Robbins Ch. 3 Flashcards
What is the cellular infiltrate for acute inflammation?
neutrophils
What is the cellular infiltrate for chronic inflammation?
monocytes/macrophages and lymphocytes
What are the cardinal signs of inflammation?
rubor (redness), tumor (swelling), calor (heat), and dolor (pain)
What are the 3 main components of acute inflammation?
1: dilation of small vessels leading to an increase in blood flow
2: increased permeability of the microvasculature
3: Emigrations of the leukocytes
What is vasodilation most notably mediated by?
histamine
Contraction of endothelial cells to increase vascular permeability is elicited by what?
Histamine, bradykinin, and leukotrienes
Other than contraction of the endothelial cells, what other mechanism causes increased permeability?
Endothelial injury
What act on endothelial cells of postcapillary venules to coordinated expression of E-selectins and ligands for L-selectins?
TNF and IL-1
What is firm adhesion mediated by?
integrins
Where are integrins found?
on leukocyte surface
What induces endothelial expression of ligands for integrins?
TNF and IL-1
What adhesion molecules present in the intercellular junctions between endothelial cells are involved in the migration of leukocytes?
CD31 or PECAM-1
What are the most common exogenous chemoattractants?
bacterial products including peptides that possess an N-formylmethionine
What are the main endogenous chemoattractants?
1: cytokines (IL-8)
2: Complement (C5a)
3: arachidonic acid metabolites (mainly leukotriene B4; LTB4)
What type of infection causes the cellular infiltrate to be dominated by continuously recruited neutrophils for several days?
Pseudomonas bacteria
In what type of infection might lymphocytes be the first cells to arrive?
viral
What type of reactions cause eosinophils to be the main cells to arrive?
allergic reactions
What is one of the most successful therapies for chronic inflammatory diseases?
block TNF
What are the major opsonins, which enhance phagocytosis?
IgG antibodies, C3b from complement, and certain plasma lectins most notably mannose-binding lectin
which NOS is involved in microbial killing?
iNOS
what induces iNOS?
macrophages and neutrophils being activated by cytokines (e.g. iFN-gamma)
What is the major antiprotease in serum and tissue fluids that controls harmful proteases from neutrophil from destroying tissue?
alpha1-antitrypsin
T lymphocytes can also contribute to acute inflammation by secreting what?
IL-17 which recruits other leukocytes
What T lymphocyte secretes IL-17?
Th17
In the absence of effective Th17 responses, individuals are susceptible to what?
fungal and bacterial infections and the skin abscesses that develop are “cold abscesses”
What antiinflammatory cytokines are produced from macrophages and other cells to terminate and acute inflammation?
TGF-beta and IL-10
What are the 2 major vasoactive amines?
histamine and serotonin
What leukotriene is a potent chemotactic agent and activator of neutrophils?
LTB4
What dietary modification can be used to manipulate inflammatory responses?
increasing the consumption of fish oil
The MAC complex of the complement system is important mainly for the killing of what?
microbes wit thin cell walls such as Neisseria bacteria
inherited deficiency of C1 inhibitor is the cause of what?
hereditary angioedema
Nerve fiber containing substance P are prominent where?
lung and gastrointestinal tract
What are the 4 patterns of acute inflammation?
Serous, Fibrinous, Purulent or abscess, ulcer
What are the 3 characteristics of chronic inflammation?
infiltration with mononuclear cells, Tissue destruction, and attempts at healing
What activates M1 macrophages?
microbes and IFN-gamma
What is the job of classically activated M1 macrophages?
killing organisms and inflammation
What activates alternatively activated M2 macrophages?
IL-13 and IL-4
What is the job of alternatively activated M2 macrophages?
Tissue repair, fibrosis, anti-inflammatory
What is a granulomatous inflammation characterized by?
collections of activated macrophages, often with T lymphocytes, and sometimes associated with central necrosis
What are the important mediators of the acute phase reaction?
IL-1, IL-6 and TNF
What are the majoe clinical pathologic changes that occur during the acute phase reaction?
Fever, Acute phase proteins, leukocytosis
What are the 3 major Acute-phase proteins?
C-reactive protein, fibrinogen, and serum amyloid A protein
What is the most important source of growth factors for cell proliferation to repair injury?
macrophages that are activated by the tissue injury
What are the 3 steps in scar formation?
Angiogenesis, formation of granulation tissue, remodeling of connective tissue
What is the most important cytokine for the synthesis and deposition of connective tissue proteins?
TGF-beta
The degradation of collagens and other ECM components is accomplished by what?
matrix mealloproteinases (MMPs)
What inhibits MMPs?
TIMPs
