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Dermatology > Basic Skin Immunology > Flashcards

Basic Skin Immunology Flashcards

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Dermatology Board Prep flashcards
1
Q

What is the immunological function of keratinocytes in the epidermis?

A

Sense pathogens via cell surface receptors and help mediate an immune response.

Produce AMP that can directly kill pathogens

Produce cytokines and chemokines

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2
Q

Where have AMPs been found in high concentrations?

A

skin of patients with psoriasis

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3
Q

What is the function of cytokines and chemokine?

A

Recruit and regulate cells of the adaptive and innate immune system

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4
Q

What can keratinocytes by activated by?

A

UV light and sensitisers

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5
Q

What is the main skin resident immune cell?

A

Langerhans cells

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6
Q

Describe the roll of langerhans cells

A

Act as sentinels in the epidermis

Process lipid Ag and microbial fragments and present them to effector T cells

Help to activate T cells

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7
Q

Which type of T cells are found in the epidermis?

A

CD8+T

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8
Q

Which type of T cells are found in the dermis?

A

CD4 + and CD8+

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9
Q

What other types of T cells are found in the skin?

A

NK cells

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10
Q

What are the CD4+T cells associated with inflammation in psoriasis, atopic dermatitis and psoriasis and atopic dermatitis

A

Psoriasis: TH1
Atopic Dermatitis: TH2
Psoriasis and atopic dermatitis: TH17

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11
Q

Where are T cells produced and sensitised?

A

Produced: bone marrw
Sensitised: thymus

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12
Q

What does Ag recognition involve interaction with?

A

T cell receptor (TCR) and the Major Histocompatibility Complex (MHC)

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13
Q

Which co-recepors enhance the process of antigen recognition by T cells?

A

CD4+ Helper T cells

CD8+ Cytotoxic T cells (CTLs)

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14
Q

What do TH1 cells do?

A

Activate macrophages to destroy microorganisms

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15
Q

What do TH2 cells do?

A

Help B cells to make antibodies

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16
Q

What do CTLs do?

A

Kill infected cells directly

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17
Q

What dendritic cells are found in the dermis?

A

Dermal DC

Plasmacytoid DC

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18
Q

What is the roll of dermal DC cells?

A

Involved in Ag presentation and secreting cytokines and chemokines

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19
Q

What is the roll of Plasmacytoid DC cells?

A

Produced IFNa

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20
Q

What cell types other than DC are found in the dermis?

A

Macrophages
Neutrophils
Mast cells

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21
Q

What is the roll of mast cells in the dermis?

A

Effectors of IgE-mediated immune response (allergy)

Also activated by physical trauma/certain drugs/micro-organisms

22
Q

How do neutrophils get to the dermis?

A

Attracted by chemokines

23
Q

What does binding of mast cells to IgE cause?

A

Mast cell activation and release of inflammatory mediators?

24
Q

Name some preformed mediators from mast cells?

A

Tryptase, chymase, TNF, histamine

25
Q

Name some newly synthesised mediators from mast cells?

A

IL (3,5,6,8,13,16,18), TNF, TGFβ, IFNγ, PGD2, PGE2, LTB4, LTC4, VEGF, bFGF, IP-10, MIP-1α, MIP-1β.

26
Q

Which chromosome is MHC coded on?

A

6

27
Q

Where is MHC I found?

A

Almost all cells

28
Q

What does MHC I do?

A

Present Ag to cytotoxic T cells

Present endogenous Ag

29
Q

Where is MHC II found?

A

APC (B cells, macrophages)

30
Q

What does MHC II do?

A

Present to TH cells

Present exogenous Ag

31
Q

What is MHC important in?

A

Immunological recognition & transplant rejection.

Control the immune response through recognition of ‘self’ and ‘non-self’

32
Q

What is psoriasis triggered by?

A

Environmental factors in genetically sensitive people

33
Q

What is the Koebner phenomenon?

A

formation of psoriatic skin lesions on parts of the body that aren’t typically where a person with psoriasis experiences lesions. This is also known as an isomorphic response.

34
Q

What is the hallmark of skin lesions in psoriasis?

A

inflammation

35
Q

What is present on psoriasis skin?

A

Defensince, cepahicidins; self made antibiotics

36
Q

What happens with the keratinocytes are under stress?

A
  • release factors that stimulate pDC to produce IFNα
  • release IL-1β/IL-6 and TNF
  • Chemical signals activate DC, which migrate to skin draining lymph node to present to and activate T cells
  • > TH1 & TH17
  • T cells are attracted to the dermis by chemokines and secrete IL-17A/17F/22
  • > Stimulates KC proliferation, AMP release and neutrophil-attracting chemokines
  • CD8+ cells also contribute to pathogenesis.
  • Dermal fibroblasts become involved, which release KC and epidermal growth factors.
37
Q

Describe the autoimmune disease systemic lupus erythematosus

A

faulted apoptosis and cells breakdown, causing accumulation of DNA, there is no autoantibodies to your own DNA and the immunological tolerace is broken down and the result is autoantibodies to your own DNA- certain types of lupus are triggered by UV exposure; this is why there are skin limited forms and even in systemic lupus sun exposure makes it much worse

38
Q

What mediates type I hypersensitivity?

A

Antibody mediated: IgE.

39
Q

Describe early exposure in type I hypersensitivity?

A

Early exposure to allergen causes the production of IgE, which binds to FcεR1 receptor on mast cells.

40
Q

Describe later exposure in type I hypersensitivity?

A

Later exposure causes rapid crosslinking of the receptors, signal transduction and degranulation of the mast cell.

41
Q

Describe the visual early response in type 1 hypersensitivity?

A

minutes (wheal & flare)

42
Q

Describe the visual late response in type 1 hypersensitivity?

A

hours (cellular infiltration, nodule)

43
Q

What mediates type II and III hypersensitivity?

A

Antibody mediated: IgG, IgM

44
Q

What are type II mechanisms important in?

A

autoimmunity & transplantation
> Haemolytic disease of the newborn
> Blood transfusion recipients

45
Q

What does skin testing in type III cause?

A

Arthus reaction, which is slower than a type I skin response, but faster than a type IV skin response

46
Q

What mediates type IV hypersensitivity?

A

Cell mediated: TH1 cells.

-T cell-mediated response, which then recruits other cells to the site.

47
Q

When does type IV hypersensitivity reaction peak?

A

24-48h after contact with Ag.

48
Q

What factors in organ transplantation affect skin immune response?

A

Immunosuppression

49
Q

What factors in sunlight/UV affect skin immune response?

A

Immunosuppression

Structure

50
Q

What factors in ageing affect skin immune response?

A

> Changes in skin structure (access)

> Decreased ability to detect malignant cells- Cancer

> Decreased ability to detect Ag- Infection risk

> Decreased ability to distinguish “self” from “non-self”(tolerance)- Autoimmunity

Dermatology (15 decks)

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