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FHDT
11 - Inflammation and Repair
36
Aerospace Engineering
Kindergarten
01/25/2013

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Cards

Term
What 3 factors cause the massive vasodilatation associated with acute inflammation?
Definition
-Histamine, bradykinin, and prostaglandins
Term
What 3 factors cause the vascular permeability?
Definition
-Vasoactive amines (histamine & serotonin), bradykinin, and leukotrienes
-Same as for inflammation, but we have LKTs instead of PGs
Term
What is the lifespan of a neutrophil? What is in it's primary vs. secondary granules?
Definition
-Only about 1-2 days
-Primary; myeloperoxidase, elastase, bacteria permeaters
-Secondary; Leukocyte alkaline phosphatase (LAP), collagenase, lactoferrin

-Both also have phospholipase A2 & lysozyme
Term
What is the macrophage lifespan? What does it contain?
Definition
-60 to 120 days
-Has enzymes for tissue breakdown (elastase and collagenase
Term
What are the rolling interaction proteins for leukocyte and epithelium vs. the arresting interaction proteins? Which ones must be induced, and by what?
Definition
Rolling:
-Leukocyte; Sialyl-Lewis X
-Endothelium ; E & P-selectins

Attachment
-Leukocyte; LFA-1
-Endothelium; I-CAM-1

-in general, the endothelial factors are induced by IL-1 and TNF (cytokines from macrophages), and chemokine secretion activates integrins
-Chemokines (IL-8) converts LFA-1 to high-affinity binding state
Term
What is the purpose of IL-1 vs IL-8. What is the other name for IL-8.
Definition
-IL-1 is more involved in activating the endothelium (along with TNF), with some activation of resident leukocytes
-Whereas IL-8 serves as a chemoattractant, forming a concentration gradient to the site of injury

-IL-8 is also known as CLCX8
Term
What are the chemotactic factors for neutrophils (4)?
Definition
-Bacterial products such as N-formyl-methionine
-Leukotriene B4
-C5a*
-IL-8*
Term
When will we see giant granules in neutrophils?
Definition
-In Chediak-Higashi syndrome
-This is a microtubule polymerization disorder, so migration and cell trafficking are affected
-Neutrophils are unable to degranulate
-Auto rec with death usually in childhood
Term
What O2 independant substances are used for intracellular killing?
Definition
-Lysozyme, lactoferrin, acid hydrolases, and defensins are some
Term
What is the test for CGD and what result is abnormal? What do they get infections with?
Definition
-NBT (nitroblue tetrazolium) negative is a positive result for chronic granulomatous disease
-These patients get repeat infections with catalase positive bacteria (myeloperoxidase has no substrate)
Term
Myeloperoxidase action and deficiency?
Definition
-It make the hypochlorite from H2O2 in oxidative killing
-When deficient we get repeated Candida infections (yeast)
Term
What are the two major vasoactive amines and what is their purpose? What produces each?
Definition
-Histamine (basophils, mast cells, platelets) and serotonin (platelets)
-Both cause vasodilatation and increase in permeability
Term
When we think about basophil, mast cell, and platelet degranulation, what do we think about causing it?
Definition
-Anaphylatoxins (C3a and C5a)
-IgE reactions
-IL-1
Term
What is bradykinin? What is involved in it's production?
Definition
-It is a potent vasodilator and is also involved in the mediation of pain
-It is produced in the kinin–kallikrein system which depends on Hageman factor (factor 12) for initiation
-Bradykinin is released from HMWK (high molecular weight kininogen)
Term
What are the three classes of molecules produced by the COX pathway? What produces them and what is their action? What is the specific one that mediates pain?
Definition
-Thromboxane; produced by platelets and endothelium for vasoconstriction and platelet aggregation (reduce bleeding); reason for initial transient vasoconstriction

-Prostacyclin; produced by endothelium, has opposite effects of thromboxane (produce inflammation)

-Prostaglandins; all cells, for dilation and pain (PGE2 is major pain mediator)
-Note that in the synth pathway, PG comes first and can be converted into either of the other two
Term
What do the leukotrienes B4 thru E4 do?
Definition
-LTB4 is for neutrophil chemotaxis
-LTC4, D4, & E4 are all for vasoconstriction

