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immuno test 2 > All of them! > Flashcards

All of them! Flashcards

1
Q

Proper response to fungi

A

Neutrophils, Th1 - granuloma

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2
Q

Cyclosporine?

A

Drug for immunosuppression - inhibits IL-2 and INF-gamma

Nephrotoxic

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3
Q

Treating acute GVHD

A

Remove mature T cells from bone marrow in vitro

Treat with anti-CD3 Ab

This also reduces chance of engraftment…

Some GVHD good b/c rids pt of remaining cancers

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4
Q

Autologous bone marrow transplantation

A

Administer G-CSF (granulocyte colony stimulating factor)

Puts bone marrow stem cells to blood, extract it, can use later as bone marrow transplant stuff

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5
Q

How does trophoblast keep NK cells from killing it?

A

Trophoblast cells lack paternal MHC

HLA-G, an MHC 1-like protein, prevents NK activation where no MHC expression occurs

Secrete TGF-beta

Prevent tryptophan from crossing placenta - starves T-cells
- done by INDOLAMINE 2,3-DIOXYGENASE

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6
Q

Abnormalities predisposing to autoimmune diseases

A

Abnormalities of lymphocytes and APC’s

Genetic predisposition

Microbial infections (viruses)

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7
Q

What causes rheumatic fever?

A

Cross-reaction of streptococcal Ab with heart valve tissue

molecular mimicry

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8
Q

Cell types of sarcomas, lymphomas, leukemias

A

muscle, fat, fibroblasts
lymphoma - solid lympoid tissue
leukemia - lymphocytes and hematopoietic cells

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9
Q

Tumor Specific Antigen

A

unique to particular tumor, not present in other cell types
due to point mutations/gene rearrangements

not common in human tumors

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10
Q

Tumor Associated Antigens

A

Antigens shared by different tumors, also found on normal tissues

Oncofetal antigens - on fetal tissues, not adult tissues
Alpha fetal protein - certain liver cancers
Carcinoembryonic antigen - increased in colon cancer and smokers

NOT THERAPEUTIC TARGERS; USEFUL FOR DETECTION AND MONITORING TREATMENT

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11
Q

Differentiation antigens

A

Aid in diagnosing tumor cell origin of certain tumors

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12
Q

Does immune system respond to spontaneous tumors?

A

Not really

Rarely cause inflammation, don’t elicit co-stimulatory molecules; many tumors don’t express unique antigenic peptides

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13
Q

What is most effective immunologic response against virus-induced tumors?

A

CTL!

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14
Q

What do NK cells do with tumors? How are they activated?

A

Lyse cells of hematopoietic and viral origin

ADCC may be important

Activating signal: downregulation of I MHC
Interferons, TNF-alpha, and IL 2 (turns NK cell into LAK cell)

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15
Q

How do macrophages kill tumor cells?

A

ADCC

release of TNF-alpha

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16
Q

Tumor evasion strategies

A

Lack of expression of MHC/mutated MHC
Induce tolerance

“Sneaking through” - the tumor is the one cell the immune system can’t catch

Create their own “immunopriveleged site” by encasing in collagen and fibrin

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17
Q

How can you vaccinate against tumor cells?

A

Treat tumor cells with specifically increased immunogenicity; effective against melanoma antigens in clinical studies, incudes CTL’s

Hep B vaccine

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18
Q

Ab therapies against tumors

A

w/B cell lymphoma: Anti-idiotypic Ab to surface immunoglobulin

Ab against growth factor receptors of tumor cells (Herceptin)

Bi-specific antibodies - genetically engineered to recognize 1 tumor Ag and 1 immune cell

Immunoconjugates

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19
Q

What’s an immunoconjugate?

A

Ab coupled with toxins - specific delivery to tumor cell. (Have to use true tumor-specific Ag, and F(ab’)2 fragments must be used to avoid non-specific binding)

But - the conjugate must be endocytosed

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20
Q

How can you “purge” bone marrow of tumor cells?

A

In vitro - anti-tumor antibodies and complement

Used with autologous bone marrow transplantation in B cell lymphoma pt’s after chemo and radiation

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21
Q

Adoptive cell immunotherapy - making LAK’s

A

Culture NK cells in lots of IL-2 –> LAK cell

Reinfuse LAK cell to pt, kills tumors

Most success with renal cell carcinoma, malignant melanoma

Doesn’t work so well when you just dose the pt with IL-2 (or TGF-alpha)

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22
Q

What happens when you’re infected with HIV? (from 1 week to 10 years)

A

First few weeks - feel sick; acute illness
Seroconversion
Latent phase - up to 10 years

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23
Q

What’s seroconversion?

A

When you start making HIV Ab
“window period”
HIV Contagious, but can’t detect infection

24
Q

What’s ARC? (AIDS)

A

AIDS Related Complex

Subset of pt’s develop it; fevers, night sweats, weight loss, diarrhea, inflammatory skin…possible candidiasis; w/o treatment, you die

25
Q

Clinically, what determines AIDS?

A

CD4+ dropping below 200 cells/mm3

26
Q

What’s gp120?

A

Protein on HIV

Uses gp120 to attach to CD4 T cells or mononuclear phagocytes

27
Q

What happens after HIV binds to CD4 cells via gp120?

A

The virus then uses gp41, binds to CXCR4 or CCR5 (depending on strain)

Fuses with envelope

28
Q

Where are CCR5 or CXCR4 expressed?

A

CCR5 - CD4+ T cells, macrophages, dendritic cells

CXCR4 - activated T cells

29
Q

What’s one mechanism HIV uses to get from T cell to T cell?

