Injury associated systemic inflammatory response Flashcards
Which immunological responses occur after injury?
SIRS - systemic inflammatory response syndrome and CARS - compensatory anti inflammatory response syndrome.
Both responses purpose is to return to homeostasis. Excessive inflammatory response or reduced can lead to multiple organ failure, balance between both must be achieved to reach homeostasis.
Which cells are produced after trauma or cell stress?
Alarmins or DAMPs (damage associated molecular patterns) along with PAMPs (pathogen associated molecular patterns) interact with specific receptors both on cell surface and intracellular.
Which cells are produced after trauma or cell stress?
Alarmins or DAMPs (damage associated molecular patterns) along with PAMPs (pathogen associated molecular patterns) interact with specific receptors both on cell surface and intracellular.
Best characterized DAMP is…
HMGB1 (High mobility group protein B1)
Can mitochondrial DNA act as a DAMP?
Yes, release of mtDNA triggers inflammatory response and activates macrophage inflammasome.
mtDNA is present 1000x higher in trauma patients.
Which receptors mediate innate response to both microbial infection and sterile inflammation?
PRR (pattern recognition receptors)
Name PRR (pattern recognition receptor) classes:
TLR (toll like receptor)
NLR (nucleotide like receptor)
CLR(c type lectin receptor)
RLR fuck it
Which neuroendocrine pathways respond to injury?
HPA axis (hypothalamic pituitary adrenal) which releases glucocorticoid hormones Sympathetic nervous system which releases epinephrine, norepinephrine and catecholamines.
Which hormones pituitary gland produced?
Anterior lobe produces hGH, ACTH, TSH, LH, FSH, PRL
Posterior lobe stores vasopressin and oxytocin produced from hypothalamus.
Which hormones pituitary gland produced?
Anterior lobe produces hGH, ACTH, TSH, LH, FSH, PRL
Posterior lobe stores vasopressin and oxytocin produced from hypothalamus.
Describe adrenocorticotropin (ACTH) function.
Produced in response to biological stress.
Main functions are increased production and release of cortisol by the adrenal gland.
Describe cortisol function.
Cortisol increase gluconeogenesis, decreases immune response, aids metabolism of fat, protein and carbohydrates, also decreases bone formation.
Describe TSH function.
Stimulates thyroid gland to produce T4 and T3, which are responsible for regulation of metabolism.
Describe luteinizing hormone.
LH stimulates endocrine cells in gonads to produce androgens.
Describe FSH function.
In females stimulate growth and recruitment of immature ovarian follicles.
In males stimulate primary spermatocytes to undergo 1st division of meiosis to form secondary spermatocytes.
Describe prolactin function.
Stimulates mammary glands to produce milk.
Describe HPA axis once an injury occurs.
Once trauma occurs, hypothalamus will release corticotropin releasing hormone which will stimulate production and secretion of adrenocorticotropin hormone in the ant lobe of pituitary gland. ACTH will act on adrenal glands, stimulating secretion of glucocorticoid hormones, mainly cortisol.
Describe HPA axis once an injury occurs.
Once trauma occurs, hypothalamus will release corticotropin releasing hormone which will stimulate production and secretion of adrenocorticotropin hormone in the ant lobe of pituitary gland. ACTH will act on adrenal glands, stimulating secretion of glucocorticoid hormones, mainly cortisol.
Describe the layers of adrenal cortex.
Outermost layer is zona glomerulosa, produces mineralocorticoid, aldosterone.
Middle layer is zona fasciculata, produces glucocorticoids, cortisol.
Innermost layer is zona reticularis, produces androgens.
Describe adrenal medulla.
Surrounded by adrenal cortex, secretes catecholamines such as epinephrine, norepinephrine and dopamine in response to stimulation by sympathetic preganglionic neurons.
Describe sympathetic nervous system response to injury.
Injury occurs which activates SNS, releasing ACh in adrenal medulla, stimulating secretion and production of epinephrine and norepinephrine into the blood. These hormones will activate fight or flight response, increasing heart rate, blood pressure, heart contractility, metabolism, glycogenolysis, gluconeogensis., vasoconstriction, etc.
Function of aldosterone.
Regulates mineral balance, blood pressure and homeostasis by sodium reabsorption and potassium excretion.
During stress what happens to insulin?
Hyperglycemia and insulin resistance are hallmarks of injury and critical illness.
Aldosterone role in injury?
Interferes with insulin signaling pathways, making us more insulin resistant.
