Innate Immunity and Inflammation

Question 1

Examples of antigens that are non infectious environmental agents and clinical products

Answer 1

Environment:
Bee venom
Food
Pollen

Clinical:
Drugs
Vaccines
Transplant

Question 2

Normal immune responses

Answer 2

Puritis: Itching
Mailaise
Anorexia
Limited collateral damage

Question 3

Two examples of an overactive immune system

Answer 3

Hypersensitivites

Autoimmune disorders

Question 4

First line of defense

Answer 4

Physical:
Skin- tight junctions and turn over
Mucous membranes
Temperature (Cool skin limits bacterial growth)

Mechanical:
Blinking 
Coughing 
Urination 
Vomitting 
Cilia

Biochemical:
Tears, mucous, sweat, sebum, earwax: Antiviral 
Gastric juices: pH
Saliva: Digestive  
Normal bacterial flora

Question 5

What activates inflammation?

Answer 5

Activation of immune system components
Mast cell degranulation
Cellular injury- necrosis

Question 6

Systemic Manifestations of Inflammation

Answer 6

Fever due to pyrogens that tap hypothalamus
Increased pulse
Increased blood pressure
Leukocytosis (more circulating WBC)
Increased plasma protein synthesis (complement, kinin, coagulation)
Cytokine effects- IL, TNF-a, Interferons

Question 7

5 steps of vascular response

Answer 7

1. Brief vasoconstriction. Causes transudate- movement of fluid out due to constriction.
2. Vasodilation due to histamine from mast cells.
3. Increased capillary permeability due to histamine.-allows exudation (leakage/build up)
4. Diapedesis
5. Chemotaxis

Question 8

Exudative fluids

Answer 8

Serous

• Watery, easily reabsorbed, early inflammatory
• Central serous chorioretinopathy

Fibrinous

• Indicates more advanced inflammation. Thick and clotted. Leads to scars.
• Pseudomembrane. Worst form of pink eye.

Purulent

• Indicates bacterial infection. Pus due to neutrophils
• Bacterial conjunctivitis

Hemorrhagic exudate: Contains blood. Indicates vascular disease.
-Diabetic retinopathy

Question 9

Trasudate vs exudate

Answer 9

Transudate: Fluid exits vessel due to vasoconstriction.
Exudate: Fluid exits due to inflammatory response. Can cause serous, fibrinous, purulent, or hemorrhagic exudate.

Question 10

PRR

Answer 10

Pattern recognition receptor found on immune cells that will bind to group of pathogens. PAMPs (pathogen associated molecular patterns). Will also recognize cellular debris.

Non specific. Part of innate immune system.

Question 11

Phagocytic mobilization 4 steps

Answer 11

1. Margination
2. Adherence
3. Diapedesis
4. Chemotaxis

Question 12

Monocytes

Answer 12

Macrophages in the blood system. Become macrophages after they leave the blood.

Question 13

What is found in phagolysosome?

Answer 13

ROS, lactoferrin, defensins, lactic acid.

Question 14

Where are mast cells located?

Answer 14

In loose connective tissue and in high risk areas of the body.

Gi tract, lungs, skin, other mucosal tissues

Question 15

Mast cells. What is immediate and what is delayed

Answer 15

Immediate: Degranulation of histamine and chemotactic factors for neutrophils and eosinophils
Delayed: Synthesis of prostaglandins (pain with pro and anti inflammatory characteristics) and leukotrienes (arachidonic acid cascade. Similar to histamine)

Question 16

What role does histamine have?

Answer 16

Vasoactive amine (dilates blood vessels) and causes capillary contraction. 
Causes increased tear and mucous production 
CNS stimulant (Which is why anti-histamines make you sleepy)

Question 17

What 2 things does NK cells release?

Answer 17

Perforin- poke holes

Granzyme- induces apoptosis

Question 18

Platelets carry what?

Answer 18

pre-formed granules that they release upon activation.

Question 19

Role of platelets

Answer 19

Contribute to clot formation and wound healing.

Question 20

3 phagocytic cells

Answer 20

Neutrophils, macrophages, and eosinophils

Question 21

Eosinophils play what role

Answer 21

Defend against parasites. Cause allergies and asthma. Vasodilator.

Question 22

How long does it take for macrophages to reach inflammatory site?

Answer 22

3-7 days.

Question 23

What three checks are in place to control inflammation?

Answer 23

Neutrophil life span is short
Anti-inflammatory cytokines
Inflammatory mediators degrade quickly.

Question 24

4 outcomes of acute inflammation

Answer 24

• Healed completely
• Scar due to fibrinous exudate
• Abscess formation- pus in confined space due to proteases.
• Chronic inflammation after 2 weeks.

Question 25

What can cause chronic inflammation?

Answer 25

High lipid and wax content on microorganism.
Ability to survive inside macrophage
ToxinsChemicals
Physical irritants

Question 26

Signs of chronic inflammation

Answer 26

Granuloma
Fibrosis (thickening and scarring of connective tissue)
Angiogenesis (due to hypoxic tissues releasing VEGF)