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Pathoma > Neutrophil arrival and function > Flashcards

Neutrophil arrival and function Flashcards

1
Q

Name the steps of neutrophil arrival and function

A
  1. Margination
  2. rolling
  3. Adhesion
  4. Transmigration and chemotaxis
  5. Phagocytosis
  6. Destruction of phagocytosed material
  7. Resolution
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2
Q

Where does margination occur?

A

Vasodilation in the post capillary venules

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3
Q

What are the names of the speed bumps in the second step?

A

Rolling step: P selectin

E selectin

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4
Q

The selectins of the rolling step are induced by what molecules?

A

P selectin- Histamine

E selectin : TNF and IL 1

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5
Q

Function of TNF and IL 1

A

Induce production of E selectin

Upregulation of cellular adhesion molecules in the endothelium

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6
Q

The E selectin is released from what part of the cell?

A

The Weibel Palade Bodies

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7
Q

In Step 3, what are the cells that bind each other?

A

Endothelium- cellular adhesion molecules

Neutrophils- Integrins

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8
Q

The selectins binds to what molecules on leucocytes?

A

Sialyl Lewis X

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9
Q

The integrins are upregulates by what molecules

A

C5a

LTB4

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10
Q

What is the sickness related with a defect in step 3?

A

Leukocyte adhesion deficiency

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11
Q

What is the Leukocyte adhesion deficiency

A

Autosomal recessive defect of integrins (CD18 subunit)

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12
Q

Clinical features of Leukocyte adhesion deficiency

A
  • Delayed separation of umbilical cord
  • Increased circulating neutrophils
  • Recurrent bacterial infections that LACK PUS formation
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13
Q

The neutrophils are chemotactic to what molecules?

A

IL 8
LTB4
Bacterial products
C5a

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14
Q

Phagocytosis is enhanced by what molecules?

A

Opsonins ( IgG and C3b)

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15
Q

How does phagocytosis occur?

A
  1. Neutrophil recognixes pathogen
  2. Pseudopes from leukocytes extend from phagosomes
  3. Internalized and merged with lysosomes to form phagolysosomes.
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16
Q

What is the sickness related with a defect in step 5?

A

Chediak- Higashi Syndrome

17
Q

What is the Chediak- Higashi Syndrome?

A

Autosomal Recessive Protein tracking defect (microtubules)

Characterized by impaired phagolysosome formation

18
Q

Clinical features of Chediak- Higashi Syndrome

A
  • Increase risk of pyogenic infections
  • Giant granules leukocytes
  • Defective primary hemostasis
  • Albanims
  • Peripheral neuropathy
19
Q

Mechanism to obtain HOCL?

A

One pathway :
O2 converted to O2- by NADPH oxidase (oxidative burst)
O2- converted to H2O2 by SOD
H2O2 converted to HOCL’by MPO

Second pathway
Bacterias catalase negative produce H2O2
H2O2 converted to HOCL’by MPO

20
Q

Mechanism by which macrophages call in additional neutrophils to continue acute inflammation?

A

Via IL-8

21
Q

What are the next steps of acute inflammation mediated by the macrophages?

A

Resolution and healing
Continued acute inflammation
Abscess
Chronic Inflammation

22
Q

How does the Macrophages continue the acute inflammation?

A

Via IL 8 to call neutrophils

23
Q

What are the pathways to the destruction of phagocytosed material? Which one is more effective?

A

O2 dependent killing

O2 independent killing

24
Q

What molecules destroys the phagocytosed material?

A

HOCl

25
Q

What is the sickness related with a defect in step 5?

A

Chronic granulomatous disease

MPO deficiency

26
Q

what is the Chronic granulomatous disease

A

Poor dependet killing due to NADPH oxidase defect ( X linked or A Recessive)

27
Q

Why the catalase positive infection create granulomas?

A

Because the catalase destroys the H2O2. so there is no way to create HOCl and there can be destruction of the infection.

28
Q

What are the catalase positive organisms

A 
S. aureus
P. CEPACIA
S. marcescens
Nocordia
Aspergillus
29
Q

A patient undergo nitroblue tetrazolium test? It report blue staining what does that mean?

A

There is NADPH oxidase that conver O2 to O2-

30
Q

Patient comes with oral candida. Denies other symptoms. A nitroblue tetrazolium test is realized, it stains blue? What is the probable diagnosis?

A

MPO (mieloperoxidase) deficiency

Defective conversion of H2O2 to HOCl

31
Q

Macrophages undergo what pathway for killing the phagocytosed material

A

The O2 independent killing

Via enzymes presents in secondary granules (LYSOZOMES and major basic proteins)

32
Q

What is the peak of Macrophages?

A

2-3 days

33
Q

What are the 3 phases of acute inflammation?

A

Fluid phase
Neutrophil phase
Macrophages phase

34
Q

How does the neutrophils die in the resolution step?

A

By apoptosis

35
Q

what cell mediates the abscess creation?

A

Macrophages

36
Q

Patients with an 8 weeks of cough with pus, in what phase of inflammation is?

A

Acute inflammation

37
Q

What are the anti inflammatory molecules macrophages secrete so there can be resolution and healing?

A

IL 10 and TFG B

Pathoma (14 decks)

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