A

During viral replication, the plasma membrane expresses HIV gp120

gp120 binds to CD4, initiates membrane fusion

30
Q

Say you were to get rid of all a person’s HIV-infected T cells. Are they rid of HIV?

A

No, because HIV also infects monocytes and macrophages

These cells aren’t susceptible to lysis, but still serve as in “in vivo” reservoir

31
Q

How does HIV kill T cells? (6 ways)

A

Direct lysis via budding of HIV (loss of membrane)

Large quantities of viral DNA toxic to a cell

Syncytia formation of infected cells w/uninfected cells - can destroy lymphocytes

Autoimmune - binding of gp120 to infected/uninfected cells can lead to ADCC

CTL-mediated destruction of infected cells

gp120 cross-linking with CD4 can cause apoptosis

32
Q

HIV uses 2 other way to inactivate T cells/depress . What are they?

A

Free gp120 can bind to all the CD4 protein of an uninfected T cell, preventing MHC II presentation

Destroys follicular dendritic cell network, which destroys architecture of lymphoid organs

33
Q

Why is humoral and cell-mediated responses ineffective against HIV?

A

HIV remains latent

HIV has high mutation rate

You seroconvert, but CTL’s more important against HIV

34
Q

Obstacles to forming HIV vaccine

A

It’s so darn diverse

There isn’t a good animal model

We don’t get why the virus progresses in the face of an immune response. It just doesn’t make sense, ok!?

35
Q

How are people resistant against HIV?

A

Malformed CCR5 protein

Vigorous CTL response

36
Q

Who is ELISA?

A

Cheap way of determing HIV infection

HIV antigens bound to well of plate, your serum injected to well, then color-changing secondary Ab added

Color change = infection

37
Q

What’s wrong with ELISA? (ag form)

A

Lots of false positives, from people who are reacting to the MHC proteins of H-9 cell line

pregnant females, autoimmune diseases, tranfusion pt’s…

Use ELISA (Ag form) up to 3 months after infection (before virus goes latent) and then after AIDS develops

38
Q

Western Blotting

A

Same thing as ELISA, ‘cept you separate the proteins first

Can differentiate which proteins are MHC and HIV

39
Q

What’s the ideal vaccine?

A 
No side effects
Easy to administer
Highly immunogenic
Highly protective
Long-term immunity
40
Q

Tell me about live, attenuated viruses - and give examples

A

Pass virus strain through animal, weakens potency

Sabin polio vaccine
Measles
Mumps
Rubella
Yellow fever

Long lasting immunity! Virus undergoes limited replication, resulting in greater antigenic stimulus

41
Q

Which vaccines produce cell-mediated immunity (CTL’s)

**IMPORTANT FOR TEST!!!**

A

ONLY LIVE, attenuated viruses

Everything does Ab production; only live viruses get CTL’s as well

42
Q

Bad things about attenuated viral vacines?

A

Virus can revert to full -fleged virus

FATAL in immunocompromised (SCID)

Potential risk to fetus

43
Q

What are inactivated viral vaccines?

Give examples

A

Virus has been chemically treated and inactive. Not as much protection of live vaccines

Influenza - shot form
Rabies
Polio (Salk polio)

44
Q

Viral vaccines - subunit?

Example?

A

Single viral protein

Hep B surface antigen

45
Q

Inactivated bacterial vaccines

A

Heat killed bacteria

pertussis (cellular vaccine)

Pretty nasty side effects, including death

Pertussis reformulated to be acellular; lots better

46
Q

What’s a toxoid? What’s special about these vaccines

A

A “detoxed” toxin which still maintains immunogenicity

Diptheria and Tetanus

Actually, if you give a toxoid to an immunocompromised person, they don’t die! Though it doesnt’ do any good

47
Q

Bacterial conjugate vaccine?

A

Takes a bacterial polysaccharide, conjugates it with protein carrier - get high IgG response

Normally, polysaccharides don’t form IgG

Highly tested on boards

Hemophilus influenzae B
Pneumonia (strep pneumonia)
Neisseria Meningitis

48
Q

What do you give an infant born to Hep B surface Ag+ mom?

A

Vaccine AND Hep B immunoglobulin within 12 hours of birth at separate injection sites

49
Q

Does the pertussis vaccine prevent whooping cough infection?

A

No

Serum Ab generated to vaccine antigens WILL NOT ERADICATE BACTERIA, but instead neutralize toxins that cause disease

Organisms eliminated by hose defense mechanisms

50
Q

What type of vaccine is the hemophilus influenzae type B vaccine?

A

Polysaccharide + Protein conjugate vaccine

Get memory T response, affinity maturation, and isotype switching to IgG

51
Q

What is the hemophilus influenzae type B vaccine conjugated with?

A

Actually, Tetanus or diphteria or meningitis toxoid

These are already proven safe…why try something new?

52
Q

What type of vaccine is the MMR?

A

Live, attenuated vaccine

We’re immunized against rubella is only to protect fetuses, actually

Contraindicated in immunocompromised and pregnant

53
Q

What type of vaccine is varicella vaccine (chickenpox)?

A

Live, attenuated (viral)

No chance of increased risk of shingles

98% effective in protecting against severe form of disease, but only 70-85% protected against mild form of disease

54
Q

Rotavirus vaccine?

A

live, attenuated

Diarrheal pathogen in children

55
Q

Pneumococcal vaccine?

A

Conjugate

56
Q

Flu Vaccine?

A

Two types: nasal spray = attenuated

Shot = inactivated

57
Q

HPV vaccine?

A

“L1 protein-expressing virus-like particles”
“L1 - major capsid protein of HPV”

whatever that means…

immuno test 2 (5 decks)

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