15. Cytokines Flashcards

1
Q

which cytokines is made during the innate response but drives the production of cytokines used during the adaptive immune response?

A

IL-12

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2
Q

IFN-gamma, produced by activated Th1 cells, can act back on macrophages to activate them to do what?

A

become “classically activated” - more microbicidal

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3
Q

cytokines and pleiotropy - what is it and what is the downside?

A

a single cytokine may act on many different cell types, mediates diverse biological effects

but limits use of many cyotkines therapeutically (unwanted side-effects)

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4
Q

cytokines and redundancy - what is it and what is the downside?

A

multiple cytokines have the same functional effects (eg IL-4 causes IgE production, Th2 differentiation, and inhibiiton of macrophages)

but antagonize a single cytokine and you many not eliminate the response

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5
Q

how are IL-1 and TNF an example of cytokine redundancy?

A

both endogenous pyrogens that act on the hypothalamus to induce a prostaglandin-mediated fever

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6
Q

what three cytokines commonly lead to proliferation?

A

IL-2, IL-4, and IL-5

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7
Q

cytokine cascades and interaction- action usually is what?

A

sequential - biological effect may be elicited by final cytokine in series

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8
Q

cytokines and synergy

A

two cytokines necessary for one response - eg IFN-gamma and TNF mediate increased expression of class I MHC molecs on many cell types

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9
Q

cytokines and antagonism

A

two cytokines may have different/opposing effects - eg IFN-gamma activates macrophages and IL-4 inhibits macrophage activation

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10
Q

example of cytokine paracrine action?

A

virus induces IFN production which acts on adjacent cells to induce antiviral state

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11
Q

example of cytokine endocrine action?

A

LPS on macrophages to induce TNF, IL-1, and IL-6 which induce fevere (hypothalamus = target site distant from site of production)

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12
Q

example of cytokine autocrine action?

A

IL-2 and T cells or IFN-gamma and macrophages (may be high effective [ ] )

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13
Q

cytokine mediators/regulators of innate immunity - ____ is really important. They are made mostly by ______ in response to microbial stimuli. There is _____-dependent signaling in most cases.

A

balance; macrophages; TLR

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14
Q

what is a cytokine storm?

A

cytokine overproduction - as in sepsis…can lead to shock/death (systemic inflammaotry response syndrome = SIRS)

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15
Q

what are the cytokines that drive hematopoiesis?

A

M-CSF (monocyte CSF) which is released by macrophages, endoth cells, bone marrow cells, and fibroblasts to target committed progenitors to make monocytes

G-CSF (granulocyte CSF) which is released by macrophages, fibroblasts, and endoth cells to target committed progenitors to make granulocytes

GM-CSF (granulocyte-monocyte CSF) which is released by T cells, macrophages, endoth cells, and fibroblasts to target immature and committed progenitors (and mature macrophages) to make granulocytes/monocytes or to induce macrophage activity

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16
Q

what do we give to pts who are neutropenic to bump up neutrophils after chemo and radiation?

A

G-CSF

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17
Q

cytokines in the adaptive immune system are produced primarily by ______ upon antigen recognition. They then do what?

A

T-lymphocytes

they regulate differentation/growth of lymphocyte subpopulations (Th1, Th2, Th17), recruit/activate/regulate specialized effector cells (eg eosinophils), and they eliminate antigens in the effector phase of the immune response

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18
Q

cytokines bind with high affinity, so what does this mean?

A

act at low concentrations (low % receptor occupancy required to initiate signaling)

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19
Q

most cytokines induce gene expression (interaction with receptors results in activation of signaling pathways that result in activation of DNA binding proteins that direct txn, eg STAT1 activation through IFN-gamma R). What are some exceptions?

A

chemokines induce rapid cell migration (actin mobilization)

TNF induces apoptosis without de novo protein synthesis (TNF->activ of sphingomyelinase -> ceramine -> apoptosis of endoth cells)

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20
Q

all cytokine receptors are comprised of >= 1 transmembrane protein - role of extracellular domain and intracellular domain?

A

extra: binding of cytokine
intracell: signaling

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21
Q

Type I cytokine receptors

A

dimerize

conserved cysteines in extracellular domains (2 conserved region per extracell domain)

bind cytokines that form 4 alpha-helices; specificity determined by amino acids that distinguish extracellular domain; additional signal transducing chains co-associate with receptor

22
Q

TNF receptor family?

A

induce apoptosis or gene expression….receptor trimerizes

23
Q

7-TM alpha-helical receptors?

A

chemokine receptor; GPCRs

24
Q

within a receptor class, certain chains may be shared - this leads to what?

