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NancyMEDSCI203 > Lecture 8: Acute Inflammation: Blood Flow > Flashcards

Lecture 8: Acute Inflammation: Blood Flow Flashcards

1
Q

What are the 4 cardinal signs of inflammation?

A

Heat
Swelling
Pain
Redness

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2
Q

What is inflammation a response of?

A

Injury and infection

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3
Q

List the roles of inflammation

A
  • delivers nutrients and oxygen to injured sites
  • generates an exudate where toxins may be transported out of an affected area
  • generates exudate which carries antibodies and other substances into affected area to neutralise harmful agents
  • mobilises work force to remove debris after an injury
  • mobilises defence force to eradicate harmful agents
  • limits spread of harmful agents
  • provides hydrolytic enzymes to digest inflammatory exudates when crisis is over
  • initiates repair
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4
Q

What are the three types of ‘go’ signals that tissue damage unleashes?

A
  1. Neurons which release bioactive peptides in response to pain
  2. Broken cells which release intracellular molecules signalling the presence of damage
  3. Microbial products which are recognised as pathogen associated molecular patterns by pattern recognition receptors.
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5
Q

What are some examples of microbrial products?

A

Endotoxins, LIPS

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6
Q

What signals/intracellular molecules are released by broken cells?

A

damage/danger associated molecular patterns (DAMPS)

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7
Q

what are DAMPS and PAMPS sensed by?

A

pattern recognition receptors

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8
Q

What type of receptors are pattern recognition receptors?

A

they may be soluble proteins (complement) or cell bound (toll like receptors, TLRs)

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9
Q

Which tissue resident cells rapidly respond to the 3 types of ‘go’ signals?

A

Mast cells (or basophils) and macrophages

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10
Q

how do mast cells and macrophages initiate inflammtory responses?

A
  • release inflammatory mediators, lipid derived signals and cytokines
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11
Q

what are some examples of inflammatory mediators that mast cells and macrophages release to initate an inflammatory response?

A

histamine, proteases, tryptases

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12
Q

what is an example of a cytokine that mast cells and macrophages release

A

tumour necrosis factor

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13
Q

describe mast cells

A

they are full of granules (storage organelles)

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14
Q

what do the signals released by mast cells and macrophages cause?

A

a rapid change in microvascular system

an elect i the redness-heat-swelling-pain response

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15
Q

What does vasodilation occur with

A

the relaxation of smooth muscles surrounding arterioles.

this increases diamter of vessles,

allowing increased blood flow into capillary network.

this casues redness and heat

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16
Q

what is hyperanemia

A

increased blood

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17
Q

most blood vessels are lined with what?

A

endothelial epithelium

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18
Q

what are the endothelial cells closely connected by

A

tight junctions and adherens junctions

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19
Q

When does vascular permeability occur?

A

when endothelial cells retract to create gaps in the endothelial lining

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20
Q

what happens following mild injury such as an insect bite (in relation to endothelial cells)

A

Inflammatory signals cause endothelial cells of small venules to rapidly and reversibly retract

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21
Q

what happens when these ECs retract?

A

gaps of 0.1-0.4 micrometer size are created between cells

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22
Q

what is significant about the creation of these gaps between ECs?

A

Gaps allow fluid and solutes (including proteins) to pass through

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23
Q

what is the protein rich fluid called?

A

inflammatory exudate

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24
Q

What does more severe injury lead to (in relation to endothelial cells)

A

EC damage and detachment from basement membrane. This results in persistent increases in vascular permeability

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25
Q

what happens in delayed vascular permability in relation to ECs following severe injury

A

leakage occurs from capillaries and venules

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26
Q

What are some examples of delayed EC damage following severe injury

A

sunburn, xrays, bacterial toxins

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27
Q

what happens in immediate vascular permeability in relation to ECs following severe injury

A

Leakge from all types of vessles occurs until vessl is blocked with clot or repaired

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28
Q

Give an example of what would cause immediate vascular permeability following severe injury

A

burns, trauma

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29
Q

What are the three types of ‘go’ signals that tissue damage unleashes?

A
  1. Neurons which release bioactive peptides in response to pain
  2. Broken cells which release intracellular molecules signalling the presence of damage
  3. Microbial products which are recognised as pathogen associated molecular patterns by pattern recognition receptors.
How well did you know this?
1
Not at all
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3
4
5
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30
Q

What are some examples of microbrial products?

A

Endotoxins, LIPS

How well did you know this?
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3
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31
Q

What signals/intracellular molecules are released by broken cells?

A

damage/danger associated molecular patterns (DAMPS)

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32
Q

what are DAMPS and PAMPS sensed by?

A

pattern recognition receptors

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33
Q

What type of receptors are pattern recognition receptors?

A

they may be soluble proteins (complement) or cell bound (toll like receptors, TLRs)

How well did you know this?
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34
Q

Which tissue resident cells rapidly respond to the 3 types of ‘go’ signals?

