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Flashcards in Inflammation Deck (30):
1

An inflammatory reaction is

A pathophysiological process which
i) destroys
ii) dilutes
iii) walls off
an inflammatory initiating agent:
-> microbrial infection, noxious stimuli, neoplasm trauma

2

Basic physiological events:

1. Vascular- dilation
2. Cellular- anti-microbial
3. Induction - antigen presents
4. Effect - lymphocyte recruitment

3

Outline vascular - dilation phase

1. Increased vasodilation increases vascular permeability
2. Fluid extravasation
3. Endothelial cell activation -> express CAMS
4. Leukocytes in blood vessel adhere to endhothelium
5. Transmigrate to site inflammation

4

Cellular response involves which 2 types of cells :

1. Polymorph nuclear cells (PMN's) e.g. neutropil
-> phagocytosis microbial nature -> respiratory burst
-> proteases/ recruit more leukocytes

2. Monocytes -> differentiate into macrophages which
i) phagocytose
ii) release host inflammation mediators
-> reactive o2 species
- lipid mediators
- cytokines/ chemokines

3. Present antigen to lymphocytes

5

Henry Dale's criteria for chemical mediator:

Be present, cause inflammation, releived if synthesis. release manipulated

6

Histamine is released from _____ or ____ by a variety of stimuli including XYZ

Mast cells/ basophilis by
X: IGE cross linking
Y: Amphylation C5a and C3a
Z: Morphine

7

H1 mediates

endo cell activation by rounding up -> I.C. spaces form, arteriolar and arterial relaxation

8

Histamine is formed by

Histidine by histidine decarboxylase

9

H1 antagonists that cross BBB and what they're used for:

Gaq - diphenhydramine, chlopheniramine
-> sedation, motionsickness, allergies (but drowsy)

10

H1 antagonists that don't cross BBB

Cetirizine, terfenadrine
-> allergies (partially effective)

11

H2 antagonists

Gas
e.g. rantidine
suppression gastrin secretion
-> heals duodenal ulcers

12

Types of kinins and origins

Bradykinins + kallidin (lys-bradykinin)
-> formed from plasma protein precursors (kinninogens)

13

Kallikans

Enzymes that produce kinin from kinnogens

14

Kinin is destroyed by X and Y with a plasma half life of

X- Carboxypeptidase N
Y- Angiotensin coverting enzyme
20 minutes

15

Kinin functions and mediators

1. Vasodilators, increase venular permeability, cause pain + contract smooth muscle
2. Actions mediated by B2 receptors but B1 also exist/ histamine. prostaglindin release

16

How does beta 2 mediate kinin function?

- constitutive
- acts through other mediators
- NO + prostaglandins
- agonist: bradykinin, kalidin
-antagonist : icibant HOE140

17

How does beta 1 mediate kinin function?

- induced via cytokines
- not internalised
- agonist: des-arg kalidin DABK (des-arg bradykinin)
- antagonist: des-arg icibant

18

Prostaglandin characteristics

20 carbon with HO group at C15

19

Prostaglandin E.synthase:

1) cytosolic: constituitive production
2) membrane: inflammatory mediators e.g. arachindonic acid -> prostenoid + relevant synthase (COX)

20

How do the EP receptors differ?

1. Bronchial G.I, sm mu contraction, pain
2. Bronchodilation, vasodilation, stimulation of intestinal fluid secretion + G.I. sm. muscle relaxation
3. Intestinal Sm. mu. contraction gastric acid secretion inhibition, increase gastrine mucus secretion
4. Bronchial constriction + vaso D, leukocyte suppression

21

How does PGE2 cause fever?

Hypothalamus

22

How does PGE2 cause pain?

Induces hyperalgesia at peripheral terminals of primary afferent nociceptors and spine

23

How does PGE2 cause oedema?

Synergy with other mediators

24

PGE2 and leukocytes

Inhibits leukocytes

25

PGD2

Synthase found predominantly in mast cells and brain
DP- receptors: Vasodilatation, inhibit platelet aggregation, Relaxation GI muscle & uterine
TP-receptors:- Bronchoconstrictor
CRTH 2:- Chemoattractant for Th2 cells

26

PGF2

FP-receptors:- Smooth muscle contraction, Bronchoconstriction, Reproductive physiology

27

PGI2

prostacyclin
-> synthase found in vascular endothelium
- IP- receptors: Vasodilatation, Inhibit platelet aggregation, renin release

28

Thromboxane A2

Synthase found in platelets
TP receptors: Vasoconstriction, platelet aggregation

29

Cytokine + Chemokine characteristics

Simple polypeptides/ glycoprotein with molecular weight <30KD -> production transient
- bind to high affinity CS receptors
-> alter gene expression in target cells

30

Binding affinity of cytokine + chemokines

10-9 - 10-12 M