Pathology - Viral Diseases Flashcards
Outcomes of acute infl
Resolution and healing
Continued acute infl
Abcess infl
Chronic infl
Resolution and healing as a result of acute infl
Macrophages produce anti-infl cytokines
Anti infl cytokines
IL-10
TGF-beta
Continued acute infl as an outcome of acute infl
Persistent pus formation
Macrophages produce IL-8, which recruits additional neutrophils
Abcess formation as an outcome of acute infl
Acute infl surrounded by fibroids
Macrophages produce fibrogenic growth factors and cytokines
Chronic infl as an outcome of acute infl
Macrophages present antigen to activate CD4+ T-helper cells, which secrete cytokines promoting chronic infl
Chronic infl
Response of prolonged period e.g. weeks or months
What is the response causing chronic infl due to
Persistence of a stimulus, causing disordered homeostasis
Causes of chronic infl
Persistent infection - most common
Autoimmune disease
Foreign materials
Carcinoma
How does persistent infection cause chronic infl
Causes delayed type sensitivity
Chronic infl cells
Macrophages
Lymphocytes
Plasma cells
Macrophages as chronic infl cells
Dominant chronic infl cells
Phagocytosis
Display antigen to T-cells and respond to T cell signals and production of cytokines
Lifespan is several months or years
Macrophage activation pathways
Classical
Alternative
Classical macrophage activation pathways
M1 macrophages produce No and ROS and up regulate lysosomal enzymes, killing ingested organisms
They secrete cytokines and stimulate infl
How is the classical macrophage activation pathway induced
Induced by bacterial products which engage toll-like receptors or by interferon-gamma produced by T cells
How is the alternative macrophage activation pathway induced
By cytokines other than interferon-gamma e.g. IL-4 and 13, from T-cells
Alternative macrophages activation pathway
M2 macrophages secrete growth factors promoting angiogenesis, fibroblast activation and collagen synthesis
Principal function is tissue repair
T lymphocytes in acute infl
T-cell receptor undergoes gene rearrangement and progenitor cells become CD4+ or CD8+
T cells use TCR complex for antigen surveillance
Th1, Th2 and CD8+ all are activated
Th1 cells in acute infl
Secreet interferon-gamma to recruit macrophages
Th2 cells in acute infl
Involved in allergies
Can recruit eosinophils and cause B-lymphocytes to produce IgE
CD8+ T cells in acute infl
Either release perforin and granzymes or bind FAS-ligand to FAS on target cells
Perforin
Creates pores allowing granzyme to enter cell
B lymphocytes in acute ink
Produced in bone marrow + undergo immunoglobulin gene rearrangement to become naïve B-cells, expressing IgM and IgD
Antigen binds to IgM or IgD, causing maturation of plasma cells
Granuloma
Collection of activated macrophages or epithelioid histiocytes. Can be caseating or non-caseating
Conditions associated w/ granulomatous infl
Foreign material Sarcoidosis Crohn’s disease Cat scratch disease Mycobacterial and fungal infection – caseating granulomas
Granuloma formation
Macrophages process and present antigen on surface in association w/ MHC-II molecules to CD4+ helper T-cells
Macrophages secrete IL-2 causing CD4+ helper T-cells to differentiate into the Th1 subtype
Th1 cells secrete interferon gamma converted macrophages into epithelioid histiocytes and giant cells
How is TB diagnosed
Clinical detection of interferon-gamma