-LTA4 is just a precursor
Term
What are the four possible outcomes of acute inflammation?
Definition
1. Regeneration (resolution)
2. Scarring (fibrosis)
3. Abscess formation
4. Transition to chronic inflammation (when pathogen is not eliminated)
Term
What special names do we use for macrophages in the following tissues; connective, lung, liver, bone, and brain? What do we call them when they are modified for granulomas/activated?
Definition
-Connective; histiocyte
-Lung; pulmonary alveolar macrophages
-Liver; Kupffer cells
-Bone; osteoclasts
-Brain; microglia

-In granulomas; epitheliod cells
Term
What are the major things released by eosinophils compared to basophils?
Definition
-Eosinophils release a major basic protein that is toxic to parasites while basophils release mostly histamine
Term
What transforms macrophages into epitheliod cells? What other type of cells do we see in granulomatous inflammation?
Definition
-IFN-gamma
-We also see multinucleated giant cells which can be either of the Langhans-type (peripheral nuclei) or foreign body type (haphazard nuclei)
Term
In what disease do we see caseous necrosis?
Definition
-In TB and a few other granulomatous diseases
-It is the cell death in the granulomas
Term
What are some granulomatous diseases?
Definition
-TB, cat-scratch fever, syphilis, leprosy, fungal infections, parasitic infections, sarcoidosis
-We usually see granulomatous inflammation associated with slow-growing organisms
Term
What is necrotizing inflammation? Give an example?
Definition
-When a virulent organism produces severe tissue damage and extensive cell death
-Necrotizing faciitis (flesh eating disease)
Term
When do we usually see interstitial inflammation?
Definition
-In viral infections
Term
What are the major immune cells of chronic inflammation as apposed to acute?
Definition
-Acute is all about the vasodilation and neutrophils
-Chronic is more about the macrophages
Term
What is cytopathic/cytoproliferative inflammation? Examples?
Definition
-Where infecting cell is altered
-From infection with virus
-Cells may show inclusion bodies with viral aggregates, have increased proliferation, or merge with other cells
-Seen in herpes and rabies
Term
What are labile cells?
Definition
-Primary stem cells
-Regenerate throughout life
Term
What are stable cells?
Definition
-These are stem cells and differentiated cells that replicate at low level throughout life
-They can divide if stimulated, like with liver cells
Term
Name a few factors that stimulate fibrosis?
Definition
-TGF-beta
-PDGF
-FGF (fibroblast GF)
Term
What is granulation tissue?
Definition
-Tissue with newly formed and highly permeable capillaries involved in wound healing (angiogenesis)
-Also contains many proliferating fibroblasts
-Forms a few days after injury and remains up to two weeks when it is replaced with scar tissue

-Most prominent in secondary union
Term
What cells mediate wound contraction?
Definition
-Myofibroblasts; between fibroblast and smooth muscle cell in differentiation
Term
Primary vs. secondary union?
Definition
-Primary is when there is a clean cut with close edges
-Secondary is when there is chunks of tissue missing
-Secondary will have more granulation tissue
Term
What are the proliferative cells in the brain? Describe what happens in brain repair?
Definition
-Astrocytes (supportive cells)
-Neurons can't be regenerated, but the microglia (macrophages of brain) can remove their debris, and the preexisting space is then occupied by the proliferating astrocyte cells
Term
What are the proliferative cells of the lungs?
Definition
-Type II pneumocytes replace both type I and II after injury
-Remember, the type II are cuboidal and produce surfactant while the type I are for gas exchange
Term
What is the difference between a hypertrophic scar and a keloid?
Definition
-Hypertrophic is just big; raised but not outside boundaries of initial injury
-A keloid is a large tumor-like scar composed mostly of type III collagen (should be remodeled to type I)
Term
Put the five steps of regeneration and healing in order?
Definition
-Hemostasis, inflammation, regeneration, fibrosis (type III collagen), remodeling (type III to type I collagen)
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