Inflammation and Immune Response
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Questions and Answers

What does "dysbiosis" mean?

Dysbiosis is an imbalance of the microbial flora in the body.

What is the meaning of inflammation, in terms of homeostasis?

Inflammation is the body's way of returning to homeostasis, the state of balance and equilibrium.

Which of the following are considered professional cells involved in the innate immune response? (Select all that apply)

  • Neutrophils (correct)
  • Natural killer cells (correct)
  • Epithelial cells
  • Macrophages (correct)
  • Dendritic cells (correct)

    • What are the transcription factors involved in the activation of the inflammatory response by receptors?

    <p>NFkB</p> Signup and view all the answers

    What are acute phase proteins, and what is their role in inflammation?

    <p>Acute phase proteins are proteins produced by the liver during inflammation. Their role is to amplify the systemic inflammatory response.</p> Signup and view all the answers

    IL-6 acts primarily on a local level in the inflammatory response.

    <p>False</p> Signup and view all the answers

    Which of the following is not a factor that can influence erythrocyte sedimentation rate (ESR)?

    <p>Blood Glucose Levels</p> Signup and view all the answers

    What is considered a negative acute phase protein and why?

    <p>Transferrin is considered a negative acute phase protein because its production decreases during an inflammatory response.</p> Signup and view all the answers

    What protein is used as a marker for the severity of COVID-19 and what type of cell is it produced by?

    <p>Pentraxin-3 (PTX3) is used as marker for the severity of COVID-19 and is produced by endothelial cells and macrophages.</p> Signup and view all the answers

    What is the benefit of using a high-sensitivity C-reactive protein (hs-CRP) test?

    <p>The high-sensitivity C-reactive protein (hs-CRP) test can detect very low levels of CRP, making it more effective in identifying individuals at risk for cardiovascular disease.</p> Signup and view all the answers

    What is the clinical significance of Procalcitonin (PCT) levels?

    <p>Procalcitonin (PCT) levels can help to differentiate bacterial infections from other conditions like viral infections and guide the use of antibiotics.</p> Signup and view all the answers

    What are the key characteristics of Procalcitonin (PCT) that make it a valuable tool for diagnosing early sepsis?

    <p>Procalcitonin (PCT) is a rapid and specific biomarker for sepsis, meaning it is elevated early on in the disease and is not significantly affected by other conditions.</p> Signup and view all the answers

    What is the role of iron in bacterial growth, and what do iron-binding proteins do?

    <p>Iron is an important growth factor for bacteria, which they use to develop and multiply. Iron-binding proteins bind to iron, making it unavailable to bacteria and preventing their growth.</p> Signup and view all the answers

    What is the clinical significance of measuring ferritin levels?

    <p>Ferritin levels can indicate iron deficiency, iron overload, and can also be used as a marker for inflammatory processes.</p> Signup and view all the answers

    What is the role of fibrinogen in coagulation and tissue repair?

    <p>Fibrinogen is a protein that is converted to fibrin, which forms an insoluble clot, contributing to the coagulation process (blood clotting) and providing a scaffold for tissue repair.</p> Signup and view all the answers

    What is the function of lactate dehydrogenase (LDH) and how is it relevant to inflammation or tissue damage?

    <p>Lactate dehydrogenase (LDH) is an enzyme involved in the metabolism of glucose that converts pyruvate to lactate, primarily used in anaerobic conditions. LDH levels increase when tissues are damaged due to inflammation or cell death, making it a helpful indicator of tissue damage.</p> Signup and view all the answers

    What does a lower than normal ferritin level indicate in the context of anemia?

    <p>Iron deficiency</p> Signup and view all the answers

    In chronic liver disease, why should ferritin not be used as a marker without additional context?

    <p>Multiple factors can affect ferritin levels alongside liver disease.</p> Signup and view all the answers

    What role does fibrinogen serve during inflammatory processes?

    <p>It facilitates the formation of insoluble clots.</p> Signup and view all the answers

    How is d-dimer clinically relevant during Covid-19?

    <p>It is a byproduct of fibrinogen degradation.</p> Signup and view all the answers

    What is the primary association of elevated ferritin levels in chronic inflammation?

