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Toledo PT Inflammation and Tissue Repair
Toledo PT Inflammation and Tissue Repair
94
Physiology
Graduate
09/08/2009

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Term
Inflammation
Definition
protecttive response intended to eliminate the intial cause of cell injury as well as the necrotic cells and tissues resulting from the original insult.
Term
What does endothelium release in inflammation process?
Definition
NO (nitric oxide)
Term
What cells are located in the connective tissue for the inflammation process?
Definition
macrophage, lymphocyte, mast cell, monocyte
Term
What does the cell membrane release in the cell membrane?
Definition
leukotrienes from arachidonic acid.
Term
Plasma Circulating Cells
Definition
neutrophils, eosinophils, basophils, lymphocytes, monocytes, platelets, clotting factors, high-molecular weight kininogen, fibrinolytic factors & complements.
Term
Vascular wall cells
Definition
endothelial cells, smooth muscle cels, nitric oxide
Term
Connective tissue cells
Definition
mast cells, macrophages, lymphocytes, fibroblasts
Term
Cell membrane
Definition
arachidonic acid metabolites: prostaglandins, leukotrienes, lipoxins, & thromboxane
Term
Acute inflammation characterisitics
Definition
minutes to days, blood vessel dilation and leakage, neutrophils entering the surrounding tissues.
Term
Chronic inflammation characterisitics
Definition
lymphocytes, plasma cells, macrophages, healing cells, long term exposure to the noxious agent.
Term
What is the primary cellular effectors of acute inflammation?
Definition
polymorphonuclear neutrophil leukocytes.
Term
What cells are involved in chronic inflammation?
Definition
monocytes, macrophages, lymphocytes, and plasma cells. Collectively referred to as mononuclear leukocytes or mononuclear phagocytes.
Term
T/F At any given point an immune reaction is either purely acute or chronic inflammatory phases.
Definition
False.
Term
Polynuclear neutrophil leukocytes reffer to what immunological cell?
Definition
Neutrophils
Term
Erythema
Definition
redness of an area experiencing increased blood flow during an immune reaction.
Term
Stasis
Definition
RBC beome concentrated w/ an increase in viscosity and flow slowly
Term
Margination
Definition
increased vascular permeability causing fluid to move out & slowing blood flow causes leukocytes to accumulate in the periphery of vessels
Term
Exudate
Definition
After increasing vascular permeability, protein-rich fluid moves into the interstitum.
Term
Edema of acute inflammation
Definition
increases in osmotic pressure in interstitial fluid causes outflow of H2O into extravascular space, resulting in edema.
Term
Integrin Ligand (ICAM-1)
Definition
Binds to Integrin in its (high affinity state) on the basal membrane
Term
PECAM-1
Definition
protein where leukocyte will transmigrate through the membrane into the interstitial space.
Term
Rolling
Definition
when leukocytes stick along the endothelial surface
Term
Selectin
Definition
proteins that are responsible for the rolling of leukocytes.
Term
Selectin E & P
Definition
expressed on endothelium.
Term
L-Selectin
Definition
expressed on the surface of leukocytes.
Term
What inflammatory mediators stimulate the upregulation of selectins?
Definition
Histamine, thrombin, cytokines (IL-1 & TNF)
Term
What proteins are responsible for adhesion of leukocytes on endothelial surfaces?
Definition
Interaction between integrins on leukocyte cell and integrin ligands expressed on endothelial surfaces.
Term
Diapedesis
Definition
movement of leukocytes.
Term
Chemotaxis
Definition
refers to leukocyte migration toward injyry sites after extravasating from blood vessel.
Term
Chemotaxis mechanism
Definition
G-protein activation. Phospholipase C activation. IP3 causes increase in intracellular Ca2+ which triggers the assembly of cytoskeletal contractile elements for formation of pseudopod.
Term
Process of Phagocytosis & degradation
Definition
microbes bind to phagocyte receptors, engulfment of microbes by phagocyte, phagosome fuses with lysosome, degradation of microbes by digestive enzymes & ROS in lysosome.
Term
Vasodilation
Definition
Prostaglandins, Lipoxins, Nitric Oxide
Term
Prostaglandins
Definition
Prostacyclin (PGI2), PGD2, PGE2, PGF2
Term
Vasoconstriction
Definition
Prostagalndin: thromboxane A2 (TXA 2), Leukotrienes (C4, D4, E4).
