Inflammation, Tissue Repair, and Wound Healing (P) Flashcards
1
Q
What is immunity?
A
It is the ability to resist harmful effects of microorganisms and other foreign substances
2
Q
What are the 2 types of immunity?
A
1) Adaptive immunity
2) Innate immunity
3
Q
What are the characteristics of adaptive immunity?
A
It exhibits:
1) Specificity and
2) Memory
4
Q
What are the characteristics of innate immunity?
A
It does not show:
1) Specificity or
2) Memory
1) It responds quickly
5
Q
Innate immunity consists of what?
A
1) Mechanical mechanisms
2) Chemical mediators and blood proteins (complement)
3) Cells
4) Inflammatory response
6
Q
What are the exs of cells that are present in innate immunity?
A
1) Macrophages
2) Neutrophils
3) NK cells
7
Q
What are the mechanical mechanisms that are present in innate immunity?
A
1) Skin and mucosae prevent entry of microorganisms
2) Tears, saliva, and mucus remove them
8
Q
*What are the inflammation mediators (or chemical mediators) in innate immunity?
A
1) Histamine
2) Serotonin
3) Arachidonic acid metabolites
4) Cytokines (ILS / chemokines)
9
Q
What are the diff cytokines?
A
1) Interferon alpha (IFNalpha[sign])
2) Interferon beta (IFNbeta[sign])
3) Interferon gamma (IFNgamma[sign])
4) Interleukin-1 (IL-1)
5) Interleukin-2 (IL-2)
6) Interleukin-4 (IL-4)
7) Interleukin-5 (IL-5)
8) Interleukin-8 (IL-8)
9) Interleukin-10 (IL-10)
10) Interleukin-15 (IL-15)
11) Lymphotoxin
12) Perforin
13) Tumor necrosis factor alpha(sign) (TNF[sign])
10
Q
What are the functions of IFNalpha(sign)?
A
1) It prevents viral replication
2) It inhibits cell growth
11
Q
What secretes IFNalpha(sign)?
A
It is secreted by virus-infected cells
12
Q
What are the functions of IFNbeta(sign)?
A
1) It prevents viral replication
2) It inhibits cell growth
3) It decreases the expression of major histocompatibility complex (MHC) class I and II molecules
13
Q
What secretes IFNbeta(sign)?
A
It is secreted by virus-infected fibroblasts
14
Q
What is the characteristic of IFNgamma(sign)?
A
About 20 diff proteins that activate macrophages and natural killer (NK) cells
15
Q
What are the functions of IFNgamma(sign)?
A
1) It stimulates adaptive immunity by increasing the expression of MHC class I and II molecules
2) It prevents viral replication
16
Q
What secretes IFNgamma(sign)?
A
1) Helper T cells (Th cells)
2) Cytotoxic T cells (Tc cells)
3) NK cells
17
Q
*What is IL-1?
A
It is the costimulation of B and T cells
18
Q
What are the functions of IL-1?
A
1) It promotes inflammation through prostaglandin production
2) It induces fever acting through the hypothalamus (pyrogen)
19
Q
What secretes IL-1?
A
1) Macrophages
2) B cells
3) Fibroblasts
20
Q
*What is IL-2?
A
It is the costimulation of B and T cells
21
Q
What are the functions of IL-2?
A
1) It activates macrophages
2) It activates NK cells
22
Q
What secretes IL-2?
A
Helper T cells (Th cells)
23
Q
What is the function IL -4?
A
It plays a role in allergic rxns by activation of B cells, resulting in the production of IgE
24
Q
What secretes IL-4?
A
Helper T cells (Th cells)
25
What is the function of IL-5?
It is a part of the response against parasites by stimulating eosinophil production
26
What secretes IL-5?
Helper T cells (Th cells)
27
What is IL-8?
It is a chemotactic factor
28
What is the function of IL-8?
It promotes inflammation by attracting neutrophils and basophils
29
What secretes IL-8?
Macrophages
30
What are the functions of IL-10?
1) It inhibits the secretion of IFNgamma(sign)
| 2) It inhibits the secretion of ILs
31
What secretes IL-10?
Suppressor T cells
32
What are the functions of IL-15?
1) It promotes inflammation
2) It activates memory T cells
3) It activates NK cells
33
What is the function of lymphotoxin?
It kills target cells
34
What secretes lymphotoxin?
Cytotoxic T cells (Tc cells)
35
What is the function of perforin?
It makes a hole in the membrane of target cells
36
What is the result of the action done by perforin?
It results in the lysis of the cell
37
What secretes perforin?