    <p>An increase in ferritin production by the liver.</p> Signup and view all the answers

    What condition is characterized by iron overload due to abnormal production of iron transport molecules?

    <p>Hemochromatosis</p> Signup and view all the answers

    Which acute phase protein is significantly implicated in the coagulation process?

    <p>Fibrinogen</p> Signup and view all the answers

    What is the relationship between tissue repair and coagulation based on the acute phase response?

    <p>Coagulation creates a matrix that supports tissue repair.</p> Signup and view all the answers

    What is the main role of an opsonin in the immune response?

    <p>To recognize pathogens and encourage their clearance</p> Signup and view all the answers

    What causes an increase in C-reactive protein (CRP) levels in the body?

    <p>Infectious or inflammatory stimuli</p> Signup and view all the answers

    Which of the following conditions would NOT affect the levels of C-reactive protein (CRP)?

    <p>Anemia</p> Signup and view all the answers

    What is a characteristic of CRP levels during an inflammatory response?

    <p>They peak quickly and then return to baseline within about a week</p> Signup and view all the answers

    What is the range of normal CRP concentration in a healthy adult?

    <p>0.8 mg/l to 3 mg/l</p> Signup and view all the answers

    How often does CRP get produced following an inflammatory stimulus?

    <p>A few hours after the stimulus with a low half-life</p> Signup and view all the answers

    Which factor differentiates CRP from the erythrocyte sedimentation rate (ESR)?

    <p>CRP is less affected by pregnancy</p> Signup and view all the answers

    What does a rise in CRP levels above 500 mg/l indicate?

    <p>An acute and significant pathological condition</p> Signup and view all the answers

    What is the primary purpose of inflammation in the immune response?

    <p>To restore homeostasis through defense and repair mechanisms</p> Signup and view all the answers

    How quickly does the innate immune response typically develop after exposure to a harmful condition?

    <p>Within minutes to hours</p> Signup and view all the answers

    Which of the following components is typically NOT associated with the innate immune response?

    <p>Antibodies</p> Signup and view all the answers

    What is a key factor that can influence the type of immune parameters found in a patient?

    <p>The kinetics of the condition being studied</p> Signup and view all the answers

    What type of immune response is activated in the presence of tissue damage?

    <p>Innate immunity, specifically inflammation</p> Signup and view all the answers

    Which condition is associated with dysbiosis?

    <p>Abnormal ratios between microbiota genera and species</p> Signup and view all the answers

    What aspect of inflammation is emphasized in both innate and adaptive immune responses?

    <p>It is present in almost every condition encountered</p> Signup and view all the answers

    Which line of defense is primarily associated with inflammation?

    <p>Second line of defense</p> Signup and view all the answers

    What is one primary condition that can cause an increase in the erythrocyte sedimentation rate (ESR)?

    <p>Inflammation</p> Signup and view all the answers

    Which factor is NOT associated with a decreased erythrocyte sedimentation rate?

    <p>Thrombocytopenia</p> Signup and view all the answers

    What is the role of C-reactive protein in the body?

    <p>Serve as a marker for inflammation</p> Signup and view all the answers

    Which age and gender consideration must be made when evaluating sedimentation rates?

    <p>Both age and gender influence normal erythrocyte sedimentation rates.</p> Signup and view all the answers

    What process allows for the production of C-reactive protein in response to inflammation?

    <p>Production stimulated by IL-6</p> Signup and view all the answers

    In which condition is the erythrocyte sedimentation rate likely to be invalid or unreliable?

    <p>Extreme hyperviscosity</p> Signup and view all the answers

    What is a common reason for elevated ESR during pregnancy?

    <p>Increased plasma volume and proteins</p> Signup and view all the answers

    What shape does C-reactive protein take, and why is it significant?

    <p>Pentamer; serves as a classical acute phase protein</p> Signup and view all the answers

    Which acute phase protein is considered a negative acute phase protein because its production decreases following an inflammatory stimulus?

    <p>Transferrin</p> Signup and view all the answers

    What is one of the primary roles of acute phase proteins in the body?

    <p>Participating in tissue repair</p> Signup and view all the answers

    How does the kinetic response of C-reactive protein differ from that of fibrinogen after an inflammatory stimulus?

