Podcast
Questions and Answers
What is the meaning of inflammation, according to the content?
What is the meaning of inflammation, according to the content?
Inflammation is a physiological process that aims to bring back the organism to a homeostatic state by activating defense and repair mechanisms.
Which of the following are NOT included in the first line of defense against pathogens?
Which of the following are NOT included in the first line of defense against pathogens?
- Skin
- Innate immunity (correct)
- Normal microbiota
- Mucous membranes
Adaptive immunity is the first line of defense against pathogens.
Adaptive immunity is the first line of defense against pathogens.
False (B)
The ______ is a key transcription factor involved in regulating genes associated with inflammation.
The ______ is a key transcription factor involved in regulating genes associated with inflammation.
What are acute phase proteins?
What are acute phase proteins?
Only positive regulators of inflammation are important for understanding the state of inflammation in a patient.
Only positive regulators of inflammation are important for understanding the state of inflammation in a patient.
Match the cytokines with their primary roles in inflammation
Match the cytokines with their primary roles in inflammation
What is the main difference between the kinetics of CRP and PTX3 during an acute myocardial infarction?
What is the main difference between the kinetics of CRP and PTX3 during an acute myocardial infarction?
High-sensitivity CRP (hs-CRP) is more useful than standard CRP for detecting low-grade, chronic inflammation.
High-sensitivity CRP (hs-CRP) is more useful than standard CRP for detecting low-grade, chronic inflammation.
What is the purpose of the JUPITER trial?
What is the purpose of the JUPITER trial?
Procalcitonin (PCT) is primarily produced by the thyroid.
Procalcitonin (PCT) is primarily produced by the thyroid.
What distinguishes PCT as a biomarker of bacterial infection?
What distinguishes PCT as a biomarker of bacterial infection?
PCT levels are always elevated in patients diagnosed with sepsis.
PCT levels are always elevated in patients diagnosed with sepsis.
Explain the importance of fibrinogen and its byproducts in tissue repair and coagulation?
Explain the importance of fibrinogen and its byproducts in tissue repair and coagulation?
Which of the following statements is TRUE about lactate dehydrogenase (LDH)?
Which of the following statements is TRUE about lactate dehydrogenase (LDH)?
What is the role of transferrin in iron metabolism?
What is the role of transferrin in iron metabolism?
How can ferritin levels assist in diagnosing iron deficiency and overload?
How can ferritin levels assist in diagnosing iron deficiency and overload?
Procalcitonin (PCT) is a more rapid marker of inflammation than CRP, with a shorter half-life.
Procalcitonin (PCT) is a more rapid marker of inflammation than CRP, with a shorter half-life.
The levels of PCT in sterile conditions, like trauma or surgery, are typically similar to levels in sepsis.
The levels of PCT in sterile conditions, like trauma or surgery, are typically similar to levels in sepsis.
What is the key difference between SIRS and sepsis?
What is the key difference between SIRS and sepsis?
What are the three lines of defense in the immune system?
What are the three lines of defense in the immune system?
The innate immune system is the first response to infection and takes several days to activate.
The innate immune system is the first response to infection and takes several days to activate.
What are some of the conditions that activate inflammation?
What are some of the conditions that activate inflammation?
What is the meaning of inflammation?
What is the meaning of inflammation?
Which of these cells are considered professional cells in innate immunity?
Which of these cells are considered professional cells in innate immunity?
What are some examples of receptors that activate an inflammatory response?
What are some examples of receptors that activate an inflammatory response?
Acute phase proteins are produced during inflammation and can help determine whether an inflammatory response is present.
Acute phase proteins are produced during inflammation and can help determine whether an inflammatory response is present.
Which cytokines are the main leaders of the cytokine cascade?
Which cytokines are the main leaders of the cytokine cascade?
IL-6 acts locally, while TNF and IL-1 act at a systemic level.
IL-6 acts locally, while TNF and IL-1 act at a systemic level.
What are some of the factors that IL-1 and TNF regulate in the local response to inflammation? (Select all that apply)
What are some of the factors that IL-1 and TNF regulate in the local response to inflammation? (Select all that apply)
What are the main effects of IL-6 in systemic inflammation?
What are the main effects of IL-6 in systemic inflammation?
The erythrocyte sedimentation rate (ESR) is a very sensitive test that is commonly used to diagnose inflammation in hospitals.
The erythrocyte sedimentation rate (ESR) is a very sensitive test that is commonly used to diagnose inflammation in hospitals.
What is the definition of the erythrocyte sedimentation rate (ESR)?
What is the definition of the erythrocyte sedimentation rate (ESR)?