Term
Increased vascular permeability
Definition
histamine, bradykinins, leukotrienes, complements (C3, C5a)
Term
T/F defects inleukocytes led to incresed infection.
Definition
True
Term
Defects in leukocyte function
Definition
radiation injury, cancer therapy, drug sensitivity, defects in leukocyte adhesion molecules, lack of ability to generate superoxide.
Term
Inflammation-induced tissue injury causes
Definition
Lysosomal enzymes, free radicals, vascula damage to allow diapedesis, phagocytosis of local cells.
Term
Possible outcomes with acute inflammation
Definition
Complete resolution, Healing by scarring or fibrosis, progression to chronic inflammation
Term
Complete resolution
Definition
no or minimal tissue damage.
Term
Healing by scarring or fibrosis
Definition
after substantial loss in connective tissue framework or damage to non-regenerating cells
Term
Progression to chronic inflammation
Definition
when neutrophils and their fast-acting molecular allies cannot remove the noxious agent. Injurious agent persists over a prolonged period, causing concomitant tissue destruction.
Term
Cardinal signs of acute inflammation
Definition
Redness, Warmth, Swelling, Pain, Functional loss
Term
Chronic Inflammation
Definition
Inflammation of prolonged duration. Lacks the vascular changes which are typical of acute inflammation.
Term
Characteristics of chronic inflammation
Definition
mononuclear phagocyte system, tissue destruction by inflammatory cells, repair involving new vessels (angiogenesis), fibrosis: proliferation of fibroblasts, resulting in the accumulation of ECM.
Term
Mononuclear phagocyte system
Definition
infiltration with mononuclear cells
Term
Mononuclear phagocyte system
Definition
infiltration with mononuclear cells (macrophages, lymphocytes and plasma cells)
Term
Causes of chronic inflammation
Definition
persistent infections, prolonged expsoure to toxic agents: smoking, chronically elevated plasma lipd levels: atherosclerosis, non-degradable exogenous materials, inahled particulate silica.
Term
Autoimmune disorders
Definition
immune reactino against self-antigen, multiple sclerosis, rheumatoid arthritis.
Term
Macrophages
Definition
Derived ffrom monocytes which are attracted to the area of inflammation. Transformed in the extravascular tissue.
Term
Cells involved in chronic inflammation
Definition
monocytes, macrophages, lymphocytes, plasma cells.
Term
Vascular changes during acute inflammation
Definition
initial vasoconstriction foolowed by vasodilation
Term
Erythema
Definition
redness because of increased blood flow
Term
transudate
Definition
protein-poor blood fluid moves out of the vessel into interstitial space
Term
Erythrocyte packing: stasis
Definition
RBCs become concentrated w/ an increse in viscosity and flow slowly.
Term
Margination
Definition
neutrophilos start to acuumulate along the endothelial surface.
Term
Transmigration
Definition
Neutrophiuls migrate through vascular wll into interstitial space.
Term
Exudate
Definition
upon further increasing vascular permeability, protein-rich fluid moves into the interstitum.
Term
Edema
Definition
an increase in osmotic pressure in interstitial fluid causes outflow of H2O into extravascular space, resulting in edema.
Term
Inflammatory mediators
Definition
stimjulate the upregulation of selectins such as histamine, thrombin, cytokines (Il-1 & TNF)
Term
Adhesion
Definition
occurs through interaction b/n integrins expressed on leukocyte cell surfaces and integrin ligands (VCAM-1) & ICAM-1 expressed on endothelial surfaces.
Term
Where are macrophages tansformed into macrophage?
Definition
Extravascular tissue
Term
What particle activates macrophages?
Definition
Cytokines secreted from activated T cells.
Term
What biologically active products are released by macrophages?
Definition
Proteases, reactive oxygen species, cytokines (Il-1, Il-6, TNFa), complement components, arachidonic acid metabolites.
Term
What chemicals recruit B & T cells?
Definition
Adhesion molecules and chemokines that recruit monocytes.
Term
What activates lymphocytes?
Definition
They are activated by processed antigen fragments present in macrophages.
Term
What do mast cells do in an injury?
