acquired immunodeficiency disorders. Flashcards
the immune system is coordinated by four powerful immune modulators what are they /
hormonal glucocorticoids
cytokine system - interleukins and interferons
network connectivity - idiotypic and antiidiotypic response
antigen response
what is the affect of glucocorticoids in the immune system ?
acton on immune cell trafficking , cytokine synthesis
administration of corticosteroid have what immune trafficking changes changes ?
changes in circulating leukocyte population
lymphocytopenia = maximal for 4-6 hours and return to normal by 24 hours
T cells are affected more than b cells
TCD4 cells are more affected the TCD8 cells
monocytopenia
neutrophiliia = due to reduction of cells and release of mature stored cells in the bone marrow
administration of corticosteroids have what affect on t cell activation and cell maturation
(T cell activation and proliferation inhibited
not responsive to IL-1 AND therefore unable to synthesise IL-2
inhibit the early stage of b cell maturation by blocking monocytes and t cells )
have lift affect on mature b cells
inhibit production of IL-1 and TNF by monocytes
do not block the affects of cytokines on phagocytosis = they can actually promote it
binding of interferon gamma and expression of HLA-DR molecules and FC receptors may be increased in low doses
what are the corticosteroid affect on cytokines ?
inhibit the synthesis of cytokines but NOT THEIR FUNCTION
reduce IL-1, IL-2 , 4,6,10
TNF-A , IFN-Y
= major consequence of t cells activation inhibition
what is the effects of cyclophosphamide on the immune system ?
affects lymphocyte numbers and PMN cells remain unchanged
low dose ORAL THERAPY affect on cell mediated response
BOLUS intermittent treatment effect on antibody production
(CYTOTOXIC - their FUNCTION S AFFECTED )
cyclophsophamide is used to treat what type of disease
autoantibody disease and allograft ejection
what is the effects of azathioprine on the immune system ?
affects the dna synthesis
cyclophosphamide is CYTOTOXIC AZOTHRIPINE IS CYTOSTATIC
it is only active on dividing cells
modest reduction in T AND B CELLS
NK cell activity surpassed
humeral immunity and delayed hypersensitivity are not altered
what is the effects of methotrexate on the immune system ?
structural analogue of folic acid and block folic acid dependant dna synthesis
(immunoglobulin synthesis is reduced after prolonged treatment - after three months )
inhibitor of PMN = anti-inflammatory effects
inhibitory effect of arachidonic acid = anti-inflammatory effects
reduction in CRP AND ESR -
what is the immune effects of cyclosporin and tacrolimus fk506 and rapamycin ?
three drugs has effect on T cell singling and T cell function
they bind to cytoplasmic proteins called immunophillins = which are involved intending signals from cell surface to cell nucleus
rapamycin blocks T cell proliferation
what are the main drugs which causes immunodeficiency ?
corticosteroids cyclophosphamide azathioprine methotrexate cyclosporin tacrolimus rapamycin
what are other causes for immunodeficiency from the environmental factors ?
malnutrition
infection -AIDS
nutrition does not affects the immune reaction to all infections equally what are some infections where nutrition is important ?
influenza and HIV
which tissues are most affected by malnutrition ?
lymphoid tissues - lymphoid atrophy is an indication for malnutrition
extend of damage depends on the cell proliferation , amount and rate of protein synthesis ,and role of individual nutrients in critical metabolic pathways
which lymphoid tissue suffers great in malnutrition and describe the changes from normal ?
the thymus
the lobular structure is more ill defined and loos of corticomedually demarcation, fewer lymphoid cells
periarteriolar areas of the spleen
paracortical section of the lymph nodes
