Week 1 Lecture 2- Inflammation

Question 1

What is inflammation

Answer 1

Part of the innate defence mechanisms of the body against infectious or non infectious aetiologies (things that’s effect)

Any type of tissue damage or infliction that initiates a set of vascular and cellular events to clear out cellular deplores or pathogens, initiating repair

Question 2

List causes OF inflammation

Answer 2

Genetic abnormalities
Nutritinal abnormalities
Immunologic reactions (damage caused by immune system)
Endocrine
Physical agents
Chemical agents
Infectious agents
Hypoxia (abnormality respiratory or circulatory function)

Question 3

How long is acute inflammation

Answer 3

6 weeks (less than)

Question 4

How long does chronic inflammation last

Answer 4

6 weeks <

Question 5

List the 5 cardinal signs of acute inflammation

Answer 5

Redness
Heat
Swelling
Pain
Loss of function

Early tissue response followed by healing

Question 6

Aims of inflammation (4)

Answer 6

Bring immune cells to the area
Destroy pathogens
Remove cellular debris
Begin repair

Question 7

List defence cells

Answer 7

Neutrophil
Eosinophil (allergy in gIT)
Basophil
Monocyte
T-cell
B-cell
Natural killer
Macrophage

Question 8

List acute phase protein

Answer 8

There is a sudden increase in plasma conc of certain protein in a self defence

C reactive protein (CRP) increase from 7 hours. Decrease after 48 hours

Elevated segmentation rate (ESR) increased of this from 7 days of defence

Ferritin

Question 9

List acute inflammation phases (2)

Answer 9

Vascular phase
Cellular phase

Question 10

Explain vascular phase of acute inflammation

Answer 10

-Vasodilation occurs
-Increasing the permeability of the vascular barrier
-Regulated by chemical mediators
-Exudation of fluid (to area fluid moves w plasma)
-Oedema- allows proteins such as immunoglobins to migrate through. Removes pathogens and cell debris through lymphatic drainage.

Question 11

Explain cellular phase of acute inflammation

Answer 11

• Polymorphonuclear neutrophils migrate and adhere to swollen epithelial cells
through either:

 Margination – cells line up against the endothelium
 Rolling – close contact with and roll along the endothelium
 Adhesion – connecting to the endothelial wall
 Migration – cells move through the vessel wall to the affected area

• They push through the cell membranes passing into the area of damage through a
process called CHEMOTAXIS
.
• Phagocytosis of the foreign body (the pathogen is engulfed and contained with a
phagosome).
• The phagosome is then destroyed but release proteolytic enzymes

Question 12

Explain extravasation

Answer 12

The movement of white blood cells and fluid from blood vessels to the surrounding tissues.

In response to injury, infection or other inflammatory stimuli.

Helps eliminate harmful agents

Question 13

What do mast cells secrete through their glands

Answer 13

Histamine
Leukotreins
Protoglandins
(Inflammatory mediators located into the intra space)

Question 14

When we have a fever, the PG3 protein stimulates the hypothalamus which gives us ab increase in temp. What is the purpose of this?

Answer 14

Cellular metabolism
Denature DNA of pathogens
Iron to area as hR increases so more blood is pumped too the area

Question 15

What is the outcome of acute inflammation

Answer 15

• removal of the exudate
• resolution (restore to normal via replacing cells, chemical substances are neutralised, normalisation of vascular permeability, apoptosis of inflammatory cells, lymph drainage)
• healing by scar
  -progression to chronic inflammation

Question 16

List clinical examples of acute inflammation

Answer 16

Asthma
Sepsis
Vasculititis
Meningitis
Acute trauma

Question 17

Causes of chronic inflammation

Answer 17

Sensitivity (external trigger that can be result in allergy)
Exposure (low-level exposure or irritants like chemicals)
Autoimmune disorders (immune system mistake attacks normal healthy tissues
Auto inflammatory disease (genetic factors)

Question 18

List factors for chronic inflammation

Answer 18

Age
Obesity
Standard American diet
Smoking
Low sex hormones
Stress
Sleep problems

Question 19

What does inflammation cause

Answer 19

Angiogenesis (formation of new blood vessels)
Mononuclear cell infiltration (macrophages, lymphocytes, plasma cells)
-fibrosis (scar)

Question 20

Compare acute vs chronic inflammation

Answer 20

Acute inflammation onset is immediate whereas chronic is delayed.

Acute duration is a few days whereas chronic is up to months and years

Causative agents for acute is bacteria and injured tissues whereas chronic is persistent acute inflammation, viral autoimmune

Acute major cells are neutrophils, basophils, monocytes, macrophages whereas chronic is mononuclear, mono, lymphocytes, plasma cells, fibroblast

Acute primary outcomes are resolution, abscess formation and chronic inflammation. Chronic outcomes are tissue destruction, fibrosis, necrosis

Question 21

What do cytokines release

Answer 21

(They are the Little messages released for an immune response )

The granules released are mainly histomines
Prostoglandins

Question 22

Describe diapydesis

Answer 22

Process by leukocytes move from bloodstream into tissues.

Pass through blood vessel wall

Question 23

Describe positive chemotaxis, what undergoes this?

Answer 23

Movement towards a higher conc of a chemical or a signalling molecules

Neutrophils undergo this when moving to the site of inflammation in response to cytokines sending signals.

Question 24

Describe the process of innate immunity

Answer 24

Bacteria with antigen on surface releases endotoxins
Endotoxins act on mast cell nucleus to release inflammatory cytokines
Stimulating P-selectin on endothelial cells to initiate extravasation (leakage of blood or lymph)

Transmigration, margination, adhesion, diapedeasis and positive chemotaxis occurs

The inflammatory cytokines act on endothelial cells causing them to contract and increase permeability (swelling)
Smooth muscle cells are acted on and they relax leading to vasodilation and heat and redness

Neutrophils undergo exocytosis of free antigens. Apoptosis

Macrophages undergo phagocytosis forming a phagolysosome
MCH2 recombination and attach to specific antigen and present on cell membrane
Macrophage turns into antigen presenting cell

Question 25

Describe the process of innate immunity

Answer 25

Bacteria with antigen on surface releases endotoxins
Endotoxins act on mast cell nucleus to release inflammatory cytokines
Stimulating P-selectin on endothelial cells to initiate extravasation

Transmigration, margination, adhesion, diapedeasis and positive chemotaxis occurs

The inflammatory cytokines act on endothelial cells causing them to contract and increase permeability (swelling)
Smooth muscle cells are acted on and they relax leading to vasodilation and heat and redness

Neutrophils undergo exocytosis of free antigens. Apoptosis

Macrophages undergo phagocytosis forming a phagolysosome
MCH2 recombination and attach to specific antigen and present on cell membrane
Macrophage turns into antigen presenting cell

Question 26

Describe adaptive immunity (cellular)

Answer 26

Viral or cancer infected cell exposes viral protein on self antigen

Cytoxic t clell bind to viral protein on viral cell with a CD8 receptor

Cytoxic T cell releases performing
Granzymes we hitch move through pores and activate pro-apoptosis genes

Question 27

What is irons role in immune repsonse

Answer 27

Sequesters excess iron depriving pathogens of iron they need for replication and reducing oxidative stress that can damage tissues

Question 28

What does p-selectin do in innate immunity

Answer 28

Stimulated by cytokines which the mast cell released

Found on endothelial walls it starts extravasation - leak of fluids into surrounding tissues