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infection > 2.2 > Flashcards

2.2 Flashcards

1
Q

innate immunity definition ?

A

antigen-independent immune response

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2
Q

In Innate immune response :
1. antigen presenting cells present antigens to what ?
2. providing link between …?

A
  1. antigens to CD4+ T cells
  2. innate and adaptive immune system
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3
Q

what’s difference in definitions of innate and adaptive immunity ?

A

innate = antigen-INDEPENDENT immune response
adaptive = antigen-DEPENDENT immune response

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4
Q

antigen= substance that can ….

A

induce an immune response

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5
Q

a substance that can induce an immune response defines what ?

A

antigen

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6
Q

Innate immune response has 3 ways to deal with pathogens , Name these 3 ways and briefly explain them?

A

CAP

complement
* opsonisation of pathogens
* formation of membrane attack complex

antigen presenting cell
* Presents antigens to CD4+ T cells
* link between innate and adaptive immune system

phagocytes
* produce pro-inflammatory cytokines
* leads to inflammatory pathway

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7
Q

In Innate immune response
1. what does complement system do to pathogens?
2. formation of…?

A
  1. opsonisation
  2. membrane attack complex
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8
Q

3 functions of innate immune response ?

A
  1. recognition of pathogens and damaged cells
  2. activation
  3. elimination of unwanted substances
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9
Q

In Innate immune response :
1. what do phagocytes produce ?
2. leading to what ?

A
  1. pro-inflammatory cytokines
  2. inflammatory pathway
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10
Q
  1. what disorders are primary immunodeficiencies ?
  2. resulting from ?
  3. usually present at ?
  4. diagnosed when ?
A
  1. (PID) – inherited immune disorders
  2. genetic mutations,
  3. birth
  4. in childhood.
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11
Q

Examples of encapsulated bacteria that are possible consequences of the secondary immunodeficiency acquired aplasia

A
  • S. pneumoniae
  • H. influenzae
  • N. meningitidis
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12
Q

5 major manifestations of acute rheumatic fever

A

SEA between 2C’s

1.carditis (chest pain, palpitations, dyspnea)
2. subcutaneous nodules (collagen collections)
3. erythema marginatum (non-itch rash)
4. arthritis (joint pain)
5. chorea (involuntary jerking muscle movements)

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13
Q

What are the antibodies that form against group A Streptococcus for Acute rheumatic fever cross reactive to?

A

cardiac myosin

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14
Q

what is acute rheumatic fever ?

A
  • autoimmune disease
  • mostly occurs following group A Streptococcal throat infction
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15
Q
  1. What is acute rheumatic fever ?
  2. mostly occurs following what ?
  3. Antibodies form against…?
  4. what are these antibodies cross reactive to ?
  5. typically presents ….following tonsilitis
A
  1. an autoimmune disease that
  2. group A Streptococcal throat infection
  3. Group A Streptococcus
  4. cardiac myosin
  5. 2-4 weeks
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16
Q
  1. Autoimmune disease can be ….. cell mediated - loss of ‘self tolerance’
  2. Interaction with … remains a direct trigger of autoimmune disease - molecular mimicry
  3. antibodies induced during …. can also bind self-antigens - often detect ….
  4. …. cells are usually ‘deleted’ or kept inactive, but in autoimmune disease there is a failure of these ….mechanisms
A
  1. T or B
  2. micro-organisms
  3. infection, autoantibodies
  4. autoreactive T, regulatory
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17
Q

If there is a reaction to exogenous (non-self) antigens what is it ?

A

allergy

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18
Q

If there is a reaction to endogenous (self) antigens it’s …?

A

autoimmune

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19
Q

Type I hypersensitivty reactions are mediated by ?

A

IgE

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20
Q

Type II hypersensitivty reactions are mediated by ?

A

IgG or IgM

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21
Q

Type III hypersensitivty reactions are mediated by ?

A

antigen-antibody

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22
Q

Type IV hypersensitivty reactions are mediated by ?

A

T cell

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23
Q

If protozoa and helminths/ parasitic worms are :

extracellular then what is very important in killing helminths ?

