Lipid mediators of inflammation Flashcards

1
Q

What are prostaglandins, thromboxanes, lipoxins and leukotrienes referred to as collectively?

A

Eicosanoids

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2
Q

How are the eicosanoids divided up?

A

2 branches:

  • -> prostaglandins + thromboxanes (prostanoids) via cyclooxygenases (cyclic)
  • -> leukotrienes + lipoxins via lipooxygenases (linear)
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3
Q

Eicosanoids are molecules with powerful inflammatory actions. Therefore, they are targets of which major anti-inflammatory drugs?

A
  • NSAIDS
  • Glucocorticoids
  • Lipoxygenase inhibitors
  • Leukotriene antagonists
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4
Q

What is a key difference between the formation of prostanoids (PG + TX) and histamine?

A

Prostanoids are not ‘ready-to-go’ unlike histamine

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5
Q

What is the rate-limiting step of prostanoid formation?

A

Prostanoids are generated from arachidonic acid (AA, poly-unsaturated fatty acid) - this is rate limiting.

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6
Q

How are AAs (arachidonic acids) produced?

A
  • Produced from phospholipids (PLs) via 1-step/2-step pathways
  • Steps triggered by many agents eg. thrombin on platelets and antigen-antibody rxns on mast cells
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7
Q

What impact do bradykinin and adrenaline have on formation of prostanoids?

A

They are known initiators of the cascade in production of AAs and can initiate phospholipase action at the cell membrane

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8
Q

Describe the enzyme responsible for converting AA to prostanoids

A
  • Cyclooxygenase
  • Two main isoforms: COX-1 + COX-2
  • COXs are fatty acids, attached to endoplasmic membrane
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9
Q

What are key characteristics of the COX-1 enzyme?

A
  • Constitutively active - already there
  • Responsible for ‘physiological’ roles of PGs/TXs such as…
    • regulation of peripheral vascular resistance
    • renal blood flow
    • plateley aggregation
    • gastric cytoprotection
  • So COX-1 produces PGE2 and TXA2
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10
Q

What are key characteristics of the COX-2 enzyme?

A
  • Needs to be stimulated by IL-1, TNF-a
  • Responsible for role of PGs/TXs in inflammatory responses:
    • pain
    • fever
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11
Q

What are key characteristics of the COX-3 enzyme?

A
  • Variant of COX-1
  • Pain perception of CNS
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12
Q

Leukotriene A4 can be converted to Leukotriene B4 by a hydrolase. What is the role of Leukotriene B4 (LTB4)?

A
  • Very important chemoattractant
  • Attracts cells to site of inflammation
  • To remove debris/bacteria
  • Needs to be controlled otherwise start eating healthy cells
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13
Q

Which molecule are most of the end prostanoids derived from?

A

PGH2

it makes PGI2, TXA2, PGD2, PFG2a, PGE2

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14
Q

What is epoprostenol?

A
  • Synthetic PGI2
  • Important vasodilator
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15
Q

What are tissue-specific isomerases?

A

Tend to be synthases of some sort - mainly PGD2, PGE2, PGF2a synthases.

They help to form those above from PGH2

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16
Q

What is the role of PGD2?

A
  • Bronchoconstriction
  • Inhibits platelet aggregation
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17
Q

What is the role of PGF2a?

A
  • Bronchoconstrictor
  • Uterine contraction
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18
Q

What does Thromboxane A2 do and what drug inhibits it?

A
  • TXA2 found on activated platelets -> cause platelet aggregation
  • For homeostatic balance
  • Formation inhibited by aspirin
19
Q

What are functions of PGE2?

A
  • Promotes labour - softens cervix + stimulates uterine contractions
  • Induces fever
  • Promotes duct-dependent congenital heart diseases
  • Promotes vasodilation - relaxes smooth muscle
  • Promotes resolution of inflammation by suppressing T cell receptor signalling
20
Q

What is 5-lipooxygenase and what is FLAP?

A
  • 5-lipooxygenase forms LTA<strong>4</strong> (leukotrienes) from AA
  • FLAP is a protein needed to activate 5-lipooxygenase
  • FLAP engages with AA first
21
Q

What are the sulphidopeptide leukotrienes?

A
  • LTC4, LTD4, LTE4
  • Contain amino acids in structure
  • Formed from LTA4
22
Q

What is the general role of lipoxins and cyPG during resolution?

A

There is a switch for PG synthesis from pro-inflammatory (PG + LTs) at onset of inflammation to anti-inflammatory lipoxins and cyPG during resolution.

23
Q

How do lipoxins bring about resolution in their anti-inflammtory role?

A
  • Lipoxins recruit monocytes
  • To clear site of necrotic apoptotic neutrophils
  • Regulate activation levels of neutrophils
  • And dampen their damaging effects (inc phagocytosis of neutrophils)
24
Q

How does cyPG act in concert with lipoxins to bring about an anti-inflammatory effect?

