Immunology - Macrophages And The Later Stages Of Inflammation - Ch 4

Front 1

What is the most important immune system cell in the body (according to Dr. Pastey)?

Back 1

The macrophage. But he's just following George Bernard Shaw's lead.

Front 2

What type of white blood cell is this? How can you tell? Where would you find this cell?

Back 2

This is a monocyte. You can tell because of the kidney bean shaped nucleus. These guys are found in the blood.

Front 3

What is a macrophage called in the brain?

Back 3

Microglia

Front 4

What is a macrophage called in bone?

Back 4

Osteoclast

Front 5

What is a macrophage called in a blood vessel?

Back 5

Mesangial cell

Front 6

What is a macrophage called in connective tissue?

Back 6

Histiocyte

Front 7

What is a macrophage called in the liver?

Back 7

von Kupffer cell

Front 8

What is a macrophage called in the lung?

Back 8

Alveolar macrophage

Front 9

What is a macrophage called in the skin?

Back 9

Langerhans cell

Front 10

What is a macrophage called in the lymphatic organs?

Back 10

Dendritic cell

Front 11

What is a macrophage called in a granuloma?

Back 11

Epitheloid

Front 12

What are the most potent antigen presenting cells? Why?

Back 12

Langerhans cells and dendritic cells. They act locally, then take their antigens for presentation at a local lymph node to stimulate a cell-mediated immune response. The other macrophage types secrete chemoattractants and interleukins locally, but don't go anywhere.

Front 13

Do macrophages phagocytose something and then die, or keep going?

Back 13

Macrophages can repeatedly phagocytose.

Front 14

How do macrophages interact with B and T cells?

Back 14

They secrete substances that initiate and amplify the response by B and T cells.

Front 15

What do the cytokines that macrophages produce induce?

Back 15

inflammation, pyrexia, lethargy, anorexia and more

Front 16

How are macrophages different from neutrophils? (4)

Back 16

Macrophages respond in a day or two, where neutrophils respond in 6-8 hours.

Neutrophils hone to sites of infection and release chemotactic factors to attract macrophages.

Macrophages and neutrophils both use the respiratory burst mechanism, but use catalase instead of myeloperoxidase.

In addition to respiratory burst, they kill by nitric oxide (except in humans, pigs, goats, or rabbits), where neutrophils don't use that method.

Front 17

What are the three types of activation by macrophages? What is the difference between them (what is their fx, by what are they triggered)?

Back 17

Innate activation - triggered by TLRs, have inflammatory products. The most common form - results in phagocytosing

Alternative activation - not involved in destruction, but healing

Immune activation - triggered by IFNy, IL-12 and TNFa. Phagocytoses intracellular bacteria.

Front 18

Is M1 or M2 involved in the killing?

Back 18

M1 macrophage is involved in the killing (innate and immune activation). M2 macrophage is involved in the healing (alternative activation).

Front 19

How do macrophages kill by nitric oxide? In what species do macrophages kill by nitric oxide?

Back 19

NO binds to metal binding enzymes which are important in bacterial DNA synthesis. So in effect, NO blocks DNA synthesis.

Cattle, sheep, horses and rodents use this mechanism.

Front 20

What is the substance released by macrophages that kills through oxidative and nonoxidative mechanisms?

Back 20

Lysosomes

Front 21

What complements do macrophages release?

Back 21

C2, C3, C4, and C5

Front 22

What are the substance released by macrophages that dissolve damaged or necrotic tissue?

Back 22

Proteases, elastases, collagenases, plasminogen activator.

Front 23

What are the healing factors released by macrophages?

Back 23

Angioblastic and fibroblastic cytokines.

Front 24

What are the inflammatory cytokines produced by macrophages? What do they induce besides inflammation?

Back 24

IL1, IL6, TNFa

They also induce anorexia and pyrexia

Front 25

What type of toxin produces septic shock syndrome? What kind of bacteria produces that toxin?

Back 25

Septic shock syndrome produced by endotoxins of gram negative bacteria

Front 26

What type of toxin produces toxic shock syndrome? What kind of bacteria produces that toxin?

Back 26

Toxic shock syndrome produced by exotoxins of gram positive bacteria

Front 27

What are the acute phase proteins? What is their purpose?

Back 27

SAA (serum amyloid A), SAP (serum amyloid P), MBP (mannose binding proteins), C-reactive protein

Acute phase proteins are used to reduce and control the inflammation.

Front 28

What cytokine activates Th-2 cells? What immune produces them?

Back 28

IL-1
Produced by antigen-presenting cells (APC)

Front 29

What interleukin activates Th-2? What immune cell produces it? What does it promote?

Back 29

Interleukin-6 is produced by macrophages and other APC acts on Th-2 cells to promote antibody synthesis

Front 30

What interleukin stimulates Th-1 cells to produce IL-2 and IFNy and other cytokines?