A

Th2 & humoral immunity very important, eosinophils and IgE are also very important in killing helminths

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24
Q

If protozoa and helminths/ parasitic worms are :

intracellular e.g () then what ?

A

plasmodium in malaria, Th1

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25
Q

List 2 examples of intracellular fungi

A
  • cryptococcus
  • pneumoycstis
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26
Q

Fungi is normally …I… and therefore ..II..

some intracellular fungi (Th1) such as ..III.. , ..IV.. and well known to cause infections when there is defective ..V.. (e.g. HIV)

A

I = extracellular
II = Th2

III = cryptococcus
IV = pneumocystis

V = cell mediated immunity

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27
Q

Viruses are intracellular and therefore are always =….I…. response

..II… cells are important for a viral response

…III… antigens expressed on the surface of infected cells and therefore ..IV… develop against the …V.. antigens - important for …VI… testing

IFN-y = …VII… response

A

I = cell mediated immune
II = NK
III = viral
IV = antibodies
V = viral
VI = serology
VII = cytokine

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28
Q

What cascade is important for bacterial infection ?

A

complement

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29
Q

List 4 examples of intracellular bacteria

A
  • Neisseria
  • salmonella
  • chlamydia
  • Mycobacteria
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30
Q

4 examples of intracellular bacteria

A
  1. neisseria
  2. salmonella
  3. chlamydia
  4. mycobacteria
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31
Q

What happens to bacteria that are intracellular ?

A
  1. Th1
  2. cellular immune response
  3. activation of APCs e.g. macrophages
  4. cytotoxic T cells
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32
Q

Bacterial infections are usually …. (therefore Th2 ->….response with B cells and….)

A
  • extracellular
  • humoral
  • antibodies
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33
Q

… Presentation takes place with the activation of ….

A
  • antigen
  • specific T helper cells (Th1, Th2)
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34
Q

What does the innate immune system trigger in order to contain an infection ?

A

an acute inflammatory response

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35
Q

What is IFN-y ?

A

interferons- gamma

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36
Q

What are Treg cells ?

A

regulatory T cells (Tregs) are T cells

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37
Q

Treg = T regulator cells

What role do Treg cells have ?

A

regulating or suppressing other cells in the immune system

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38
Q

What do Tregs control ?

A

immune response to self and foreign antigens & help prevent autoimmune disease

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39
Q

What do Treg cells suppress activation of ?

A

CD4+ and CD8+ T cells

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40
Q
  1. What do some bacteria have ?
  2. what does being encapsulated enhance for a bacteria ?
  3. what does being encapsulated inhibit for a bacteria ?

Therefore the body relies on other opsonins such as antibodies

A
  1. a capsule
  2. ability to evade phagocytosis
  3. binding of complement, and complement interactions with phagocytes (opsonisation)
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41
Q

Which 4 areas of the body are B cells found ?

A

spleen, peyer’s patches (ileum), tonsils, appendix

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42
Q
  1. B cells internalise …. that bind to their ….
  2. can also present ….
  3. when activated by a …cell, they undergo …., maturation and formation of …. cells
  4. Activated B cells mature into … and start to make…
  5. found in 4 areas of the body…
A
  1. antigens, B cell receptor
  2. antigens
  3. T, isotype switching, memory
  4. plasma cells, antibodies
  5. spleen, Peyer’s patches, tonsils, appendix
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43
Q

Hummoral immunity (Th2) is used to kill …1…. as :
antibodies …2… on ….3… surface
…4…pathogens
activates …5……pathway

A
  1. extracellular pathogens
  2. bind to antigens
  3. pathogen
  4. opsonise
  5. classical complement
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44
Q

Humoral immunity is the term for a specific adaptive immune response activated by …1..
leading to the production of …2…

A
  1. Th2 cells
  2. B cells and antibodies
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45
Q
  1. What are CD8+ cytotoxic T cells also referred to as ?
  2. they recognise …?
  3. release ..?
  4. induces ..?
  5. release what interleukin ?
A
  1. T killer cells or Tc cells
  2. antigen on presented by APC on MHC I
  3. perforin - makes hole in cell wall
  4. apoptosis of infected cells
  5. IFN-y
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46
Q

Cell mediated immunity (Th1) is used to kills what ? give examples

A

intracellular infections e.g.
* viruses
* intracellular bacteria
* fungi
* some protozoa (plasmodium, toxoplasma)

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47
Q

What is cell-mediated immunity a term for ?

