Park Lec 1

Question 1

what are the characteristics of acute inflammation

Answer 1

1. Rapid in onset and short duration
   –> Minutes to days
2. Accumulation of fluid and plasma proteins
   –> Exudation
3. Accumulation of neutrophils
4. Tumor necrosis factor (TNF), interleukin-1 (IL-1), chemokines

Question 2

what are the characteristics of chronic inflammation

Answer 2

1. Insidious and of longer duration (months to years)
2. Tissue destruction by inflammatory cells
3. Vascular proliferation and fibrosis
   –> Scarring
4. Influx of lymphocytes and macrophages
5. Interferon- y (IFN-y) by T cells and interleukin-I2 (IL-I2) by macrophages
   –> Synergistic stimulation

Question 3

what are some characteristics of inflammation

Answer 3

• Occurs upon infections or noxious stimuli
  –> Injuries, burns, foreign bodies, etc.
• Eliminates harmful agents and necrotic cells
  –> Microbes and toxins
• Initiates the healing process

Question 4

inflammation can cause injury but what are the different types of responses

Answer 4

1. Too strong response
   –> Severe infection
2. Prolonged response
   –> Persistent or recurrent infection
3. Inappropriate response
   –> Self-antigens in autoimmune diseases

Question 5

what are some pharmacologic approaches of inflammation

Answer 5

1. Glucocorticoids
2. NSAIDs
3. Antihistamines
4. Leukotriene antagonists
5. Biologics targeting cytokine signaling

Question 6

what are the characteristics

Answer 6

1. Heat
   – calor
2. Redness
   – rubor
3. Swelling
   – tumor
4. Pain
   – dolor
5. Loss of function
   – Functio laesa

Question 7

what are the events occurring during the acute inflammation response

Answer 7

1. Phagocytosis in tissues recognize offending agents and liberate chemical mediators of inflammation
2. Chemical mediators widen blood vessels (vasodilation) and increase their permeability in the vicinity
3. Plasma and circulating leukocytes diffuse to the location of the offending agents
   –> Leukocyte recruitment
4. Activated leukocytes remove the offending agents
   –> Phagocytosis
5. Leukocytes produce signaling molecules that suppress inflammation
   – Lipoxins
6. The damaged tissue is repaired
   – Cell proliferation

Question 8

what are some vascular stages responses

Answer 8

1. vasodilation
2. increased lipophilicty

Question 9

whaat are some stages of cellular acute inflammation

Answer 9

1. Leukocyte recruitment
2. phagocytosis

Question 10

what results in vasodilation

Answer 10

1. Decrease in fluid velocity
2. Increased viscosity
   –> Due to fluid loss to tissues
3. Increased leukocytes settling along the inner surface of the blood vessels
   –> margination

Question 11

what results in increased lipophilicty

Answer 11

1. Gaps due to endothelial contraction
   –> Most common mechanism
   –> Histamines, leukotrienes, bradykinin
2. Increase fluid life through endothelial cells
   –> transcytosis
3. Direct endothelial traumatic injury
4. Leukocyte dependent endothelial cell damage/death due to release of toxic mediators by leukocytes
5. Leakage from new blood vessels that form at the site of injury

Question 12

what changes can result from vascular changes

Answer 12

1. Transudate
   –> Small holes
   –> Plasma with little proteins
   –> No cells
2. Exudate
   –> Bigger holes
   –> Protein rich fluid with numerous cells
3. Edema
   –> Accumulation of fluid and swelling at site of inflammation

Question 13

what are the secret of events in leukocyte recruitment

Answer 13

1. Margination
2. Loose attachment and rolling
   –> Selectins
3. Adhesion
   –> Integrins
4. Transmigration
5. Chemotaxis
   –> Bacterial products
   —–> LPS
   –> Chemokines
   –> Complement system
   —–> C5a
   –> Leukotriene B4 (LTB4)

Question 14

what is involved in the recognition of phagocytosis

Answer 14

direct and indirect

Question 15

what is the engulfment of phagocytosis

Answer 15

• Receptor-mediated endocytosis
• Pseudopods extend around foreign body and form a phagosome

Question 16

what is the intracellular killing of phagocytosis

Answer 16

1. Fusion of the phagosome with a lysosome (phagolysosome)
2. Lysosomal degradation
   –> Digestive enzymes and defensins
3. Release of toxic nitrogen and oxygen compounds (oxidative burst)
   –> H2O2, hydrochloric radical, NO

Question 17

what is involved in direct recognition

Answer 17

• microbes by pattern recognition receptors
  –> Toll-like receptors — LPS, flagellin, etc.
  –> Mannose receptors

Question 18

what is involved in indirect recognition

Answer 18

• Opsonins: IgG, C3b, and collectins (carb-binding lectins)
• Coat of foreign body and dead cells
  –> Opsonization
• Specific receptors recognize opsonins
  –> Fc receptor; C3b receptor