Session 1 - Immunology, Immune System Disorders & Sepsis

• What are 3 examples of an overreactive immune system response?

  1. Allergies
  2. Autoimmune diseases
  3. Microvascular inflammation
• examples of microvascular inflammation diseases?

  1. Atherosclerosis
  2. Ischemic stroke
  3. Traumatic brain injury (TBI)
  4. Meningitis
  5. Encephalitis
  6. Adult respiratory distress (ARDS)
• what is vascular artheroscleoris?

  Hardening of arteries due to plaque buildup.
• an example of vascular atherosclerosis?

  Coronary artery disease
• What is the role of mast cells in atherosclerosis progression?

  Inflammation
• How do mast cells progress atherosclerosis?

  1. lipid molecules accumulate within walls of blood vessels, this triggers immune response by mast cells.
  2. T cells & macrophages are key players in plaque formation. Mast cell degranulation enhances activation of T cells/macrophages.
  3. Form foam cells by macrophages engulfing low density lipoproteins (LDL)
  4. Foam cells secrete cytokines and chemokines (signaling molecules) to promote inflammation.
• How do mast cells contribute to plaque destablization and rupture?

  1. occurs in increased endothelial permeability
  2. when plaque ruptures, leads to acute coronary syndromes (ACS)
• How does hypoxia and ischemia-induced microvascular inflammation work?

  Reactive oxygen species (ROS) - highly reactive molecules containing O2 are generated in hypoxia and ischemia.

  • ROS activates mast cells = inflammation.
• What is the role of the complement system in microvascular inflammation?

  response to ischemia and reperfusion (restoration of blood flow after a period of ischemia).
• What are the consequences of microvascular inflammation?

  1. Inflammation from hypoxia, ischemia or reperfusion --> tissue damage.
• Microvascular coagulation & Disseminated Intravascular Coagulation (DIC)

  unchecked microvascular coagulation (clotting in small blood vessels) leads to thrombus formation (blood clot), resulting in bleeding where factors are consumed.
• Consequences of unchecked inflammation in microvascular inflammation?

  1. widespread vasogenic edema (fluid accumulation) resulting in compromised tissue/organ perfusion.
  2. Eg. traumatic injuries, severe systemic infection, widespread ischemia, hypoxia or stroke.
• what protects the brain?

  skull
• what protects the spinal cord?

  Vertebrae
• what does the skull and vertebrae shield CNS from?

  external trauma
• What happens when the brain is vulnerable to inflammation?

  Neurological disorders
• What is the blood brain barrier?

  Protective barrier between the bloodstream and the brain that regulates the passage of substances into the brain.
• What are the causes of inflammation in the brain?

  CNS inflammation - stroke, traumatic injuries, infections such as meningitis and encephalitis.
• What are space occupying lesions on the brain?

  tumours, that can badly impact other tissues
• what is primary inflammation in microvascular inflammation of the brain?

  originates from traumatic injury
• what is the secondary inflammation in microvascular inflammation of the brain?

  hypoxia caused by ischemia
• what is intracranial pressure?

  inflammation within enclosed space of skull
• what are the affects of intracranial pressure in intracranial inflammation?

  cerebral blood flow and nervous system functions.
• how do you diagnose neurological conditions for microvascular inflammation of the brain?

  1. signs and age
  2. CT
  3. MRI
  4. Blood tests
• What is the treatment approach for microvascular inflammation in the brain?

  1. perfusion maintenance and hydration
  2. antibiotics
  3. therapeutic hypothermia
  4. fluid drainage
  5. craniotomy to relieve ICP
• What is the aim of treatment approaches for microvascular inflammation in the brain?

  maintain adequate cerebral perfusion, so allowing blood flow back to the brain.
• What is microvascular inflammation in the pulmonary?

  inflammation in pulmonary system
• what is an example of a microvascular vascular disease in the pulmonary?

  adult respiratory distress syndrome (ARDS)
• What is acute respiratory distress syndrome?

  pulmonary edema in lungs
• What are the causes of ARDS?

  1. Inhaling toxic substances
  2. pneumonia
  3. burns
  4. Drug overdose
  5. head/chest injuries
• how do the causes of ARDS trigger inflammation in lungs?

  microvascular inflammation resulting in fluid leakage in alveoli (air sacs)
• how does the breakdown of alveolar-capillary barrier contribute to an edema?

  the break down allows fluid to shift from blood vessels to alveoli, resulting in pulmonary edema
• What is the alveolar capillary-barrier?

  seperates the air spaces of lungs from bloodstream
• What is the role of interleukins in ARDS?

  inflammation in lungs.
• What is an cytokine?


  Signaling molecule.
• An example of a cytokine?

  interleukin
• what are the effects of alveolar infiltration in ARDS?

  can wash out surfactant (substance that reduces surface tension in alveoli and keeps them open)
• Treatment of ARDS?

  1. invasive methods - mechanical ventilation (breathing tube)
  2. Non invasive - continuous positive airway pressure (CPAP) OR bilevel position airway pressure (BiPAP)
• what is the aim of treatment in ARDS?

  Improve oxygenation
• what is atheroscleoris?

  arterial disease. buildup of plaque in arteries leading to microvascular inflammation, increasing risk of heart attacks.