A

a specific adaptive immune response activated by Th1 cells

48
Q

What does cell mediated immunity lead to ?

A

activation of antigen-presenting cells and a cytotoxic T cell response

49
Q
  1. What 2 cells can T helper (CD4+) cells be divided into ?
  2. What’s the difference between these 2 cells ?
A
  1. Th1 or Th2 cells
  2. differences:
    * Th1 cells - stimulate cellular immune response, secrete inflammatory cytokines, activate macrophages
    * Th2 cells - stimulate humoral immune response
50
Q

What are the functions of CD4+ Th cells ?

A
  • regulate immune response
  • release cytokines
  • allow B cells to mature
51
Q

What are CD8+ cytotoxic T cells primarily involved in ?

A
  • destruction of cells infected by foreign agents e.g. virsuses
  • killing of tumour cells expressing appropriate antigens
52
Q

What are CD8+ cells & CD4+ cells ?

A

CD8+ cells = cytotoxic T cells
CD4+ cells = T-helper cells

53
Q

What does antigen presentation process stimulate ?

A

T cells to differentiate primarily into either cytotoxic T cells or Th cells (CD8+, CD4+)

54
Q

What action of the MHC-antigen complex and TCR further control the immune response ?

A
  • MHC-antigen complex activates the TCR
  • T cell secretes cytokines
55
Q

What are the opportunities for the right T cells to be in contact with an APC carrying the appropriate peptide MHC complex increased by ?

A
  • circulation of T cells throughout the body (via lymphatic system & blood stream)
  • their accumulation (together with APCs) in lymph nodes
56
Q

When are T cells activated ?

A

when they encounter an APC that has digested an antigen and is displaying the correct antigen fragments (peptides) bound to its MHC molecules

57
Q

CD4 or CD8 molecule are T cell molecules known as co-receptor, which are required for antigen recognition alongised TCR.
1. Where is CD4 present & only binds to what ?
2. Where is CD8 present & only binds to what ?

A
  1. T helper cells, antigen-MHC II complexes
  2. cytotoxic T cells, antigen-MHC I complexes
58
Q

As well as the TCR, another T cell molecule is required for antigen recognition
1. what is this known as ?
2. these are either what molecules ?

A
  1. a co-receptor
  2. CD4, CD8
59
Q

T cell receptors (TCR):
1. TCR are specific for…
2. they only recognise an antigen if…., what is this known as ?

A
  1. specific not only for a particular antigen but also for a specific MHC molecule
  2. only recognise an antigen if a specific antigen with a specific MHC molecule is present : phenomenon called MHC restriction
60
Q
  1. Where does T cell maturation occur ?
  2. Any …. T cells with ….for self-antigens are …
  3. What happens to T cells that survive selection ?
  4. What can T cells that survive encounter ?
A
  1. thymus
  2. immature, receptors, removed
  3. mature and leave the thymus
  4. antigens
61
Q

List 6 adaptive immune cells

A
  • B cells
  • plasma cells
  • T helper cells (CD4+)
  • cytotoxic T cells (CD8+)
  • regulatory T cells
  • memory cells (T and B cells)
62
Q

Function of B cells as an adpative immune cells

A

humoral immunity

63
Q

Function of plasma cells as an adpative immune cells

A

mature B cells that secrete antibodies

64
Q

Function of T helper cells (CD4+) as an adpative immune cells

A
  • activate immune system
  • stimulate macrophages
  • pro-inflammatory cytokines
65
Q

Function of cytotoxic T cells (CD8+) as an adpative immune cells

A
  • cell mediated immunity
  • destruction of infected cells
  • induce apoptosis
66
Q

Function of regulatory T cells as an adpative immune cells

A

limit the immune system to prevent excessive damage

67
Q

Function of memory cells (T and B cells) as an adpative immune cells

A

‘remeber’ so can have a faster, more effective response on secondary infection

68
Q

What importance does the function of the adaptive immune response being able to recognise specific ‘non-self’ antigens have ?