Back 30

IL-12

Front 31

What is the triphasic process of clearing soluble antigens?

Back 31

distribution, catabolism and immune elimination
Distribution decreases concentration as the antigen dilutes out to the different organs. After 6-7 days, the antibodies are produced, which leads to immune elimination.

Front 32

What cells remove the intravenous antigens in dogs, rodents and humans?

Back 32

Kupffer cells in the liver

Front 33

What cells remove the intravenous antigens in ruminants, cats, equine and pig?

Back 33

Pulmonary intravascular macrophages

Front 34

What cells remove the antibody coated antigen?

Back 34

Spleenic macrophages will remove antigens coated in antibody in all species.

Front 35

What cells remove the complement coated antigen?

Back 35

Liver macrophages

Front 36

What cells remove intradermal antigen?

Back 36

Langerhans dendritic cells

Front 37

What cells remove intranasal antigen

Back 37

Alveolar macrophages

Front 38

What cells remove intramuscular antigen and antigens from the digestive tract?

Back 38

Lymph node dendritic cells and macrophages.

Front 39

What respective percentages are antigens removed from the liver and the lungs in the dog and cat?

Back 39

80% liver/6.5% lungs in the dog.
14% liver/86% lungs in the cat.

Front 40

What is the difference in time of clearance in a body with antibody response and without?

Back 40

The opsonization by antibodies (as in a secondary response to an antigen) signifigantly drops the response time from the first interaction with no antibodies yet.

Front 41

If the stimulus is nonimmunogenic, then ___________ are included in the granuloma formation

Back 41

Giant cells - accumulated macrophages fused to be a giant cell with many nuclei

nonimmunogenic stimulus would be like mineral oil.

Front 42

If the stimulus is immunogenic, then ___________ are included in the granuloma formation

Back 42

lymphocyte infiltration

immunogenic stimulus would be like mycobateria

Front 43

If the stimulus is toxic to macrophages, then ___________ are included in the granuloma formation

Back 43

excessive tissue damage and local scarring

Stimuli toxic to macrophages would be like asbestos.

Front 44

What happens if macrophages try to remove a foreign material and cannot?

Back 44

This results in persistent stimulus (chronic inflammation), which leads to more macrophages, fibroblasts, excessive collagen, loose CT and new blood vessels, which all lead to granuloma.

Front 45

What is excessive collagen called?

Back 45

fibrosis

Front 46

Neutrophils secrete lipoxins in the recovery from inflammation. What part do they play?

Back 46

Suppress leukotriene synthesis.

Front 47

Macrophages secrete serine protease inhibitor and interferon gamma in the recovery from inflammation. What part do they play?

Back 47

Serine protease inhibitor inhibits elastase and oxidants. It protect TGF-b (the anti-inflammatory cytokine)

Front 48

TGF-b - inflammatory cytokine or anti-inflammatory cytokine? What relationship does it have with serine protease inhibitor?

Back 48

Anti-inflammatory.

Serine protease inhibitor is released from macrophages in the recovery of inflammation, the protease inhibitor protects TGF-b to combat the inflammatory response.

Front 49

Which cytokines inhibit the release of TGFa? What role does TGFa play in the recovery from inflammation?

Back 49

IL-10 and TGF-b are anti-inflammatory cytokines because they block the release of TGF-a, a cytokine that is inflammatory.

Front 50

What are the acute phase proteins? What are their role?

Back 50

SAA, SAP, and CRP (c-reactive protein) are the acute phase proteins, so named because their synthesis is associated with acute infections and inflammation. They enhance phagocytosis and promote healing.

Front 51

Which of the consequences of septic shock actually lead to the death? Which type of bacterial toxin leads to septic shock?

Back 51

Bacterial endotoxins lead to septic shock.

Endothelial damage and intravascular coagulation cause the eventual death.

Front 52

What is pathogenesis of toxic shock?

Back 52

The macrophages react to the bacterial exotoxins and bind "permanently" to the helper cells. This cause and overproduction of IL1 and TNFa with leads to organ failure and death.

Front 53

What is the definition of amyloidosis?

Back 53

The abnormal deposition of insoluble protein in tissues leading to loss of organ function.

The important thing is that this is a deposition of INSOLUBLE protein in tissue.

Front 54

What is reactive amyloidoses?

Back 54

Deposits of misfolded SAA. Indicates chronic, uncontrolled suppurative or autoimmune conditions.

Front 55

What is immunogenic amyloidosis?

Back 55

Deposits of misfolded antibody light chains (myelomas)

Front 56

What is the difference between Mad Cow Disease and Alzheimer's Disease?

Back 56

Mad cow is prion deposition in the neurons.

Alzheimer's is amyloid fibril deposition in the neurons.

Front 57

What is the pathogenesis that leads to amyloid fibril deposition?

Back 57

The circulating proteins misfold and deposit and draw other proteins out of solution to deposit with them.