Lec #1 (Wk 1): Innate Immunity Flashcards

1
Q

What are the cells of the immune system?

A

Monocytes (which differentiate into macrophages once in the tissue).
Mast cells
Dendritic cells
Natural Killer cells
Neutrophils
Eosinophils
Basophils
T-cells
B-cells

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2
Q

Let’s say a WBC is flowing & crosses through an organ, how does it distinguish between self & non-self cells?

A

Identifies self since there are self markers called MHCs which label the body’s cells.
MHC = Major Histocompatibility Complex.

Identifies non-self by looking for the antigens at the surface; antigen is a molecule that the immune system recognizes as a foreign.

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3
Q

what does it mean for something to be antigenic?

A

Can elicit an immune response.

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4
Q

Compare between innate & adaptive immunity.

A

INNATE IMMUNITY:
- Inherited from parents & passed on to offsprings thus, it is present at birth.
- Non-specific; will get rid of all foreign things in the same way.
- Time taken to initiate its job is rapid (Within 0-12 hours).
- No memory cells created (meaning if you were exposed to the same pathogen, body will react the same exact way).
- Composed of 1st & 2nd lines of defenses; skin, circulating effector cells (neutrophils, macrophages, & NK cells), Compliment proteins, erythrocytes, & platelets.

ADAPTIVE IMMUNITY:
- Cannot be inherited, built with immunization, vaccination, & exposure to pathogen.
- Created in response to exposure to the antigens.
- It is SPECIFIC and antigen-mediated meaning: specific antigens create the response.
- Response is slow & takes time to build up a response after encountering an antigen (1-2 weeks).
- Produces memory; if the body recognizes the same pathogen again, it will recognize it & try to kill it.
- 3rd line defense; lymphocytes & their products (e.g antibodies).

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5
Q

Which immunity involves, 1st, 2nd, & third line of defense?

A

Innate immunity = 1st + 2nd which is composed of the compliment proteins, skin, neutrophils, macrophages, NK cells, erythrocytes, & platelets.

Adaptive immunity = 3rd line of defense is
the lymphocytes + antibodies.

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6
Q

The innate immunity doesn’t work alone, it works with the adaptive immunity. Initial response will be carried out by the innate immunity & after that adaptive takes over. What cells are responsible for such crosstalk?

A

Antigen-Presenting Cells (APCs) like dendritic cells & macrophages. The APCs mediate the cellular immune response by processing & presenting antigens for recognition by the adaptive immunity. After that, adaptive immunity takes over & the T-cells & B-cells undergo clonal expansion thus the lymph nodes become swollen & tender.

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7
Q

What are the functions of the lymph nodes?

A

Lymph nodes are secondary lymphoid organ.
1- Inactivation & killing of mature T-cells.
2- Initiating & resolving immune responses.
3- Place for T cell - APC crosstalk.
In the case of endogenous antigens (antigens inside our body), it won’t be presented or produce any response but in exogenous antigens, the lymph nodes would present the antigen to the T-cells & produce a response.

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8
Q

Where does the crosstalk happen between T-cell & APC?

A

Lymph nodes

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9
Q

Function of dendritic cells?

A

Present in a small amount in the tissues. In the blood, they are in the immature state. They are Antigen Presenting Cells which capture the microbes entering the lymphatic vessels until they reach the lymph node where they present the antigen to the Naïve T cells & initiate an adaptive immune response.

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10
Q

What if the immune system attacks the self cells thinking they’re non-self?

A

Autoimmune disease.

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11
Q

What are the 3 lines of the immune system?

A

first line defense; made of physical, chemical, & biological barrier such as: skin, mucous membrane, & secretions of the skin + mucous membrane.

Second line of defense; This is the innate immunity. Involves;
- specialized cells: neutrophils, mast cells, basophils, eosinophils, NK cells, & macrophages.
- Proteins: complement system, cytokines, Mannose-Binding Lectin (MBL), & C-reactive protein (CRP).

3rd line of defense; Adaptive immunity like lymphocytes & antibodies.

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12
Q

What does no memory being made means?

A

It doesn’t remember a prior encounter with microbes & resets to baseline after each encounter. So acts against repeated exposure the same way (same potency & speed) = monotonic.

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13
Q

How does the innate immunity recognize that there is a pathogen trying to attack us?

