Term
| What 3 factors cause the massive vasodilatation associated with acute inflammation? |
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Definition
| -Histamine, bradykinin, and prostaglandins |
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Term
| What 3 factors cause the vascular permeability? |
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Definition
-Vasoactive amines (histamine & serotonin), bradykinin, and leukotrienes
-Same as for inflammation, but we have LKTs instead of PGs |
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Term
| What is the lifespan of a neutrophil? What is in it's primary vs. secondary granules? |
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Definition
-Only about 1-2 days
-Primary; myeloperoxidase, elastase, bacteria permeaters
-Secondary; Leukocyte alkaline phosphatase (LAP), collagenase, lactoferrin
-Both also have phospholipase A2 & lysozyme |
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Term
| What is the macrophage lifespan? What does it contain? |
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Definition
-60 to 120 days
-Has enzymes for tissue breakdown (elastase and collagenase |
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Term
| What are the rolling interaction proteins for leukocyte and epithelium vs. the arresting interaction proteins? Which ones must be induced, and by what? |
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Definition
Rolling:
-Leukocyte; Sialyl-Lewis X
-Endothelium ; E & P-selectins
Attachment
-Leukocyte; LFA-1
-Endothelium; I-CAM-1
-in general, the endothelial factors are induced by IL-1 and TNF (cytokines from macrophages), and chemokine secretion activates integrins
-Chemokines (IL-8) converts LFA-1 to high-affinity binding state |
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Term
| What is the purpose of IL-1 vs IL-8. What is the other name for IL-8. |
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Definition
-IL-1 is more involved in activating the endothelium (along with TNF), with some activation of resident leukocytes
-Whereas IL-8 serves as a chemoattractant, forming a concentration gradient to the site of injury
-IL-8 is also known as CLCX8 |
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Term
| What are the chemotactic factors for neutrophils (4)? |
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Definition
-Bacterial products such as N-formyl-methionine
-Leukotriene B4
-C5a*
-IL-8* |
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Term
| When will we see giant granules in neutrophils? |
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Definition
-In Chediak-Higashi syndrome
-This is a microtubule polymerization disorder, so migration and cell trafficking are affected
-Neutrophils are unable to degranulate
-Auto rec with death usually in childhood |
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Term
| What O2 independant substances are used for intracellular killing? |
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Definition
| -Lysozyme, lactoferrin, acid hydrolases, and defensins are some |
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Term
| What is the test for CGD and what result is abnormal? What do they get infections with? |
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Definition
-NBT (nitroblue tetrazolium) negative is a positive result for chronic granulomatous disease
-These patients get repeat infections with catalase positive bacteria (myeloperoxidase has no substrate) |
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Term
| Myeloperoxidase action and deficiency? |
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Definition
-It make the hypochlorite from H2O2 in oxidative killing
-When deficient we get repeated Candida infections (yeast) |
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Term
| What are the two major vasoactive amines and what is their purpose? What produces each? |
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Definition
-Histamine (basophils, mast cells, platelets) and serotonin (platelets)
-Both cause vasodilatation and increase in permeability |
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Term
| When we think about basophil, mast cell, and platelet degranulation, what do we think about causing it? |
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Definition
-Anaphylatoxins (C3a and C5a)
-IgE reactions
-IL-1 |
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Term
| What is bradykinin? What is involved in it's production? |
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Definition
-It is a potent vasodilator and is also involved in the mediation of pain
-It is produced in the kinin–kallikrein system which depends on Hageman factor (factor 12) for initiation
-Bradykinin is released from HMWK (high molecular weight kininogen) |
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Term
| What are the three classes of molecules produced by the COX pathway? What produces them and what is their action? What is the specific one that mediates pain? |
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Definition
-Thromboxane; produced by platelets and endothelium for vasoconstriction and platelet aggregation (reduce bleeding); reason for initial transient vasoconstriction
-Prostacyclin; produced by endothelium, has opposite effects of thromboxane (produce inflammation)
-Prostaglandins; all cells, for dilation and pain (PGE2 is major pain mediator)
-Note that in the synth pathway, PG comes first and can be converted into either of the other two |
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Term
| What do the leukotrienes B4 thru E4 do? |
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Definition
-LTB4 is for neutrophil chemotaxis
-LTC4, D4, & E4 are all for vasoconstriction
-LTA4 is just a precursor |
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Term
| What are the four possible outcomes of acute inflammation? |
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Definition
1. Regeneration (resolution)
2. Scarring (fibrosis)
3. Abscess formation