A

distinguish them from ‘self’ antigens

69
Q

What are the 3 primary functions of the adaptive immune response ? & why that’s important

A
  • recognition of specific “non-self” antigens - distinguishing them from “self” antigens;
  • generation of pathogen-specific immunologic effector pathways - that eliminate specific pathogens or pathogen-infected cells
  • development of an immunologic memory - that can quickly eliminate a specific pathogen should subsequent infections occur
70
Q

When do NK cells become inhibited ?

A

when NK cells detect MHC-I on the surface of ‘self’ cells

71
Q

which cells are killed by NK cells ?

A

any cells with no MHC-I on the surface

72
Q

what do NK cells initiate ?

A

apoptosis

73
Q

If cells are infected with virus :
1. what is suppressed ?
2. what can NK cells release when the above is suppressed ?
3. to do what ?

A
  1. MHC-I
  2. toxic granules
  3. induce apoptosis
74
Q

Which response are NK cells part of ?

A

non-specific immune response

75
Q

There are different classes of MHC, which have different functions.

what are the classes and differences between them[found where, typically present what] ?

A

MHC class I molecules
* found on all nucleated cells (not just professional APCs)
* typically present intracellular antigens such as viruses

MHC class II molecules
* found on APCs
* typically present extracellular antigens such as bacteria

76
Q
  1. Where are MHC class I molecules found ?
  2. typically present as …?
A
  1. found on all nucleated cells (not just professional APCs)
  2. typically present intracellular antigens such as viruses
77
Q
  1. Where are MHC class II molecules found ?
  2. typically present as …?
A
  1. found on APCs
  2. typically present extracellular antigens such as bacteria
78
Q

How are antigens delivered to the surface of APCs?

A

major histocompatibility complex (MHC) molecules

79
Q

What are major histocompatibility complex molecules known as in humans ?

A

HLA = human leukocyte antigen

80
Q
  1. What does antigen presentation link between ?
  2. 2 examples of antigen presenting cells
  3. what do APCs display ?
A
  1. innate (antigen independent) and adaptive (dependent)
  2. dendritic cells, macrophages
  3. antigens on the surface for other immune cells to recognise
81
Q
  1. Acute inflammatory response = localise and contain the infection from …hours after onset before …occurs
  2. Initiated by …. cells, …. cytokines and …. system
  3. Initiates …., increased …. permeability
  4. release of ….mediators
  5. ….of neutrophils to the site of ….
A
  1. 4-96 , immune response
  2. innate immune, pro-inflammatory, complement
  3. vasodilation, vascular
  4. inflammatory
  5. migration, inflammation
82
Q

what is neutrophil chemotaxis ?

A

process where neutrophils are attracted to and migrate towards sites of infection in response to chemical signals called chemoattractants

83
Q

List 8 cytokines (interleukins, TNF, chemokines):

A

IL-1
IL-6
IL-8
IL-12
TNF-alpha
IL-4, IL-5 + IL-13
IFN-γ
IL-10

84
Q

activation of complement pathway and formation of C3 convertase induces what ?

A
  • inflammatory reactions
  • opsonisation
  • C5-C9 phagocytosis
  • lysis of target pathogens
85
Q

With inflammatory reactions what are the important mediators of inflammation ?

A

C5a, C4a, C3a

86
Q

3 complexes involved in opsonisation

A

C3b, C4b, C1q

87
Q

C5-C9 phagocytosis and lysis of target pathogens via what ?

A

Membrane attack complex

88
Q

What are the 3 different pathways of the complement system ?

A
  1. classical
  2. lectin
  3. alternative
89
Q

How many pathways can activate the complement system ?

A

3 different pathways

90
Q

In the complement system :

most of the proteins are normally …1…but in response to the recognition of …2… of microorganisms they become ..3…activated in an ….4…cascade - the activation of one protein enzymatically ….5… the next protein in the cascade

A
  1. inactive
  2. molecular components
  3. sequentially
  4. enzyme
  5. cleaves and activates
91
Q

what does the complement system refer to ?

A

a series of >20 proteins, circulating the blood and tissue fluids

92
Q

What is an opsonin ?

A

any molecule that enhances phagocytosis by marking an antigen for an immune response

93
Q

How do opsonin molecules usually bind ?

