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Path300 > Inflammation & Repair: Inflammation & Wound Healing > Flashcards

Inflammation & Repair: Inflammation & Wound Healing Flashcards

1
Q

What TXA2 do?

A

VasoC

Aggregation

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2
Q

What prosctacyclin do (PGI2)?

A

Decrease platelets aggregation

VasoD of endo cells

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3
Q

What does steroidal anti-inflammatory drugs do?

Eg.: cortisol

A

Inhibit phospholipase
Decrease synthesis of LTE and PG

LTE leukotrienes
PG prostaglandins

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4
Q

Adverse effect of NSAIDs = ?

A

Ulcers

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5
Q

What does NSAIDs (aspirin, ibuprofen) ?

A

Inhibit COX-1 and/or 2
Compensatory increase in LTE

Inhibition of COX = diminution of PG because COX is the enzymes used to metabolize PG

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6
Q

What are the chemotaxis protein in acute inflammation?

A

IL-1
IL-6
TNF

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7
Q

The activation of macrophage, mast cells and endothelial cells release which chemokines (2)?

A

IL-1
TNF

IL-1 also released via activation of INFLAMMASOME

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8
Q

What are the main fct of TNF and IL-1?

A

Local recruitment of leukocytes via expression of selectin/integrin

Increase prod of cytokines and eicosanoids (prod later PG and LTE) via activation of macrophage.

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9
Q

What is the fct of IL-1?

A

Increase proliferation of fibroblast in ECM and chemokines.

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10
Q

What is the fct of TNF?

A

Increase membrane permeability

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11
Q

In chronic inflammation, TNF and IL-1 may enter in circulation and create systemic effects. What are they (4)?

A 
Fever
Drop in BP
Increase metabolic waist
«         » synthesis of acute phase prot 
         - also stimulate by IL-6
«         » leukocytes synthesis

But also

  1. Fever
  2. Leukocytosis
  3. Acute phase prot response
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12
Q

Which chemokines promote insuline resistance in skeletal muscle?

A

IL-1

TNF

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13
Q

Which chemokine promote formation of thrombus?

A

TNF

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14
Q

What are the chemical mediators of inflammation (8)?

A 
Vasoactive amines
     -serotonine, histamine
Plasma protease
      -complement factors, coagulation factors
Kinin syst
    -bradykinin

PG and LTE

Cytokines and chemokines
-IL-1, TNF, IL-6

Lysosomal enzymes & free radical

NO

Platelet activation factor (PAF)

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15
Q

Explain the systemic effect of inflammation called FEVER

A

IL-1 and TNF = pyrogen
Increase PG synthesis
Increase temperature set point in the thermoregulatory center (HYPOTHALAMUS)
Result in shivering and vasoC to generate heat and decrease heat lost

It increase the speed of migration of leukocytes and weaken microbes

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16
Q

Explain the systemic effect of inflammation called LEUCOCYTOSIS

A

Increased synthesis of
Macrophages
Monocytes
Lymphocytes

Increased maturation of developing leukocytes from bone marrow

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17
Q

Explain the systemic effect of inflammation called ACUTE PHASE PROTEIN RESPONSE

A

CRP monitored to dx chronic inflammation and risk of myocardial infarct in pt w/ atherosclerosis

Fibrinogen = blood clotting

Serum amyloid A (SAA); activate complement prot

SAA and CRP increase microbial elimination and opsonins

18
Q

Lysosomal enzymes and free radical can activate what (2)?

Eg.: elastase, collagenase, cathepsin

A

Vasoactive complement prot

Bradikinin-like peptides

19
Q

Lysosomal enzymes and free radicals can be inhibited by what?

A

a1-antitrypsin (elastase)

a2-macroglobulin

20
Q

NO is released by what (2)?

A

Endothelial cells (vasoD)

Activated macrophages (kills microbes)

21
Q

PAF is released by what type of cells(3)?

