immune disease 1 (W12)

Question 1

innate lymphocytes features?

Answer 1

fast response
not adaptive - born with them and haven’t changed

Question 2

innate lymphocytes function?

Answer 2

respond quickly to alert signals from sentinel cells near surfaces, and shape the subsequent adaptive immune response with cytokines

Question 3

what life history factors can predispose you to different types of immunological tuning

Answer 3

nutrition (eg high salt = more inflammatory)
pollutants
chronic infection
sex hormones
immune ageing

Question 4

2 types of harmful immune reactions

Answer 4

hypersensitivity (allergy)
autoimmunity (intolerance of self antigens that drives tissue damage)

Question 5

how do we lose self-tolerance enough to cause disease?

Answer 5

neoantigen - self antigens become modified
molecular mimicry - microbe antigens resemble self
damage exposes hidden antigens (eg histones in dna)

Question 6

majority of autoimmune diagnoses in men or women?

Answer 6

women (80%)

Question 7

serum autoantibodies?

Answer 7

just having serum autoantibodies alone doesn’t mean disease. low level autoantibodies common with age, some produced after damage may help clear disease

Question 8

susceptibility genes for autoimmunity?

Answer 8

risk alleles - MHC alleles, affect peptide binding for antigen presentation

Question 9

why are most autoimmune diseases more common in women

Answer 9

sex steroids
X-chromosome influence autoimmunity

Question 10

sex steroids and immune system/inflammation

Answer 10

oestrogen usually pro-inflammatory
progesterone usually anti-inflammatory
testosterone immunosuppression

Question 11

pregnancy effects on RA and SLE (lupus)

Answer 11

RA flares improve
SLE flares worsen

Question 12

post-partum effects on RA and SLE (lupus)

Answer 12

SLE and RA flares worsen

Question 13

menopause effects on RA and SLE (lupus)

Answer 13

SLE flares improve, RA flares worsen

Question 14

what is converted to oestrogen and why in inflamed tissues

Answer 14

androgen converted to oestrogen.
cytokines increase aromatase which cause this. makes tissue more inflammatory

Question 15

what inhibits conversion of androgen to oestrogen

Answer 15

TNF (cytokine) inhibitors

Question 16

atopy?

Answer 16

predisposition to become IgE-sensitised to innocuous environmental Ag (allergen)

Question 17

unwanted anti-parasite immune response to innocuous antigen?

Answer 17

exposure to antigen in skin/mucosa, ILC2 react, dendritic cells migrate and present antigen in node. naive T cells polarise to TH2 cells that induce B cells to switch to IgE production and mature

Question 18

IgE-mediated mast cell reactions

Answer 18

mast cells collected IgE. Synthesis of PG, LT, cytokines, chemokines. degranulation (histamine, proteases)
immediate and late effects

Question 19

immediate effects of IgE-mediated mast cell reactions

Answer 19

skin- itch, oedema, redness
airway- mucosal oedema, bronchospasm
gut- colic, diarrhoea, vomiting
blood- anaphylaxis

Question 20

late effects of IgE-mediated mast cell reactions? what can these be treated with

Answer 20

more oedema
inflammatory cells
glucocorticoids

Question 21

symptoms of anaphylaxis

Answer 21

difficulty breathing
vascular shock (low bp, tachycardia)
skin- evolving redness, itch, swelling
mucosal oedema
gut spasm

Question 22

treatment of anaphylaxis

Answer 22

early i.m. adrenaline (+ oxygen, antihistamine, corticosteroid

Question 23

non-allergen causes of mast cell degranulation?

Answer 23

radiocontrast medium, opiates, NSAID, anaphylotoxins (C3a, C5a), physical (heat/cold/vibration)

Question 24

chronic example of igE-mediated allergic diseases?

Answer 24

chronic allergic asthma

Question 25

chronic allergic asthma?

Answer 25

would healing scarring response - airway remodelling. goblet cell metaplasia, fibrosis of sub-epithelial collagen, hypertrophy of smooth muscle, chronic inflammation

Question 26

rhinovirus infection significance in chronic allergic asthma patients

Answer 26

patients airways are permanently narrowed therefore increased risk to irritants such as rhinovirus