Exam 9 - Immunology Flashcards
Antigen examples
- microorganisms
- allergenic cells / transplant
- malignant cells
- infected cells
Immunogen
- anything that can stimulate immune response
- all are antigenic
- BUT not ALL antigens are immunogens
Pathogen
- antigen that can cause disease
- usually microorganism or toxin
Leukocytes
- WBCs
- 75 billion… 5-10K per ml
Granulocytes
- most common
- neutrophils / basophils / eosinophils
Monocytes
- large white cells….no granules
- monocytes in blood….macrophage once in tissue
- made in marrow
- monocytes in blood 1-2 days
- macrophages in tissue for month to years
Lymphocytes
- specific cells
- B and T cells
- circulate in blood
- wait in lymph nodes
- role in organ rejection
Neutrophils
- granulocyte
- made in marrow
- 50% circulate / 50% on vessel wall (margination)
- function = phagocytosis
- 1st to show up….most common
- eat up invader…die…eaten up by macrophages
Eosinophils
- granulocyte
- develop and mature in marrow
- appear in parasites
- allergic reactions
- kill cells with IgG and IgE
- reside in tissue
- release MBP to destroy organisms…MBP can also kill own
- kill parasitic worms
Basophils
- granulocyte
- least common
- chemotaxis and phagocytic
- releases HEPARIN to keep blood circulating
- also release histamine
- reside in blood
- receptors for IgE
- similar to mast cells…histamine…but in blood…NOT tissue
T cells
- mature in thymus
- learn to recognize our own self cells
- antigen presenting cells (macrophages) present to T cells
- once bound to antigen…release cytokines
Types:
- helper (CD-4)… release cytokines
- killer (cd-8)… kill infected cells
- regulatory…stop immune response once antigen destroyed
- memory
Antibody
- made by B cells (plasma cells)
- 14 days to reach full power
- always present in small amounts
- bind to specific antigen…opsonize (coats/marks)
- activate compliment cascade
Five classes: - IgG
- IgA
- IgM
- IgE
- IgD
Type of B cell that secretes antibodies
Plasma B cell
Opsonization
- coating of antigen with antibody and compliment
- targeting mechanism
- provides point for phagocyte to attach
2 Phagocyte receptors
- Fc: binds with antibody
- C3: binds with compliment
MAC
- membrane attack complex
- produced by compliment activation
- MAC will lyse antigens membrane
Neutralization
- antibody renders antigen toxin harmless
Most antibodies are what class
IgG or IgM
- determined by amino acid sequence on Fab parts
IgM
- 1st produced
- high levels mean new infection
- first produced in fetus…high levels mean infection in newborn
- very large…stays in vascular
- activate compliment
- Ex: anti-A and anti-B
IgD
- 2nd to be released
- may assist in B cells into plasma cells
IgE
- 3rd class
- low [ ]
- allergic rxns and parasite infection
- asthma, hay fever
- bind with basophils / mast cells / eosinophils to release histamine
IgG
- 4th class
- most important / most potent
- 80%
- produced most in second exposure
- come from memory B cells
- ONLY one that can cross placenta….Rh antibody
- Rho-GAM is what is given
IgG1
Bacteria
IgG2
Rest of bacteria
IgG3
Compliment
IgG4
Vasodilator
IgA
- in body fluids and mucous
- cannot activate compliment system
- BUT can trigger cell-mediated immune response
Largest subgroup
IgM
Most [ ] subgroup
IgG1 and IgG2
Longest life subgroup
IgG1
IgG2
IgG4
Subgroups that activate compliments the most
IgM
IgG3
Subgroup that likes mast cells
IgE
Subgroup with opsonization
IgG1
Subgroup that goes across epithelium
IgA
Subgroup that goes across placenta
IgG1
5 characteristics of adaptive immunity
- specificity
- diversity
- memory
- self-regulation
- self-tolerance
3 phases of immune response
- cognitive: antigen interacts with T cells
- activator: T cells release cytokines / cyotkines make T and B
- effector: granulocytes / macrophages / compliment activated
Antigen targeted and engulfed
Cell mediated immunity
- T cell response to antigen
- T cells have direct immune response
MHC II
- CD-4
- extracellular
- helper T cell…don’t kill antigen directly…activate other white cells
Two classes:
- TH1: inflammatory / convert inactive T cells into killer T cells
- TH2: activate B cells
MHC I
- CD-8
- Intracellular
- cytotoxic T cell comes to kill infected cell
MHC
Major histocompatibility complex
CD40:CD40L
CD40: marker on B cells
CD40L: activated CD4 cells have marker
Both come together in order to make antibodies
Dendritic cells
- skin cells…antigen presenting
4 signs of inflammation
- red
- heat
- swelling
- pain
3 stages of inflammation
- vasodilation
- emigration
- tissue repair
Vasodilator mediators
- NO
- Histamine
increased vascular permeability mediators
- C3a
- C5a
- bradykinin
- leukotrienes
Recruitment and activation mediators
- C5a
- Luekotrine B4
- Chemokines
- IL-1
- Bacteria
Fever mediator
IL-1
Source of histamine
- mast cells
- basophils
- eosinophils
- platelets
Source of lysosomal enzymes
- neutrophils
- macrophages
Extravasation
Movement of luekocytes from vessel into IF
SIRAB
Systemic inflammatory response after bypass
SIRAB activator
- contact activation with pump most common
- sheer stress
- suction
- reperfusion
- Hypothermia
- altered blood flow
SIRAB indicators
- temp above 38…below 36
- HR > 90
- RR > 20
- Leukocyte > 12,000
Risk factor of SIRAB
- Length of CPB
- but not necessarily
Post op effects of SIRAB
- immune system cells drop…all except…
- CD8
- can give solumedrol to prevent…protect platelets
