Immune Function Flashcards
We have ___ lines of defense that protects us from the outside world and can signal danger and possibly get rid of the danger
3
Our ____ defense is barriers that we were born with
Innate
Is our innate defense specific or nonspecific?
Nonspecific
What are two examples of anatomical barriers that are part of our innate defense?
-Skin
-Mucous membranes
Skin has a ____ temperature than the inside of our bodies which is not conducive to many bacteria and viruses
Cooler
Endothelial cells of the skin also have ___ ___ to keep invaders out
Tight junctions
The skin also secretes ___ ___ which make it an inhospitable environment for invaders
Fatty acids
Tears and saliva also create a biochemical barrier because they are filled with enzymes like ____ that poke holes in bacteria and viruses and also create an acidic environment that invaders do not like
Lysozymes
Where are mucus membranes are present?
-GI and urinogenital tract
-Urethra
-Bladder
-Mouth and nose
-Lungs
(any warm and wet membranes)
Mucus membrane contains mucus to help ___ invaders and possibly cough them back up if they are in the lungs
Trap
There are bacteria in the gut that promote good activity and can secrete ____ to kill off bad bacteria
Enzymes
____ that line lungs and other tissues pulse mucous and invaders out of the body
Cilia
Endothelial cells secrete ____ and ____ which poke holes in bacteria cell walls
Cathelicidins and defensins
____ binds iron which keeps iron away from bacteria that could use it to reproduce
Lactoferrin
Biochemical barriers include ____ from cells
Secretions
We also have ___ ___ ___ immunity which is why we do not have to worry about getting things like avian flu
Species-specific natural immunity
____ is another type of innate, non-specific defense
Inflammation
What are three things that are involved with inflammation as an innate defense?
-Pattern recognition receptors
-Pathogen-associated molecular patterns
-Damage-associate molecule patterns
Pattern recognition receptors bind to the microbe and stick out from the ___ ___, similar to immunoglobins or antibodies
B cell
Pattern recognition receptors recognize ____ put on an invaders surface
Proteins
____-___ ___ ___ are exogenous ligands that may be part of the bacteria or virus DNA, RNA, membrane, etc.
Pathogen-associated molecular patterns
Pathogen-associated molecular patterns are present on the invaders’ surface and allow the ____ to recognize it
Body
Damage-associated molecular patterns are endogenous ligands like nucleic acids, oxidized LDL, etc, that our own body releases when ____
Damaged
Damage-associated molecular patterns will be recognized by…
Pattern recognition Receptors
Acquired defense is also known as our ____/____ immune system
Specific/adaptive
Acquired defense is when the body recognizes specific invaders and develops an immune response to that ___ ___
Specific invader
____ launches the acquired response
Inflammation
Acquired defense requires a ____ ____
First exposure
What are two types of acquired defense?
-Cell-mediated (T-cell mediated)
-Humoral-mediated immunity
What are three examples of endogenous immune modifiers?
-Age
-Sex
-Genetics
The older you are, the worse your immunity get because you have less lymphocytes, specifically ___ ___
T cells
T cells grow in the ___ ____ and this gland begins to atrophy around age 40 so we get fewer T cells and less response to pathogens and less response to pathogens
Thymus gland
As you age, other ____ and disease can also decrease your immunity
Comorbidities
____ has beneficial effects on the immune system, so women are better protected against pathogens up until menopause
Estrogen
____ are an immune modifier
Genetics
Many autoimmune diseases are part of a syndrome that have a genetic focus; many genetic disorders occur because there is a lack of ___ ___
Immune development
___/___ cells mark the cell as belonging to the host; these proteins say that this is a cell that is ours
MHC/HLA
A, B, C, E, F, G, K, L regions are class ___ MHC/HLA
I
DM, DO, DP, DQ, DR regions are class ___ MHC/HLA
II
We have 2 ____ of MHC/HLA, which is important for transplants because we need a match
Haplotypes
MHC/HLA genes are transmitted ____
Intact
Siblings have a ___ match with MHC/HLA genes
1/4
MHC class I molecule (HLA A, B, and C) participate in antigen presentation to ___ ___ cells
Cytotoxic T (CD8+)
MHC class II molecules (DP, DQ, DR) participate in antigen presentation to ___ ___ cells
Helper T (CD4+)
What are four examples of exogenous immune modifiers?