A

Looks for:
1- Pathogen Associated Molecular Patterns (PAMPs); those are derived from the micro-organisms itself such as LPS (in gram -), nucleic acids, bacterial peptides like flagellin, peptidoglycans, lipotechoic acid, and lipoproteins.

2- Damage Associated Molecular Patterns (DAMPs); those are derived from the HOST cells, so the cell once its damaged starts releasing things like intracellular proteins, EC matrix proteins, and non-proteins such as ATP, & uric acid.

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14
Q

What receptors recognize the PAMPs & DAMPs?

A

Immune cells have Pattern Recognition Receptors (PRRs) on the surface of their cell membrane. The binding of the PRRs to the PAMPs/DAMPs recruits other immune cells like:
- Phagocytes
- NK cells
- Leukocytes

PRRs are divided into 4 families;
1- Toll-Like receptors (TLR)
2- Nucleotide-Binding Oligomerization domain like receptors (NLR).
3- C-type lectin receptors (CLR).
4- RIG-1 like receptors (RLR).

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15
Q

Pattern Recognition Receptors (PRRs) are divided into 4 families which are?

A

1- Toll-Like Receptors (TLR)
2- Nucleotide-binding Oligomerization domain like receptors (NLR).
3- C-type Lectin receptors (CLR)
4- RIG-1 like receptors (RLR)

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16
Q

What are toll-like receptors responsible for?

A

Recognizing the PAMPs. Those receptors are found on the innate immune cells like the macrophages, granulocytes, dendritic cells, & lymphocytes.

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17
Q

Where are toll-like receptors (TLR) found?

A

Found in the innate immune cells in 2 different locations;
1- Cell membranes
TLRs expressed on the cell membrane of the innate immune cells recognize the products of the extracellular microbes.
TLRs found on cell membrane: TLR 1, 2, 4, 5, & 6.

TLR4 (four) respond to the lipopolysaccharide thus recognize gram-negative bacteria.
TLR5 (Five) respond to Flagella so they recognize motile bacteria.

2- Endosomes
TLRs expressed on the endosomes recognize nucleic acids (since microbes are digested within the endosomes & their nucleic acids are released).
TLRs expressed on the endosomes: TLR 3, 7, 8, & 9.
So they can recognize viruses too.

**we have 10 TLRs but we don’t know the location of TLR10.

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18
Q

Which toll-like receptors are expressed on the cell membrane of the innate immune cells?

A

TLR1, TLR2, TLR4, TLR5, & TLR6.
**remember TLRs respond to PAMPs and since they are expressed on the cell membrane, they recognize the products of extra cellular microbes.

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19
Q

Which toll-like receptors are expressed on the endosomes of the innate immune cells?

A

TLR3, TLR7, TLR8, & TLR9.
**remember TLRs respond to PAMPs and since they are expressed on the endosome, this means that they recognize nucleic acids of the pathogen and can consequently recognize viruses too.

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20
Q

Explain the stages of phagocytosis.

A

1- Phagocytes (like neutrophils or macrophages) move to the site where the pathogen is via chemotaxis & adheres to the microbe by forming pseudopods.

2- Phagosome is formed which fuses with the lysosome to form a phagolysosome.

3- Those lysosomal enzymes start digesting the pathogens and breaking them down into smaller pieces then finally discharges them to go to the T-cells.

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21
Q

What are the cells of the innate immune system?

A

Phagocytic cells:
- Neutrophils
- Macrophages
- Dendritic cells.

Non-phagocytic cells:
- basophils
- eosinophils
- NK cells

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22
Q

Where are macrophages originated? What is their name in the blood? tissue?

A

Originate from the bone marrow.
In blood we call them monocytes, but once in tissue macrophages.
**BIG NOTICE:: Some monocytes differentiate to dendritic cells, so not necessarily always macrophages.

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23
Q

What can monocytes differentiate into?

A
  • Macrophages
  • Dendritic cells (that have different names in different organs).

Both are antigen presenting cells that present the antigen to the T-cells at the lymph node.

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24
Q

What do we call the dendritic cells (phagocytic cell belonging to the innate immunity) in the:
Liver?
Connective tissues?
Bone marrow, spleen, & lymph nodes?
Skin?
Bone?
Kidney?
Brain?
Blood?