A
  • cyPGs promote phagocytic clearance of apoptotic cells by macrophages -> resolution of inflammation
  • cyPG - inhibits macrophage activaiton -> decrease uncontrolled tissue damage; decrease NF-kB activation
  • This helps to decrease activation of inflammatory genes
25
What cells are specialised to make PGD2?
Mast cells
26
What cells are specialised to make PGI2 and PGE2?
Endothelial cells
27
What cells are specialised to make TXA2?
Platelets
28
What type of receptor do eicosanoids act at?
Act at **specific G-protein-coupled receptors**. They exert diverse and often contradictory actions of inflammation and are subject to local inactivation.
29
Where do PG subtype eicosanoids act?
Act at DP, FP, IP & EP (EP1,2,3) receptors
30
Where do TXs act at?
TP receptors
31
Where do LTs act act and what physiological actions does this induce?
* LTB4 - at **BLT** receptors * LTC4, LTD4, LTE4 at **Cys-LT** receptors * -\> chemotactic; bronchoconstrictor; inc vasc perm; oedema; inc secretion of thick, viscous mucus
32
PG receptors are found in lungs, vessels, gut, CNS, kidney and uterus. What is the physiological action of the following PG receptors: * DP * FP * IP
* **DP receptors**: vasodilatation, decrease platelet aggregation, bronchoconstriction * **FP receptors:** contraction of myometrial sm muscle, bronchoconstriction * **IP receptors**: vasodilatation, decrease platelet aggregation, renin release
33
What is the physiological actions of the EP1,2,3 receptors?
* **EP1** : contraction of bronchiole/GIT smooth muscle * **EP2** : bronchodilation, vasodilation, relaxation of GIT smooth muscle, inc intestinal fluid secretion (watery/bicarb) * **EP3** : contraction of intestinal sm muscle, inc gastric mucus secretion, decrease gastric acid secretion, pyrexia
34
Thromboxane receptors (TP receptors) are found in vessels + platelets. What physiological action is induced by binding of the TP receptors?
**TP** : vasoconstriction, inc platelet agregation
35
Leukotrienes are for general inflammation and in lungs/vascular for acute allergy responses. What are the actions of the BLT and Cys-LT receptors?
* **BLT (1,2)** : chemotaxis + proliferation of immune cells, inc adhesion * **cysLT (1,2)** : bronchoconstriction, vasodilation, inc vascular perm
36
For, **leukotriene receptor antagonists**, give the following: * Which LTs act at which type of receptor * Action of LTs * When is receptor blockade useful * Side-effects * Examples
* **cys-LT** receptors - (LTC4, LTD4, LTE4 etc) * These LTs cause aiway oedema, secretion of thick mucus + sm muscle contraction * Blockade useful in following: * prevention of mild to moderate **asthma** * early to late bronchoconstrictor effects of **allergens** * **exercise**-induced asthma + asthma provoked by **NSAIDs** * **Side effects** include GI upset, irritability, dry mouth/thirst + rashes/oedema * **Examples**: zafirlukast, montelukast, pranlukast, zileuton
37
How is asthma provoked by NSAIDs?
* There are 2 routes of eicosanoids being made * Aspirin (and NSAID) will block only the COX route * But not the LOX (lipoxygenase) route * Lipoxygenase route therefore makes leukotrienes * Leukotrienes -\> bronchconstriction, airway mucus etc -\> asthma!
38
What is the difference of action between leukotrienes (LTD4, LTDC4, LTE4) and histamine in the lung?
* Leukotrienes are much **more potent** (contraction) than histamine * Order: LTD4, LTC4, LTE4, histamine * They increase cellular infiltration of eosiniphils + neutrophils * Increase mucus secretion * Increase bronchoconstriction * Increase airway oedema
39
Which eicosanoids are important for haemostatic balance?
* **TXA**2 : _promotes platelet aggregation_, binds to TP receptor -\> inc [Ca2+] -\> contraction * **PGI**2 : _inhibits platelet aggregation_, binds to IP receptor -\> inc cAMP -\> relaxation Have opposite effects + released by endothelial cells
40
In gastric acid secretion, histamine is released from ECL cells to act on what receptor + cell?
* Histamine acts on parietal cells * by binding to H2 receptor * promotes **acid (H+) secretion**
41
What receptor(s) does PGE2 bind to in mediating gastric acid secretions? What is the action of this?
* PGE2 binds to **EP3** receptors on * parietal cell -\> inhibit acid secretion * mucus secreting cell -\> stimulate mucus/bicarb secretion
42
Why are poly-unsaturated fatty acids of interest to us?
* PUFAs; omega-3 essential fatty acids * Perceived beneficial effects for our health * EPA - eicosapentaenoic acid * DHA - docosahexaenoic acid * Derivatives of EPA and DHA (**resolvins/neuroprotectins**) have **anti-inflammatory actions**
43
What happens to the pathway when you take PUFA (poly-unsaturated fatty acids)?
* PUFA intake (fish oil supplementation) increase * -\> **Decrease in arachidonic acid** (AA) * **Replaced with an increase in EPA + DHA** * EPA + DHA become substrates for COX * Generates alternative eicosanoids * _Decrease_ in PGE2, TXB2, LTB4, 5-HETE, LTE4 * _Increase_ in LTB5, TXA3, LTE4, 5-HPETE (these eicosanoids diff structure to those generated from AA) * LTB5 is 10-100 less chemotactic to neutrophils
44
A number of novel group of mediators have also been identified from COX-mediated action on EPA and DHA. What are they?
* E-series resolvins (resolvin D1-D4; **EPA-derived mediators**) have anti-inflammatory actions * Docosatrienes + neuroprotectins (D-series resolvins; **DHA-derived mediators**) also have anti-inflammatory effects