inflammatory mediators Flashcards

1
Q

what are inflammatory reactions characterised by

A
increased blood flow
increased vascular permeability
pain
cellular infiltration
loss of function
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2
Q

what type of molecules are inflammatory mediators labelled as and which molecules are they

A

local hormone/autacoid; since they are produced locally around the site of stimulus

histamine, 5HT, eicosanoids, kinins, platelet activating factor and cytokines

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3
Q

how is histamine produced, how is this inhibited

A

produced from histidine via the enzyme histidine decarboxylase

enzyme inhibitor: alpha methyl histidine

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4
Q

what might stimulate acute inflammation

A

infarction, bacterial infections, toxins, trauma

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5
Q

what happens during acute inflammation

A

vascular changes; vascular dilation, increased blood flow, increased permeability

neutrophil recruitment

release of inflammatory mediators

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6
Q

what might stimulate chronic inflammation

A

viral infections, chronic infections, persistant injury, autoimmune disease

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7
Q

which inflammatory mediators cause increased blood flow

A

histamine, 5HT, nitric oxide, bradykinin, platelet activating factor, PGE2 and PGI2

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8
Q

which inflammatory mediators lead to increased vascular permeability to allow cellular filtration

A

histamine, bradykinin, platelet activating factor, TNFalpha and IL-1, PGE2

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9
Q

what inflammatory mediators cause pain

A

substance P, bradykinin, calcitonin gene-related peptide

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10
Q

what inflammatory mediators cause loss of function

A

lipases, proteases, free radicals

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11
Q

how do neutrophils cross vasculature

A

(check immunology notes)

Rolling: neutrophils are attracted to vasculature via selectins and mucins; selectins P and E are expressed on endothelium, expression is caused by cytokines, sugar on neutrophil surface binds to these selectins

tight adhesion: after neutrophils bind to selectins it causes neutrophils to start expressing integrins such as LFA-1

LFA-1 allows neutrophil to bind to ICAM-1 on endothelium causing firm binding/ adhesion

ICAM-1 is caused by TNF and other inflammatory mediators

transmigration: after adhesion neutrophil can squeeze through since vasculature is more permeable due to cytokines, the process is called diapedesis

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12
Q

what role doe mast cells play in inflammation

A

they are activated by IgE and complement

release of inflammatory mediators: histamine, leukotrienes, prostaglandins, platelet activating factor, interleukins (IL4-6)

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13
Q

what is role of neutrophils in inflammation

A

first cells to migrate through vasculature (via ICAM-1)

function: phagocytosis and kill opsonised bacteria

neutrophils release leukotrienes, prostaglandin free radicals, proteases and interleukins: IL-1 and TNFalpha

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14
Q

what is role of eosinophils in inflammation

A

similar to neutrophils however they have more granules

aid in parasitic infections and in late phase asthma and allergic inflammation

release leukotrienes, prostaglandins, proteases, interleukins (1, 5, 6, 8 and TNFalpha)

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15
Q

what is role of macrophages in inflammation

A

antigen presentation, microbe killing, granuloma formation, angiogenesis, wound healing

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16
Q

what function do neurones have in inflammation

A

only in neurogenic inflammation; release of neuropeptides which is activated by bradykinin and 5HT

17
Q

how is bradykinin synthesised

A

2 pathways:

one pathway:
low molecular weight kininogen is produced in glands, pancreas, kidney and neutrophils
low molecular weight kininogen is converted to kallidin by tissue kallikrein

kallidin (lys-bradykinin) is converted to bradykinin by aminopeptidase

other pathway:

high molecular weight kininogen is converted to bradykinin via plasma kallikrein

bradykinin and kallidin (lys-BK) are both metabolised by carboxypeptidases which add a des-Arg group to them, both metabolites are still active

18
Q

describe the bradykinin receptors

A

B1 and B2 receptors, both GPCRs, both are Gq/i

B2: consitutive (always there)

acts through release of other mediators such as nitric oxide and prostaglandins, quickly desensitised through internalisation, agonists are bradykinin and kallidin, antagonist: HOE140

B1:
expression of B1 receptors is induced via cytokines

not internalised so is resistant to desensitisation

agonists: des-Arg kallidin (lys-des-arg bradykinin, a kallidin metabolite)
and des-Arg bradykinin (DABK) (a bradykinin metabolite)

(metabolites of B2 receptors are B1 receptor agonists)

antagonists: des-Arg HOE140

19
Q

whre are bradykinin receptors located

A

endothelium, vascular smooth muscle, fibroblasts, epithelium, sensory nerves, leukocytes

20
Q

how do ACE inhibitors affect bradykinin

A

ACE converts bradykinin into inactive peptides, so ACE inhibitors will increase bradykinin concentrations, also preventing angiotensin 2, a vasoconstrictor

21
Q

how is complement activated

A

3 pathways: alternative pathway(activated by microbes), classical pathway( activated by antibody), lectin pathway( activated by manose, a bacterial sugar)

22
Q

what is they key event in all pathways of complement

A

C3 convertase cleaves C3 into C3a and C3b

23
Q

what are important complement molecules and what is their function

A

C3a: activates degranulation of mast cells

C3b: causes clearance of immune complexes, and opsonisation

C5a: causes degranulation of mast cells

MAC (membrane attack complex): (end product of complement cascade), causes pores to form in bacterial cell wall causing lysis

24
Q

where is histamine found as what causes its release

A

mast cells (found in complex with acidic protein and heparin), basophils and histaminergic neurones

release is caused by; IgE, C5a and C3a, substance P, and morphine (exogenous)

25
how is histamine metabolised
it is oxidised by diamine oxidase (histamines) N-methylation via N-methyltransferase acetylation: via gut flora oral doses of histamine are acetylated and oxidised (diamine oxidase is in gut and liver)
26
what is effect of kinins, including bradykinin
vasodilation, increase venular permeability, cause pain, contract smooth muscle