A

Liver; Kupffer cells.
Connective tissues; histiocytes.
Bone marrow, spleen, & lymph nodes; macrophages.
Skin; Langerhans cell.
Bone; osteoclast.
Kidney; Mesangial cells.
Brain; Microglial cells.
Blood; monocytes.

Dendritic cells are antigen presenting cells which will present the antigen to the T cell at the lymph nodes.

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25
Q

Talk about how neutrophils look like, where we find them, and their functions?

A

Neutrophils are found in the bloodstream. They are circular containing granules with nucleus which is multi lobed (usually 3 lobes).
Functions:
1- On the surface of the neutrophils we have Fc receptors to the IgG & igA.
**Fc receptor will bind with the Fc region of the antibodies that are attached to infected cells or invading pathogens.

2- Intracellular killing by lysosomal granules.

3- Cytokine production which recruit other inflammatory cells.

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26
Q

What do we call basophils in the bloodstream, tissues, and mucosa?

A

Bloodstream: Basophils.
Tissue & mucosa: Mast cells.

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27
Q

What are the 2 types of mast cells?

A

1- Connective tissue mast cell
2- Mucosal mast cell (plays a role in allergy).
Degranulation of the mast cells release mediators which contribute to the allergy reaction.

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28
Q

Which cell plays a role in allergy?

A

Mucosal mast cells.

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29
Q

Which cell is responsible for capturing & killing cells with down-regulated MHC’s?

A

Natural Killer cells.
Cells with down-regulated MHCs are the cancer cells, cells infected by a virus.

Natural killer cells use perforins to create a hole in the cell then use granzymes to induce apoptosis.

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30
Q

NK cells perform their actions by expressing 2 receptors, what are they?

A

1- Killer Activation Receptors (KAR) –> recognize stress-related molecules.
2- Killer Inhibition Receptors (KIR) –> detects the presence of MHC protein on the host cells. If a cell has MHCs and when it binds to the KIR, it will inhibit it thus cannot perform its action. But, when a host cell without MHC binds, it will activate it thus killing the cell.

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31
Q

How do NK cells kill cells?

A

They do NOT attack the pathogen directly, they firstly detect when the cells are infected and release substances like Perforin & Granzymes.
Perforin –> perforate the cell wall (i.e make a hole).
Granzymes –> after the perforation was formed, this enables the granzymes to enter and trigger apoptosis.

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32
Q

What cell produces perforins and granzymes? Functions?

A

Natural killer cells.
Perforins –> perforate the cell membrane.
Granzymes –> enter the cells through the hole and trigger apoptosis.

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33
Q

List the proteins belonging to the innate immunity.

A

1- Complement proteins.
2- Mannose Binding Lectin (MBL)
3- C-Reactive Protein
4- Coagulation factors

34
Q

1 of the proteins belonging to the innate immunity is the Mannose Binding Lectin (MBL), functions?

A

1- Causes opsonization.
2- Activation of the lectin pathway of the complement system.

35
Q

1 of the proteins belonging to the innate immunity is the C-reactive proteins, functions?

A

1- Causes opsonization.
2- Activation of the complement.

36
Q

1 of the proteins belonging to the innate immunity is the coagulation factors. How does it contribute to the innate immunity?

A

They make a clot to localize the infection & stop it from spreading.

37
Q

Describe the structure of antibody.

A
  • Has a fab region which is the Binding site to the antigen (it is the one w 2 parts)
  • Fc region is the tail which binds to the Fc receptor present on some immune cells + binds to some proteins of the complement system.

It is made up of 4 polypeptide chains; 2 heavy chains & 2 light chains. The variable region is the very top part whereas the constant region is everything below.

38
Q

What is the Fab region of antibody responsible for?

A

This is the one made up of 2 parts thus can bind to 2 antigens. It is the binding site for antigens.

39
Q

What is the Fc region of the antibody responsible for?

A

This is the tail which interacts with the Fc receptor and some proteins of the complement system.

40
Q

What are cytokines?

A

They are small soluble proteins that confer instructions & mediate communication among immune & non-immune cells.

41
Q

functions of cytokines?

A

1- Initiate the inflammatory response.
2- Regulate host defense against pathogens mediating the innate immunity.
3- Some have additional roles like acting as growth factors.