A

redundancy

25
low quantities of TNF-alpha does what?
local inflammation (eg leukocyte activation, endothelial cell express adhesion molecules and release of IL-1 and chemokines to drive recruitment of more white cells through diapedesis)
26
moderate quantities of TNF-alpha do what?
systemic effects (signal to the hypothalamus to cause a fever, signal to liver to release acute phase proteins, signal to bone marrow to produce more lymphocytes)
27
what do high quantities of TNF-alpha do?
septic shock (low CO, low resistnace -> thrombi -> DIC, is a glucocorticoid antagonizing factor that blocks gluconeogenesis -> hypoglycemia)
28
TNF-alpha is the primary mediator in the inflammatory response to what type of infection?
gram(-)
29
primary source of TNF-alpha?
macrophages thanks to LPS induction
30
what are the two receptors for TNF?
TNFRI and TNFRII (TNFRI mediates most of the biological effects like NF-kB translocation and apoptosis)
31
antagonism of TNF-alpha has been very successful in which disease?
rheumatoid arthritis - eg Etanercept/Enbrel = soluble TNF receptor-immunoglobulin Fc fusion protein dimer that competes with cell-assocaited receptor or free TNF or Ifliximab/Remicade//adalimumab/humira are Mab to TNF
32
potential side effects of anti-TNF Rx?
exacerbation of latent TB
33
What two cytokines are involved in RA?
IL-1 and TNF-alpha (produced by macrophages and fibroblasts in the synovial fluid - IL-1R are found on cells with various functions and when stimulated they release secondary cytokines to mediate inflammation, tissue remodeling, and cartilage destruction)
34
IL1 & TNF-a in RA? just | IL1? just TNF-a?
both: ^COX2, ^PGE2, ^adhesion molecs, ^IL6, ^chemokines, ^collagenases IL1: ^TNF-a, ^osteoclast activ, ^angiogenic factors TNF-a:^IL1, ^apoptosis
35
why does enbrel have an IgG1 FcR?
increases half life
36
The binding of IL-1 to high affinity IL-1R (type I) does what?
draws in the IL-1R accessory proteins, the adaptor protein MyD88 is recruited, NF-kB mediated signaling commenses through recruitment of downstream kinases
37
IL-1Ra does what?
natural antagonist that provides negative feedback in response to inflammatory stimuli - prevents binding to IL-R1 (competes with IL-1)
38
IL-1RA or anti-IL1 antiboies are being used clinically to treat what?
Type II diabetes, gout, muckle-wells
39
what drug is an IL-1Ra used to block inflammation in RA by binding to IL-1R1 but doesn't signal?
anakinra/kineret
40
IL-1B and gout
inflammasome signaling (NALP3 = NLRP3) leads to processing of pro-IL1B to active IL-1B....uric acid crystals in joints activates NLRP3 and drives production of IL-1B to cause gout...rilonacpet (arcalyst) used in gout to trap IL-1 fusion protein muckle wells is a mutation in NLRP3
41
IL-12 is a ____ protein and the primary mediator of what response?
heterodimeric protein, primary mediator of innate response to intracellular microbes
42
IL-12 is a key inducer of cell-mediated immunity through its ability to induce what?
IFN-gamma
43
primary stimuli to make macrophages secrete IL-12?
LPS, intracellular bacteria
44
major function of IL-12?
stimulates production of IFN-gamma by NK and T cells - results in synergistic production of TNF in response to LPS - stimulates differentiation of CD4+ cells to become IFN-gamma producers (Th1 response) - enhances CTL and NK cell activity (through production of IFN-gamma)
45
therapeutic approaches to IL-12?
recombinant IL-12 in trials to boost cell-mediated immunity in pts w/immunodefic or cancer anti-IL-12 therapy to block pathology associated with crohn's disease
46
IL-17 is implicated in which diseases?
RA, lupus, asthma, allograft rejection, MS, CF, involved in crohn's antagonizing IL-17 seen as an approach to arthritis and psoriasis
47
for a low PMN count, what would you perhaps give a patient?
G-CSF
48
IFN-a/B does what to viral replication?
inhibits
49
effects of IFN-a/B on immune response
- increases Class I MHC expression on infected cells (increases CTL recognition) - inhibits proliferation of many cell types, including lymphocytes - activates macrophages (increases IL-10 and FcR, decreases IL-12) - contributes to larger repertoire of inflammatory genes induced by TLR4 agonists
50
IFN-a/B is used clinically to treat what disease?
Hep B and C recently for SARS outbreak in toronto hairy cell leukemia MS - unknown mechanism