Cytotoxic T cells (Tc cells)
38
What are the functions of TNFalpha(sign)?
1) It activates macrophages
| 2) It promotes fever (pyrogen)
39
What secretes TNFalpha(sign)?
Macrophages
40
Each complement pathway involves a what?
A cascade in w/c complement proteins are activated in an orderly sequence
41
*What are the end results when complement proteins are activated in an orderly sequence?
1) Cell lysis
2) Phagocytosis
3) Inflammation
42
What is complement?
It refers to a grp of 20 or so proteins that circulate in the blood in an inactive form
43
What are the functions of complement?
1) It provides a major mechanism for destroying foreign substances in the body
2) It amplifies all aspects of the inflammatory response
3) It kills bacteria and certain other cell types (our cells are immune to complement)
44
What pathways can activate complement?
Either:
1) Classical pathway or
2) Alternative pathway
45
Classical pathway is a part of what type of immunity?
Adaptive immunity
46
What is the characteristic of classical pathway?
It depends on the binding of Abs to invading organisms
47
What is the action present in classical pathway?
Subsequent binding of C1 to the Ag-Ab complexes (complement fixation)
48
Alternative pathway is a part of what type of immunity?
Innate immunity
49
What is the characteristic of alternative pathway?
It is triggered by the interaction among factors B, D, and P, and polysaccharide
50
What is the process (or steps) of classical pathway?
1) The classical pathway begins when an Ag-Ab complex binds to C1. The C1-Ag-Ab complex activates C4
2) Activated C4 forms a complex w/ C2 that activates C3
3) The alternate pathway begins when C3 is spontaneously activated
4) Foreign substances and factors B, D, and P stabilize activated C3
5) Once C3 is activated, the classical and alternate pathways are the same. C3 activates C5, C5 activates C6, C6 activates C7, C7 activates C8, and C8 activates C9
6) Activated C3-C7 promote phagocytosis, inflammation, and chemotaxis (attracts cells)
7) Activated C5-C9 combine to form a membrane attack complex (MAC), w/c forms a channel through the plasma membrane (only C9 of MAC is shown)
51
What are the IS cells that are present in innate immunity?
1) Neutrophil
2) Monocyte
3) Macrophage
4) Basophil
5) Mast cell
6) Eosinophil
7) NK cell
52
What are the primary functions of neutrophil?
1) Phagocytosis
2) Inflammation
3) Usually the first cell to leave the blood and enter infected tissues
53
What is the primary function of monocyte?
1) It leaves the blood and enters tissues to become a macrophage
54
What are the characteristics of macrophage?
1) It is the most effective phagocyte
| 2) It is located throughout the body to "intercept" foreign substances
55
What are the primary functions of macrophage?
1) It is important in later stages of infection and in tissue repair
2) It processes Ags
3) It is involved in the activation of B and T cells
56
What is the characteristic of basophil?
It is a motile cell
57
What are the functions of basophil?
It leaves the blood, enters tissues, and releases chemicals that promote inflammation
58
What is the characteristic of mast cell?
It is a nonmotile cell in connective tissues
59
What is the function of mast cell?
It promotes inflammation through the release of chemicals
60
What are the functions of eosinophil?
It enters tissues from the blood and releases chemicals that inhibit inflammation
61
What are the functions of NK cell?
1) It lyses tumor
| 2) It lyses virus-infected cells
62
What are the IS cells that are present in the adaptive immunity?
1) B cell
2) Plasma cell
3) Memory B cell
4) Cytotoxic T cell
5) Delayed hypersensitivity T cell
6) Helper T cell
7) Suppressor T cell
8) Memory T cell
9) Dendritic cell
63
What is the primary function of B cell?
After activation, it differentiates to become plasma cell or memory B cell
64
What is the primary function of plasma cell?
It produces Abs that are directly or indirectly responsible for the destruction of the Ag
65
What are the primary functions of memory B cell?
1) It is executes quick and effective response to an Ag against w/c the IS has previously reacted
2) It is responsible for immunity
66
What is the primary function of cytotoxic T cell?
It is responsible for the destruction of cells by lysis or by the production of cytokines
67
What is the primary function of delayed hypersensitivity T cell?
It produces cytokines that promote inflammation
68
What are the primary functions of helper T cell?
1) It activates B cells
| 2) It activates effector T cells
69
What are the primary functions of suppressor T cell?
1) It inhibits B cells
| 2) It inhibits effector T cells
70
What are the primary functions of memory T cell?
1) It executes quick and effective response to an Ag against w/c the IS has previously reacted
2) It is responsible for adaptive immunity
71
What are the primary functions of dendritic cells?
