Exam 2 Review Flashcards

1
Q

Adjuvant

A

A substance that when administered with an antigen (vaccine), provide local inflammation, drawing immune system cells triggering maturation of dendritic cells

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2
Q

Herd immunity (community immunity)

A

If a significant portion of the population is immunized (85%) it is protective against outbreaks

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3
Q

Basic reproductive number (Ro)

A

How many secondary cases generated by a primary case in a susceptible population

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4
Q

Conjugate vaccine

A

Capsular polysaccharide atttached to protein antigen (such as toxin), B cell and T cell response, get memory

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5
Q

Virus vectored vaccine

A

COVID 19 J and J vaccine, spike protein gene in adenovirus vector

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6
Q

mRNA vaccines

A

mRNA for spike protein into muscle/dendritic cell, get robust B and T cell response

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7
Q

Immunological tolerance

A

-Unresponsiveness of the adaptive immune system to antigens, results in the inactivation or death of antigen specific lymphocytes

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8
Q

Homeostasis

A

Decline in Ag-specific effector lymphocytes

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9
Q

Control mechanisms of T cells (3)

A

FasL/FAs on T cells
CTLA/PD-1 on T cells
Tregs
Deficiencies result in autoimmunity

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10
Q

Central tolerance

A

Deletion of self-reactive lymphocytes during development Neg selection in both B and T cells

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11
Q

Peripheral tolerance mechanisms (3)

A

Tregs (CD4+, CD25+ T cells) producing IL-10 and TGFB
Lack of Costimulation (No second signal B7-CD28)
Repeated stimulation

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12
Q

T regulatory cells

A

CD4+, CD25+ T cells that secrete IL-10 ad TGFB which inhibits other T cells

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13
Q

Anergy

A

happens as a result of lack of second signal, just floats around until it dies

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14
Q

Apoptosis

A

Repeated stimulation leads to self Fas FasL apoptosis

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15
Q

Autograft

A

Recipient and donor are the same person

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16
Q

Isograft (syngraft)

A

Recipient and donor are genetically identical

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17
Q

Allograft

A

Recipient and donor are genetically different

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18
Q

Xenograft

A

Recipient and donor are different species

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19
Q

Types of rejection (3)

A

Hyperacute
Acute
Chronic rejection

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20
Q

Hyperacute rejection

A

Happens in minutes and hours due to preformed antibodies in the recipient

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21
Q

Preformed antibody in transplantation methods (3)

A
  • Childbirth
  • Previous blood transfusion
  • Previous organ transplant rejection
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22
Q

Acute rejection

A

Happens in 10-14 days, mediated by CD8+ T cells

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23
Q

Chronic rejection

A

Happens in months to years, Mediated by CD4+ T cells (chronic inflammation), antibodies and NK cells

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24
Q

Preventing hyperacute rejection (2)

A
  • Match for blood group compatibility

- Test for pre formed abs (cross match)