-Stress
-Sunlight
-Medications
-Illness
Stress causes a release of ____ which depresses the immune system by depressing all cell synthesis and decreasing immunoglobulin production
Cortisol
Sunlight is a ____ genetic modifier
Positive (helpful)
Sunlight helps the body make usable ___ ___ which helps with better white blood cell formation
Vitamin D
____ often suppress the immune system (cortisol)
Medications
What types of illnesses suppress the immune system?
-Diabetes
-CVD
(most chronic or acute diseases are bad for immune function)
What are 5 components of the immune system?
-Marrow
-Spleen
-Thymus
-Lymphatic tissue
-Specialized cells
The marrow is where ____ are born
Lymphocytes (T and B cells)
The spleen stores ___ that can turn into macrophages which are helpful for immune function
Monocytes
The ___ includes areas that are exposed to immune cells
Thymus
The lymphatic tissue contains…
MALT (Mucosa-associated lymphoid tissue); Nodes
What are examples of Mucosa-associated lymphoid tissue?
-Adenoids
-Tonsils
-Peyer’s Patch
-Appendix
What are 4 types of antigen-presenting cells?
-B cells
-Macrophages
-Dendritic cells
-Other
____ are small white blood cells that are not immunocompetent
Lymphocytes
Lymphocytes are in the ___ and ___ of the fetus
Liver and spleen
Lymphocytes are in the ___ ___ of children and adults
Bone marrow
Lymphocytes circulate to become committed either in the ___ ___ to the thymus or the ___ ___ to the bone marrow, and are then activated
T line; B line
There is potentially a hybrid of B and T cells called an ___ ___ which has characteristics of both and are found in people with Type 1 Diabetes
X lymphocyte
Clonal selection refers to cell ___ and ____ after first exposure (this allows for specific recognition and memory for the next time we are exposed)
Proliferation and differentiation
What are the three steps of the initial response of the immune system?
-Exposure and breach of barriers
-Inflammation
-Cell-mediated response (T cells)
If we did not have inflammation, we would get sick ___ (inflammation helps keep the response down)
Immediately
Within the cell-mediated response, the first step is…
T cell formation
Roles of T cells:
-Attack and destroy diseased cells
-Orchestrate, regulate, and coordinate the overall immune response
-Responsible for cell-mediated immunity
-Influences humoral immunity
T cells mature in the thymus where they are exposures to other ___ ___
Host cells
T cells are stimulated by ____
Hormones
T cells develop both ___ and ___ markers
CD4 and CD8
____ refers to clonal deletion and negative section which means that T cells will die in the thymus if they are too reactive to our own cells (if some of these to make it out, we hope that helper T cells would kill them)
Autoreactivity
Cytotoxic T cells (CD8) recognize MHC class ___ molecules
I
Cytotoxic T cells help rid the body of cells that have been infected by…
-Viruses
-Cancer cells
-Damaged cells
Cytotoxic T cells are also responsible for the ____ of tissue and organ grafts
Rejection
Examples of cytotoxic T cells:
-Killer cells (filled with perforin)
-Granzymes (causes apoptosis)
Helper T cells (CD4) recognize MHC class ___ molecules
II
____ helper T cells act on invaders and infected cells
Effector
____ helper T cells maintain antigen recognition/memory for the future
Memory
____ helper T cells control the immune response; they dampen the response to prevent autoimmune diseases (turn off the response when the pathogen is cleared)
Regulatory
__ __ cells do not recognize a specific antigen to kill a cell
Natural killer
Natural killer cells have ____ receptors and ____ receptors
Activating; inhibitory
Natural killer cells release…
-Perforin
-Granzyme
-Cytokines
To stop cells from killing healthy cells, natural killer cells scan the body looking for ____
Invaders
Natural killer cells are ___ independent
MHC
T cell accessory cells are produced by the ____ cell line and include monocytes, macrophages, eosinophils, neutrophils, mast cells, and basophils
Myeloid
T cell accessory cells can all become ____
Phagocytic
T cell accessory cells can be…
-Complement
-Cytokines
-Interleukins
____ are “nonself” molecules
Antigens
Antigens are present on…
-Bacteria, viruses, fungi, parasites
-Pollens
-Foods
-Venom
-Drugs
-Vaccines
-Transplanted tissues
____ are proteins produced by the body to attack and fight off antigens (they are specific to each antigen)
Antibodies
Antibodies are also known as _____
Immunoglobulins
An ___ is the region of the antigen that our body can recognize in our immune system (if there is prior exposure)
Epitope
The ____ is the part of the antibody where the antibody binds to the antigen
Paratope
____ are antigens that are too small to be recognized
Haptens
____ is the innate ability of an antigen to bind with an antibody
Antigenicity
____ is the ability of an antigen to react with T and B cells
Immunogenicity
Successful binding of the antigen receptor to the epitope results in…
-Neutralization
-Precipitation
-Proliferation and differentiation
-Opsonization
-Activation of the inflammatory response
The Ag/Ab binding and cell-mediated response includes what 4 steps?