1) It processes Ag
| 2) It is involved in the activation of B and T cells
72
What are the diff ways of initiating an inflammatory response?
1) Chemical mediators cause vasodilation and increase vascular permeability, w/c allows the entry of other chemical mediators
2) Chemical mediators attract phagocytes
3) The amt of chemical mediators and phagocytes increases until the cause of the inflammation is destroyed. Then the tissue undergoes repair
73
What is inflammatory response?
It is a local inflammation that produces various symptoms
74
What are the symptoms being produced by inflammatory response?
1) Redness
2) Heat
3) Swelling
4) Pain
5) Loss of function
75
What are the symptoms of systemic inflammation?
1) An increase in neutrophil #s
2) Fever
3) Shock
76
What are the mediators of inflammation?
1) Histamines
2) Kinins
3) Prostaglandins
4) Leukotrienes
5) Others
77
What are the characteristics of mediators of inflammation?
1) These are produced in rapid bursts, only as long as the stimulus persists
2) They have short half-lives
3) They are degraded after their release
78
What is the characteristic of neutrophils?
They have short half-lives in tissues
79
What is the characteristic of inflammation?
It triggers a variety of stop signals that serve to actively terminate the rxn
80
*What are the mechanisms under inflammation in connection for it triggering a variety of stop signals that serve to actively terminate the rxn?
1) Switch in the type of arachidonic acid metabolite produced, from pro-inflammatory leukotrienes to anti-inflammatory lipoxins
2) Liberation of anti-inflammatory cytokines, including transforming growth factor-beta(sign) (TGF-beta[sign]) and IL-10, from macrophages and other cells
3) Production of anti-inflammatory lipid mediators, called resolvins and protectins, derived from polyunsaturated fatty acids
4) Neutral impulses (cholinergic discharge) that inhibit the production of TNF in macrophages
81
When does chronic inflammation occur?
It occurs when inflammation is prolonged or when there is interference to healing
82
Chronic inflammation results into what?
It results into replacement of normal tissue by a fibrous connective tissue = scarring
83
Provide an ex of chronic inflammation
Chronic granulomatous inflammation
84
What is the hallmark of chronic granulomatous inflammation?
*Presence of epitheloid cell
85
What is tissue repair?
It is the substitution of viable cells for dead cells
86
What are the mechanisms (or actions) present in tissue repair?
By regeneration or replacement
87
Tissue repair occurs depends on what?
1) Type of cell involved
2) Severity of the injury
3) Type of inflammation
88
*Cells (in tissue repair) are classified based on what?
Based on their ability to produce new cells
89
What are the 3 types of cells (in tissue repair) based on their ability to produce new cells?
1) Labile cells
2) Stable cells
3) Permanent cells
90
True or False
Generally, the more severe the injury is, the more likely replacement will take place
True
91
Tissue repair involves what?
1) Clot formation
2) Inflammation
3) Formation of granulation tissue
4) Regeneration or replacement of tissues
92
In severe wounds, what can occur?
Wound contracture
93
What is the simplified process (or steps) of healing and repair (of tissue)?
1) Injury
2) Hemostasis
- > PLTs
- > fibrin
- > fibronectin
- > transglutaminases
3) Inflammation
- > neutrophils
- > macrophages
- > lymphocytes
- > plasma proteins
4) Demolition
- > macrophages
- > collagenases
5) Proliferation
- > granulation tissue
- > anglogenesis
- > extracellular matrix synthesis
- > wound contraction
- > epithelial proliferation
6) Maturation
- > collagen crosslinking
- > remodeling
- > capillary resorption
94
What are the factors modifying the quality of the inflammatory-reparative response?
1) Adequacy of blood supply
2) Nutrition
3) Presence or absence of infection
4) Health status
5) Intake of drugs (e.g. steroids)
95
What are the functions of adaptive IS?
It is a functional system that:
1) Recognizes sp foreign substances
2) Acts to immobilize, neutralize, or destroy foreign substances
3) Amplifies inflammatory response and activates complement
96
What are the characteristics of adaptive IS?
1) It is Ag-specific
2) It is systemic
3) It has memory
97
What are the 2 separate but overlapping arms of adaptive IS?
1) Antibody-mediated (humoral) immunity
| 2) Cell-mediated immunity
98
Humoral immunity is provided by what?
It is provided by Abs in the blood and lymph
99
What are involved in cell-mediated immunity (CMI)?
Lymphocytes
100
What are Ags?
