respiratory system Flashcards

1
Q

what is inhalation

A

route of exposure

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2
Q

respiratory toxicology is _

A

Toxic responses of the cells of the respiratory tract, regardless of exposure route (may be inhalation or systemic, parent compound or metabolite)

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3
Q

what are the compound of interest in pheumotoxicology

A

occupational & environmental chemicals
therapuetic agents

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4
Q

what is the structure & function of the lungs

A

Nasopharangeal region = Nasal cavity, Pharynx and laynx
Trachea and Bronchi which is the conducting airway
Lower respiratory tract = trachea, primary bronchi and lungs
Respiratory bronchioles and alveoli = gas exchange regions

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5
Q

why os the respiratory tract susceptible to toxicty

A
  • Highly perfused (Lung receives 100% of right side cardiac output, Exposed to systemic toxins and their metabolites)
  • Exposed to air (Defence mechanisms)
  • Highly complex tissues, numerous cell types
  • Local xenobiotic metabolism
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6
Q

the air leaving the nasal cavity is

A

warm, moist, clean, turbulence free

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7
Q

the nasopharyngeal contains _ mucosa

A

olfactory
contains specialised epithelium which is responsible for the sense of smell

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8
Q

what is the structure of the olfactory mucosa

A

the olfactory mucosa is high in the nasal cavity and coverted in a mucus layer
- olfactory receptor cells are located in the olfactory epithelium.
- columnar epithelial cells, olfactory stem cells and the cribriform plate separates the olfactory bulb and the mucosa
- nerve fibre are within the bulb which linkeds to the olfactory tract

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9
Q

Can the olfactory mucosa be used for drug transport

A
  • Recent research suggests that the olfactory mucosa is a realistic route for delivery of therapeutics
  • Toxicological route = Some evidence in experimental animals that some metals (when inhaled) can translocate into CNS via the olfactory cells, but not others
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10
Q

how would the nasopharyngeal region be described

A

vascularised mucous epithelium
- large particles filtered out by nostril hairs
- water soluble molecules absorb
- nasal squamous cell carcinoma in long term inhalation studies in rats with HCHO
- perforated nasal septum with chromium (VI)

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11
Q

what is the pharynx

A

First recognisable tube of the respiratory system. Halfway down there is an opening in the wall of the pharynx which connects to the middle ear. This is called the Eustachian tube and serves to allow pressure changes to be communicated to the ear so that the eardrum can maintain the correct tension

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12
Q

What is formaldehyde and what is caused by inhalation

A

a common chemical, found primarily in adhesive or bonding agents for many materials found in households and offices, including carpets, upholstery, particle board, and plywood paneling.
The release of formaldehyde into the air may cause health problems, such as coughing; eye, nose, and throat irritation; skin rashes, headaches, and dizziness.

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13
Q

what is the trachea

A

10cm tube which extends from the larynx
lined with classical psuedo stratified ciliated colomnar epithelium which is risk in goblet cells

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14
Q

how does mucus work in the cilia

A

bathes the surface of the cilia which beat regularly and move the cilia up the trachea. Any particulate matter that has got through the upper defences will (hopefully) become trapped in this mucous and be moved upwards and expelled by coughing or swallowing. This defence mechanism is also known as the mucociliary escalator.

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15
Q

what is the lamina propria

A

made up of loose connective tissue; mucous and serous glands and some elastic fibres. It also maintains the characteristic C-shaped cartilage rings which are connected at the anterior of the tube by smooth muscle. These rings serve to maintain an open airway and the smooth muscle allows for control of lumenal diameter.

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16
Q

what is the entire trachea encased in

A

adventitia of connective tissue

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17
Q

what tissue and cells are located in the thracheobronchial region

A

(conducting airways)
- smooth muscle – allow lumenal diameter control (salbutamol)
- Ciliated epithelial cells
- Mucous (goblet) and serous epithelial cells
- Club cells (non ciliated)
- nerves
- mucociliary escalator

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18
Q

how does the smooth muscle work to change the dilation of the bronchiole

A

Parasympathetic nervous system: the vagal nerve releases acetylcholine which acts on the muscurinic receptors causing constriction of the bronchial smooth muscles.

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19
Q

what are club cells and what are they involved in

A

Cilia-free domed cells, abundant in the tertiary bronchioles. High content of xenobiotic metabolising enzymes. Progenitor cells for a variety of lung epithelial cells
Involved in: Protection (secretion of oxidases and anti-proteases and antimicrobials)
Surfactant secretion (processing of the liquid liner to the lung)
Origin of the most common form of lung cancer

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20
Q

what are the cells involved in the alveoli region

A

Alveolar type I cells (type 1 pneumocytes)
Alveolar type II cells ( type 2 pneumocytes)
Interstitial cells
Macrophages

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21
Q

how are the two types of pneumocytes different

A

Type I = squamous, 0.15um, constitutes 95% of area for gas exchange
Type II = cuboidal, granules (for storing surfactant), only 5% of area for gas exchange but 60% of total cells.
Type II cells can differentiate into Type I cells.