    <p>C-reactive protein peaks rapidly, fibrinogen increases more slowly.</p> Signup and view all the answers

    Which molecule is defined as not ready for clinical use but is a relative of C-reactive protein?

    <p>Pentraxin-3</p> Signup and view all the answers

    What role does interleukin-6 (IL6) play in the systemic immune response?

    <p>It stimulates the production of acute phase proteins in the liver.</p> Signup and view all the answers

    What is a common characteristic of biomarkers used for detecting inflammation?

    <p>They have specific kinetic responses based on the molecule.</p> Signup and view all the answers

    What is the primary function of complement molecules in inflammation?

    <p>Recognizing pathogens and activating opsonization</p> Signup and view all the answers

    What is the primary effect of interleukin-1 (IL1) on the liver?

    <p>It triggers the synthesis of acute phase proteins.</p> Signup and view all the answers

    Which of the following statements is true regarding the regulation of inflammation?

    <p>Negative regulators are produced to prevent excessive inflammation.</p> Signup and view all the answers

    Which statement best identifies the role of fibrinogen in the body?

    <p>It contributes to coagulation and tissue repair.</p> Signup and view all the answers

    What is one of the primary functions of leukocytes during an immune response?

    <p>They promote survival and activation of the immune response.</p> Signup and view all the answers

    What is unique about the kinetic response of pentraxin-3 compared to C-reactive protein?

    <p>Pentraxin-3 peaks more quickly after an inflammatory insight.</p> Signup and view all the answers

    What could indicate the state of inflammation in a patient?

    <p>Measurement of both positive and negative regulators can provide insight.</p> Signup and view all the answers

    What can lead to the activation of interleukin-1 (IL1)?

    <p>Injury or tissue damage.</p> Signup and view all the answers

    Why is interleukin-1 often referred to as one of the 'kings of cytokines'?

    <p>It is involved in many inflammatory processes.</p> Signup and view all the answers

    What overall effect do glucocorticoids have in inflammation?

    <p>They help to regulate and reduce excessive inflammation.</p> Signup and view all the answers

    Which of the following is a positive acute phase protein that rapidly increases after an inflammatory stimulus?

    <p>Pentraxin-3</p> Signup and view all the answers

    C-reactive protein returns to its baseline level after the inflammatory stimulus has been eliminated.

    <p>True</p> Signup and view all the answers

    What type of immune response is characterized by the recognition of pathogens and activation of the complement system?

    <p>humoral innate immunity</p> Signup and view all the answers

    Transferrin is considered a __________ acute phase protein because its production is reduced after an inflammatory stimulus.

    <p>negative</p> Signup and view all the answers

    Match each acute phase protein with its corresponding behavior during inflammation:

    <p>C-reactive protein = Rapid increase after stimulus Fibrinogen = Slow increase over time Transferrin = Decrease after stimulus Pentraxin-3 = Very rapid elevation</p> Signup and view all the answers

    Which of the following molecules is primarily produced in the liver and acts as an inflammation marker?

    <p>Fibrinogen</p> Signup and view all the answers

    Pentraxin-3 is currently widely used in clinical settings as a reliable inflammation marker.

    <p>False</p> Signup and view all the answers

    What is one of the roles of acute phase proteins in the body?

    <p>Tissue repair or extracellular matrix remodeling</p> Signup and view all the answers

    What is the normal range of C-reactive protein (CRP) levels in mg/liter?

    <p>0.8-3</p> Signup and view all the answers

    CRP levels may return to baseline quickly after the elimination of an inflammatory problem.

    <p>True</p> Signup and view all the answers

    What technique is currently used to test for C-reactive protein?

    <p>Nephelometry</p> Signup and view all the answers

    CRP levels indicating active inflammation, such as during a bacterial infection, may reach __________ mg/l.

    <p>200</p> Signup and view all the answers

    Match the following CRP level ranges with their associated conditions:

    <p>0.8-3 mg/l = Normal levels 2-10 mg/l = Metabolic inflammation (e.g. atherosclerosis) 10-40 mg/l = Mild inflammation (e.g. mild viral infection)</p> <blockquote> <p>200 mg/l = Severe bacterial infection or burn</p> </blockquote> Signup and view all the answers

    Which of the following conditions might not cause an increase in C-reactive protein (CRP) levels?

