9. Mechanisms of tolerance Flashcards

1
Q

What is immune system tolerant to?

A

Immune system is tolerant to self (self-tolerance)

Immune system is tolerant to harmless antigens such food or environmental ag

Immune system is tolerant to commensal microbiota

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is immunological tolerance?

A

Immunological tolerance refers to the mechanisms by which lack of immunological reactivity is induced and maintained

Like immunity, tolerance is antigen specific (unlike immunosuppression)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do T cells recognise antigens?

A

Through TCR

Express TCR/CD3 (plus CD4 or CD8)

Recognise self MHC
Recognise peptide ag

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is significant about the T cell repertoire regarding tolerance?

A

The primary repertoire of T cells (and B cells & BCRs) is enormous as a result of combinatorial diversity

This repertoire contains self-reactive TCRs (*) and yet a normal immune system does not exhibit self-reactivity (i.e. autoimmunity).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where does T cell development initially take place?

A

Lymphoid progenitors migrate from the bone marrow to the thymus where they develop into mature T cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Role of thymus in T cell differentiation

A

The thymus is absolutely required for the differentiation of immature precursor into mature T cells.
Children without thymus (Di-George syndrome) or mice lacking a thymus (nude mice) do not have mature T cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How does the thymus change with age?

A

The human thymus is fully developed before birth and increases in size during puberty

Thymus is most active in the young and it atrophies markedly with age

It progressively shrinks (fat replaces areas where thymocytes existed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What happens to the thymus by age 30

A

Degeneration is complete by the age of 30, but residual thymic activity persists until advanced age

The reduced production of T-cells does not completely impair immunity. Once established the repertoire of the T-cells is long-lived

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is immunosenescence

A

immunosenescence : progressive deterioration of immune responses mainly associated with age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What happens to TCR genes in the thymus?

A

they undergo DNA rearrangement in thymus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why is a mechanism for repertoire selection and self-tolerance needed?

A

Generation of the TcR repertoire involves many random mechanisms to allow diversity

The specificity of TcR in the immature repertoire is also random & will include cells with receptors that are:

  1. Harmful - negatively selected
  2. Useless - neglect
  3. Useful - positively selected
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which cells will form the peripheral T cell pool?

A

Only cells that bear antigen receptor with appropriate affinity for the peptide presented in self MHC complexes complete their maturation and form the peripheral T cell pool

Naïve T cells 
which are:
self MHC restricted 
and 
self tolerant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Where do most T cells die?

A

T cells mature in the thymus but most die there.
98% of cells die in the thymus without inducing any inflammation or any change in the size of the thymus.

Thymic macrophages phagocytose apoptotic thymocytes.
5x10^7 go in per day but only 2x10^6 leave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Where does T cell development occur?

A

T cell development occurs in defined thymic microenvironment

Thymic stroma (epithelial cells + connective tissue) provides the microenviroment for T cell development and selection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are thymocytes associated with?

A

Thymocytes are intimately associated with epithelial cells as they develop in the thymus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does the T cell screening system involve?

A

Discrete forms of selection

Positive selection and negative selection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Positive selection

A

Retention of thymocytes expressing TcR that are RESTRICTED in their recognition of antigen by
self MHC
i.e. selection of the USEFUL

18
Q

Negative selection

A

Removal of thymocytes expressing TcR that either recognise self antigens presented by self MHC
i.e. selection of the HARMFUL

19
Q

Steps of positive selection

A

T cells from bone marrow negative for CD4,CD8,TCR: double negative go into thymus

in thymus: somatic rearrangement of genes encoding for b and a chains of TCR and expression of both CD4 and CD8 (small non-dividing cortical thymocytes, short life-span).

Thymocytes express TCR
Thymocytes able to recognise self MHC expressed on the surface of cortical epithelial cells SURVIVE

Induction to survival, differentiation, maturation (long-lived cells).

Those who cannot, DIE (apoptosis by dendritic cells)

20
Q

Central tolerance steps

A

Positive selection: MHC restriction, get rid of those that bind too weakly

Negative selection: tolerance induction - get rid of those that bind too strongly

21
Q

What T cells does the thymus accept?

A

The thymus accepts T cells that fall into a narrow window of affinity for MHC molecules

22
Q

Where do positive and negative selection occur?

A

Positive and negative selection occur in distinct thymic microenvironments after interaction with different types of thymic stromal cells

Positive - using cortical epithelial cell in cortex
Negative - using dendritic cells in cortico-medullary junction

23
Q

How can the thymus express all self antigens – including self antigens only made by specialised tissues?

How do we become self tolerant to these antigens?

A

Transcription factor expressed at high levels by thymic medullary epithelial cells

Mutations of AIRE lead to autoimmune polyendocrinopathy with candidiasis and ectodermal dysplasia (APECED), also called autoimmune polyendocrine syndrome (APS-1)
Mouse knockout: failure to express many self antigens in the thymus and expression of autoantibodies

24
Q

How is self-tolerance established to antigens that

cannot be expressed in the thymus?