What are some of the factors that promote sedimentation in the ESR?
What are some of the factors that promote sedimentation in the ESR?
What are some of the conditions that can cause a decreased ESR?
What are some of the conditions that can cause a decreased ESR?
C-reactive protein (CRP) is a very sensitive acute phase protein with a rapid induction time and a short half-life.
C-reactive protein (CRP) is a very sensitive acute phase protein with a rapid induction time and a short half-life.
What are some of the uses of CRP in clinical practice?
What are some of the uses of CRP in clinical practice?
CRP levels are affected by factors such as pregnancy and anemia, similar to the ESR.
CRP levels are affected by factors such as pregnancy and anemia, similar to the ESR.
Which of these conditions is NOT typically associated with an increase in CRP?
Which of these conditions is NOT typically associated with an increase in CRP?
What is the difference between a high-sensitivity CRP (hs-CRP) test and a standard CRP test?
What is the difference between a high-sensitivity CRP (hs-CRP) test and a standard CRP test?
What is procalcitonin (PCT) and how is it produced?
What is procalcitonin (PCT) and how is it produced?
PCT levels are elevated in the presence of sterile conditions.
PCT levels are elevated in the presence of sterile conditions.
What are some of the clinical conditions that PCT is particularly useful for diagnosing?
What are some of the clinical conditions that PCT is particularly useful for diagnosing?
Procalcitonin is a very sensitive marker for diagnosing early sepsis, with a longer half-life than CRP.
Procalcitonin is a very sensitive marker for diagnosing early sepsis, with a longer half-life than CRP.
What is the difference between SIRS, sepsis, and septic shock?
What is the difference between SIRS, sepsis, and septic shock?
Procalcitonin is a sensitive and specific marker for early sepsis, but it is not very helpful for differentiating sepsis from SIRS.
Procalcitonin is a sensitive and specific marker for early sepsis, but it is not very helpful for differentiating sepsis from SIRS.
Procalcitonin is a relatively cheap and easily accessible test.
Procalcitonin is a relatively cheap and easily accessible test.
The FDA has cleared the use of procalcitonin to guide antibiotic therapy for all respiratory infections, including viral infections.
The FDA has cleared the use of procalcitonin to guide antibiotic therapy for all respiratory infections, including viral infections.
What is the role of iron in the body and why is it important to understand iron metabolism in inflammation?
What is the role of iron in the body and why is it important to understand iron metabolism in inflammation?
What are some of the molecules involved in iron metabolism that are upregulated during the acute phase response?
What are some of the molecules involved in iron metabolism that are upregulated during the acute phase response?
What is the role of transferrin during inflammation?
What is the role of transferrin during inflammation?
Why is it important to understand ferritin levels in the context of inflammation?
Why is it important to understand ferritin levels in the context of inflammation?
What is fibrinogen and what is its role in inflammation and tissue repair?
What is fibrinogen and what is its role in inflammation and tissue repair?
What is d-dimer and how is it measured?
What is d-dimer and how is it measured?
Elevated levels of d-dimer are a common finding in Covid-19.
Elevated levels of d-dimer are a common finding in Covid-19.
What are some of the inhibitors of proteolytic enzymes that are released during the acute phase response?
What are some of the inhibitors of proteolytic enzymes that are released during the acute phase response?
The acute phase response is a relatively recent evolutionary mechanism.
The acute phase response is a relatively recent evolutionary mechanism.
What is lactate dehydrogenase (LDH) and what is its role in the body?
What is lactate dehydrogenase (LDH) and what is its role in the body?
Elevated LDH levels can be seen in both muscle injury and infection.
Elevated LDH levels can be seen in both muscle injury and infection.
The normal range of LDH is higher in children than in adults.
The normal range of LDH is higher in children than in adults.
Flashcards
First line of defense
First line of defense
The first line of defense against pathogens. It includes physical barriers like skin and mucous membranes, as well as the normal microbiota.
Second line of defense
Second line of defense
The second line of defense, activated quickly after the first line is breached. It involves inflammation and the activity of innate immunity.
Third line of defense
Third line of defense
The third line of defense, found only in vertebrates. It is a highly specific and adaptive immune response.
