Diseases of the Immune System V Flashcards
p24
capside protein in HIV
-target for antibodies for diagnosis of HIV
enzymes of HIV
protease
reverse transcriptase
integrase
p17
matrix protein in HIV
gp120 and gp41
two viral glycoproteins on viral envelope
targets of HIV infection
CD4 T cells and CNS
infection of cells by HIV
gp120 - bind CD4
also, gp120 - binds CCR5 and CXCR4
R5 strains
M-tropic
X4 strains
T-tropics
gp120
binds CD4
conformation change to receptors for chemokines
gp41
attached to gp120
inserts into membrane with gp120 activation
fuses with membrane
viral replication
reverse transcription to synthesis of double strand DNA
naive T cells and HIV
have APOBEC3G
introduces mutations into HIV genome
-ineffective to infect naive cells
NF-kappa-beta
gene transcribed with T cell activation
this is bound by the HIV genome
-allowing HIV to thrive when T cells and M0s are activated
synctia
fusion of T cells forms giant cells
-in T-tropic X4 type of HIV-1
cells infected with HIV
CD4 cells
T cells, M0s, dendritic cells
reservoirs of HIV
M0s
follicular dendritic cells
CNS cells and HIV
macrophages and microglia
almost exclusively M-tropic
course of HIV
begins with acute infection - acute retroviral syndrome
middle, chronic phase - asymptomatic
clinical AIDs
HIV specific CD8 cells
detected in blood when viral titers fall
-initial containment of HIV infection
acute retroviral syndrome
3-6 weeks after infection
-resolves 2-4 weeks
myalgia, sore throat, fever, weight loss (flu-like)
viremia
HIV in blood
-in acute retroviral syndrome
clinical latency
asymptomatic
- number of CD4 cells declines
- host defense eventually decreases
progression to AIDs
long lasting fever
fatigue
weight loss
diarrhea
clinical presentation of AIDs
fever weight loss diarrhea lymphadenopathy neurologic disease secondary neoplasms
candidiasis
most common fungal infection with AIDs
oral cavity, vagina, esophagus
cytomegalovirus
viral infection with AIDs
affects eye and GI tract
pneumonia in AIDs
fungus pneumocystis jiroveci
atypical mycobacterial
bacterial infection with AIDs
kaposi sarcoma
most common neoplasm in patients with AIDs
proliferation of spindle shaped cells
-markers for endothelial and smooth m cells
NOT malignant
iniated by KS herpesvirus
-cofactor is HIVs
lymphomas
systemic, primary CNS and body cavity
B-cells
HAART
anti-retroviral treatment
amyloid
fibrillar proteins that can aggregate
- cross-beta-pleated sheet tertiary conformation
- can accumulate extracellular
- pressure atrophy
common forms of amyloid
AL
AA
A-beta (alzheimers)
primary amyloidosis
immunocyte dyscrasias with amyloidosis
-AL type amyloid
systemic
reactive secondary amyloidosis
AA type amyloid
associated with chronic inflammation
hemodialysis associated amyloidosis
beta-2 microglobulin not filtered
-in joints, synovium, tendon sheaths
familial mediterraneal fever
heredofamililal amyloidosis
amyloid of aging
80-90yo
transthyretin
congo red stain
stains amyloid salmon pink
-with polarized light - see yellow-green birefringence
sago spleen
deposits in splenic follicle
lardaceous spleen
deposits in red pulp
Dx of amyloidosis
Bx and congo red stain
prognosis for amyloidosis
poor
- if systemic
- survival of B-cell - 2 years
myeloma associated worse
reactive better outlook