Chapter 12

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  1. What is the initial periapical immune response comprised of? Chronic?
    Innate immunity with phagocytic leukocytes and cytokines

    Adaptive immunity takes over when chronic
  2. Where are APC dendritic cells found in pulp?
    Odontoblastic layer
  3. Where are the macrophage like cells found in pulp?
    Centrally in pulp
  4. Describe the presence of adaptive immunity components in the pulp?
    Small number of T cells (BVs), B cells rare, plasma cell progeny are absent.
  5. Earliest pulp response to bacteria includes infiltration of?
    PMNs, neutrophils, monocytes, NK cells

    mechanism is incapable of clearing the infection
  6. Describe the second line defense of the immune response in the pulp?
    purpose of immune response is to localize the infection within the confines of the root canal system and prevent it's travel to the whole body
  7. How can teeth be vital and cause pain with periapical radiolucencies?
    tissue destruction is indirect by soluble host-derived mediators

    osteoclastogenesis is dependent on innate immune response which is first to occur
  8. What cells comprise the mixed infiltrate of the immune response?
    • 1. T
    • 2. B
    • 3. PMNs
    • 4. Macro
    • 5. DC
    • 6. Plasma
    • 7. NK
    • 8. Eosinophils
    • 9. Mast
  9. Which cells are most numerous in immune response?
    Lymphocytes or macrophages
  10. What are the three types of DCs?


  11. Describe levels of immunoglobulins with caries present?
    IgG1>IgA1, IgM, IgA2
  12. Describe levels of plasma cells during chronic lesions?
    IgG (.7) IgA (.14) IgE (.1) IgM (.04)
  13. What are the potentially destructive products of PMNs?
    Elastase, cathepsin G, leukotriene B4
  14. Name some diseases that have PMNs defects
    Chronic granulomatous disease

    Cyclic neutropenia

    Papillon-Lefevre syndrome

    Chediak Higashi syndrome

    Leukocyte adhesion deficencies (LADs)
  15. Describe LADs.
    LAD-1: genetic defect of integrins affects transmigration

    LAD-2: defect in sialyl Lewis X ligand affects rolling adhesion
  16. What two drugs cause neutropenia?
    Cyclophosphamide and methotrexate
  17. What cytokine stimulates the anti-bacterial properties of mature neutrophils?
  18. This biologic modifier is derived from yeast?
    PGG Glucan

    reduced bone destruction by 40% in periapical lesion
  19. How do PMNs play a role in neurogenic inflammtion?
    secrete Subst. P
  20. Name some adaptive immunity diseases.
    SCID (severe combined immunodef)

    DiGeorge Syndrome (thymic aplasia)


    selective IgA and IgG deficencies
  21. SCID is defects in both?
    Humoral and Cellular immunity
  22. Which cytokine "primes" PMNs for elevated oxidative burst?

    also IL-1 and TNF (prime for better phagocytosis)
  23. Which two chemokines synergize to increase inflammatory responses?
    IL-6 and PGE2: increase inflammatory response (IL-6 prim anti-inf)

    IL-1 and PGE2: bone resorption
  24. What chemokines comprise the osteoclast-actviating factor (OAF)?

    IL-1beta (most activity) (stimulate RANKL)


  25. Only 10-15% of resorptive action is due to what chemokine?

    60% is by IL-1
  26. IL-1beta is _____ times more potent than TNF in bone resorption.
  27. What are autacoids?
    Termed resolvins, produced by acetylated COX-2 from omega-3 fatty acids
  28. Name anti-inf cytokines.
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Chapter 12
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