A

on one end to the receptor present in the antigen & on the other end to the receptors on the phagocytes

94
Q

what does the binding of opsonin molecules result in ? ultimately leading to what ?

A

different mechanisms , destruction or removal of the particular antigen

95
Q

2 examples of opsonins

A
  • MBL
  • complement proteins C3b
96
Q

what is the acute phase response ?

A

a rapid and nonspecific reaction of the body’s innate immune system to tissue injury, infection or inflammation

97
Q

During the acute phase response the liver produces…. such as… in response to …..like IL-6.

A
  1. PRRs (pattern recognitiion receptors)
  2. CRP and MBL
  3. proinflammatory cytokines
98
Q

How many PRRs are produced during the acute phase response ?

A

a number of PRRs

99
Q

What is acute phase response is stimulated by ? e.g.

A

pro-inflammatory cytokines e.g. IL-6 in response to injury

100
Q

Where are PRRs produced and released ?

A

p: in liver
r: into bloodstream

101
Q

what does CRP bind to ?

A

C-polysaccharide (phosphocholine)

102
Q

what does MBL bind to ?

A

mannose of pathogens

103
Q

Raised CRP levels in the blood is commonly used as a marker of what ?

A

infection and inflammation

104
Q

How can bacterial pathogens evade the immune system ?

A

by inhibiting TLR signalling

105
Q
  1. What PRRs are involved in the recognition of bacterial cell wall ?
  2. what do these PRRs detect ?
A
  1. NOD-like receptors detect the peptidoglycan on the cell wall
  2. TLR4 (Toll-like receptor) detects LPS
106
Q

2 examples of GN bacteria one being a spp

A

Enterobacteriaceae
Neisseria spp

107
Q

What happens when a PRR attaches to a PAMP ?

PRR = pattern recognition receptor
PAMP = Pathogen-associated molecular pattern

A

triggers a signalling cascade within the immune cells, leading to release of various cytokines

108
Q

List 3 cytokines that could be included in the various cytokines that are released when a PRR attaches to a PAMP

A
  • IL-1 (interleukin-1)
  • IL-6 (interleukin-6)
  • tumor necrosis factor-alpha (TNF-alpha)
109
Q

3 types of PRRs (pattern recognition receptors of immune cell) + an example

A
  • membrane bound PRRs e.g. toll-like receptors
  • cytoplasmic PRRs e.g. NOD-like receptors
  • secreted PRRs e.g. MBL (mannose-binding lectin) [regarded as member of C-type lectin family]
110
Q

Example of receptor that is membrane bound PRRs

A

toll-like receptor

111
Q

Example of receptor that’s cytoplasmic PRR

A

NOD-like receptors

112
Q

Example of receptor that is secreated PRRs ?

A

MBL (mannose-binding lectin) [regarded as member of C-type lectin family]

113
Q

What are PRRs ? what are they designed for ?

A

(immune cell) pattern recognition receptors
to recognise and bind to only non-self antigens

114
Q

What are PAMPs ?

A

Pathogen associated molecular pattern - found on surface of pathogens which leukocytes recognise as ‘foreign’

115
Q

5 examples of PAMPs and where each is found

A
  1. LPS (lipopolysaccharides) from GN bacterial cell wall
  2. peptidoglycan found in bacterial cell wall
  3. lipoteichoic acid in GP cell wall
  4. mycolic acid in acid fast bacterial cell wall (e.g. - M. tuberculosis)
  5. nucleic acid in viruses and bacteria
116
Q

…1…constantly travel around the body to see if there are any pathogens
Pathogens have …2…on the surface (e.g., peptidoglycan) that the …3.. recognise as ‘foreign’
Damaged cells have ..4…. so the …5… recognise them as injured.
The receptor on the surface of a ..6… that recognises ….7… is called a …8…

A
  1. Leukocytes
  2. Pathogen associated molecular pattern (PAMPs)
    3.leukocytes
  3. Damage associated molecular pattern (DAMPs)
  4. leukocytes
  5. leukocyte
  6. PAMPs and DAMPs
  7. Pattern recognition receptor (PRR)

infection (29 decks)

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