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Respiratory system > Allergy and asthma > Flashcards

Allergy and asthma Flashcards

1
Q

Innate immunity timeline

A

6-12 hours

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2
Q

Adaptive immunity timeline

A

12 hours to week

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3
Q

Helper T cell activation and action

A

Antigen recognition - MHCII and CD4+

Clonal selection to effector cells and memory T cells

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4
Q

How do Treg cells form?

A

CD4+

IL-2 and TGF-beta

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5
Q

What do Treg cells do?

A

Release TGR-beta, IL-10, IL-35, STAT6 and FOXP3
Suppresses tumour immunity
Promotes immune tolerance
Maintains lymphocyte homeostasis

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6
Q

How do TH1 cells form?

A

CD4+

IL-12

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7
Q

What do TH1 cells do?

A 
IFN-gamma
LT-alpha
STAT4
T-bet 
Promotes tumour immunity
Intracellular pathogens
Drives autoimmunity
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8
Q

How do TH2 cells form?

A

CD4 cells

IL-4

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9
Q

What do TH2 cells do?

A

IL-4, IL-5, IL-13, STAT6, GATA3
Extracellular pathogens
Allergy
Asthma

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10
Q

How do Th17 cells form?

A

CD4 cells
TGF-beta
IL-6
IL-21

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11
Q

What do TH17 cells do

A 
IL-17A
IL-17F
IL-22
IL-21
CCL20
STAT3
Controversial tumour immunity
Breaks immune tolerance
Extracellular bacteria
Autoimmunity
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12
Q

How do Treg cells maintain balance between TH1 and TH2

A

Release IL-10 and TGF-beta

TH1 and TH2 suppress eachother

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13
Q

What happens in allergic reaction

A
  • TH2 dominant to TH1
  • Humoral response is IgE secretion
  • IgE = death of helminth cells
  • Eosinophils destroy helminths and get rid of worms
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14
Q

How are eosinophils activated?

A

TH2 + IL-5 -> IgE

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15
Q

What happens when you encounter an antigen for the first time?

A

DC present on MHC ii to naive T cell
Differentiation and clonal expansion occurs
Produce IL-4, IL-13 which acts on B cells to produce IgM
IL-4 and IL-13 cause class switching to produce IgE and memory B cells by clonal expansion
B cells can activate T cells to enter system

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16
Q

Where are IgE Fc receptors found?

A

Mast cells in tissue (most)
Basophils in blood
B-lymphocytes but less so

17
Q

What happens when you are re-exposed to an antigen?

A

IgE on mast cells and basophils
Cross links with at least 2 Fc-e0R1 receptors to prevent misfiring
When this happens, mast cells/basophils degranulate

18
Q

What does histamine do?

A

Vasodilation, vascular leakage, bronchoconstriction

19
Q

Second phase of allergic reaction

A
  • Calling in basophils and eosinophils by increased inflammatory cell migration and activation
  • Takes basophils up to 6 hours to appear at site of exposure - biphasic reaction at 6 hours
  • Keep children who have allergic reaction in hospital for 6 hours
  • Can lead to chronic inflammation because of leaky vessels from TNF-alpha
20
Q

Eosinophils

A
  • Elevated in lungs and blood in asthma
  • Allergy and parasitic infections
  • Activated by cytokines
  • Release toxins, leukotrienes and cytokines
  • Activation causes bronchial hyperactivity
21
Q

Chronic allergic reaction

A

Persistant inflammation
Prolonged/repetitive exposure to antigens
Large numbers of innate and adaptive immune cells
Fibroblasts - implicated in normal healing process and scar formation, thickening of basement membrane

22
Q

Cause IgE response

A
  • Hives - drug, hormones, genetics, illness, food, stress
  • Drugs - antibiotics, NSAIDs, biological treatments, contrast agents, blood
  • Infection, chronic parasites, cutaneous fungal infections
  • Viruses - acute viral syndrome, hepatitis, Ebstein Barr virus, HSV
  • Bacteria - streptococcal, Coxsackie, H. pylori
  • Foods - nuts, milk, eggs, wheat, soy, fish, shellfish, sesame
23
Q

Clinical presentation of asthma

A
  • SOB (exercise, interval)
  • Expiratory wheeze
  • Nocturnal cough
  • Episodic
  • Reversible
  • Diagnosis based on likelihood and assessment
  • Rationale for diagnosis needs documentation
24
Q

Asthma triggers

A
  • Hyperventilation in teenagers
  • Viral induced wheeze
  • Primary ciliary dyskinesia
  • Bronchiectasis
  • CF
  • Vocal cord dysfunction
  • Persistent bacterial bronchitis
25
Q

Hypothetical causes of atopy

A 
Breast milk
Infant formula
Vaccination history 
Pets/animals
Family background

Respiratory system (23 decks)

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