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Renal Test 2 > Renal Inflammation > Flashcards

Renal Inflammation Flashcards

1
Q

What is the functional criteria of Acute Kidney Injury?

A

Increase in serum creatine by 50% within 7 days

or

Increase in serum creatine by 0.3 mg/dl within 2 days

or

Oliguria

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2
Q

What are the causes of AKI?

A

Hypoxia inducing illnesses

Intravascuplar Volume Depletion and Hypotension

Decreased Effective Intravascular volume

Hepatorenal syndrome

Sepsis

Renal vascular disease

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3
Q

What is the major cause of acute renal failure?

A

Ischemic acute kidney injury leading to metabolic acidosis and ATP depletion

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4
Q

How are DAMPs released?

A

Released from parachymal kidney cells during ECM degredation

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5
Q

What binds DAMPS and activates the classical complement pathway?

A

C-reactive Proteins

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6
Q

How do DAMPS induce innate immune response and renal inflammation?

A

Binding to toll-like receptors

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7
Q

What are the examples of DAMPS discussed?

A

HMGB1

Uric Acid

HSPs (Exosomes)

S100 protein (cytoplasm)

Hylauronans in ECM

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8
Q

What cell is activated during acute kidney injuries and infections?

A

Dendritic Cells

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9
Q

What cell is activated during IC-GN, diabetes, and sepsis?

A

Endothelial cells

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10
Q

What to endothelial cells release as part of an inflammatory response?

A

TNF, IL-6, Chemokines, and IFNa

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11
Q

What are the pattern recognition receptors discussed?

A

Toll-like

NOD like

C-type lectin

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12
Q

What do M2 cells release as part of the anti-inflammatory response?

What is the overall function of an M2 cell?

A

Arginase-I

IL-10

Clearance of apoptotic cells

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13
Q

What activates a classically activated M1?

A

PAMPS and DAMPS through binding of TLR and other PRRs

IFN-y also promotes differentiation

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14
Q

What factors reprogram an M2 cell?

A

CSF-1 (M-CSF)

IL-10

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15
Q

What induces M2 activation?

A

IL-4 and IL-13

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16
Q

What substances are secreted by M1 macrophages for microbicidal purposes.

A

ROS, NO, and lysosomal enzymes

17
Q

What substances are secreted by M2 macrophages in wound repair?

A

Proline

Polyamides

TGF-B

18
Q

What cells assist in the generation of myofibroblasts and production of ECM during wound repair?

A

Pericytes

19
Q

What stimulates differentiation of a Naive CD4+ T cell into the following:

IL-12

IL-4

IL-6

A

Th1

Th2

Th17

20
Q

The “chemokine pattern” that plays a roll in recruitment of neutrophils is released by what cells?

A

Meangial and tubular epithelial cells

These have been influenced by IL-17 secreted by Th17.

21
Q

What does CCL20 or MIP-3 do?

A

Stimulates the infiltration of monocytes, Th1, and Th17 cells

22
Q

What are they key regulators of the inflammatory response?

What do they secrete?

A

TREG Cells

TGF-B and IL-10

23
Q

Type II hypersensitivity reactions are caused by what mechanism?

Example?

A

IgG or IgM is bound to cellular antigen, triggering complement pathway.

Anti-glomerular basement membrane mediated glomerular nephritis

24
Q

Which hypersensitivity pathway is involved in neutrophil recruitment triggered by antigen-antibody complexes?

A

Type III

25
Q

What are the key concepts influencing transplantation?

A

Donor-host antigenic disparity

Immunosupressive regime

Condition of allograft

Strength of host anti-donor response

26
Q

What peptides increase local vascular permeability and serve as a chemoatractant for neutrophils and macrophages?

A

Fibren peptides

27
Q

What substance results from the kinin cascade?

What does this substance do?

A

Bradykinin

Vasodilation

28
Q

What transplantations are not sensitive to donor differences in ABO blood type or Class I/II HLA abs.

A

Corneal

Heart valves

Bone and tendon grafts

29
Q

How is microcytotoxicity test for performed Abs performed?

A

Recipeint serum added to donor cells

Complement then added

Dye is then added

The if the Abs bount to an antigen on the donor cells, they will have induced the complement system, making the cells porous. These porous cells should retain the added dye.

30
Q

What are the class I antibodies that are strong barriers to transplantation?

A

HLA-A and HLA-B

31
Q

What are the most important class II HLA ags in transplantation?

A

HLA-DR

HLA-DQ

HLA-DP

32
Q

What is measured to determine Class II HLA compatibility?

What substance allows for this to be measured?

A

Proliferation of recipeint cells

Labled with 3H-thymididine

If there is no proliferation of lymphocytes you can transplant

33
Q

What substances are release when humeral rejection occurs?

What cells release these?

A

IL-4, IL-5, IL 10

Th2

34
Q

Which form of allorecognition occures whe MHC II molecules that have been processed and presented by APCs trigger an immune response?

A

Indirect allorecognition

35
Q

At what time does the following rejections occur?

Hyperacute

Acute

Chronic

A

Immediately (within minutes)

Acute (days to weeks)

Chronic (months to years)

36
Q

Acute rejection results in what pathology?

A

Inflammation and leukocyte infiltration of the grafted vessels

Parenchymal cell damage and interstitial inflammation

37
Q

What are the non-immunological factors that influence this Chronic host vs graft rejection?

A

Ischemia-reperfusion damage

Recurrence of disease that causes failure of the kidneys

Nephrotoxic drugs (cyclosporine A)

38
Q

What causes a Graft-versus-host response?

A

Reaction of grafted mature T cells of bone marrow with all antigens of the host.

Directed against minor HLA Ags of the recipient

39
Q

What are the symptomes of Acute Graft versus Host Disease (GVHD)?

A

Rash

Jaundice

Diarrhea

GI Hemorrhage

Renal Test 2 (7 decks)

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