12: Renal Immunology Flashcards
Risk factors for kidney injury
Age, race, genetic factors, HTN, DM, metabolic syndrome
What does AKI cause?
Metabolic acidosis and acute renal failure
Acute renal failure
Abrupt decrease in kidney function
How many critically ill patients have AKI?
Up to 30%
Early, middle, and late stage AKI: major players
Early: Th17, Th1
Middle: M1
Late: Th1
Role of Tregs in AKI
Prevent AKI progression and restrict inflammation, promote repair
Autografts, isograft, allografts and xenografts
- Autografts: from same individual
- Isografts: from an identical twin
- Allografts: from another human
- Xenografts: from another species
How to avoid rejection of a xenografts
Human HLA genes inserted into the genomes of donor animals
Microcytotoxicity test for pre-formed Abs steps
- Recipient serum with Abs added to donor cells
- Complement is added
- Dye is added
- If dye is detected in cells -> mismatch
Microcytotoxicity test for class I HLA compatibility
- Anti-HLA-A3 Abs are added to recipient cells + separately to donor cells
- Complement is added
- Dye is added
- If dye is found in recipient cell + in donor cell -> match!
Donor-host Ag disparities doesn’t matter in which tissues?
Cornea, heart valve, bone, tendon, and SCs
Mixed lymphocyte response for testing class II HLA compatibility
- Donor cells are irradiated so they cant proliferate
- Recipient cells are labeled with thymidine and added to donor cells
- If recipient T cells find Ags on donor DCs -> proliferate
- Cell proliferation noted by radioactive thymidine present in the cells -> no compatibility
Why are adaptive immune responses greater against grafts than they are against pathogens?
Higher frequency of T cells that recognize the graft as non self
Direct and indirect allorecognition **
- Direct: recipient T cells arrive in graft -> recognize MHC molecules on donor APCs
- Indirect: donor MHCs are taken up -> presented by recipient APCs for activation of recipient T cells
