INFLAMMATION

Joey Ellston
Mind Map by , created over 6 years ago

Pathology Mind Map on INFLAMMATION, created by Joey Ellston on 04/29/2013.

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Joey Ellston
Created by Joey Ellston over 6 years ago
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INFLAMMATION
1 Acute
1.1 Stimuli
1.1.1 Infection

Annotations:

  • Toll-like receptors (TLRs)
1.1.2 Tissue necrosis

Annotations:

  • Uric acid, ATP, HMGB-1 -->inflammation Hypoxia --> HIF-1a --> VEGF
1.1.3 Hypersensitivity Reaction

Annotations:

  • Cytokines
1.2 Morphology
1.2.1 Blood vessels
1.2.1.1 Vasodilation

Annotations:

  • histamine NO stasis of blood (moving slowly as increased calibre, decreased volume --> margination of leucocytes.
1.2.1.2 ⇑Permeability

Annotations:

  • IMMEDIATE TRANSIENT RESPONSE (15-30mins) VEGF/histamine/leukotrienes/substance P: endothelium retracts, increased transcytosis DELAYED PROLONGED RESPONSE Toxins/UV/XR - endothelial damage
1.2.2 Leukocytes

Annotations:

  • Neutrophil 6-24h Monocytes 24-48h Varies Pseudomonas - neutrophils for several days Viral - lymphocyte first
1.2.2.1 Functions
1.2.2.1.1 Classical activated
1.2.2.1.1.1 Adhesion
1.2.2.1.1.1.1 Margination
1.2.2.1.1.1.2 Rolling

Annotations:

  • Selectins: P (platelets) E (endothelium) -bond with Sialyl Lewis X-modified glycoprotein L (leukocytes) -Glycam1, CD34Enhanced by increased expression of adhesion molecules by cytokines.
1.2.2.1.1.1.3 Firm Adhesion

Annotations:

  • INTEGRINS _leukocyte surface proteins) ICAM-1, various integrins
1.2.2.1.1.2 MIgration

Annotations:

  • -transmigration/diapedesis -mainly in post-capillary venules -towards chemokines chemical [gradient] -PECAM-1 (CD31) -may adhere at site needed via INTEGRINS and CD44
1.2.2.1.1.3 Chemotaxis

Annotations:

  • 'locomotion along chemical gradient' ENDOgenous -IL-8, complement, EXOgenous -bacterial products (N-formylmethanyl peptides, lipids) These all react at GPCR -polymerisation of actin leading edge and myosin at back -filopodia that pull back of cell in direction of extension --> migration 
1.2.2.1.1.4 Recognition

Annotations:

  • See written notes. Various receptors -GPCR (bacterial peptides, chemokines) -TLR (microbial products) -Phagocyte receptors  -Cytokine receptors (IFN 7)
1.2.2.1.1.5 Phagocytosis
1.2.2.1.1.5.1 Recognition & Attachment

Annotations:

  • macrophage mannose-R (glycoproteins/glycolipids) opsinons-R  scavenger-R (LDL)
1.2.2.1.1.5.2 Engulfment

Annotations:

  • lysosomal enzymes
1.2.2.1.1.5.3 Killing & Degradation

Annotations:

  • ROS & NO  phagocyte oxidase RESPIRATORY BURST protected within lysosome H2O2 + Cl- + MPO = hypochlorite (kills by halogenation)
1.2.2.1.2 Alternatively activated
1.2.2.1.2.1 Anti-inflammatory

Annotations:

  • TGFB IL-10
1.2.2.1.2.2 Repair/fibrosis

Annotations:

  • IL-3, IL-4 Arginate proline polyamnoses
1.2.2.2 Injury
1.2.2.2.1 Collateral damage
1.2.2.2.2 Autoimmune
1.2.2.2.3 Allergy
1.2.2.3 Defects
1.2.2.3.1 Genetic
1.2.2.3.1.1 Leucocyte adhesion deficiency
1.2.2.3.1.1.1 1

Annotations:

  • mutation in B chain CDH/8
1.2.2.3.1.1.2 2

Annotations:

  • mutation in fucosyl transferase
1.2.2.3.1.2 Chronic granulomatous disease

Annotations:

  • phagocyte oxidase mutation
1.2.2.3.1.2.1 X-linked

Annotations:

  • membrane
1.2.2.3.1.2.2 Recessive

Annotations:

  • cytoplasmic
1.2.2.3.1.3 MPO deficiency
1.2.2.3.1.4 Chediak-Higashi syndrome

Annotations:

