Inflammation

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Acute Inflammation
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Terms in this set (56)
Acute Inflammation
Rapid onset, short duration
Vasodilation and increase un capillary permeability
Influx of inflammatory cells (mainly neutrophils)
Chronic Inflammation
Longer duration
Infiltration of macrophages, lymphocytes, and fibroblasts
Persistent inflammation, angiogenesis, tissue necrosis, fibroblasts proliferation
Role of endothelial cells in inflammation
Produce vasodilators and vasoconstrictors to regulate blood flow, regulate leukocyte extravasation, synthesize and release inflammatory mediators, and participate in repair process through production of growth factors
Role of platelets in inflammation
Releases potent inflammatory mediators, increase vascular permeability, alter chemotactic/adhesive/protolytic properties of endothelial cells
What is atherosclerosis, migraine headaches, and systematic lupus associated with?
Platelet activation
Granulocytes
Contain specific cytoplasmic granules and a multi-lobed nucleus;
Neutrophils
Eosinophils
Basophils
Mast Cells
Agranulocytes
Lack cytoplasmic granules and have a single nucleus;
Monocytes
T Lymphs
B Lymphs
Neutrophils
1st to appear at site of inflammation; 90 min following injury, short lifespan; engulfs bacteria and cell debris
Eosinophils
2-3 hrs after neutrophils; longer lifespan. Involved in allergic reactions. Present in chronic inflammation
Basophils
Prominent in allergic reactions mediated by IgE
Mast CellsRelease histamine, TNFa, IL-6, growth factors, lipid mediators; involved in allergic reactionsMonocyte/MacrophageMonocytes mature into macrophages; produce prostaglandins, leukotrienes, cytokines,; engulf bacteria. Important in chronic inflammationStages of Acute InfflammationRedness Swelling Heat Pain Loss of FunctionWhat happens during Acute Inflammation's Vascular Stage (Stage 1)Increased blood flow, increased vascular permeability, release of histamine and NO, and redness and warmnessWhat happens during Acute Inflammation's Cellular Stage (Stage 2)Emigration of leukocytes (mainly neutrophils) from microcirculation and accumulation of them to site of injury. Release of histamine, bradykinin, and leukotrienes. Swelling, pain, and impaired function.Depending on severity of injury, vascular changes can follow one out of three patterns of response during the Vascular Stage. What are they?Immediate transient response Immediate sustained response Delayed ResponseImmediate Transient ResponseMinor injury, develops rapidly, usually reversible and short durationImmediate Sustained ResponseMore serious injury, continues for several days, usually due to direct damage to endothelium (burns, bacterial infections)Delayed ResponseIncreased permeability begins after a delay of 2-12 hours (radiation, sunburn)Steps of Cellular PhaseMargination Transmigration Chemotaxis Activation and PhagocytosisMarginationProcess in which free flowing leukocytes exits the central blood stream and flow nearer to the vessel wallTransmigrationLeukocytes (neutrophils, monocytes, and tissue macrophages) exits the blood vesselsWhat does the release of Arachidonic Acid following injury during inflammation initiate?Cascade of events that lead to production of Eicosanoid family of inflammatory mediatorsOutcome of Acute InflammationComplete Resolution Substantial scarring and fibrosis (tissue can't regenerate) Progression to chronic inflammationCauses of Chronic InflammationPersistent infections Viruses, bacteria Autoimmune Diseases ObesityThermoregulatory CenterHypothalamusWhat happens when body is above temperature set point?Dilation of superficial blood vessels/sweating (heat dissipating behaviors)What happens when body is below temperature set point?Shivering and teeth chatteringPyrexiaElevation in body temperature cause be cytokine-induced upwards displacement of the set point of the hypothalamic thermoregulatory centerCause of feverPyrogens Proteins from bacteria Noninfectious disorders Malignant CellsStages of FeverProdromal Period Chill Flush DefervescenceProdromal PeriodMild headache, fatigue, fleeting aches and painsChillSensation of being cold, onset of chills, vasoconstriction, and piloerectionFlushCutaneous vasodilation, skin warm and flushedDefervescenceInitiation of sweatingCommon manifestations of feverAnorexia, myalgia, arthralgia, fatigueCommon manifestations of fever in elderelyConfusion/deliriumCommon manifestations of fever in childrenFebrile seizures with rising tempsManagement of FeverTreat Primary Cause Modify environment (lukewarm bath, cooling blanket) Fluid and carbohydrates to support hyper-metabolic state and combat dehydration Antipyretic DrugsWhere are plasma derived mediators synthesized?LiverPlasma Derived Mediator SystemsAcute phase System Complement System Coagulation System Kinin SystemWhat happens during the acute phase protein system?-Synthesis is stimulated by cytokines -Fibrinogen and C-Reactive Proteins (CRP) are the main proteins -IL-6 is produced by macrophages in response to infection and induces liver to produce active phase proteinsWhat happens during the complement system?3 Pathways: Classical, Lectin, Alternative *All pathways use C3What happens during the coagulation system?Fibrinous meshwork at injured inflamed sites that prevent spread of infection. The main protein is fibrinWhat happens during the Kinin System?-Inflammatory cells are activated and assist with dilation of blood vessels, pain, and smooth muscle contractions -Kinin is the primary proteinCell Derived Inflammatory Mediators-Released from cells that are present at site of inflammation Eicosanod, Vasoactive, Cytokines and Chemokines, Platelet Activating Factors, NO, Reactive Oxygen SpeciesEicosanoid FamilyProstaglandins and leukotrienesVasoactive AminesHistamine and SeratoninExamples. of Cytokines and ChemokinesTNF-a, IL-1, LPS, IFN-yLPSLipopolysaccharide, found in outer membrane of gram negative bacteriaIFN-yInterferon gamma, cytokine produced un lymphocytes critical for adaptive and innate immunityEicosanoids are derived fromArachidonic acidEicosanoids can be divided intoLypoxygenase (bronchodilation) and Cycloxygenase pathways (bronchoconstriction)The Lypoxygenase pathway will produce ________________________ and the Cycloxygenase pathway will produce ___________________________ and _______________________Leukotraines; Prostaglands and ThromboxanesWhat will steroids block?Arachidonic AcidsWhat will NSAIDS and aspirin block?Cycloxygenase Pathway