A

Platelets
Basophils
Neutrophils

22
Q

What is the fct of PAF

A

Increase membrane permeability and vasoD (more puissant than histamine)
BronchoC
Increased synthesis of eicosanoid (PG LTE)
« » cytokines
« » leukocytes recruitment
« » leukocytes degranulation
« » oxidative burst

23
Q

What are the characteristics of chronic inflammation (3)?

A

Infiltration of tissue by macrophage/lymphocyte

Tissue damage d/t ROS, lysosymes

Repair healing
Via fibrosis and angiogenesis

24
Q

What are the major player macrophage in chronic inflammation?

A

M1 macrophage

25
Q

In chronic inflammation macrophage initiate (2)

A

Fibrosis

Secrete inflammatory mediators (IFN-y)

Can activate lymphocytes which can activate more macrophages

26
Q

What is a granuloma?

A

Aggregation of activated macrophages/lymphocytes

27
Q

Give 3 examples of disease that present granuloma

A

TB
Bacteria resistent to macro
Foreign body

TB: Via chronic activation of macrophage by t-cells

High concentration of IL-1 triggers granuloma formation.

BACTERIA RESISTANT TO MACROPHAGES
-leuko aggregate & surround bacteria to protect the rest of the cells & prevent bacteria spreading.

AROUND A FOREIGN BODY
-splinters

28
Q

Wich type of cell can fuse and become multinucleated cell in the case of GRANULOMA?

A

Macrophages

29
Q

What are the type/patterns of inflammation (4)?

A

Serous

Fibrinous/membranous

Abscess

Ulcer

30
Q

Describe a serous inflammation

A

Blister (cloque)

Minor edema of watery prot-poor liquid

EFFUSION liquid separating the epidermis from the dermis

31
Q

Describe a fibrinous/membranous infla.

Where?

What can clean it up?

A

Severe edema
Fibrinogen exudate
(Deposit of fibrin on tissue)

Meninges
Lung pleura
Pericardium

Fibrinolysis
Scarring occur if cannot clean up all fibrin

32
Q

Abscess

Cause

A

Pus

Excessive necrosis

Heavy tissue destruction under abscess = SCARRING

33
Q

Ulcer

Where

A

Necrosis+infla
D/t ischemia+bacterial infection

GIT

34
Q

What are the repair mechanisms of a tissue? 2

A

Regeneration healing by 1st intention

Scarring 2nd

35
Q

Regeneration
Healing by 1st intention

Regenerative capacities 3

Examples

A

Cells replaced by the SAME TYPE

CELL PROLIFERATION

  1. Labile tissue (constant)
  2. Stable (in resp to injury/QUIESCENT)
  3. Permanent (low regenerative cap)
  4. Surface epithelial, GIT, hemapoethic cells of bone marrow
  5. Hepatocyte, liver kidney
  6. Neuron, cardiomyocytes, skeletal muscle cells
36
Q

Scarring
2nd intention

Collagenase enzyme is secreted by which cell?

Give an example

What is is role

A

Complete regeneration impossible
Another type of cell

Macro

Matrix metalloproteinases

Digest connective tissue
Make place for replacement tissue

Then secrete angiogenetic/fibrigenic factors
=granulation tissue
=wound contraction(reorganize fibrous tissue)
Produce stable scar

37
Q

In granulation tissue, fibroblast produce what?

A

ECM to stabilize the wound

38
Q

In granulation tissue, fibroblast are recruited by what cytokine?

Give examples

A

Growth factor
(Also stimulate ECM deposition)

TGF-b
PDGF
FGF-2
Cytokines

39
Q

Fibroblast can become what type of musle?

When does it happen during the granulation tissue formation?

A

Myofibriblast
Weak contractil properties

Last stage

40
Q

Keloid

Does it decrease w/ age?

A

Excessive scarring for minor injuries

Excessive ECM/ fibrous tissue deposition

Yes

41
Q

What are the factors affecting infla and repair?

Systemic

Local

A

Malnutrition
Db
Leukocytes defect
Glucocorticoids

Infection
Foreign bodies
Ischemia
Location of injury

Path300 (12 decks)

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