A

Mast cells (or basophils) and macrophages

How well did you know this?
1
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2
3
4
5
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35
Q

how do mast cells and macrophages initiate inflammtory responses?

A
  • release inflammatory mediators, lipid derived signals and cytokines
How well did you know this?
1
Not at all
2
3
4
5
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36
Q

what are some examples of inflammatory mediators that mast cells and macrophages release to initate an inflammatory response?

A

histamine, proteases, tryptases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what is an example of a cytokine that mast cells and macrophages release

A

tumour necrosis factor

How well did you know this?
1
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3
4
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38
Q

describe mast cells

A

they are full of granules (storage organelles)

How well did you know this?
1
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2
3
4
5
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39
Q

what do the signals released by mast cells and macrophages cause?

A

a rapid change in microvascular system

an elect i the redness-heat-swelling-pain response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What does vasodilation occur with

A

the relaxation of smooth muscles surrounding arterioles.

this increases diamter of vessles,

allowing increased blood flow into capillary network.

this casues redness and heat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what is hyperanemia

A

increased blood

How well did you know this?
1
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2
3
4
5
Perfectly
42
Q

most blood vessels are lined with what?

A

endothelial epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what are the endothelial cells closely connected by

A

tight junctions and adherens junctions

How well did you know this?
1
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2
3
4
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44
Q

When does vascular permeability occur?

A

when endothelial cells retract to create gaps in the endothelial lining

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

what happens following mild injury such as an insect bite (in relation to endothelial cells)

A

Inflammatory signals cause endothelial cells of small venules to rapidly and reversibly retract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

what happens when these ECs retract?

A

gaps of 0.1-0.4 micrometer size are created between cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what is significant about the creation of these gaps between ECs?

A

Gaps allow fluid and solutes (including proteins) to pass through

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

what is the protein rich fluid called?

A

inflammatory exudate

49
Q

What does more severe injury lead to (in relation to endothelial cells)

A

EC damage and detachment from basement membrane. This results in persistent increases in vascular permeability

50
Q

what happens in delayed vascular permability in relation to ECs following severe injury

A

leakage occurs from capillaries and venules

51
Q

What are some examples of delayed EC damage following severe injury

A

sunburn, xrays, bacterial toxins

52
Q

what happens in immediate vascular permeability in relation to ECs following severe injury

A

Leakge from all types of vessles occurs until vessl is blocked with clot or repaired

53
Q

Give an example of what would cause immediate vascular permeability following severe injury

A

burns, trauma

54
Q

What pushes fluid from capillaries at arteriolar end normally?

A

Hydrostatic pressure normally forces fluid out this way

55
Q

What happens during inflammation in terms of hydrostatic pressure

A

Increased hydrostatic pressure in capillaries + increased water binding capacity of proteins in exudate => retained fluid in the extravasulcar space between cells

56
Q

What is the extra vascular space between cells called?

A

The interstitium

57
Q

What does accumulated fluid generate?

A

Swelling, aka oedema

58
Q

What is the result of oedema ?

A

Stretches tissue and along with chemical mediators, causes pain

59
Q

Give some examples of chemical mediators

A

PGE2 and bradykinin

60
Q

During inflammation, Where are chemical signals which control blood vessel function secreted?

A

Locally, by cells

61
Q

During inflammation, What are chemical signals that control blood vessel function also derived from?

A

Circulating plasma proteins

62
Q

Where is histamine stored?

A

In performed granules of mast cells/basophils and platelets

63
Q

What does histamine release cause?

A

Vasopermeability

Endothelial adhesion

Synthesis of lipid mediators

Bronchi constriction

64
Q

Give a situation in which vasopermeability occurs as a result of histamine release

A

The watery fluid experienced by a runny nose when having cold or hayfever is called exudate

65
Q

What is endothelial adhesion for?

A

To make it easier for neutrophils

66
Q

What are examples of lipid mediators which are synthesised as a result of histamine release

A

Prostacyclin I2

And platelet-activating factor (PAF)

These lead to vasodilation

67
Q

What is histamine?

A

A vasoactive amine

68
Q

Where are serine proteases released from?

A

Mast cells

69
Q

What do serine proteases cleave?

A

Protease-activated receptors (PARs) on other mast cells, endothelium and neutrophils

70
Q

What happens as a result of PAR cleavage?

A

The same results as histamine release,
Vasopermeability
Endothelial adhesion for leu yes
Platelet activating factor release with vasodilation
Probably also involved in bronchonconstriction

71
Q

What is an example of a tryptase?

A

Serine protease

72
Q

What do inflammatory signals acting through intracellular Ca2+ activate?

A

Cytosolic phospholipase A2 (PLA2)

73
Q

What does cytosolic phospholipase A2 (PLA2) do?

A

Cleaves membrane phospholipids like phosphatidylcholine into lysophosphatidylcholine and arachidonic acid

74
Q

What is PLA2

A

Phspholipase A2

75
Q

What is an arachidonic acid?

A

A 20Carbon unsaturated fatty acid

76
Q

What is platelet activating factor derived from?

