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Module 7 > Mediators of Inflammation > Flashcards

Mediators of Inflammation Flashcards

1
Q

what is inflammation

A

response of vascularized tissue to physical, chemical or infection

brings cells and molecules of defence to area where they are required

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2
Q

what are the 5 Rs in inflammation

A
  1. recognition of offending agent
  2. recruitment of leukocytes and plasma proteins and activation of these
  3. removal of agents
  4. regulation = termination of reaction
  5. repair of damaged tissue
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3
Q

what are the benefits of inflammation

A
  1. dilution/inactivation of biological and chemical toxins
  2. killing/sequestering/degrading of microbes, foreign material, necrotic tissue and neoplastic cells
  3. providing wound healing factors
  4. restricting movement allowing for repair
  5. increasing temperatire to induce vasodilation and inhibit replication of pathogens
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4
Q

what are the consequences of inflammation

A

local tissue damage

harmful if misdirected, excessive/prolonged/difficult to control

or anti-inflammatory drugs

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5
Q

what is acute inflammation

A

onset: minutes or hours

neutrophils

innate immunity

usually mild and self-limited tissue injury

prominent local and systemic signs

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6
Q

what are the vascular effects of acute inflammation

A
  1. dilation
  2. congestion
  3. increased permeability (edema, plasma proteins, emigration of leukocytes from microcirculation)
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7
Q

what is the outcome of acute inflammation

A
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8
Q

what are the features of chronic inflammation

A

days

lymphocytes, PC, adaptive immunity

often severe and progressive tissue injury, fibrosis

less local and systemic signs

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9
Q

what are the causes of chronic inflammation

A

persistent infection

hypersensitivity (auto-immune and allergy)

prolonged exposure to potential toxic agents (exogenous/endogenous)

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10
Q

what are the mediators of acute inflammation

A
  1. vasoactive amines
  2. lipid products
  3. cytokines/chemokines
  4. complement proteins
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11
Q

where are mediators of acute inflammation secreted from

A

secreted by cells or produced in the liver

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12
Q

when are mediators produced

A

in response to stimuli

short lived

can stimulate release of other mediators

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13
Q

what cells are major produces of acute inflammation

A

macrophages, mast cells, dendritic cells

minor producers: platelets, neutrophils, endothelial cells, epithelial cells

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14
Q

what are histamines produced by

A
  1. mast cells
  2. blood basophils, platelets
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15
Q

when are histamines released

A

tramua, cold, heat

binding of anti-bodies (IgE) –> allergy

complement fragments C3a and C5a (anaphylatoxins)

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16
Q

what are the receptors of histamine

A

H1 on microvascular endothelial and

H2-H4

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17
Q

what are the results of histamine (7)

A
  1. dilation of arterioles
  2. increase of permeability of venules
  3. endothelial activation
  4. contraction of smooth muscle
  5. tachycardia
  6. eosinophil chemotaxis
  7. pain and pruritus
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18
Q

what are the inhibitors of histamine

A

H1-R-antagonist (in anti-histamines)

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19
Q

what are serotonies produced by

A
  1. platelets
  2. neuroendocrine cells
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20
Q

what are the result of serotonine

A
  1. vasoconstriction
  2. neurotransmitter in GIT
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21
Q

how are histamines and serotonine stored

A

as pre-formed molecules –> amongst first mediators to be released

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22
Q

what are arachnidonic acid metabolites

A

(eicosanoids)

  1. prostaglandins
  2. leukotriens
  3. lipotoxins
23
Q

what are prostaglandins produced by

A
  1. mast cells
  2. macrophages
  3. endothelial cells
24
Q

what are the inhibitors of prostaglandins

A
  1. aspirin
  2. NSAIDs
  3. selective COX2 inhibitors
25
Q

what are the enzymes involved in the prostaglandin pathway

A

COX1 and COX2

26
Q

what are leukotriens produced by

A
  1. mast cells
  2. leukocytes
27
Q

what are the enzymes in leukotriens pathway

A

lipoxygenase (3 types)