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22
Q

what are the defense mechanism of the lungs

A
  • Clearance of particles: (mucociliary escalator, phagocytosis [alveolar macrophages to lymphatics –> dissolution])
  • Release of chemical mediators as protectants eg glutathione, protein
  • Specific defences - immune system
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23
Q

what are the particle sizes found in the lungs

A

Nano = Ultrafine = < 100 nm (Conventional)
Nano = <10 nm (suggested by unique quantum and surface-specific functions)
Fine = 100 nm - 3 m
Respirable (rat) = < 3 m (max = 5 m)
Respirable (human) = < 5 m (max = 10 m)
Inhalable (human) = ~ 10 - 50 m

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24
Q

Aerosol particle size influences site of deposition =

A
  • Interception: occurs with the larger particles actually being intercepted by the upper airways
  • Inpaction: inertia moves the particle further down the airway and enter the bronchial region
  • Sedimentation: deposition in the smaller bronchi, velocity is low
  • Diffusion: important in the deposition of particles in the sub-micrometer size
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25
Q

how are particles cleared from the airway

A

Nasal-mechanically removed
Tracheobronchial-mucociliary escalator
Pulmonary- macrophages, me, or penetrate the epithelial membrane and transported in the blood

26
Q

what cells are involved in xenobiotic metabolsim

A
  • Nasal (olfactory) mucosa
  • Club cells (Highest activity)
  • Type I and II alveolar cells
    many toxicants are activated by these enzyme systems
27
Q

What CYPs are active in human lungs

A

IAI (mRNA,protein and induced by smoking)
1A2 (+/- mRNA + protein)
1B1 (++ mRNA + protein, related catalytic activity)
2A6 (++ mRNA, +/- protein)
2B6 (+++ mRNA + protein, related catalytic activity)
2C (+/- mRNA + Protein)
2E1 (+++ mRNA + protein, related catalytic activity)
2FI, 2J2, 2S1, 3A4, 3A5, 3A7, 4B1

28
Q

which phase II enzymes are expressed higher in the lung vs the liver

A

SULT1A1
SULT1A3/4
SULT1C2
SULT2B1/2
UGT2A1

29
Q

desribe the specific toxicity of trichloroethylene to mouse club cells (how was it discovered)

A
  • Mice given a single, 6h exposure to trichloroethylene showed dose dependent vaculoation of club cells
  • Isolated Club cells produced a range of metabolites including chloral (major metabolite), trichloroethanol, and trichloroacetic acid, but no glucuronides
  • In hepatocytes the major metabolite was trichloroethanol and its glucuronides
  • UDP glucuronyl transferase activity was compared between cell types; hepatocytes could form glucuronides from tri-chloroethanol; Club cells could not
  • However, only chloral could cause the specific lesion observed in Club cells; results in vivo from a failure to conjugate trichloroethanol
30
Q

describe the pathogenesis of lung damage

A
  • Local irritation
  • Cancer
  • Allergic response
  • Cellular
  • Fibrosis
31
Q

what causes local irritation

A
  • Ammonia and Chlorine are examples of Irritant gases = Cause bronchial restriction and oedema
    (Chronic effects are rare)
  • Arsenicals = induce irritation on acute exposure, prolonged exposure may cause lung cancer
  • Ground-level ozone (air pollution) = exacerbate chronic respiratory diseases, cause short-term reductions in lung function
32
Q

Describe ammonia & chloride and how they are considered an irritant

A

The site of deposition of gases in the respiratory tract define the pattern of toxicity.Water solubility is critical in determining how deeply a gas penetrates.
Highly soluble gases dissolve in the naso-pharangeal region and are not transported further into the resp. tract.
They can cause LOCAL effects.

33
Q

what is the most toxic form of arsenic

A

arsine gas

34
Q

how is it thought that ozone and oxides of nitrogen cause here effects

A

peroxidation of cellular membranes = causes increased membrane permeability and results in fluid accumulation = Oedema

35
Q

what happens when type II cells come into contact with ozone/oxide of nitrogen

A

Proliferate to form Type I cells.
More extensive exposure can lead to the formation of fibrous tissues.

36
Q

what is Ipomeanol

A

toxin produced by the mould Fusarium solani

37
Q

how does 4-Ipomeanol effect the lungs

A

Selective necrosis of Club cells in experimental animals and cattle
Club cells bioactivate 4IP. Metabolites high affinity for macromolecules cause necrosis
=Oedema and hemorrhage
Activated intermediate (? Epoxide) covalent protein binding
5 times greater concentration than liver

38
Q

why is 4-Ipomeanol not an issue in humans

A

lower expression of enzyme (CYP4B1?)

