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Hypersensitivity and Autoimmunity Flashcards

1
Q

What cells are involved in innate immunity

A 
Phagocytes
Eosinohpils
Basophils
Mast cells
APCs
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2
Q

What receptors are involved in innate immunity

A 
Fc
Complement
Toll-like
Mannose
Cytokine
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3
Q

What molecules are involved in innate immunity

A

Complement
Acute phase reactants
Inflammatory mediators
Cytokines

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4
Q

What cells are involved in adaptive immunity

A

B cells

T cells

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5
Q

What receptors are involved in adaptive immunity

A 
Ig
TCR
HLA
Cytokine
Complement
Toll-like
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6
Q

What molecules are involved in adaptive immunity

A

Immunoglobulins

Cytokines

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7
Q

What does immunity involve

A 
Recognition
Interaction
Response
Elimination
Control and regulation
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8
Q

What is hypersensitivity

A

A group of disorders where the normally beneficial components of the immune response act in an exaggerated or inappropriate fashion to environmental antigens which do not normally cause tissue damage.

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9
Q

What is responsible for the tissue damage caused by hypersensitivity

A

The exaggerated response directed at the antigen

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10
Q

How can humans come into contact with allergens

A

Inhaled
Ingested
Injected
Contact

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11
Q

Describe the pathogenesis of an allergen

A 
Allergen leaches on cell
Enters to form APC which has MHC, a class II protein and epitope
T helper cell helps B cells
IgE produced
IgE binds to inflammatory cell 
Causes clinical effects

(Allergen could attach straight to Fc epsilon receptor to cause a response)

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12
Q

What can T helper CD4 cells form

A

Th 1 - found in type IV (IL-2, gamma-IFN, TNF)

Th2 - found in type I (IL-4,6,10,13)

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13
Q

Define Atopy

A

A genetic tendency to produce IgE to normally innocuous, common environment allergens

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14
Q

How many people does atopy affect

A

About 40% of the population

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15
Q

Define allergy

A

A clinical expression of the atopic tendency

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16
Q

How many people does allergy affect

A

15-20% of the population

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17
Q

State some specifc IgE triggers

A 
Insect venom
Pollen
Mould spores
Animal dander
Food allergens
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18
Q

State some non-specific allergy and atopy triggers

A 
Exercise
Acetylsalicylic acid
Tobacco
Sulphur dioxide
Cold air
Temperature
Pressure
Water 
Food items
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19
Q

What are some of the symptoms of allergy and atopy

A 
Anaphylaxis
Asthma
Rhinitis and conjunctivitis
Urticaria
Gastrointestinal
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20
Q

What can cause allergy

A 
Genes
Environment (allergen)
Immune dysregulation
Environment (other)
Internal influences
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21
Q

What types of mast cell mediators are there

A

Preformed

Newly synthesised

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22
Q

Name some preformed mast cell mediators

A 
Histamine
Heparin
Tryptase
Chymase
Eosinophil/neutrophil chemotactic factors
23
Q

Name some newly synthesised mast cell mediators

A

Prostaglandins

Leukotrienes

24
Q

Describe the pathogenesis of type I hypersensitivity

A

Allergen exposure trigger mast cells and IgE
This causes degranulation of preformed mediators and synthesis of new mediators
Response includes: mucosal oedema, secretions, vasodilation, capillary leakage and smooth muscle contraction.

25
When does an early phase response occur
Within minutes using preformed mast cell mediators
26
When does a late phase response occur
Takes hours using newly synthesised mediators, Th2 cytokines and eosinophil mediators
27
Describe type II hypersensitivity
IgG/IgM mediated and its target antigens are either found on the cell surface or fixed in certain tissues Involves immune effectors/target cell interactions
28
How can tissue damage arise in type II hypersensitivity
Complement activation Fc binding of immunogloubin and stimulation of phagocytes Antibody-dependent cellular cytotoxicity (ADCC) Effects on target cell function (inhibition of function or stimulation)
29
What is the function of the immune complex
When formed under normal/physiological conditions has protective mechanisms including opsonisation, transportation and destruction When formed under pathological conditions it has antigen factors and host response factors
30
How can the immune complex form
In circulation causing systemic deposition in tissues (serum sickness) Locally in tissues (arthus reaction)
31
What is type III hypersensitivity
When there is an excessive or abnormal immune complex formation causing complement activation and the recruitment of inflammatory cells which leads to tissue damage
32
How long does it take for type IV hypersensitivity to occur
Over 24 hours | Th1 mediated
33
How does type IV hypersensitivity occur
An exogenous hapten (low molecular weight antigen) and endogenous protein (carrier) or microorganism cause antigen presenting cells (HLA class II) to form this stimulates Th1 cytokine production and causes inflammation
34
Define automimmunity
A large group of clinical disorders which are characterised by tissue or organ damage mediated through aberrant immunological mechanisms which are directed against autoantigens
35
What type of selection does central tolerance have
Positive or negative selection
36
What is peripheral tolerance dependent on
``` Tregulatory cells Antibody idiotype regulation Immune complex formation Oral tolerance Th17 cells ```
37
What causes autoimmune disease
``` The interaction of: Genetic factors Immune regulatory factors Hormonal factors Environmental factors ‘Other’ factors ```
38
What does MHC stand for
Major histocompatibility complex
39
What type of effector mechanisms are there
``` Cell - mediated Antibody - mediated Antibody + complement Immune complex - mediated Recruitment of innate components ```
40
Describe how an autoimmune disease occurs
An event initiates the process (e.g. infection) coupled with genetic susceptibility Causes the breakdown of self-tolerance Auto-reactivity occurs to cause either a humoral or cellular response Leads to tissue damage
41
What can autoimmune diseases range between
Organ specific to non-organ specific
42
Where can organ specific autoimmune diseases occur
Thyroid Stomach Adrenal glands Pancreas
43
Name some autoimmune thyroid diseases
Hashimoto’s thyroiditis Primary myxoedema Thyrotoxicosis
44
Name an autoimmune stomach, adrenal and pancreatic disease
Stomach - pernicious anaemia Adrenal - Addison’s disease Pancreas - juvenile diabetes
45
Where can non-organ specific autoimmune diseases occur
Muscle - dermatomyositis Kidney - SLE Skin - scleroderma Joints - rheumatoid arthritis
46
How many types of hypersensitivity mechanisms are there
``` 4 Type I Type II Type III Type IV ```
47
How are Types I, II and III hypersensitivity mediated
Through antibodies
48
What is type IV hypersensitivity caused by
By the inappropriate actions of Th1 cells
49
What is type I hypersensitivity also known as
Allergy
50
How does type I hypersensitivity arise
Through inappropriate synthesis of IgE by the immune system | IgE is directed at allergens
51
Why does type I hypersensitivity arise
Due to a combination of interacting genetic factors, environmental influences, hormonal and neurological influences and immune regulatory factors
52
Where can the antigens triggering type II and III sensitivity be derived from
External (exogenous) | Self (therefore almost an autoimmune disease)
53
How do clinical conditions arise in type III hypersensitivity
Due to abnormal: Deposition of formed antigen (Ag) Antibody (immune) complexes in tissues
54
Where to immune complexes go once formed
Bloodstream - kept soluble in blood Transported (usually attached to red cells) to the liver and spleen where fixed phagocytes (e.g. Kupffer cells) take up and destroy them

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