A

Lysophosphatidylcholine

77
Q

Where is PAF found?

A

In activated inflammatory cells,
endothelial cells and
injured tissue cells

78
Q

What are the functions of PAF

A

Increase permeability and vasodilation
Activate and aggregate platelets
Leukocyte adhesion and chemotaxis - reduce blood loss

79
Q

Describe the type of response arachidonic acid generates

A

Rapid, short half life, short range derivatives

80
Q

What are the two derivatives of arachidonic acid

A

Cyclooxygenases & 5-lipooxygenases

81
Q

What is COX1/2

A

Cyclooxygenases, a derivative of arachidonic acid

82
Q

What do cyclooxygenases generate?

A

Prostaglandins

83
Q

What are some examples of prostaglandins generated by cyclooxygenases?

A

Thromboxanes

Prostacyclins

84
Q

What are cyclooxygenases inhibited by?

A

Non steroidal anti-inflammatory drugs (NSAIDs)

85
Q

What are some examples of NSAIDs

A

Aspirin, ibuprofen/neurofen, diclofenac/voltaren

86
Q

What is 5-lipoxygenase?

A

The other derivative of arachidonic acid

87
Q

What does 5-lipoxygenase generate?

A

Leukotrienes

88
Q

What does LTB4 potentially recruit?

A

Neutrophils

89
Q

What is LTB4

A

Leukotriene B4

90
Q

What were cysteinyl leukotrienes called?

A

Slow reacting substance if anaphylaxis

91
Q

What do cysteinyl LTs induce?

A

Vasopermeability and bronchoconstriction

92
Q

List the agents which are of prostaglandin class

A

Thromboxane, PCI2 and PGE2

93
Q

What does TXA2 induce

A

Vasoconstriction, platelet aggregatoon

94
Q

What does PCI2 induce

A

Vasodilation, platelet disaggregation

95
Q

What does PGE2 induce?

A

Vasodilation, pain

96
Q

What are agents of the leukotrienes class?

A

LTB4 and cysLTC4, D4, E4,

97
Q

What does leukotrieneB4 induce?

A

Neutrophil chemotaxis and activation

98
Q

Which agents induce vasopermeability and bronchoconstriction

A

Cysteinyl leukotrienes C4, D4 and E4

99
Q

Where to components of interconnected inflammatory signalling cascades circulate?

A

In the blood

100
Q

What do proteolytic events activate

A

The coagulation of fibrinolytic, Kinin and complement cascades

101
Q

What do proteolytic events lead to

A

Rapid development of inflammation with potent vasoactive effects

102
Q

Name the four types of interconnected inflammatory cascades

A
  1. Coagulation
  2. Fibrinolytic
  3. Kinin
  4. Complement
103
Q

The coagulation cascade is induced following damage to what?

A

Vascular endothelium

104
Q

Where is tissue factor released

A
  1. From apoptotic endothelial cells on micro particles and

2. From exposed basement membrane

105
Q

What does tissue factor release lead to?

A

Activation of thrombin

106
Q

What does thrombin do?

A
  1. It cleaves soluble fibrinogen into fibrin

2, cleaves protease activated receptors

107
Q

What is the importance of fibrin?

A

Traps platelets and other cells to form clots with the arrest of bleeding (haemostasis)

108
Q

What do PARs do?

A

Induce vascular permeability,
platelet activating factor release with vasodilation,
Leukocyte adhesion like mast cell tryptases

109
Q

What does hageman factor do?

A

Activates thrombin to propagate clots as thrombi which may occlude blood vessels

110
Q

How is FXII activated?

A

In vino
By poly phosphates from activated platelets,
Heparin from mast cells or
RNA from damaged cells

111
Q

What does fibrinolytic system generate?

A

The protease plasmin

112
Q

What does plasmin do?

A
  1. Degrades fibrin (which allows blood flow to occur again)
  2. Cleaves extracellular matrix proteins
  3. Activates matrix metalloproteases - remodelling tissues during wound healing
  4. Cleaves cell surface receptors to induce release of inflammatory signals
113
Q

What are MMPs

A

Matrix metalloproteases

114
Q

What does FXII mediate?

A

Proteolytic activation of the protease kallikrein

115
Q

What does the protease kallikrein do?

A

It releases the peptide bradykinin ( from the Kinin system)

116
Q

What effects does bradykinin have?

A

Vascular dilation,
Vascular permeability
Pain inducing

117
Q

What is the antimicrobial complement system activated by ?

A

Proteases, antigen-antibody complexes, and bacterial products

118
Q

List some proteolytic cleavage products

A

C3a, C3b, C5a and components of a membrane attack complex

119
Q

List the functions of the complement system

A
  1. Mast cell degranulation, vascular permeability, neutrophil chemotaxis (by C3a and C5a)
  2. Opsonisation - the promoting of phagocytosis of particles (by C3b)
  3. Part of membrane attack complex for bacterial cell lysis (by C5b)

NancyMEDSCI203 (12 decks)

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