42
Q

What are the complement systems?

A

Those are soluble proteins made in the liver & released into the blood. The complement proteins are from C1 till C9. They are activated when cut/cleaved.
Complement system consist of 3 pathways:
1- Classical pathway (first to be discovered).
2- Alternative pathway (working all the time).
3- Lectin pathway.
When the complement proteins are activated, they recruit WBCs to the site of infection and trigger inflammation; swelling, redness, & pain.

43
Q

What complement proteins are used in the classical pathway?

A

C1 till C9.

44
Q

What activates the classical pathway of the complement system?

A

Activated when antigen and antibody bind together to form the antigen-antibody/immune complex.

45
Q

Describe the classical pathway of the complement system?

A

1- Once the antigen(of the foreign substance) and antibody bind together, they form an immune complex.
2- The C1 complex which is a multimeric complex made up of C1q, C1r, & C1s, the C1q in particular binds to the Fc portion of the antibody (so on the other side of the immune complex).
3- C1q is the exposed portion thus is the one binding to the Fc portion, upon binding it activates the C1r which consequently activates C1s.
4- C1s then cleaves C4 and C2 into C4a/C4b and C2a/C2b.
5- C4b and C2b will form the C3 convertase (C4b2b).
6- C3 convertase cleaves C3 into C3a & C3b.

46
Q

Which part of the C1 complex binds to the Fc portion in the classical pathway?

A

C1q

47
Q

Once C1s of the classical pathway is activated, what does it do?

A

C1s then cleaves C4 & C2 into C4a/4b & C2a/2b and form the C3 convertase (C4b2b). C3 convertase cleaves the C3 into C3a and C3b.

48
Q

What does the C3 convertase do?

A

Cleaves C3 into C3a & C3b.

49
Q

In the classical pathway, what cleaved the C4 and C2 into C4a/4b & C2a/2b respectively?

A

C1s

50
Q

What activates the lectin pathway of the complement system?

A

The pathogen has mannose on its surface, so when a carbohydrate-binding plasma protein known as Mannose-Binding Lectin (MBL) binds to the mannose, it activates the lectin pathway.

**whereas in the classical pathway, the activator was antigen and antibody binding together.

51
Q

Describe the steps of the lectin pathway in the complement system.

A

1- Mannose, present on the surface of the pathogen, binds to the Mannose-Binding Lectin (MBL) present in the plasma.
2- MBL then binds with the MBL Associated Proteins (MASP-1) and circulates in the serum as this complex which induces a conformational change.
3- This conformational change results in the auto-activation of MASP-2.
4- MASP-2 then cleaves C4 & C2 into C4a/4b & C2a/2b.
5- C4b and C2b form the C3 convertase (C4b2b).

52
Q

In the lectin pathway, what cleaves the C4 and C2?

A

In the lectin pathway, MASP-2 cleaves both.

**BS IN THE CLASSICAL PATHWAY, IT IS C1s

53
Q

What is the purpose of the alternative pathway in the complement system?

A

Alternative pathway happens at a very low rate with the purpose of cleaning dying cells.

54
Q

What activates the alternative pathway of the complement system?

A

Spontaneous hydrolysis of C3 (into C3a & C3b) & deposition of the C3b on the surface of the pathogen.

55
Q

Describe the alternative pathway of the complement system.

A

1- Spontaneous hydrolysis of C3 (into C3a and C3b), and the C3b gets deposited on the surface of the pathogen. **notice!! C3b is an opsonin meaning it will help in phagocytosizing the cell.

2- This C3b combines with other complement proteins; Factor B, factor D, & Properdin.

3- Factor D will cleave factor B into Ba and Bb.

4- Ba is thrown away whilst Bb combines with the C3b to form C3bBb which is the C3 convertase.
C3 convertase (C3bBb).

56
Q

C3 convertase cleaves the C3 into C3a and C3b, what is the function of C3a?

A

C3a is the smaller fragment & is an anaphylotoxin.

57
Q

C3 convertase cleaves the C3 into C3a and C3b, what is the function of C3b?

A

C3b is the larger fragment (b for bigger) which deposits on the pathogenic surface and is responsible for:
1- opsonization (help trigger phagocytosis) (remember C3b is an opsonin).
2- Formation of the C5 convertase (formed when the C3b from here combines with the C4b2b which is the C3 convertase, together they form: C4b2b3b which is called the C5 convertase.

