WBR0736

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Author [[PageAuthor::Yazan Daaboul, M.D. (Reviewed by Yazan Daaboul, M.D.)]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Immunology
Sub Category SubCategory::Hematology
Prompt [[Prompt::Neutrophils are considered a primary line of defense against bacterial infections and non-specific inflammatory processes. They are an important component of the innate immune response and are able to migrate by a process called chemotaxis. Chemotaxis requires complex intracellular signaling pathways that allow neutrophils to move towards chemoattractant molecules that drive them towards regions of inflammation. According to the image below, which of the following pathways is most likely involved in neutrophil chemotaxis?

]]

Answer A AnswerA::A
Answer A Explanation AnswerAExp::LTB4 plays a major role in neutrophil chemotaxis.
Answer B AnswerB::B
Answer B Explanation AnswerBExp::LTC4 and LTD4 are important to increase bronchial tone. They play a role in inflammatory bronchoconstrictive lung diseases, such as asthma.
Answer C AnswerC::C
Answer C Explanation AnswerCExp::The classical role of prostacyclin (PGI2) is the prevention of platelet aggregation. It also decreases vascular, bronchial, and uterine tonicity.
Answer D AnswerD::D
Answer D Explanation [[AnswerDExp::Prostaglandins share some characteristics with prostacyclin; they decrease vascular and bronchial tone. However, they have an opposing role in uterine tonicity. They increase uterine tone. As such prostaglandin analogs may be used in conjunction with other medications to induce labor in pregnancy.]]
Answer E AnswerE::E
Answer E Explanation AnswerEExp::Thromboxane (TXA2) has an opposing role to prostacyclin in platelets. It increases platelet aggregation. Also, it increases both vascular and bronchial tonicity.
Right Answer RightAnswer::A
Explanation [[Explanation::Chemotaxis is an important feature of neutrophil activity. Chemotaxis allows neutrophils to migrate into specific sites of inflammation and to defend against bacterial infections. The pathway shown in the image is the arachidonic acid pathway that involves 2 main enzymes: Lipoxygenase which forms hydroperoxides to yield leukotrienes, and cycloxygenase (COX), which forms endoperoxides. The 2 enzymes have significant roles in different unrelated domains. In the pathway, LTB4 is an important neutrophil chemotactic agent.

Educational Objective: LTB4 is an important neutrophil chemotactic agent.
References: Nuzzi PA, Lokuta MA, Huttenlocher A. Analysis of neutrophil chemotaxis. Methods Mol Biol. 2007;370:23-36.
First Aid 2014 page 224 and 439]]

Approved Approved::No
Keyword WBRKeyword::Neutrophil, WBRKeyword::Chemotaxis, WBRKeyword::LTB4, WBRKeyword::Leukotriene, WBRKeyword::Arachidonic acid, WBRKeyword::Lipoxygenase, WBRKeyword::Inflammation, WBRKeyword::Chemoattractant
Linked Question Linked::
Order in Linked Questions LinkedOrder::