Inflammation
Inflammation
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Professional cells
Professional cells
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Non-professional cells
Non-professional cells
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Receptors that activate transcription factors
Receptors that activate transcription factors
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Soluble molecules
Soluble molecules
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Cytokine cascade
Cytokine cascade
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Interleukin-1 (IL-1)
Interleukin-1 (IL-1)
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Interleukin-6 (IL-6)
Interleukin-6 (IL-6)
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Acute phase proteins
Acute phase proteins
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Erythrocyte sedimentation rate (ESR)
Erythrocyte sedimentation rate (ESR)
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C-reactive protein (CRP)
C-reactive protein (CRP)
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High-sensitivity CRP (hs-CRP)
High-sensitivity CRP (hs-CRP)
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Procalcitonin (PCT)
Procalcitonin (PCT)
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Sepsis
Sepsis
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Pentraxin-3 (PTX3)
Pentraxin-3 (PTX3)
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Lactate Dehydrogenase (LDH)
Lactate Dehydrogenase (LDH)
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Iron metabolism in inflammation
Iron metabolism in inflammation
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Ferritin
Ferritin
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Transferrin
Transferrin
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Fibrinogen
Fibrinogen
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D-dimer
D-dimer
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Fibronectin
Fibronectin
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α1-antitrypsin
α1-antitrypsin
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Acute Phase Proteins (e.g., α1-antitrypsin, α2-macroglobulin, α1-acid glycoprotein)
Acute Phase Proteins (e.g., α1-antitrypsin, α2-macroglobulin, α1-acid glycoprotein)
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Fibrinolysis
Fibrinolysis
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Autoimmune disorder
Autoimmune disorder
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Polycythemia
Polycythemia
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Sickle cell anemia
Sickle cell anemia
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Study Notes
Inflammation
- Inflammation is a phylogenetically conserved process of coming back to homeostasis.
- It involves activating defense mechanisms and repair mechanisms.
- It's always present in almost every condition, including infection, tissue damage, homeostatic imbalances, dysmetabolism, and dysbiosis.
- Inflammation is activated by the recognition of tissue damage or microbial moieties (dysbiosis) through receptors on cells, which sense abnormalities.
Markers of Inflammation
-
The immune system has three lines of defense:
- First line: skin and mucous membranes, normal microbiota
- Second line: inflammation and innate immunity
- Third line: adaptive immunity (only vertebrates)
-
Innate immunity responds in hours, while adaptive immunity takes days.
-
Inflammation is crucial for innate immune response, as well as adaptive immunity.
Professional and Non-professional Cells
-
The cells involved in sensing abnormalities are:
- Professional cells (leukocytes): macrophages, neutrophils, dendritic cells, natural killer cells
- Non-professional cells: epithelial cells, stromal cells, endothelial cells
-
These cells have receptors (located on cell membrane, cytoplasm, or phagosomes) to detect imbalances.
-
Soluble molecules released by these cells are also involved in inflammation.
Classification of Receptors
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Innate Immunity involves receptors that activate transcription factors, mainly NF-κB and IRF, which regulate inflammation.
-
These receptors activate cytokines, interferons, and acute-phase proteins, including acute phase proteins (APPs).
-
These receptors include Toll-like receptors, integrins, and sensors of viral molecules.
Inflammatory Markers
- Acute Phase Proteins (APPs): produced by the
liver, and involved in inflammatory response,
including:
- C-reactive protein (CRP): Rapid induction and return to baseline, useful diagnostic marker.
- Fibrinogen: Slow increase and sustained levels,
- Others: Pentraxin-3, Serum amyloid A, Complement factors
- These markers are produced in response to inflammation and play crucial roles for tissue repair, coagulation, and innate immunity. They are also involved in pathogen recognition, complement activation, and apoptotic cell clearance.
C-reactive Protein (CRP)
- CRP is produced by the liver in response to inflammatory stimuli.
- High levels of CRP are indicative of a wide range of conditions, including inflammation.
- It reflects the active inflammatory state and is a useful diagnostic marker.
- CRP levels are measured in mg/L, with typical healthy adult range between 0.8 and 3 mg/L. High levels ( >500 mg/L) indicate significant inflammation.
Erythrocyte Sedimentation Rate (ESR)
- ESR measures the rate at which red blood cells settle in a sample.
- Increased ESR is indicative of inflammation.
- It's inexpensive and available in basic labs.
- Affected by factors such as anemia and pregnancy.
Procalcitonin (PCT)
- PCT is a biomarker for bacterial infection.
- It's rapidly induced after bacterial infection.
- Elevated PCT levels are associated with sepsis and severe conditions.
- Faster response time than CRP.
Pentraxin-3 (PTX3)
- PTX3 is another inflammatory marker produced by different cell types.
- It's associated with more severe conditions, especially cardiovascular diseases, infections, and inflammation.
- It has a faster response time than CRP.
- PTX3 can be a more reliable indicator of the severity of disease, especially in chronic inflammatory conditions compared to CRP.
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