    <p>Healthy lifestyle</p> Signup and view all the answers

    A CRP level of 10 to 40 mg/l is indicative of severe inflammation.

    <p>False</p> Signup and view all the answers

    What happens to CRP levels after the problem causing inflammation is resolved?

    <p>They decrease towards basal levels.</p> Signup and view all the answers

    Which of the following conditions is NOT associated with an increase in the erythrocyte sedimentation rate (ESR)?

    <p>Polycythemia</p> Signup and view all the answers

    The erythrocyte sedimentation rate (ESR) is the same in males and females regardless of age.

    <p>False</p> Signup and view all the answers

    What is the primary acute phase protein produced by the liver in response to inflammation?

    <p>C-reactive protein</p> Signup and view all the answers

    During pregnancy, the erythrocyte sedimentation rate may ______ due to hormonal changes.

    <p>increase</p> Signup and view all the answers

    Match the following conditions with their effect on erythrocyte sedimentation rate (ESR):

    <p>Inflammation = Increase Polycythemia = Decrease Sickle cell anemia = Decrease Autoimmune disorders = Increase</p> Signup and view all the answers

    Which factor leads to a decrease in the erythrocyte sedimentation rate?

    <p>Hyperviscosity of blood</p> Signup and view all the answers

    What shape does C-reactive protein take?

    <p>Pentamer</p> Signup and view all the answers

    Low plasma protein levels can lead to an increased erythrocyte sedimentation rate.

    <p>False</p> Signup and view all the answers

    What condition is characterized by organ dysfunction due to severe inflammation?

    <p>Sepsis</p> Signup and view all the answers

    Procalcitonin (PCT) levels increase in response to viral infections.

    <p>False</p> Signup and view all the answers

    What is the typical range of normal levels for the protein mentioned in inflammatory conditions?

    <p>below 0.01 μg/L</p> Signup and view all the answers

    The half-life of the protein related to bacterial infection is approximately _______ hours.

    <p>25-30</p> Signup and view all the answers

    Match the following conditions with their definitions:

    <p>SIRS = Severe inflammatory response syndrome Sepsis = Presence of organ dysfunction due to infection Septic shock = Life-threatening organ failure Bacterial infection = Infection caused by bacteria</p> Signup and view all the answers

    Which factor does NOT influence the production of the protein during inflammation?

    <p>Viral infection</p> Signup and view all the answers

    The production of the protein increases during sterile inflammation.

    <p>False</p> Signup and view all the answers

    What is a key indicator that a patient may be experiencing septic shock?

    <p>Organ failure</p> Signup and view all the answers

    Which of the following cytokines is known for its anti-inflammatory properties?

    <p>IL-10</p> Signup and view all the answers

    High levels of Procalcitonin (PCT) are associated with lower mortality rates in patients.

    <p>False</p> Signup and view all the answers

    What biomarker is mentioned as a better discriminator between sepsis and SIRS compared to CRP?

    <p>Procalcitonin (PCT)</p> Signup and view all the answers

    The concentration of IL-10 is associated with the __________ of the patients.

    <p>survival</p> Signup and view all the answers

    Match the following conditions with their associated Procalcitonin (PCT) behavior:

    <p>Viruses = Levels not modified Major trauma = Physiological elevation Severe burns = Elevation after surgical intervention Small cell lung cancer = Abnormal variations</p> Signup and view all the answers

    When Procalcitonin (PCT) levels are low, what condition cannot be excluded?

    <p>Bacterial infection</p> Signup and view all the answers

    High Procalcitonin (PCT) levels are always conclusive for the diagnosis of sepsis.

    <p>False</p> Signup and view all the answers

    What is the physiological condition that influences abnormal PCT variations in neonates?

    <p>Physiological elevation within the first 48 hours of life</p> Signup and view all the answers

    What condition is associated with iron overload and abnormal production of iron transport molecules?

    <p>Hemochromatosis</p> Signup and view all the answers

    Ferritin levels are directly related to the total amount of iron in the body.