A

T cells bearing TcR reactive with proteins expressed in the thymus are deleted.
Some self proteins are not expressed in the thymus e.g. antigens first expressed at puberty
Self tolerance needs to be induced and maintained outside the thymus

-> PERIPHERAL TOLERANCE

25
Q

Peripheral tolerance

A

Tolerance to foreign antigens is induced and maintained in mature lymphocytes

Not all potential ‘self’ molecules are present in the thymus during TCR development
eg lactose, insulin, antigens first expressed at puberty etc etc …

Don’t want to make an immune response against harmless things / food

Don’t want excessive lymphocyte activation and tissue damage during normal protective responses against infections

Auto-immunity/allergy - breakdown of peripheral tolerance: the immune system responds to self or environmental ag

26
Q

mechanisms of peripheral tolerance

A

IGNORANCE:
lymphocytes fail to recognise or respond

CLONAL ANERGY:
binding of ag makes lymphocyte unresponsive

CLONAL EXAUSTION:
continued stimulation by persistent antigen may ‘wear out’ responsive cells

SUPPRESSION:
interaction with other cells (or cytokines) may inhibit responsiveness

27
Q

Clonal ignorance

A

self reactive lymphocytes fail to recognise or respond to some self antigens in the periphery
cells neither die nor become anergic

28
Q

What is immune privilege?

A

Self -reactive T cells sometimes ignore ag

antigens anatomically sequestered from the immune system: T cells cannot reach cells bearing the ag
Tissue grafts placed in these sites are not rejected

immunologically privileged sites
(eye, testis, uterus/placenta)

if sequestred ag is released autoimmunity can result (many vasectomised males have anti-sperm Abs)

29
Q

Eye as an immune-privileged site

A

Eye anterior chamber is an immune-privileged site. Normally, self-antigens in this site are not exposed to the immune system
Physical trauma in one eye can initiate autoimmune response to both eyes. This can cause blindness in the both damaged and undamaged eyes: Sympathetic ophthalmia

30
Q
  1. Induction of anergy
A

presentation without costimulation
CTLA-4 signaling

CD28 and CTLA-4 have opposing functions

Knockout of CTLA-4 in mice and heterozygous mutation in humans results in immune dysregulation (lymphoproliferation, multi-organ inflammation)

31
Q

Therapeutic application of CTLA-4

A

Blocking CTLA-4 promotes tumor rejection
CTLA-4 limits immune responses to tumors

Administration of antibody that blocks CTLA-4 in
tumor-bearing mouse leads to tumor regression

Anti-CTLA-4 antibody is approved for tumor immunotherapy (enhancing immune responses against tumors)
Even more impressive results with anti-PD-1 in cancer patients

32
Q

Activation-induced cell death (AICD)

A

Repeated stimulation of T lymphocytes by persistent antigens results in death by apoptosis of the activated cell

Elimination of T cells specific for abundant peripheral antigens: Clonal exhaustion (expression of inhibitory receptors on exhausted T cells, e.g. CTLA-4, PD-1)

33
Q

suppression

A

Treg cells are critical components in the maintenance of peripheral tolerance through “suppressive” mechanisms

Tregs suppress the activation of effector responses and are critical for regulating homeostasis and tolerance to self antigens

34
Q

Treg deficiency

A

Deficiency of T regulatory cells is associated with aggressive autoimmunity IPEX [Immunodysregulation, Polyendocrinopathy and Enteropathy, X-linked syndrome]: fatal autoimmune disorder characterised by systemic autoimmunity in the first year of life

35
Q

Treg clinical application

A

Critical role of Treg in promoting tolerance
may be exploited to:

strengthen or re-establish self-tolerance
in autoimmune disease

induce tolerance to non-self-antigens
in organ transplantation, GVHD and allergy

Induce tumour immunity in cancer patients

36
Q

What determines whether an antigen is tolerogenic or immunogenic

A

the same antigen can be
tolerogenic or immunogenic,
depending on how/when/where it is encountered

How the antigen is presented to lymphocytes:
concentration
timing
persistence
tissue distribution
nature of the cell presenting the antigen
How the responses of specific lymphocytes to that antigen are regulated

37
Q

Antigen properties

A

Molecular weight
Smaller, soluble, not-aggregated molecules favors tolerance
large, aggregated, complex molecules favors immunogenicity

Dosage
very small or large favors tolerance
intermediate favors immunogenicity

Routes of administration
Oral, intratracheal, orbital exposure can activate T cells to secrete TGFbeta (Tregs).

38
Q

Oral tolerance

A

Interaction of food proteins with gut-associated lymphoid tissue (GALT) in the intestinal transit is the essential prerequisite for oral tolerance.

Different cells of the immune system participate in oral tolerance induction, with regulatory T cells being the most important.

39
Q

Clinical applications of oral tolerance

A

clinical trials :

Disease				Antigen	
Multiple Sclerosis (MS)		Myelin Basic 						Protein (MPB) 

Rheumatoid Arthritis (RA) Type II collagen

Type I Diabetes Insulin

40
Q

Hyposensitisation ImmunotherapyOral immunotheraphy (OIT)

A

using small amount of allergens (food, pollen) to induce antigen specific tolerance

continuous administration of the allergen, rather than its elimination, to promote the development and maintenance of tolerance

Oral/sublingual desensitisation immunotherapy for peanut allergy holds promise for the control of allergy

Note: Sensitization to food antigen can occur through cutaneous exposure!