 decks)

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