-Antigen capture
-Antigen digestion
-Antigen presentation
-Response
Successful binding of the antigen receptor to the epitope results in ___ and ___, as well as proliferation and differentiation
Neutralization and precipitation
Successful binding of the antigen receptor to the epitope also results in stimulation of the cell to leave ___ and enter the cell cycle
G0
Repeated mitosis leads to the development of a clone of cells bearing the same ___ ___ with identical specificity
Antigen receptor
____ refers to successful binding of the antigen
Opsonization
____ are glycoproteins produced by plasma cells
Immunoglobulins
Immunoglobulins are the same as ____
Antibodies
What are the two units of an immunoglobulin molecule?
-Variable region
-Constant region
An immunoglobin also has a ___ chain and a ___ chain
Light, heavy
The ___ region of the immunoglobulin is the antibody binding fragment; it is variable so it rearranges until it matches the antigen and can recognize it
Fab
The ___ region of the immunoglobulin releases inflammatory mediators
Fc
___ describes the number of binding sites of an immunoglobulin
Valance
The ____ class of immunoglobulins is the most common and has 4 subclasses (80% of circulating immunoglobulin)
IgG
IgG has a valance of ___
2
IgG is involved in ____ activation
Complement
IgG is good ___ in the infection to control how much of the agent gets in
Early
What are the two subclasses of IgA?
-IgA1 in blood
-IgA2 in saliva and tears
IgA1 has a valance of ___
2
IgA has a ____ role
Preventative
IgA2 is a dimer with a secretory piece and has a valance of ___
4
IgA has an important role in keeping the invader from getting into the body by preventing it from attaching to ___ ___
Mucus membranes
____ is the first immunoglobulin produced in an infection
IgM
IgM are very large (pentamer) and have a valance of ___ (but only 5 are used)
10
There are small amounts of ___ in the blood
IgD
IgD has a valance of ___
2
IgD has a possible role in ___ synthesis
Ab
IgD are also found on developing ___ ___ where the are Ag receptors
B lymphocytes
____ immunoglobulins are the least concentrated in the blood
IgE
IgE are involved in ___ and ___ infections
Allergic and parasitic
IgE has a valance of ___
2
B (Bursal) cells are present in what two places?
-Bone marrow
-Spleen
____ drive specific antibody production
Hormones
Mature B cells exposed to the antigen of interest become ____ cells
Plasma
The humoral response from B cells is involved with…
-Immunoglobin secretion
-Immune memory
Once B cells circulate through the bone marrow/spleen, they are programmed to produce ____/____ against the antigen
Antibodies/immunoglobins
Once B cells are converted to plasma cells, they produce ___ ___ that are stored in the peripheral lymphoid organs
Memory cells
B cell receptors have a ___ region and an ___ region
Fab and Fc
B cell action allows for adaptive ___ ___ and ___
Immune response and memory
What are three types of B cells:
-B cells
-Memory B cells
-Plasma B cells
What are the 4 phases of infection and immune response?
