immonology Flashcards
MTX mech of action?
dTMP, thymine synthestase
Hydroxyurea
dTMP, thymine synthestase
5-FU
dTMP, thymine synthestase inhibition
LeFlumanide
inhibits orortic acid
6-Mercatopurine/ Azathioprine
inhibits purine synthesis
Mycopholate
inhibits guanine synthesis
Tracrolimus
NF-AF, Calcineurin inhibitor, preventing IL-2 trasncription
Sirolimus
mTor, prevents IL-2 response
Rituximab
CD20 on Bcells
Etanercept
TNF alpha decoy
Adalimumab, infliximab
TNF alpha
Type 4 hypersensitivity
MS, Celiac, Crohns, UC, RA
Muronomab
CD3
Basiliximab
IL2
TH1 secrets and induces:
for intracellular pathogens secret IL2—->IL12, IFN gamma
TH2 secrets and induces:
for worms and parasites, secrets IL4, IL5 —-> IL2, IL4
TH17
for extracellular path, secrets IL17 —->TGF-beta, IL6
immunodeffi: Hyper IGE syndrome
Treg
stops everything, immonodeff: IPEX
FOXP3 mutation
IPEX syndrome, immune dysregulation of t-cells
Respitory burst
=oxidative burst, activation phagocyte NADPH oxidation complex
plays a role in both the creation and neutralization of ROS.
Myeloperoxidase contains a blue-green, heme-containing pigment that gives sputum its color.
X-linked (Bruton) agammaglobulinemia
defect in BTK, a tyrosine kinase—>no B-cell maturation, in Boys, CD19
Autosomal dominant hyper-IgE-syndrome/ Job syndrome
def. in TH17 cell due to STAT3 mutation—–> impaired recruitment of neutrophils
severe combined immunodeficiency
enzyme? cytokine?
defectice IL2 gamma chain, m.c. X-linked ress., adenosine diaminase defiency (b-and t-cell disorder)
Wiskott-Aldrich syndrome
WAS gene mutation, leukocyte and platelets unable to recognize actin skeleton (b-and t-cell disorder). Causes WATER: Wiskott-Aldrich, Thrombocytopenia, Eczema, Recurrent
Chediak-Higashi
defectic lysosomal traficking regulator gene (LYST) Microtubale dysfunction in phagosome-lysosme fusion, autosomal ressesive
Thymic aplasia
22q11 deletion, failure to develop 3rd/4rd pharyngeal pouch.
Digeorge syndrome:- thymic, parathyroid, cardiac defect
Velocardiofacial syndrome- palate,facial, cardiac defects
IL12 recepor deficiency
Th1 decrease, auto ress., IFN gamma decresed, fungal infection, Tb after vaccine
chronic mucocutaneus candiadiasis
T-cell dysfunction. impaired cell-mediated immunity against candida
Ataxia-telangiectasia
def. in ATM gene—> failure to detect DNA damage, Ataxia, Angiomas, IgA, increased AFP,(b-and t-cell disorder)
Hyper IgM syndrome
def. CD40L on TH cells—>class switch defect, severe pyognic infection, PCP, Crypto, CMV,(b-and t-cell disorder)
hyper Christmas trees drop 40 ligands! on th cells! and cryptos
chronic ganulomatous disease
defect of NADPH oxidase, decrease in oxygen species, abnomal dihydrorhodamyne test
corn neck granny doesnt have a PHD!
type 1 hypersensitivity
IgE, Basophils, Mastcells
anaphylactic, atopic, IgE on mast cells, food, asthma
early IgE, late: chemokines
type 2 hypersensitivity
IgG&IgM autoantibodies
+complement
NK, Eosonophisl, Neutrophils, Macrophages
Antibodies bind to the cell-surface antigens, direct combs test.
Cellular destruction: Phagocytosis, NK.
Inflammation: bindinding Antibody
good pastures, RA, hyper-acute transplant rejection,
myastenia gravies, graves disease, pemphigus vulgaris
type 3 hypersensitivity
Immune complex deposition/ antibody–antigen complex
Neutophils
(IgG), SLE, polyarthritis nodosa, poststrep glumerulonephritis.
Serum sickness
Arthus reaction- local
type 4 hypersensitivity
T-cell and Macrophages
CD8+ cytotoxic T kill target directly, inflammatory through CD4 realse of cytokines. TB, transplant rejection, Chrons, MS, GB, Celiac, RA
positive slection
thymic cortex
negative selection
thymic medulla
C3b
opsonisation b for binding to bacteria
C3a, C4a, C5a
a for anaphylaxis
C5a
neurophil chemotaxis
decay acc. factor (DAF, aka CD55) and C1 esterase inhibitor
help prevent complement activation
early complement deficiencies
(C1-C4) sinus, respitory infec. SLE
terminal complement deficiencies
(C5-C9) increased susceptibility to current neisseria infections
Hyperacute transplant rejection
within minute, type 2 hypersensitivity, activates compliment, widespread thrombosis of graft vessels. Graft must be removed
Acute transplant rejection
cellular: CD8+ T cell or CD 4+ activated against donor MHCs (type 4 hyper. reaction). ——Vaculitis of graft vessels and dense interstitial lymphocytic cellular infiltrate. Revers. with immunosup. Humoral
Chronic trans. rejection
CD4+T cell responds to recipient APCs presenting donor potides including allogeneic MHC. Humoral and cellular type 1 and type4. Recipient T cell react an secret cytokines—–> prolif of smooth muscles, parenchymal atrophy, interstitial fibrosis
graft versus host disease
graft immunocompetent Tcells proliferate in the immunocompromised host and reject host cells with foreign proteins—-> severe organ disfunc. Type 4
macupapular rash, jaudice, diarrhea, hepatomegaly, bone marrow and live rich in neutophiles
what is an allergic reaction/ anphylactic reaction of a blood transfusion?
type 1 against plasma proteins in the transfused blood. IgA deficient induv. must receive blood products without IgA
min to 2-3 hours
acute hemolytic transfusion reaction is?
type 2 hypersensisitivity reaction, intravasal hemolysis ABO incompatibility or extravascular hemolysis ( host antibody reaction against foreign antigen on donor RBC)
1 hour
febrile nonhemolytic transfusion reaction
induced by cytokines that are accumulated by blood products storage or type 2 with host antibodies directed against donor HLA And WBC
1-6 hours
transfusion-related acute lung injury
donor anti-leukocyte antibodies against recipient neutrophils and pulmonary endothelial cells
live attenuated vaccine
microorganism losses pathgenicity, induces cellular and humeral response. MMR—-> longlife ummunity
killed and inactivated vaccine
inactivated pathogen, maintaned epitope —> manily humural response—–> requires booster
RIP Rabies, Influenza, Polio
subunit vaccine
includes antigen—-> may lead to adverse effect but weaker immune response HBV
Toxoid vaccine
denatured bacterial toxin with intact receptor for binding, stimulates immune system to make antibodies without causing disease. protects against bacterial toxin. Diphtheria and tetani
Interleukin-10
Attenuates inflammatory response.
Decreases expression of MHC class II and Th1 cytokines.
Inhibits activated macrophages and dendritic cells. Also secreted by regulatory T cells.
TGF-β and IL-10 both attenuate the immune respons
