Mechanisms of inflammation Flashcards

1
Q

Describe the vascular and cellular events

A
  • Controlled by complex web of cellular interactions

- Pro/Anti- inflammatory

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2
Q

Describe the action of cytokines as inflammatory mediators

A
  • Produced at site when required- polypeptides/ glycoproteins, small, low weight
  • Bind to receptors of target cells- affected gene transcription via 2nd messengers
  • Inflammatory cells, fibroblasts, epithelial cells and endothelial cells secrete
  • Release triggered by direct injury or stimulation by other inflammatory cells
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3
Q

Describe mediators of acute inflammation

A
  • Vascular dilation: histamine, prostaglandins and nitric oxide
  • Increased vascular permeability- histamine, bradykinins, leukotriene B4, prostaglandins and C5a
  • Adhesion of leucocytes to endothelium: IL1 and TNF-alpha
  • Chemotaxis of neutrophils: leukotriene B4 and IL8
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4
Q

Describe pro-inflammatory cytokines

A
  • TNF-alpha and IL1
  • > Endothelial adhesion molecules
  • > Increased coagulation and cytokine secretion
  • > Stimulate fibroblasts
  • > Systemic effects
  • IL6
  • > important in systemic effects
  • > Acute phase response, pyrexia, haematopoesis
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5
Q

Describe anti-inflammatory cytokines

A
  • IL10
  • > Inhibits cytokine secretion
  • > Decreased antigen presentation
  • TGF- beta (transforming growth factor)
  • > Immunological tolerance
  • > Released by macrophages
  • > Released by myofibroblasts in fibrosis
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6
Q

What is the function of macrophages?

A

Phagocytosis and co-ordination of immune response

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7
Q

What is the function of mononuclear phagocyte system?

A

In bone marrow from haemopoietic stem cells, in the blood macrophage=monocyte

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8
Q

Describe antigen presentation

A
  • Endocytosis, fragmentation, MHC Class 2 complex, presented to T cell
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9
Q

Describe B cell action

A
  • Antibodies activated
  • Plasma cells,
  • Different to lymphocytes- more cytoplasm and perinuclear hoff
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10
Q

Describe T cell action

A
  • Helper- CD4, secrete cytokines, command-and-control of immune system
  • Cytotoxic- CD8, kills abnormal cells, viral antigens result in chronic inflammation, immunotherapy involves developing immune system to cure cancer
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11
Q

Describe mast cells

A
  • Granular cytoplasm
  • Preformed mediators
  • Prostaglandins
  • Cytokine release (eosinophil chemotactic factor)
  • Significant in allergic reactions
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12
Q

Describe eosinophils

A

Mediated by IgE (immunoglobin E), allergy and parasitic infection

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13
Q

Describe neutrophils

A

Phagocyte, acute inflammation, granular cytoplasm (AB proteases, lysozymes, defensins)
- Ideal for bacterial infections

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14
Q

Describe basophils

A
  • Resemble mast cells
  • Confined to bloodstream
  • Not seen in tissue
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15
Q

Describe endothelial cells

A
  • Polymorphonuclear leucocytes bind to cell adhesion molecules
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16
Q

What are the granular polymorphonuclear leucocytes?

A
  • Eosinophils
  • Neutrophils
  • Basophils
17
Q

What colour does each granular polymorphonuclear leucocyte go with eosin stain?

A
  • Eosinophil- pink- graniles have high affinity
  • Basophil- dark blue stain
  • Neutrophil- in between (neutral)
18
Q

How does tissue heal after scarring?

A
  • Replace damaged tissue
19
Q

What does granulation tissue include?

A
  • Endothelial cells
  • Myo/fibroblasts
  • Acute inflammation cells
  • Macroscopic- red (very vascular) and granular surface
  • Microscopic- capillaries, myofibroblasts and macrophages
  • Collagen
20
Q

Describe the maturation of granulation tissue in fibrosis

A
  • Inflammatory cells leave
  • Collagen increases
  • New blood supply (fewer capillaries required)
  • Dense fibrous tissue
21
Q

Describe the function of granulation tissue in fibrosis

A
  • To produce a scar
  • Scar restores physical integrity of body
  • Regulated by cytokines- TGF-beta is important for production of collagen
22
Q

What are the positives of fibrosis?

A

Restored structural integrity

23
Q

What are the negatives of fibrosis?

A
  • Lack of function of normal tissue
  • Acellular
  • Cosmetic
  • Complications
24
Q

What are the complications involved in fibrosis?

A
  • Stricture

- Scarring in lumen results narrowing that requires surgical treatment