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25
Prevent acute and chronic rejection (2)
- Match for HLA | - Immunosuppressive drugs
26
HLA genes required for 6 point match
HLA-A, HLA-B and HLA-DR
27
Conditions for graft vs host disease
- Graft contains live, mature T cells - Recipient must be immunosuppressed - The donor and recipient must be different at HLA
28
Neoantigens
Produced by sufficiently mutated genes in different tumor cell clones
29
Inappropriate expression of cellular proteins
- unmutated proteins that are normally expressed at very low levels but are over expressed in certain tumor cells triggering immune response
30
Oncogenic virus antigens
Virus encoded proteins within a tumor cell processed and presented on class I MHC
31
Oncofetal antigens examples
``` Carcinoembronic antigen (CEA) Alphafetal protein (AFP) ```
32
CEA cancer marker
Colon cancer
33
AFP (alpha fetoprotein) cancer marker
Hepatocellular carcinoma
34
Cancer immunotherapy strategies (4)
- Checkpoint inhibition - CAR T cells - Vaccines for Oncogenic viruses - Monoclonal Abs, sometimes linked to toxin
35
Checkpoint inhibitors
Abs that inhibit CTLA4, or PD1, PDL1 that clock normal inhibitory mechanisms, allow T cells to remain active
36
CAR components
- ScFv (linked VH and VL) specific for CD19 - T-cell signaling domains (TCR and CD28, CD3) When recognizing target, acts like CD8+ T cell
37
Type I hypersensitivity
IL4 from Th2 cells drive IgE response to antigens, mast cell degranulation
38
Early phase mediators by mast cells
- Histamines, ECF-A, and IL-8 (preformed) | - Leukotrienes and prostaglandins (made within 15 mins)
39
Scratch test
Tests for type I hypersensitivity, uses histamine as positive control
40
Phases of type I hypersensitivity
- Early (preformed and immediately made mediators) | - Late phase (T cells, eosinophils, neutrophils, macrophages, things they early phase mediators recruit)
41
Allergic asthma
IgE mediated disease following the exposure of relevant antigens that leads to the development of chronic airway intervention
42
Xolair mechanism
Anti IgE antibody that prevents it from binding to mast cells, used to treat asthma
43
Hyposensitization shots
Goal is to activate Th1 cells, promotes switching to IgG, inhibits Th2 cell development and IgE Activation of Treg cells that inhibit Th2
44
Type II hypersensitivity reactions
Antibodies (IgG or IgM) directed at cells (or cell related) antigens that result in complement activation, ADCC or receptor dysfunction
45
Examples of type II hypersensitivity (6)
- Myasthenia gravis - Graves’ disease - Rheumatic fever (molecular mimicry) - Hemolytic anemia - Goodpasture syndrome - Hyperacute graft rejection
46
Type III hypersensitivity
Antibodies (IgG or IgM) directed at soluble antigens resulting in AgAb complex formation that get trapped in small vasculature and activate complement
47
What causes vasculitis
Binding of complement triggers an anti inflammatory reaction and neutrophil infiltaration that damages vessel walls (neutrophil death)
48
SLE (systematic lupus erythematosus)
Immune complex resulting in the activation of classical pathway, shows reduced levels of C3 and C4
49
Examples of type III hypersensitivity (6)
- SLE -Serum sickness - Post-streptococcal glomerulonephritis - Some drug reactions -Soreness at tetanus booster site (local) Hypersensitivity pneumonitis (local) -Farmer’s lung -Bird fanciers disease
50
Delayed Type (type IV) hypersensitivity
Equivalent to CMI reaction against self antigens
51
Patch test
Tape Ag onto skin for a couple days, if allergic then will have a raised red solid mass
52
Tb skin test
Delayed hypersensitivity response to PPD of Tb, memory T cells will mount response if you’ve had TB/are vaccinated
53
Examples of type IV hypersensitivity (4)
- Positive Tb test - Allergic contact dermatitis - Certain autoimmune diseases - Inflammatory diseases
54
Allergic contact dermatitis examples (4)
Poison ivy Cosmetics Latex Metals
55
Autoimmune DTH examples (4)
- Multiple sclerosis - Type I diabetes - Rheumatoid arthritis - Psoriasis
56
Inflammatory DTH examples
- Celiac -Crohn’s May not be self antigens
57
Autoimmunity
Results from breakdown in tolerance
58
Factors influencing the development of autoimmunity (3)
- Genetics - immune regulation defects - Microbial (environmental)
59
Genetic factor in autoimmunity
Includes HLA alleles (B27=ankylosis spondylitis)
60
Molecular mimicry
Rheumatic fever, strep antigens similar to those on heart
61
Examples of humoral immunodeficiency (4)
- Bruton’s Agammaglobulinemia - Hyper IgM syndrome - Selective Ig deficiency - Transient hypogammaglobulinemia
62
Examples of CMI immunodeficiency (3)
- DiGeorge syndrome - CD3 deficiency - HIV infection
63
Examples of innate immune deficiencies (3)
- Chronic granulomatous disease (CGD) - Leukocyte adhesion deficiency (LAD) - Complement deficiencies
64
Transient hypogammaglobulinemia of infancy
Delay in making IgG, don’t have immunity after the mother’s IgG wears off, only lasts 2-3 months
65
Neutropenia
Low neutrophil count
66
Chronic granulomatous disease (CGD)
Superoxide defect, no killing
67
Chediak-Higashi syndrome
Killing defect in phagocytes
68
LFA-1 deficiency (LAD)
Defective homing of leukocytes
69
X-linked Agammaglobulinemia (Bruton’s)
Stuck at pre-B cell stage due to defect in BTK (Bruton’s tyrosine kinase)
70
IgA deficiency
Associated with respiratory infections
71
Hyper IgM syndrome
Defect in CD40, CD40 ligand which leads to no CSR, SHM, memory B cells
72
Common variable immunodeficiency (CVI)
Ig is low all around (B cell to plasma cell defect)
73
DiGeorge syndrome
Thymic hypoplasia, no T cells
74
X-linked SCID
APprox 70% of SCID patients, defect in gamma chain of IL-2, IL-4, IL-7, IL-15, IL-21 receptors
75
ADA deficiency
15% of SCID patients, reduced T and B cell numbers
76
RAG1 or RAG2 deficiency
No V(D)J recombination, no B or T cells
77
Secondary immunodeficiency examples (5)
- Viral infections - Medical interventions - Malignancies - Malnutrition - Aging
78
Arthus reaction
Type III hypersensitivity, local reactions