39
Q

how does ozone effect the lungs

A

Exerts effects on lungs through endogenous reactions with lipids in epithelial surfactant lining (phopholipids and sterols)

40
Q

Oxidation of lipids results in numerous biological effects including:

A
  • interleukin-8 release
  • loss of mitochondrial dehydrogenase activity
  • enhanced cytotoxicity in lung macrophages as well as epithelial cells
41
Q

how do oxides of nitrogen through to cause their effects

A

= Peroxidation of cellular membranes.
Cause increased membrane permeability and results in fluid accumulation. More extensive exposure can lead to the formation of fibrous tissues

42
Q

ozone exposure causes _ from respiratory epithelial cells

A

ATP release
- believed to be a protective mechanism

43
Q

what does ATP release cause in the lung

A

stimulates activates important cell survival
signals like ERK1/2 and Akt.

44
Q

what is pulmonary fibrosis

A

chronic response to silica, Asbestos, Quarts
which can lead to a serious debilitating disease

45
Q

silica, asbestos and quarts causes pulmonary fibrosis by what toxic effects

A

1 - rupture of lysosomal membrane in macrophages
2 - lysosomal enzymes digest macrophages
3 - release of particle from lysed macrophages
4 - fibrotic changes

46
Q

what are allergic response

A

induced by direct allergens (pollen, spores, bacterial contaminants, cotton dust) & small molecules (Haptens) plus protein given allergens
- e.g Toluene diisocyanate

47
Q

what is Toluene diisocyanate

A

used in the plastic industry, a small molecule which is an allergy

48
Q

How do allergens causes pulmonary fibrosis

A

= Produces a hypersensitive response
Reacts with proteins in the blood or lung, protein becomes recognised as “foreign” by immune system. Form antigens and stimulate antibody production
Immune response on second or subsequent exposure

49
Q

what has been linked to lung cancer

A

Cigarette smoke = leading cause
Arsenic
Chromates
Nickel
Uranium
Coke oven emissions
Asbestos, silica,
Welding fumes
Potentially many others

50
Q

why is the cause of lung cancer sometimes hard to identify

A

latency period up to 20-30 years, may even be longer for mesothelioma

51
Q

what is the key mechanism for lung cancer

A

Damage to DNA. May be oxidative DNA damage or DNA adducts from e.g. PAHs

52
Q

how does asbestos cause DNA damage

A
  • absorption of carcinogens and endogenious molecules
  • chronic inflammation can be caused
  • Asbestos can cause mesothelium
  • Deletion translocation in chromosomes during mitosis can occur
  • mesothelioma can be produced
53
Q

Given an example of a systemic toxin

A

Paraquat
- non selective herbicide = highly toxic following ingestion

54
Q

How is paraquat toxic in the lungs

A

Enters alveolar cells via polyamine transporter
- once inside cells results in redox cycling accumulates in alveolar cells and elsewhere
- wide spread damage to both Type I and II pneumocytes
- Oedema leading to a massive inflammaotry response

55
Q

What is a less toxic substitute for paraquat

A

Diquat = poorer substrate for transporter

56
Q

what is the cellular mechanism of paraquat

A
  • entires via the receptors
    -PQ2+ -> PQ+- (radical) = reduced by NADPH
    (NADP+ is oxidised via Hexose monophosphate shunt to regenerate NADPH)
  • produces oxygen radical which causes fentons reaction
  • causes lipid peroxidation and cell death
    -depletes GSH levels
57
Q

what is Bleomycin

A

antibiotic with anti-tumour properties
- administered IV, IM, subQ, IP or intrapleurally
- mainly (605) excreted unchanged, deactivated by bleomycin hydrolyase mainly in the liver

58
Q

how does bleomycin induce pulmonary toxicty

A

Forms complex with Fe (II), oxidised to Fe (III), releasing free radical release, causing DNA strand breaks

59
Q

why is bleomycin dangerous in lung

A
  • no hydrolase in lung (or skin)
  • Pneumonitis which may progress into fibrosis
  • Damage to endothelium (mechanism as yet unknown but free radicals and cytokine induction involved)
  • Influx of inflammatory cells (e.g. alveolar macrophages)
  • Induction of apoptosis
    =Activation of fibroblasts - fibrosis
60
Q

Primary response of lungs to toxicity

A

Inflammation, Irritant, Oedema, Mild damage
Reversible

61
Q

secondary response of lungs to toxicity

A

Fibrosis, Emphysema, Tumours
Irreversible

62
Q

what are the study methods to look at lung toxicity

A
  • Pulmonary Function Studies
  • Morphology (biopsy)
  • Broncho alveolar Lavage (saline) =pulmonary macrophages
  • In vitro studies = Isolated perfused lung, Isolated lung cells (cultured at air-liquid interface or submersed), Precision cut lung slices