28
Q

what are inhibitors of leukotriens

A

5-lipoxygenase-inhibitor (LT-R antagonist)

29
Q

what are lipoxins produced by

A
  1. leukocytes esp. neutrophils
  2. platelets
30
Q

what enzymes are in the lipoxin pathway

A

lipoxygenase

31
Q

what are the functions of lipoxins

A

anti-inflammatory due to inhibition of recruitment of leukocytes

32
Q

what are the functions of arachidonic acid metabolites

A
  1. vasodilation: PGI2, PGE1, PGE2, PGD2
  2. vasoconstriction: TxA2, LTC4, LTD4, LTE4
  3. increased vascular permeability: LTC4, LTD4, LTE4
  4. chemotaxis, leukocyte adgesion: LTB4, HETE
  5. pain, fever: PG
33
Q

what do steroids reduce

A

transcription of genes for PLA2 and COX2

34
Q

what are cytokines of acute inflammation

A

TNF, IL-1

35
Q

what are cytokines produced by

A

mainly by macrophages but also lymphocytes, dendritic cells, epithelial/endothelial/connective tissue cells

36
Q

what is the function of cytokines

A
  1. endothelial activation (expression of adhesion molecules and mediators)
  2. leukocyte activation (response to stimuli and microbiocidal action)
  3. systemic acute phase response, including fever, and presence of cachexia
37
Q

what are the inhibitors of cytokines

A

TNF-antagonists (esp for treatment of chronic conditions such as IBD), steroids

38
Q

what are chemokines

A

chemoattractant for specific types of leukocytes

39
Q

what are the four major groups of chemokines

A
  1. C lymphocytes
  2. CC monocytes, basophils, eosinophils, lymphocytes
  3. CXC neutrophils
  4. CX3C
40
Q

what are the main functions of chemokines

A
  1. stimulation of leukocyte attachment to endothelium (via integrins)
  2. stimulation of leukocyte migration
  3. maintenance of tissue architecture (T and B cells in different areas of lymph node)
41
Q

what are the inhibitors of chemokines

A

receptor antagonists

42
Q

what are complement proteins

A

present in plasma in inactive form

43
Q

what are complement proteins activated to form

A

activated to become proteolytic enzymes –> cascade

44
Q

how is the complement protein pathway controlled

A

by cell associated and circulating proteins

45
Q

what is the critical step in the complement protein pathway

A

the proteolysis of C3

46
Q

what are the main functions of complement proteins (3)

A
  1. inflammation: C3a and C5a (anaphylatoxins) stimulate histamine release; C5a also chemotaxis for neutrophils, monocytes, eosinophils and activates lipoxygenase pathway
  2. opsonization and phagocytosis: C3b promotes phagocytosis by neutrophils and macrophages
  3. cell lysis: MAC complex (C5b-9)
47
Q

what are the inhibitors of complement proteins

A

anti-C5 antibody

48
Q

what are the functions of platelet-activating factors

A

vasoconstriction, bronchoconstriction

at low concentration: vasodilation, increased vascular permeability)

49
Q

what are the functions of kinins such as bradykinin

A

increases vascular permeability

contraction of smooth muscle

dilation of blood vessels

pain

50
Q

what are other examples of mediators of inflammation

A

neuropeptides like substance P and neuorkinin A

51
Q

what are examples of mediators of chronic inflammation

A

cytokines (IL-12, IFN-y, IL-17, IL-4, 5, 13, 2)

52
Q

what are cytokines of chronic inflammation produced by

A

lymphocytes and macrophages

53
Q

what are the functions of cytokines

A

activation of cellular populations

54
Q

what are TGF-B and IL-10

A

termination of immune response and induction of tissue repair and fibrosis

Module 7 (50 decks)

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