15) Transplantation & tumors Flashcards

1
Q

autograft

A

same individual
no imm response

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2
Q

isograft

A

genetically identical individual
no imm response

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3
Q

allograft

A

genetically dissimilar individual
imm rejection

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4
Q

xenograft

A

different species
imm rejection

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5
Q

2 types of allograft rejections (1st/2nd exposure)

A
  • first set rejection – original transplant rejection
  • second set rejection – second transplant from same donor; imm memory
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6
Q

in vitro Ab that can block transplant Ags from T-cells to enhance graft survival

A

enhancing antibodies

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7
Q

evidence for immunologic nature of rejection

A
  • lymphs/monos found at site
  • those lacking T-cells do not reject
  • rejection slows in immunosuppressed
  • specific T-cells and Ab formed against graft
  • enhancing antibodies function
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8
Q

3 types of graft rejection

A
  • hyperacute
  • acute
  • chronic
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9
Q

rejection in minutes to hours
preformed Ab to graft

A

hyperacute rejection

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10
Q

complement activated
swelling, thrombosis
fever
leukocytosis
little/no urine production

A

hyperacute rejection

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11
Q

rejection after a few days
no previous sensitization

A

acute rejection

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12
Q

—— rejection may be reduced by immunosuppressive drugs

A

acute

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13
Q

rejection months after transplant
both Ab and cell-mediated

A

chronic rejection

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14
Q

major region of immunologic importance for transplantation

A

MHC

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15
Q

graft rejection begins with…

A

activation of CD4+ T-cells by non-self MHCII on graft

CD8+ may be activated by MHCI

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16
Q

lymphs of donor and recipient reacted with panel of Ab

A

lymphocytotoxicity test

17
Q

can detect donor/recipient differences to a single AA

A

genotyping

18
Q

leukocytes from donor and recipient cultured together for several days and T-cells with radioactively labelled DNA proliferate if incompatible

A

mixed leukocyte reaction

19
Q

stabilize lysosomal membranes
inhibit T-cell cytokine production
induce lysis of lymphs

A

anti-inflammatories
(corticosteroids)

20
Q

interfere with RNA/DNA synthesis

A

anti-metabolites

21
Q

monoclonal Ab (OKT3) given before, during and after transplant; specific for lymphs

A

cytotoxic/blocking agents

22
Q

interferes with cytokine gene transcription in T-cells

even allows transplant between unmatched donor/recipient

nephrotoxic

A

cyclosporine

23
Q

similar to cyclosporine, not as nephrotoxic

24
Q

induces total immunosuppression prior to transplant

A

total lymphoid irradiation

25
helps protect fetus against rejection by mother
alpha-fetoprotein
26
Ag on malignant cells not present on normal cells
tumor specific ag
27
Ag "hidden" on normal cells or "overexpressed" on tumor cells
tumor associated ag
28
categories of tumor ag
- chemically or physically induced -- harder to tx, not cross reactive - virally induced -- cross reactivity - oncodevelopmental antigens -- expressed on normal embryo/fetus, not on normal adults - antigens of spontaneous tumors -- unknown causes
29
CEA and AFP are examples of...
oncodevelopmental ags
30
IgG and IgM are ineffective against ----- tumors
large, solid
31
parts of cell-mediated tumor defense
- cytotoxic T-cells - NK cells - lymphokine activated killer cells (LAKs)
32
how tumors escape imm system
- privileged sites (lens of eye) - antigenic modulation - blocking by soluble Ag released by tumor - tumor-specific suppressor T-cells - prostaglandins released by tumors - **large tumor mass**
33
elevated in liver cancer, cirrhosis, hepatitis
AFP
34
normally present in GI tract, but not blood except in malignancy or inflammatory disease
CEA