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Immunohematology Lecture > 2.2 > Flashcards

2.2 Flashcards

1
Q

Produced in response to antigenic stimulation

A

Gamma globulins

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2
Q

Antigenic stimulations

A

Pregnancy
Transfusion
Transplant
Bacterial and viral infection

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3
Q

Anti-I is produced in response to what bacteria

A

Mycoplasma pneumoniae

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4
Q

Anti-i is produced in response to

A

Epstein Barr virus

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5
Q

Found at the surface of B cells

A

Immunoglobulins

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6
Q

Found in the plasma produced by plasma cells

A

Antibodies

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7
Q

What are the IgM antibodies

A

-A,-B,-H,-I,-i,-M,-N,-Lewis A,-Lewis B, -Lutheran A, -Lutheran B, -P, -P1, -Pk

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8
Q

What are the IgG antibodies

A

-D,-C,-c,-E,-e,-S,-s,-Kell,-Duffy,-Kidd

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9
Q

What are the IgA antibodies

A

-Le, -A,-B,-H

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10
Q

They are not
associated with intravascular
hemolysis, but rather extravascular
hemolysis

A

IgG antibodies

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11
Q

intravascular hemolysis. The
hemolytic transfusion reaction that
may occur is a serious reaction.

A

IgM antibodies

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12
Q

usually need a high
protein (e.g., albumin) medium as a
potentiator and AHG (antihuman
globulin) to react

A

IgG antibodies

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13
Q

do not need
potentiators. In a simple saline
solution, they’re able to react

A

IgM antibodies

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14
Q

Primary function of antibody

A

to bind with antigen

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15
Q

Secondary functions/ biological effector functions:

A

Complement fixation
Placental transfer
Bind on receptor sites on tissues and other cells

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16
Q

produced in response to
antigen stimulation from the environment whose
specificity is unknown / not definitely known (bacteria,
pollen, fungi, etc.) ; non-red cell stimulated; usually IgM

A

Naturally occurring antibodies

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17
Q

produced from red cell antigen stimulation;
IgG

A

Immune

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18
Q

antibodies against red cell antigens,
where these are differently distributed among the
members of the same species; cause specific clumping of
cells. Ex: Anti-A, Anti-B

A

Isoagglutinins

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19
Q

associated with HTR, HDN and
AIHA.

A

Clinically significant

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20
Q

ab not expected to be found in serum of
patient; present in a very small human population only

A

Irregular

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21
Q

abs that react to red cells of its own
host, as well as to red cells of other individuals; produced
through stimulation by bacterial or viral infections.

A

Autoantibodies

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22
Q

antibodies that are acquired
through transfusion of plasma

A

Plasma derived or passively -transferred

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23
Q

abs that activates the
complement, and cause red cells to lyse.

A

Complement fixing

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24
Q

ab that activates the complement when it
forms a complex with specific red cell antigen; IgM in
nature; hemolysis is produced when specific red cells are
reacted upon