4. Transition to chronic inflammation (when pathogen is not eliminated) |
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Term
| What special names do we use for macrophages in the following tissues; connective, lung, liver, bone, and brain? What do we call them when they are modified for granulomas/activated? |
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Definition
-Connective; histiocyte
-Lung; pulmonary alveolar macrophages
-Liver; Kupffer cells
-Bone; osteoclasts
-Brain; microglia
-In granulomas; epitheliod cells |
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Term
| What are the major things released by eosinophils compared to basophils? |
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Definition
| -Eosinophils release a major basic protein that is toxic to parasites while basophils release mostly histamine |
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Term
| What transforms macrophages into epitheliod cells? What other type of cells do we see in granulomatous inflammation? |
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Definition
-IFN-gamma
-We also see multinucleated giant cells which can be either of the Langhans-type (peripheral nuclei) or foreign body type (haphazard nuclei) |
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Term
| In what disease do we see caseous necrosis? |
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Definition
-In TB and a few other granulomatous diseases
-It is the cell death in the granulomas |
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Term
| What are some granulomatous diseases? |
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Definition
-TB, cat-scratch fever, syphilis, leprosy, fungal infections, parasitic infections, sarcoidosis
-We usually see granulomatous inflammation associated with slow-growing organisms |
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Term
| What is necrotizing inflammation? Give an example? |
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Definition
-When a virulent organism produces severe tissue damage and extensive cell death
-Necrotizing faciitis (flesh eating disease) |
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Term
| When do we usually see interstitial inflammation? |
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Definition
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Term
| What are the major immune cells of chronic inflammation as apposed to acute? |
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Definition
-Acute is all about the vasodilation and neutrophils
-Chronic is more about the macrophages |
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Term
| What is cytopathic/cytoproliferative inflammation? Examples? |
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Definition
-Where infecting cell is altered
-From infection with virus
-Cells may show inclusion bodies with viral aggregates, have increased proliferation, or merge with other cells
-Seen in herpes and rabies |
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Term
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Definition
-Primary stem cells
-Regenerate throughout life |
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Term
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Definition
-These are stem cells and differentiated cells that replicate at low level throughout life
-They can divide if stimulated, like with liver cells |
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Term
| Name a few factors that stimulate fibrosis? |
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Definition
-TGF-beta
-PDGF
-FGF (fibroblast GF) |
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Term
| What is granulation tissue? |
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Definition
-Tissue with newly formed and highly permeable capillaries involved in wound healing (angiogenesis)
-Also contains many proliferating fibroblasts
-Forms a few days after injury and remains up to two weeks when it is replaced with scar tissue
-Most prominent in secondary union |
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Term
| What cells mediate wound contraction? |
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Definition
| -Myofibroblasts; between fibroblast and smooth muscle cell in differentiation |
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Term
| Primary vs. secondary union? |
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Definition
-Primary is when there is a clean cut with close edges
-Secondary is when there is chunks of tissue missing
-Secondary will have more granulation tissue |
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Term
| What are the proliferative cells in the brain? Describe what happens in brain repair? |
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Definition
-Astrocytes (supportive cells)
-Neurons can't be regenerated, but the microglia (macrophages of brain) can remove their debris, and the preexisting space is then occupied by the proliferating astrocyte cells |
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Term
| What are the proliferative cells of the lungs? |
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Definition
-Type II pneumocytes replace both type I and II after injury
-Remember, the type II are cuboidal and produce surfactant while the type I are for gas exchange |
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Term
| What is the difference between a hypertrophic scar and a keloid? |
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Definition
-Hypertrophic is just big; raised but not outside boundaries of initial injury
-A keloid is a large tumor-like scar composed mostly of type III collagen (should be remodeled to type I) |
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Term
| Put the five steps of regeneration and healing in order? |
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Definition
| -Hemostasis, inflammation, regeneration, fibrosis (type III collagen), remodeling (type III to type I collagen) |
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