Renal Inflammation

Question 1

What is the functional criteria of Acute Kidney Injury?

Answer 1

Increase in serum creatine by 50% within 7 days

or

Increase in serum creatine by 0.3 mg/dl within 2 days

or

Oliguria

Question 2

What are the causes of AKI?

Answer 2

Hypoxia inducing illnesses

Intravascuplar Volume Depletion and Hypotension

Decreased Effective Intravascular volume

Hepatorenal syndrome

Sepsis

Renal vascular disease

Question 3

What is the major cause of acute renal failure?

Answer 3

Ischemic acute kidney injury leading to metabolic acidosis and ATP depletion

Question 4

How are DAMPs released?

Answer 4

Released from parachymal kidney cells during ECM degredation

Question 5

What binds DAMPS and activates the classical complement pathway?

Answer 5

C-reactive Proteins

Question 6

How do DAMPS induce innate immune response and renal inflammation?

Answer 6

Binding to toll-like receptors

Question 7

What are the examples of DAMPS discussed?

Answer 7

HMGB1

Uric Acid

HSPs (Exosomes)

S100 protein (cytoplasm)

Hylauronans in ECM

Question 8

What cell is activated during acute kidney injuries and infections?

Answer 8

Dendritic Cells

Question 9

What cell is activated during IC-GN, diabetes, and sepsis?

Answer 9

Endothelial cells

Question 10

What to endothelial cells release as part of an inflammatory response?

Answer 10

TNF, IL-6, Chemokines, and IFNa

Question 11

What are the pattern recognition receptors discussed?

Answer 11

Toll-like

NOD like

C-type lectin

Question 12

What do M2 cells release as part of the anti-inflammatory response?

What is the overall function of an M2 cell?

Answer 12

Arginase-I

IL-10

Clearance of apoptotic cells

Question 13

What activates a classically activated M1?

Answer 13

PAMPS and DAMPS through binding of TLR and other PRRs

IFN-y also promotes differentiation

Question 14

What factors reprogram an M2 cell?

Answer 14

CSF-1 (M-CSF)

IL-10

Question 15

What induces M2 activation?

Answer 15

IL-4 and IL-13

Question 16

What substances are secreted by M1 macrophages for microbicidal purposes.

Answer 16

ROS, NO, and lysosomal enzymes

Question 17

What substances are secreted by M2 macrophages in wound repair?

Answer 17

Proline

Polyamides

TGF-B

Question 18

What cells assist in the generation of myofibroblasts and production of ECM during wound repair?

Answer 18

Pericytes

Question 19

What stimulates differentiation of a Naive CD4+ T cell into the following:

IL-12

IL-4

IL-6

Answer 19

Th1

Th2

Th17

Question 20

The “chemokine pattern” that plays a roll in recruitment of neutrophils is released by what cells?

Answer 20

Meangial and tubular epithelial cells

These have been influenced by IL-17 secreted by Th17.

Question 21

What does CCL20 or MIP-3 do?

Answer 21

Stimulates the infiltration of monocytes, Th1, and Th17 cells

Question 22

What are they key regulators of the inflammatory response?

What do they secrete?

Answer 22

TREG Cells

TGF-B and IL-10

Question 23

Type II hypersensitivity reactions are caused by what mechanism?

Example?

Answer 23

IgG or IgM is bound to cellular antigen, triggering complement pathway.

Anti-glomerular basement membrane mediated glomerular nephritis

Question 24

Which hypersensitivity pathway is involved in neutrophil recruitment triggered by antigen-antibody complexes?

Answer 24

Type III

Question 25

What are the key concepts influencing transplantation?

Answer 25

Donor-host antigenic disparity Immunosupressive regime Condition of allograft Strength of host anti-donor response

Question 26

What peptides increase local vascular permeability and serve as a chemoatractant for neutrophils and macrophages?

Answer 26

Fibren peptides

Question 27

What substance results from the kinin cascade? What does this substance do?

Answer 27

Bradykinin Vasodilation

Question 28

What transplantations are not sensitive to donor differences in ABO blood type or Class I/II HLA abs.

Answer 28

Corneal Heart valves Bone and tendon grafts

Question 29

How is **microcytotoxicity test for performed Abs** performed?

Answer 29

**Recipeint serum added to donor cells** **Complement then added** **Dye is then added** The if the Abs bount to an antigen on the donor cells, they will have induced the complement system, making the cells porous. These porous cells should retain the added dye.

Question 30

What are the class I antibodies that are strong barriers to transplantation?

Answer 30

HLA-A and HLA-B

Question 31

What are the most important class II HLA ags in transplantation?

Answer 31

HLA-DR HLA-DQ HLA-DP

Question 32

What is measured to determine Class II HLA compatibility? What substance allows for this to be measured?

Answer 32

Proliferation of recipeint cells Labled with 3H-thymididine If there is no proliferation of lymphocytes you can transplant

Question 33

What substances are release when **humeral rejection occurs?** What cells release these?

Answer 33

IL-4, IL-5, IL 10 Th2

Question 34

Which form of allorecognition occures whe MHC II molecules that have been processed and presented by APCs trigger an immune response?

Answer 34

**Indirect allorecognition**

Question 35

At what time does the following rejections occur? Hyperacute Acute Chronic

Answer 35

Immediately (within minutes) Acute (days to weeks) Chronic (months to years)

Question 36

Acute rejection results in what pathology?

Answer 36

Inflammation and leukocyte infiltration of the grafted vessels Parenchymal cell damage and interstitial inflammation

Question 37

What are the non-immunological factors that influence this Chronic host vs graft rejection?

Answer 37

Ischemia-reperfusion damage Recurrence of disease that causes failure of the kidneys Nephrotoxic drugs (cyclosporine A)

Question 38

What causes a Graft-versus-host response?

Answer 38

Reaction of grafted mature T cells of bone marrow with all antigens of the host. Directed against minor HLA Ags of the recipient

Question 39

What are the symptomes of Acute Graft versus Host Disease (GVHD)?

Answer 39

Rash Jaundice Diarrhea GI Hemorrhage