A

Hemolysin

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25
does not activate the complement system;
Non complement fixing
26
ab that coat the red cells, and eventually lyses them; IgM
Complete
27
ab that only coat the red cell; but not capable to lyse it.
Incomplete
28
ab that best reacts at 37 C.
Warm antibodies
29
ab that best react at 4C to ambient room temperature, (below 30C)
Cold antibodies
30
activated by the presence of foreign antigen, or abnormal autoantigen.
Immune system
31
Cells involved in immune response
APCs (antigen presenting cells)= macrophages, dendritic cells, monocytes • Lymphocytes = T helper, T cytotoxic, B cells • Natural killer, neutrophils, eosinophils, basophils, platelets
32
Types of immune responses
1.Direct B cell stimulation 2. APC and T helper cell mediation 🡪 o humoral response: IgM and IgG antibodies o Cellular response: cytotoxicity by T cells, NK cells 3. Complement activation (by Ab-Ag complex, or directly by pathogens, other substances) 4. Inflammatory response o Ab-mediated o Inflammatory cell stimulation
33
incompatible blood type of fetus to that of mother (baby’s antigen foreign to the mother) E.g. Baby is D(+), mother is D(-)
Pregnancy
34
incompatible blood type between patient (recipient) and donor blood
Transfusion
35
incompatible type between patient (recipient) and donor tissue; can lead to hyperacute rejection
Tissue or organ transplantation
36
autoantibodies are produced; viral or bacterial antigens are chemically similar to certain blood group antigens.
Bacterial, viral infection
37
Immune responses
1. antibody production 🡪 IgM and IgG 2. hemolytic reaction 🡪 mediated by IgM Ab-Ag and complement (cascade pathway) 3. inflammatory reaction 🡪 tissue necrosis (such as in organ transplantation rejection) 4. allergic reaction 🡪 plasma proteins mediated by IgE with basophils; IgA can cause transfusion related lung injury
38
MANIFESTATIONS OF ANTIGEN – ANTIBODY REACTION
Red cell agglutination Hemolysis Mixed field agglutination
39
Indications of mixed field agglutination
Weak antigens in subgroups, example : A3 • Acquired B phenomenon, example : colon cancer • Chimeras • Mixed blood in transfusion
40
No agglutination Dark turbid homogeneous supernate
0
41
Many tiny agglutinates Many free cells May not be visible without microscope Dark and turbid supernate
W+
42
Many small agglutinates Many free cells Turbid supernate
1+
43
Many medium-size agglutinates Moderate number of free cells Clear supernate
2+
44
Several large agglutinates Few free cells Clear supernate
3+
45
One large solid agglutinate No free cells Clear supernate
4+
46
Stacked-coin formation The red cells cluster and resembles a macroscopic agglutination
Rouleaux formation
47
Rouleaux formation found in patients with
Multiple myeloma Walderstrom's Macroglobulinemia or Hyperviscosity syndrome
48
Interacting antigen and antibody- the antigenic determinant fit in a cleft / space formed by the combining site of the antibody (at the Fab region, formed by variable regions of light and heavy chains)
Lock and key concept
49
That hold the Ag in the antibody combining site • Multiple bonding ensures the Ag bound to the Ab is tight and stable.
Non-covalent bonds
50
Bonds related to Ag-Ab reactions
Hydrogen bonds Hydrophobic bonds Electrostatic bonds Van der Waals forces
51
Involves binding of the paratope /combining site of the Ab and the epitope/ determinant of the Ag in a reversible reaction).
PRIMARY STAGE ( ANTIBODY SENSITIZATION)
52
Multiple erythrocytes with bound antibodies form a latticework through Ag--Ab bridges formed between adjacent erythrocytes • The lattice formed is the basis of all visible agglutination reactions.
SECONDARY STAGE OF RED CELL AGGLUTINATION (LATTICE FORMATION)
53
The nature of the bonds determines if the reaction occurs better at colder or warmer temperature.
Effects of temperature
54
Optimum pH for most antigen-antibody reactions
6.5-7.5
55
refers to charge concentration of the suspending (reaction) medium.
Ionic strength
56
Consists of 0.2 % NaCl
Low Ionic Strength Saline
57
To allow antigen/antibody reactions reach equilibrium
Incubation
58
Antigen-Antibody optimum ratio
80 parts of antibody 1 part of antigen
59
Serum:RCS ratio
2:1
60
The surface of red cells carry a negative charge due to the ionization of what carboxyl group
NeuNac (N-acetyl neuraminic acid), also called NANA or sialic acid.
61
The antibody - sensitized red cells are subjected to high gravitational force overcoming the natural repulsive effect of the red cells to one another
Effect of centrifugation
62
The number of antigen binding sites of IgM molecules (valence 10) compared with IgG (valence 2), increases the chances of random antibody-antigen collisions, leading to a greater chance of effective red cell cross-linking.
Effect of immunoglobulin type
63
Negative charges attract positive charges which in turn repel positive charges from other cells.
Ionic charges
64
Mechanism of Albumin
1.Reduce the charge density (dielectric constant) of the red cell suspending medium. 2. Reduce net repulsive force between red cells 3. It replaces the water hydration surrounding the red cell IgG antibody able to span the gap between individual positive red cells to produce agglutination.
65
The proteolytic enzymes modify various blood group antigens on the RC membrane:
1. papain (papaya) 2. ficin (figs) 3. bromelin (pineapples) 4. trypsin (lining of a hog's stomach)
66
Enzyme: Order of effectiveness in detecting IgG antibodies:
ficin > papain > bromelin > trypsin
67
Explain the effect of enzyme treatment
Treating red cells with enzymes results in the release of sialic acid from the membrane with a subsequent decrease in the negative charges and zeta potential of the RBCs • Enzymatic treatment also removes hydrophilic glycoproteins from the membrane of the RBCs and causing the red cells become hydrophobic, thus allowing the red cells come closer together. • Antibodies become more inclined to attach to
68
Produces a “bridging effect” by cross linking the antibody-sensitized red cells.
Antihuman globulin reagent
69
Water- soluble polymer used with AHG to bring sensitized cells close together and facilitate cross-linking and enhancement of agglutination reaction. Does not produce non-specific reactions.
Polyethylene glycol
70
Positively charged macromolecule which cause non-specific aggregation of sensitized red cells with IgG antibody after incubation with LISS.
Polybrene (hexadimethrine bromide)
71
Other names for IgM
Macro-globulin
72
IgA is also known as
Secretory Ig
73
Reagin is better known as
IgE
74
5-10%
IgM
75
How many percent is IgG
75-85 %
76
5-15%
IgA
77
0.001
IgD
78
0.0003%
IgE
79
Sv: 19x
IgM
80
Sv: 6.6-7s
IgG
81
Sv: 6.8-11.4s
IgA
82
Sv: 6.6 s
IgD
83
7.9-8.2s
IgE
84
Pentamer
IgM
85
Monomer
IgG IgD IgE
86
Dimer
IgA
87
900,000
IgM
88
150,000
IgG
89
160,000 & 400,000
IgA
90
180,000
IgD
91
190,000
IgE
92
Stable to 56C
IgM IgG IgA

Immunohematology Lecture (2 decks)

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