Definition
armed with IgE, produce histamines & metabolites of AA for vascular change. Central players in anaphylactic shock
Term
T/F Neutrophils can further differentiate after arriving at the site of inflammation.
Definition
False.
Term
T/F Neutrophils are incapable of cell division
Definition
True.
Term
T/F Macrophages are mitotically active
Definition
True.
Term
Macrophages do what else besides stereotypical mission
Definition
Mediate systemic effects like fever, leukocytosis, acute phase response induction.
Term
Lymphandenitis
Definition
lymph nodes maay be swollen, tneder sking over node may be reddened and hot.
Term
Lymphangitis
Definition
lymphatic vessesl are inflammed. faint obvious throbbing pain along the affected area is common, high fever and chills may be present.
Term
Lymphedema
Definition
edema caused by the buildup of too much lymph fluid in the tissues. Can result frmo surgery, radiation, infection or trauma.
Term
Acute phase reaction of systemic effects of inflammation
Definition
fever, drowsiness, malaise, anorexia, hypotension, accelerated degradation of skeletal muscle, increased WBC 15,000-20,000 (bacteria). Leukopenia (viral). Il-1, Il-6, TNF
Term
What is common effect of WBC during systemic effects of inflammation with a virus?
Definition
leukopenia.
Term
T/F. Longer inflammatory phase, the greater local tissue damage occurs.
Definition
True.
Term
Glucocorticoids
Definition
anti-inflammatory effects which can limit wound healing and fibrosis.
Term
Labile cel proliferation potential
Definition
divide continuously to replace older cells undergoing apoptosis. basal cell layer of the epidermis. lining of the respiratory and GI tract. Stem cells.
Term
Stable cell proliferation potential
Definition
cells that do not normally divide. can be induced to divide by injury: liver cells.
Term
Permanent Cell proliferation potential
Definition
incapable of regeneration after injury: heart and neurons.
Term
Fibronectin
Definition
acts like a glue to hold the components of the ECM together. links the ECM to cell via cell surface integrins.
Term
Laminin
Definition
Most abundant glycoproteins in BM. Connects cells to ECM components such as type IV collagen. modulates cell survival, proliferation, differentiation, and motility.
Term
Fibroblasts
Definition
cells that make the structural fibes and ground substance of connective tissue such as collagens, elastic fibers, and glycoproteins. tissue damage stimulates fibroblasts to unergo mitosis, increase the number of fibroblasts.
Term
Repair by connective tissue
Definition
Severe or persisten tissue injury to both parenchymal cells and stromal framework limits/ prevents regeneration of original tissue. Repaire occurs by replacing the injured/ dead parenchyme with connective tissue resulting in firbrosis and scarring.
Term
Sequential process involved in fibrous repair
Definition
Formatino of granulation tissue, angiogenesis, migration of fibroblasts & ECM deposition (Scar formation).
Term
Granulation tissue
Definition
specialized tissue characteristic of healing at injured sites. pink/red, soft with a granular appearance. composed of porliferating fibroblasts and new capillaries. progressively lays down ECM.
Term
Angiogenesis
Definition
refers to formatino of new blood vessels.
Term
Two processes for angiogenesis
Definition
mobilizing endothelial precursor cells from bone marrow to an injured site. Sprouting new blood vessesl from preexisting blood vessels.
Term
Keloids
Definition
excess amount of cllagen synthesis
Term
Proud Flesh
Definition
excess accumulation of granulation tissues.
Term
Pathway for Angiogensis from preexisting blood vessels
Definition
Increased permeability of vessel by VEGF->migration of enothelial cells toward angiogenic stimulus->proliferation of endothelial cells behind the leading edge->Recruitment of smooth muscle cells->maturation to functional vessels.
Term
Pathway of EPC angiogenesis
Definition
growth factors (PDGF,bFGF,TGF-B) secreted from activated endothelial cell & other inflammatory cells, migratino and proliferation of fibroblasts, diposition of ECM, decrease proliferating fibroblasts, gradual regression of vasculature, vascular scar formation.
Term
Remodeling of Scar
Definition
continuous modification and remodeling of scar ECM after its synthesis and depostion. outcome of ECM in each stage is balanced by synthesis. enzymes degrade collagens and other components of ECM called matrix metalloproteinases depend on zinc ion for their activity. tightly regulated in tissues since they have potential damdage tissues.
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