- Establishment of infection
- Induction of adaptive response
- Adaptive immune response
- Immunological memory
Within the cell-mediated response, there is ___-___ complex binding which is responsible for clonal expansion
MHC-Ag
The MHC-Ag complex binding signals to ___, ___, and ___ cells
Tc, Th, B
Cytotoxic T cells (Tc) release…
-Perforin
-Granulysine
-Granzymes
With the MHC-Tc interaction, ___ receptor binds to Class I HC molecules to release perforin, granulysine, and other granulocytes
CD8
In the MHC-Tc interaction, the B cell presents the antigen, and then the B cell puts it in class 2 molecules so ____ binds to the peptide to cause release of cytokines
CD4
What are three types of Th cells within the cell-mediated response?
-Effector Th cells
-Memory Th cells
-Suppressor Th cells
Following the initial exposure, there is the ___ ___
Primary response
The primary response includes both ___ ___ and ____ response
Cell-mediated and humoral
Cell mediated response requires ___ and ____ cells
Th and Tc
The humoral response requires ___ ___ to produce plasma cells and immunoglobulins
B cells
5-7 days after the primary response, we will have ___ response
IgM
With a ____ response, you are exposed to the same antigen again
Secondary
In a secondary response, there are ___ cells available
Specific
The secondary is a more ____ response
Vigorous
What types of memory cells are available for a secondary response?
-Plasma cells
-B cells
____ refers to a specific antibody that is able to be recognized without processing
Specificity
The difference between a primary and secondary response is that secondary has…
-Decreased reactivity time
-More severe reaction
-More IgG
-Memory
The first vaccine was created by doctor ___ after he realized that milkmaids who go cowpox were immune to smallpox, so he took the virus and injected it into people
Jenner
When the immune system function goes awry, it is classified into what three broad categories?
-Inappropriate function
-Too much function
-Too little function
____ reactions occur when a given stimulus initiates an abnormal/undesirable immune response to a non-threat
Hypersensitivity
There are ___ classes of hypersensitivity reaction
4
Types I-III hypersensitivity reactions are ____ mediated
Humoral (antibody)
Type IV hypersensitivity reaction is ___-___
Cell-mediated
Type I hypersensitivity reaction is ___ ___ ____
Immediate type hypersensitivity
The “normal” role of the Type I reaction is to initiate an ___ ___ to neutralize and expel intestinal parasites
Inflammatory response
Type I hypersensitivity reactions use granules that contain…
-Histamine
-Leukotrienes and prostaglandin
-Heparin
-Serotonin
-Cytokines, interleukins, inflammatory mediators
Manifestations of type I hypersensitivity are related to ___ content actions
Granule
Some examples of manifestations of type I hypersensitivity include…
-Vasodilation
-Smooth muscle and endothelial cell constriction
-Integumentary systems
Type II hypersensitivity reactions are ___ ___ ____
Antibody-mediated toxicities
Type II hypersensitivity reactions are further subdivided into what two categories?
-Cytolytic reactions
-Antibody mediated
The normal function of a cytolytic/cytotoxic reaction is…
Lysis of bacteria and other pathogens
Antibody-mediated reactions would normally function to…
-Neutralize toxins
-Viral receptor blockade
With an antibody-mediated reaction, an antibody against a functional molecule or receptor results in their activation or inactivation because the self-cell is identified as ____
Foreign
Examples of antibody-mediated reactions (type II hypersensitivity):
-Acquired hemophilia
-Grave’s disease
-Myasthenia Gravis
Type III hypersensitivity reactions are “___ ___” disorders
Immune complex
Normal function of type III hypersensitivity reactions is ___ ___ at the site of pathogen invasion (vessel walls, joints, kidneys)
Acute inflammation
With type III hypersensitivity, complement is activated and ___ and ___ are released; neutrophils are attracted by C5a and they release enzymes that destroy the endothelium and red blood cells escape from within the blood vessels
C3a and C5a
An example of type III hypersensitivity is ___ ___
Serum sickness
Serum sickness occurs __-__ days after non-human sera injection
10-14
Serum sickness results in…
-Vasculitis
-Glomerulonephritis
-Arthralgia
-Fever
Type IV hypersensitivity reactions are ___ ___ ___
Delayed type hypersensitivity
Normal function of type IV hypersensitivity is to control ____ by mycobacteria, treponema, other bacteria, fungi, viruses, and parasites
Infections
Type IV hypersensitivity reactions are classified into what two subtypes?