These are large molecules that stimulate an adaptive IS response
101
True or False
Foreign Ags are produced by the body
False, because foreign Ags are not produced by the body. Self-Ags are being produced by the body
102
What is the function of B cells?
They are responsible for Ab-mediated immunity
103
T cells are involved w/ what?
CMI
104
What are usually necessary to activate lymphocytes?
1) MHC Ag complex
| 2) Costimulation
105
Costimulation involves what?
1) Cytokines
| 2) Certain surface molecules
106
What is the action done by APCs?
They stimulate the proliferation of helper T cells
107
What is the action done by helper T cells?
They stimulate the proliferation of B or T effector cells
108
What is the characteristic of Abs?
These are proteins
109
*What are the actions that happen in Ab-mediated immunity?
1) The variable region of an Ab combines w/ the Ag
| 2) The constant region activates complement or binds to cells
110
What are the 5 classes of Abs?
1) IgG
2) IgM
3) IgA
4) IgE
5) IgD
111
What is the percentage of IgG in the total serum Ab?
80 - 85
112
What are the functions of IgG?
1) It activates complement
2) It promotes phagocytosis
3) It can cross the placenta and provide immune protection to the fetus and newborn
4) It is responsible for Rh rxns (such as hemolytic disease of the newborn)
113
What is the percentage of IgM in the total serum Ab?
5 - 10
114
What are the functions of IgM?
1) It activates complement
2) It acts as an Ag-binding receptor on the surface of B cells
3) It is responsible for transfusion rxns in the ABO blood system
115
What is the characteristic of IgM?
It is often the 1st Ab produced in response to an Ag
116
What is the percentage of IgA in the total serum Ab?
15
117
Where can IgA be found?
It can be secreted into:
1) Saliva
2) Tears
3) Mucous membranes
1) Colostrum
2) Milk
118
What is the function of IgA (in connection for it being secreted)?
To provide protection on body surfaces
119
What is the function of IgA (in connection for it being found in colostrum and milk)?
To provide immune protection to newborns
120
What is the percentage of IgE in the total serum Ab?
0.002
121
What are the functions of IgE?
1) It binds to mast cells
2) It binds to basophils
3) It stimulates the inflammatory response
122
What is the percentage of IgD in the total serum Ab?
0.2
123
What is the function of IgD?
It functions as Ag-binding receptors on B cells
124
True or False
Abs affect the Ag in many ways (in Ab-mediated immunity)
True
125
The primary response results from what (in connection to Ab production in Ab-mediated immunity)?
It results from the 1st exposure to an Ag
126
*In connection to primary response (in Ab-mediated immunity), B cells form what?
Plasma cells
127
What are the functions of plasma cells?
1) It produces Abs
| 2) It produces memory B cells
128
The secondary response results from what (in connection to Ab production in Ab-mediated immunity)?
It results from exposure to an Ag after a primary response
129
*In connection to secondary response (in Ab-mediated immunity), memory B cells quickly form what?
1) Plasma cells
| 2) Additional memory B cells
130
What are the actions present in CMI?
1) Cells infected w/ intracellular microorganisms process Ags that combine w/ MHC class I molecules
2) Cytotoxic T cells are stimulated to divide, producing more cytotoxic T cells and memory T cells, when MHC class I / Ag complexes are presented to T cell receptors
131
What is the function of cytokines in CMI?
1) Cytokines released from helper T cells also stimulate cytotoxic T cells
2) It promotes phagocytosis
3) It promotes inflammation
132
What are the function of cytotoxic T cells in CMI?
1) It lyses virus-infected cells
2) It lyses tumor cells
3) It lyses tissue transplants
133
What is the function of cytotoxic T cells in CMI?
It produces cytokines
134
Innate immunity, Ab-mediated immunity, and CMI can function together to what?
To eliminate an Ag
135
Provide the relationship (or concept diagram) of natural and artificial immunity
Natural; Artificial -> Active immunity -> Acquired adaptive immunity
Natural; Artificial -> Passive immunity -> Acquired adaptive immunity
136
What is natural immunity (in connection w/ active immunity)?
Ags are introduced through natural exposure
137
What is artificial immunity (in connection w/ active immunity)?
Ags are deliberately introduced in a vaccine
138
What is active immunity?
Immunity is provided by the individual's own IS
139
What is natural immunity (in connection w/ passive immunity)?
Abs from the mother are transferred to her child across the placenta or in milk
140
What is artificial immunity (in connection w/ passive immunity)?
Abs are produced by another person or an animal are injected
141
What is passive immunity?
Immunity is transferred from another person or an animal