  • defect in lysosomal membrane traffic
1.2.2.3.2 Acquired
1.2.2.3.2.1 BM suppression

Annotations:

  • tumours/chemo/radio
1.2.2.3.2.2 adhesion/chemotaxis

Annotations:

  • DM/cancer/sepsis/dialysis
1.2.2.3.2.3 phagocytosis/microbicidal

Annotations:

  • leukaemia/anaemia/sepsis/DM/malnutrition
1.2.3 Lymphatics

Annotations:

  • Increase flow to cope with oedema (may proliferate) Can be infected - lymphangitis.  Nodes - lynmphadenitis
1.3 Mediators
1.3.1 Cell derived
1.3.1.1 Vasoactive amines
1.3.1.1.1 Histamine

Annotations:

  • • Physical injury - trauma, cold, heat  • Binding of antibodies to mast cells - alergic reactions  • Fragments of complement - anaphylatoxins  • Histamine releasing prots from leuks  • neuropeps - subs P  • Cytokine - IL-1. Il-8   =vasodilation +^permeability
1.3.1.1.2 Serotonin

Annotations:

  • platelets (aggr) neuroendocrine cells =similar effects
1.3.1.2 AA metabolites (Eicosanoids)

Annotations:

  • synthesised by 2 major classes of enzyme COX → Prostglandins Lipo-oxygenases → leukotrienes and lipoxins    
1.3.1.2.1 Prostaglandins
1.3.1.2.2 Leukotrienes
1.3.1.2.3 Lipoxins
1.3.2 Plasma derived
1.3.2.1 Enter text here
2 Chronic
2.1 Causes
2.1.1 Persistent Infection

Annotations:

  • delayed-type hypersensitivity
2.1.2 Immune mediated

Annotations:

  • RA, MS
2.1.3 Toxins
2.2 Morphology
2.2.1 Tissue destruction

Annotations:

  • IFNa, cytokines, microbes: ROS, NOS Proteases Cytokines Coag. factors AA metabolites
2.2.2 Attempted healing

Annotations:

  • IL-4 GFs Fibrogenic cytokines Angiogenic factors Remodelling collegenases
2.2.2.1 Fibrosis
2.2.2.2 Angiogenesis
2.2.3 Cells
2.2.3.1 MACROPHAGES

Annotations:

  • MonoCYTE - Circulating MonoBLAST - Bone marrow (Hours) MonoPHAGES - TIssue (months/years)
2.2.3.2 Lymphocytes

Annotations:

  • Activate and recruit macrophages via:  TNF  IL-17 chemokines T cells 
2.2.3.3 Plasma cells

Annotations:

  • develop fromactivated B lymphocytes produce antibodies
2.2.3.4 Eosinophils

Annotations:

  • IgE mediated parasites
2.2.3.5 Mast cells

Annotations:

  • display receptor that binds Fc portion of IgE in immediate hypersensitivity IgE bound to Fc recognize antigen → degranulation → ediators released e.g. Histamine and PGs mediators limit/promote infamm reactions in different circumstances
2.2.3.6 Neutrophils

Annotations:

  • can also be present in chronic inflammation
2.3 Granulomatous

Annotations:

  • focus of chronic inflammation microscopic aggregation of macrphages epithelial-like cells surrounded by mononuclear leukocytes 'giant-cells'
2.3.1 Foreign bodies
2.3.2 Immune

Annotations:

  • T cells → Il 2 → other T cells → IFN-Ɣ → activation of Macros and transformation into epitheloid and multinucleate giant cells    
2.3.2.1 Caseating
2.3.2.1.1 TB

Annotations:

  • • focus of activated macros - epitheloid cells • rim of fibros, l’cytes, histiocytes, langerhans, giant cells • central necrosis with amorphous cellular debris, acid fast bacilli    
2.3.2.2 Non-caseating
2.3.2.2.1 Leprosy

Annotations:

  • acid fast bacilli in macros    
2.3.2.2.2 Cat scratch

Annotations:

  • Rounded granuloma with central debris and neuts giant cells uncommon    
2.3.2.2.3 Sarcoidosis

Annotations:

  • abundant macrophages    
2.3.2.2.4 Syphillis

Annotations:

  • Treponema Pallidum    Gumma: microscopic to grossly visible lesion • wall of histiocytes, plasma cell infiltrate • central cells necrotic without loss of cellular outline    
2.3.2.2.5 Crohn's

Annotations:

  • occasional non-caseating granuloma in wall of intestine, with dense chronic inflamm infiltrate    

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