-T cell mediated delayed hypersensitivity
-T cell mediated cytotoxicity
The normal function of type IV delayed hypersensitivity is to destroy ___ and ___ ___ cells
Invaders and viral infected
In type IV delayed hypersensitivity, sensitized Th cells bind to the ____-___ ____, releasing cytokines, causing inflammation and tissue damage
MHCII-antigen complex
Examples of type IV delayed hypersensitivity:
-Response to intradermal injection of mycobacterium tuberculosis-derived purified protein derivative (TB testing/PPD testing)
-Multiple sclerosis
-Direct activation of type IV hypersensitivity reactions also occur due to “superantigen” exposure
-Transplant rejection
The normal function of type IV cytotoxic reactions is to…
Destroy invaders and viral infected cells
With type IV cytotoxic reactions, ___ cells recognize MHCI-presenting cells and immediately destroy the cell
Tc
Examples of type IV hypersensitivity cytotoxic reactions:
-Contact dermatitis
-Granulomatous inflammation
-Transplant rejections
Transplant rejection reactions occur when transplanted tissue is not recognized as ___ ___ due to the immune response and MHC genotyping
Host tissue
Transplant rejection occurs in what 3 categories?
-Hyperacute rejection
-Acute rejection
-Chronic rejection
Hyperacute rejection happens in the first ___ to ___ after transplantation
Minutes to hours
Hyperacute rejection occurs due to pre-existing ____ that cause a massive inflammatory and immune response
Antibodies
Hyperacute rejection requires ___ ___
Immediate treatment
Acute transplant rejection reactions occur in the first ___ to ___ after transplant
Weeks to months
With acute rejection, the ___ itself is being attacked
Graft
Acute rejection may be reversed with ____
Immunosuppression
A chronic rejection reaction occurs ___ to ___ after the transplant
Months to years
Repeat episodes of __ rejection can result in chronic rejection
Acute
Chronic rejection reactions do not respond well to ____
Therapy
Graft versus host disease is a different type of reaction only seen in ___ ___ transplant
Bone marrow
With GVHD, the transplanted cells produce immune cells that attack the ____
Host
___ ___ occur when the immune system fails to recognize ‘self’ markers and attacks the ‘self’ tissue
Autoimmune disorders
Autoimmune disorders are ____-____ and ___-___ disorders
Collagen-vascular and connective-tissue
Autoimmune disorders are primarily ___ ___ ____ reactions
Type III hypersensitivity reactions (some type II characteristics and mechanisms)
Are autoimmune disorders more common in males or females?
Females
Autoimmune disorders can be ___ ___ or ____ diseases
Single organ or systemic
Autoimmune disorders result from a breakdown of ___ ___
Self-tolerance
What 3 major mechanisms provide for self tolerance?
-Clonal deletion (self-reactive cells)
-Clonal anergy (failure to respond to antigen)
-Peripheral suppression of/by T cells
What are some examples of single organ autoimmune disorders?
-Hashimoto’s thyroiditis
-Goodpasture’s syndrome
-Autoimmune thrombocytopenia
-Insulin-dependent diabetes mellitus
-Myasthenia gravis
-Grave’s disease
Hashimoto’s thyroiditis is a _____ (T cells) attack on thyroid cells
Lymphocytic
Hashimoto’s affects ___-___ of every 1,000 Americans
1-1.5
Does Hashimoto’s affect more women or men?
Women
Hashimoto’s usually affects people between ___-___ years old
45-65
With Hashimoto’s, the functioning thyroid cells will secret more ____, causing hyperthyroid symptoms which may be asymptomatic, or cause increased metabolism/energy (people feel good)
Thyroxine
Then, fibrosis occurs and inadequate thyroxine is produced, leading to ____ symptoms like decreased metabolism, weight gain, fatigue
Hypothyroid
What are three examples of systemic autoimmune disorders?
-Systemic Lupus Erythematosus
-Rheumatoid arthritis
-Sjogren’s syndrome
Systemic lupus erythematosus is a failure to maintain ___ ___
Self tolerance
Lupus affects ___ of every 100,000 people
53
Is Lupus more common in men or women?
Women
Lupus occurs more commonly, and with a more severe presentation, in what population?
Black Americans
What are three possible mechanisms of Lupus?