58
Q

What is the C5 convertase made up of?

A

When the C3 convertase (C4b2b) combines with the C3b it forms C4b2b3b which is the C5 convertase.

59
Q

What does C5 convertase do & its function?

A

Cleaves C5 into C5a and C5b.

  • C5a is the smaller fragment which is an anaphylatoxin & is 10,000 times more potent than C3a. Since it is more potent, what it does is bring a massive number of inflammatory cells that are full of C5a receptors.
  • C5b is the larger fragment which forms the Membrane Attack Complex (MAC).
    Membrane attack complex is composed of C5b combining with:
    C5b + C6 + C7 + C8 + C9
60
Q

What complement proteins form the membrane attack complex (MAC)?

A

C5b + C6 + C7 + C8 + C9
Upon formation of the membrane attack complex, the pathogen is dead.

MAC forms pores in the plasma membrane of pathogens or targeted cells, leading to osmolysis. Osmolysis refers to the rupture of the cell wall due to excessive osmotic pressure.

61
Q

What can cause C3 levels to be low?

A

If you are born with low levels of C3 due to a genetic condition which makes you have massive and frequent infections during childhood, this makes you susceptible to getting autoimmune disease.

62
Q

Low levels of C3 makes you susceptible to?

A

Autoimmune diseases.

63
Q

What does chemotaxis mean?

A

Movement of leukocytes towards the site of inflammation.

64
Q

What are the stages of extravasation or how do the neutrophils migrate to the site of infection?

A

1- Capture by E & P selectins:
When macrophages & dendritic cells recognize a microbe, they produce cytokines.
TNF & IL-1 will act on the endothelium near the site of infection & initiate the expression of E-selectin.
Thrombin & histamine cause expression of P-selectin.
Selectins(on the endothelium) bind to the neutrophils but with weak interactions.

2- Rolling:
The interactions between the E-selectin on the endothelium and the Mucin like CAM (on neutrophil) are weak and with the gushing blood flowing, it causes reattach and detach repeatedly.

3- Adhesion:
The presence of cytokines (mainly TNF & IL-1) stimulates the expression of ligands for the integrins (adhesion receptors), those ligands are like ICAM and VCAM-1. Affinity of neutrophils towards ICAM and VCAM increases thus irreversible binding.

4- Diapedesis & transmigration through the endothelium:
Leukocytes now cross the endothelial wall using the neutrophils integrins & PECAM-1 which is seen on both neutrophils and epithelial wall. Then diapedesis happens where the neutrophil changes their shape and squeeze thro endothelial space.

65
Q

What causes chronic inflammation?

A

1- Repetitive infections.
2- Diet rich in fat, trans-fat, and refined sugar.
3- Low sex hormone; low levels of estrogen and testosterone can suppress the production and secretion of pro-inflammatory markers.
4- Smoking & alcohol; lower production of anti-inflammatory molecules.
5- Stress
6- Poor sleeping habits.

66
Q

What are the stimuli which give rise to inflammation?

A

1- Physical like thro cuts or burns.
2- Chemicals (acid or alkali)
Those secrete Damage Associated Molecular Patterns (DAMPs) which associate with Toll-Like Receptors (TLRs).
3- infections
4- Immunological like autoimmunity
last 2 release PAMPs.

67
Q

Read the story.

A

The pathogen releases PAMPs that bind to pattern recognition receptor (PRR) present on the macrophages and polymorphonuclear cells (PMN) and that initiates many responses such as inflammation.
 Then, an antigen presenting cell will present those PAMPs to a T-cell (adaptive immunity). Therefore, memory cells will be produced in order to attack that pathogen more strongly and quickly upon the second exposure.
 A damaged (stressed) cell produce DAMPs that they can do the same activation of the adaptive immunity as PAMPs, in addition to activating a DAMP receptor that is going to initiate the clearing process and activate tissue repair.

68
Q

Why do DAMPs activate the adaptive immunity & produce memory cells?

A

Because it is very rare for you to get a sterile cell damage, meaning that if you damaged your skin, most likely there are pathogens associated w it. BIG NOTICE!! Cytotoxic T-cell will be activated BUT not the humoral mediated B-cell.

