HIV EIA (3rd generation immunoassay) – can use urine, saliva, or serum (most
accurate), need to wait until 12 weeks post exposure to see antibodies, >99% accurate
4th generation immunoassay- “gold standard”
measures P24 antigen
can test 10 days post exposure
Mast cell – Cellular bags of granules located in loose connective tisssue close to blood
vessels. Activation initiates inflammatory process.
Histamine – Causes vasodilation, increases vascular permeability, increases blood flow
to the site of injury- causes erythema and swelling.
Cytokines – Soluble factors that contribute to the regulation of innate or adaptive
resistance by affecting other neighboring cells. Can be pro-inflammatory or antiinflammatory. Can react quickly or be more delayed.
Leukotrines – Released when mast cells degranulate, prolong the inflammatory
process. Cause vasodilation, attract neutrophils, monocytes, and eosinophils.target of
inhibition for singular.
Prostaglandins – Released when mast cells degranulate, are produced by the
arachidonic pathway. Cause vasodilation, platelet aggregation at site of injury, pain, and
fever.
Chemotactic factors – Biochemical substance that attracts leukocyte to the site of
inflammation
Neutrophils – Predominant leukocyte at work during the early stages of acute
inflammation
Monocytes – Become macrophages when entering the tissue, responsible for
presenting antigens to the CD4 cell which triggers T-cell immunity and B-cell immunity.
Releases additional cytokines IL1, IL6, TNF.
Cytokine IL1 function – Causes fever, activates phagocytes & lymphocytes and also
increases the release of IL6a
Cytokine IL6 function – Stimulates production of acute phase reactants and promotes
growth and stimulation of RBCs
1 / 2
Cytokine TNF function – Causes fever, increases synthesis of proinflammatory proteins
by liver, causes muscle wasting, induces thrombosis
Cytokine growth factor function – Promotes production and maturation of neutrophils
Complement – Functions include bacterial lysis, vasodilation and increased vascular
permeability, triggers mast cell degranulation, chemotaxis, and opsonization.
Kinin – Converted to bradykinin which is responsible for pain and chemotaxis, and it
increases vascular permeability and vasodilation.
Coagulation cascade – Factor XII activates kinin. Function is to form fibrin mesh to stop
bleeding and trap micro organisms.
COX1 – Prostaglandin of arachidonic pathway. Provides gastroprotection, platelet
aggregation, fluid/electrolyte balance
COX2 – Prostaglandin of arachidonic pathway. Responsible for pain, fever, renal
protection, tissue repair, reproduction development.
COX2 inhibitors- clinical implications – Protect gastric mucosa- prevent ulcers and
bleeding. Removed from market r/t cardiac events except for Celebrex. Can impair renal
function , monitor labs.
Arachidonic pathway purpose – Synthesis of prostaglandins
Non-selective NSAIDS – Inhibit COX1 and COX2, risk for gastric ulceration, GI bleeds,
edema, renal impairment
ASA – Blocks COX1 and COX2, also inhibits Thromboxane A2 and prostaglandins
Corticosteroids – Inhibit phospholipase A2, preventing formation of prostaglandins,
thromboxane A2, prostacyclin, and leukotrines
Thromboxane – Vasoconstriction, platelet aggregation
Prostacyclin – Vasodilation, platelet aggregation (most effective one)
Type 1 hypersensitivity – E. Immediate response to allergen, food, meds, pollen,
asthma, allergic reactions
P. IgE binds with antigen at 1st exposure. Antigen binds with this complex at 2nd
exposure. Inflammatory cascade initiates.
C.M. Urticaria, rhinitis, conjunctivitis, angioedema, anaphylaxis
Atopic disorders – Genetic Type 1 hypersensitivity, asthma, hay fever, eczema,
urticaria