-Failure to maintain self-tolerance
-Genetic and environmental factors
-Possibly EBV
Manifestations of Lupus:
-Low-grade fever
-Photosensitivity
-Ulcers in mouth and nose
-Muscle aches
-Arthritis
-Fatigue
-Loss of appetite
-Butterfly rash on the face
-Inflammation of the pleura and pericardium
-Poor circulation of fingers and toes
Inadequate immune response falls into one of what two categories?
-Primary immunodeficiency is present at birth
-Secondary immunodeficiency is an acquired disorder
Whether primary or secondary immunodeficiency, the end result is poor immune response and frequent ___ ___
Opportunistic infections
Brunton’s Disease is a ____ ____ disease
Primary immunodeficiency
Bruton’s disease affects ___ in 100,000 male infants at 5-6 months old which is when T-lymphocyes die off
1
Bruton’s disease is a ____ disease
Genetic
Bruton’s disease is also called…
X-linked agammaglobulinemia
Bruton’s disease is caused by a ___ gene on the X chromosome
Bkt
The normal Bkt gene product promotes ___ ___ maturation before release into the bloodstream
B cell
Bruton’s disease causes B cells to not ___, which leads to the absence of all types of immunoglobulins
Mature
People with Bruton’s disease are prone to recurrent ___ ___
Pyogenic infections
DiGeorge Syndrome is a severe ___ ___ deficiency
T cell
DiGeorge syndrome affects ___ in ___ people
1 in 4000
DiGeorge syndrome causes significant ___ ___
Congenial defects
We can remember the symptoms of DiGeorge Syndrome with ____-___
CATCH-22
CATCH-22 stands for…
-Cardiac anomaly
-Abnormal facies
-T cell deficit
-Cleft palate
-Hypocalcemia
-Defect on chromosome 22
Manifestations of CATCH-22 include…
-Cognitive impairments
-Delayed speech
-Psychotic episode
-Death
Severe combined immunodeficiency (SCID) is also known as ___ ___ ____
Bubble Boy Disease
SCID is a severe ____ ____
Primary immunodeficiency
SCID affects 1 in ___-___
50,000-100,000
SCID is genetic and ___-linked and there may or may not be other chromosomes involved
X
Other genes affected by SCID may be:
-Common gamma chain of interleukins
-Adenosine deaminase
-Purine nucleoside phosphorylase
-RAG1/RAG2
-TAP
SCID is hallmarked by severe __ and __ cell defect
T and B
With SCID, ___ cells and ___ production are also defective
Plasma cells and immunoglobulin
Manifestations of SCID include…
-Severe, chronic/recurrent infections of all types
-Usually diagnosed at about 6 months of age when the child presents with multiple infections (newborn screening)
Treatment for SCID includes…
-Bone marrow transplant
-Total isolation
-Stem cell transplantation (rejection might be an issue)
-Gene therapy (leukemia)
AIDS is a ____ immune disorder
Secondary
There is an AIDS pandemic, affecting ___% of the worldwide population
0.6
HIV attacks ___ cells
CD4+
HIV gets into cells via ___ (early) or ____ (later) receptors
CCR5; CXCR4
HIV causes ___ ___ destruction
T cell
HIV leads to a loss of ___ ___ ___
Cell-mediated immunity
Three stages of HIV/AIDS:
-Early symptoms
-Progression
-Conversion to AIDS
Treatment of HIV includes…
-Prevention
-Antiretroviral therapy
Currently, there is no cure or ____ for HIV/AIDS
Vaccine
A ___ ___ ____ for HIV/AIDS has had limited success (2/30 cured, most died), until 2007
Bone marrow transplant
The ___ ___ had acute myeloid leukemia and HIV; he was given chemotherapy and two bone marrow transplants (CCR5 delta 32 mutation; no CXCR4 genotyping)
Berlin Patient
Since the second transplant, the patient has been off of ____
Antiretroviral therapy
In a 2010 follow-up with the Berlin Patient, HIV was undetectable since ___ days post 1st bone marrow transplant; he also has normal CD4 T cell counts
60
Disadvantages with bone marrow transplant for AIDS:
-Few CCR5 delta 32 donors
-Costly
-High risk procedure
Vaccine development for AIDS is using traditional methods as well as…
RNAi (silencing the CCR5)