    <p>False</p> Signup and view all the answers

    What happens to ferritin levels in chronic inflammation?

    <p>They are higher than normal.</p> Signup and view all the answers

    Fibrinogen is upregulated during an acute phase response, particularly in cases of _____ such as Covid-19.

    <p>inflammation</p> Signup and view all the answers

    Which of the following proteins is commonly analyzed during inflammatory processes?

    <p>Fibrinogen</p> Signup and view all the answers

    Match each acute phase protein with its primary role:

    <p>Ferritin = Iron storage and transport Fibrinogen = Coagulation D-dimer = Clot degradation CRP = Inflammation marker</p> Signup and view all the answers

    What does a rise in d-dimer levels indicate?

    <p>Increased clot formation or breakdown.</p> Signup and view all the answers

    D-dimer is only used to diagnose iron-related disorders.

    <p>False</p> Signup and view all the answers

    Study Notes

    Inflammation

    • Inflammation is a phylogenetically conserved response, activating defense mechanisms and initiating repair.
    • Inflammation is activated by tissue damage, microbial moieties, dysbiosis, dysmetabolism, and homeostatic imbalances.
    • The initial response involves receptors on cells recognizing these imbalances, with various cell types involved.
    • Professional cells (leukocytes) like macrophages, neutrophils, dendritic cells, and NKCs, and non-professional cells such as epithelial, stromal, and endothelial cells contribute.
    • Inflammation is actively present in almost every condition, associated with infection, tissue damage, and imbalances.
      • Examples: infection, tissue injury, homeostatic imbalances, dysmetabolism, dysbiosis, and cardiovascular diseases

    Markers of Inflammation

    • The immune system has three lines of defense: innate, innate immunity focused response, and adaptive immunity, which is primarily mentioned in vertebrates.
    • The innate first response functions within hours and the adaptive immunity takes days, allowing for differentiation in the patient conditions.

    Inflammatory Markers

    • Key inflammatory markers include C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT), lactate dehydrogenase (LDH), and fibrinogen.
    • CRP, a pentamer, is rapidly induced by inflammation, showing a high sensitivity for conditions, and its rapid clearance following stimulus.
    • CRP levels vary according to the severity, with mild inflammation (2-10 mg/L) considered average risk, and severe conditions (>500 mg/L) indicating high risk.
    • ESR measures the rate at which red blood cells settle. It is influenced by factors like fibrinogen, conditions such as inflammation, infections, autoimmune diseases, and anemia that may cause elevated levels.
    • PCT is produced by the liver, reflecting the severity of infection, and shows faster kinetics than CRP, which allows identifying potential severe bacterial infections.
    • Abnormal PCT levels may indicate severe bacterial infections, while lower levels suggest minor infections or other non-infectious conditions.
    • LDH is a marker associated with cell death, reflecting tissue damage.
    • Fibrinogen is upregulated in inflammation and plays a role in tissue repair and coagulation, showing elevated levels in inflammatory conditions.

    Other Inflammatory Markers (PTX3)

    • PTX3 is a long pentraxin produced by various cell types (leukocytes, stromal cells, etc.) signaling an inflammatory response.
    • PTX3, unlike CRP, correlates with mortality and the severity of several conditions (e.g., cardiovascular or infectious diseases), such as COVID complications.
    • PTX3 is produced in response to inflammatory stimuli, microbes or tissue damage, and is a marker of severity and prognosis.

    Infectious Conditions and Inflammatory Markers

    • Inflammatory response markers, like PTX3, CRP, PCT, and LDH, can be indicators of the severity of an infection.
    • COVID-19 complications can be associated with elevated PTX3 levels, and the severity of these markers can indicate whether or not to administer antibiotics.
    • Secondary infections, like bacterial or fungal, which occur in conjunction with COVID-19, can result in increased PTX3 levels.
    • Elevated PTX3 levels can correlate with poor prognosis in various diseases.

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    Description

    This quiz explores the responses of inflammation and the immune system. Learn about the roles of professional and non-professional cells, the markers of inflammation, and the distinction between innate and adaptive immunity. Test your understanding of how the body responds to tissue damage and infection.

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