69
Q

What are the 5 cardinal signs of inflammation?

A

1- Redness (Rubor).
2- Heat (Calor).
3- Swelling (Tumor).
4- Pain (Dolor).
5- Loss of Function (Functio Laesa)

70
Q

2 of the cardinal signs of inflammation are redness & heat. What causes those?

A

Histamine and bradykinin are released by the innate immune cells. Histamine cause vasodilation thus increasing the blood flow to the area (Hyperemia), and with the rushing blood we have friction as well. Thus, we have redness with heat.

71
Q

One of the 5 cardinal signs of inflammation are swelling. What causes that?

A

Histamine also causes the endothelial cells to have some gaps (increased vascular permeability), thus proteins leak out of the vessels thus causing edema.

72
Q

One of the 5 cardinal signs of inflammation is pain. What causes that?

A

DAMPs activate the leukocytes to release endogenous mediators responsible for pain like cytokines and prostaglandins. Swelling and accumulation of fluid will increase the pressure on the nerve endings and the pain receptors thus causing pain sensation.

73
Q

What is the difference between transudate & exudate?

A

Exudate happens because of inflammation & increased capillary permeability. This contains both plasma and proteins. In terms of protein distribution, we would have high albumin (due to increased permeability).
Transudate is not due to increased capillary permeability (vascular permeability is normal) but because of the increased hydrostatic pressure & decreased colloid osmotic pressure thus causing fluid to leave the vascular system. Here we have very little amount of protein distributed. Transudate is transparent, i.e only plasma no proteins.

74
Q

What is the difference between acute & chronic inflammation?

A

ACUTE:
- Onset is immediate.
- Duration is only for a few days.
- Bacteria or injured tissues are the causative agent.
- Major cells at the site are neutrophils & macrophages.
- Outcomes are resolution, abscess formation, or even chronic inflammation.

CHRONIC:
- Onset is delayed.
- Duration is for up to months or even years.
- Cause is autoimmune disease or continuously getting infected.
- Major cells are lymphocytes.
- Outcomes are tissue destruction; either fibrosis or necrosis.

75
Q

A naive T- Helper cell (Th0) would differentiate into Th1 when?

A

When we have an intracellular pathogen. Th0 is influenced by 2 cytokines (IL-4 & IL-12).
In this stage when we have an intracellular pathogen, IL-12 is the one inducing the differentiation of Th0 into Th1.

This Th1 cell produces:
1- Tissue Necrosis Factor (TNF).
2- Interferon Gamma (IFN-gamma) –> stimulate the macrophages to kill phagocytosed pathogens.
3- InterLeukin-2 (IL-2) –> stimulates the growth of helper, cytotoxic, and regulatory t-cells.

76
Q

A naive T- Helper cell (Th0) would differentiate into Th2 when?

A

Large extracellular pathogens like Large parasites that cannot be phagocytosed. Th0 is influenced by 2 cytokines (IL-4 & IL-12).
So with large extracellular pathogens Interleukin-4 (IL-4) will stimulate TH0 to become TH2.

Th2 Cell releases:
1- Interleukin-4 –> induce differentiation into TH2 & enhance switching to IgE & IgG.
2- Interleukin-5 –> Promote differentiation of B-cells.
3- Interleukin-13.

77
Q

A naive T- Helper cell (Th0) would differentiate into Th17 when?

A

Extracellular bacterial or fungal infection.

78
Q

What does the T-helper 1 cell produce? their functions?

A

1- Tissue Necrotic Factor.

2- Interferon Gamma (IFN-gamma) –> stimulate the macrophages to kill phagocytosed pathogens.

3- Interleukin-2 (IL-2) –> stimulate the growth of Helper t-cells, cytotoxic t-cells, and Regulatory T-cells.

79
Q

What does T-helper cell 2 produce?

A

1- Interleukin-4 –> induce differentiation into TH2 & enhance switching to IgE & IgG.
2- Interleukin-5 –> Promote differentiation of B-cells.
3- Interleukin-13.

80
Q

What does T helper 17 cell produce (Th17)?

A

1- Interleukin 17 (IL-17) –> increase chemokine production.
2- Interleukin-21 (IL-21) –> promote more Th-17 differentiation.