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Pathophysiology I > Immune Function > Flashcards

Immune Function Flashcards

1
Q

what is immunity?

A

collective set of defenses against a wide variety of potential threats

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2
Q

what does immunity consist of?

A

pathogens
toxins
abnormal cells (cancer)
foreign cells (transplants)

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3
Q

innate immunity

A

present at birth

nonspecific-behaves same way regardless of threat

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4
Q

adaptive immunity

A

develops after exposure to threat

specifically identifies threat and maintains memory

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5
Q

where do most adaptive immune responses occur?

A

within lymphatic system

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6
Q

what percent of circulating WBCs are lymphocytes?

A

20-30%

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7
Q

lymphocytes

A

not phagocytic
most reside in lymphatic system
key players in adaptive immunity

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8
Q

lymphatic system components

A

lymph
lymphatic vessels
lymphatic tissues & organs
lymphatic cells-lymphocytes & others

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9
Q

lymphatic system functions

A

produces & “activates” lymphocytes
returns excess interstitial fluid to bloodstream
transports lipids from digestive tract

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10
Q

lymphatic system-produces & “activates” lymphocytes

A

red bond marrow & thymus

tonsils, MALT, lymph nodes & spleen

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11
Q

lymphatic system-returns excess interstitial fluid to bloodstream

A

maintain normal blood volume

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12
Q

lymphatics

A

carry interstitial fluid that has “leaked” from capillaries to venous system
converge & empty into two major collecting vessels

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13
Q

two main collecting vessels of lymphatic system

A

thoracic duct

right lymphatic duct

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14
Q

thoracic duct

A

receives 85% of body lymph

empties into left subclavian vein

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15
Q

right lymphatic duct

A

receives 15% of body lymph

empties into right subclavian vein

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16
Q

lymphoid tissues

A

lack connective tissue capsule

associated with systems possessing external opening(s)

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17
Q

respiratory lymphoid tissues

A

tonsils

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18
Q

digestive lymphoid tissues

A

MALT (mucosa-associated lymphoid tissue)

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19
Q

other lymphoid tissues

A

urinary and reproductive

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20
Q

lymphoid tissues contain

A

high concentration of lymphocytes

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21
Q

lymphoid tissues function

A

defend portals of entry for pathogens

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22
Q

lymphoid organs

A

possess a connective tissue capsule

thymus, lymph nodes and spleen

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23
Q

thymus location

A

superior mediastinum

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24
Q

thymus site of

A

site of T-cell programming and maturation

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25
Q

how long is thymus functional?

A

becomes nonfunctional after puberty

undergoes atrophy and replaced by fat

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26
Q

lymph nodes location

A

lie along courses of lymphatics
neck, axilla, groin
afferent/efferent lymphatics

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27
Q

cortex of lymph nodes

A

B lymphocytes

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28
Q

paracortex of lymph nodes

A

T lymphocytes

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29
Q

medulla of lymph nodes

A

efferent lymphatic and vasculature

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30
Q

what are lymph nodes the sites of?

A

antigen recognition by B and T lymphocytes

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31
Q

what do lymph nodes do in response to infection?

A

enlarge

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32
Q

what happens to lymph?

A

it is purified in lymph nodes before returned to blood

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33
Q

spleen function, location

A

multifunctional, nonessential

LUQ of abdomen

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34
Q

spleen-red pulp

A

removes, recycles old RBC
stores iron
stores platelets

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35
Q

spleen-white pulp

A

stores B and T lymphocytes
same arrangement as nodes
monitor circulating blood for antigen recognition

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36
Q

lymphoid cells-lymphocytes

A

all derived from red bone marrow

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37
Q

types of lymphocytes

A

T cells
B cells
NK cells
Macrophages and dendritic cells

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38
Q

T cells

A

80% of circulating lymphocytes

responsible for “cell-mediated” immunity

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39
Q

B cells

A

15% of circulating lymphocytes

responsible for “antibody-mediated” (humoral) immunity

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40
Q

NK cells

A

5% of circulating lymphocytes

role in innate immunity

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41
Q

macrophages and dendritic cells

A

important in “antigen presentation”

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42
Q

innate immunity characteristics

A

same response against any type of threat
no memory
mainly important in defense against pathogens

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43
Q

innate immunity levels

A 
physical/chemical barriers
phagocytosis
immune surveillance
complement
inflammation
fever
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44
Q

innate immunity-physical barriers

A

skin

epithelium of internal cavities and pathways

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45
Q

innate immunity-chemical barriers

A

some epithelium produce flushing secretions
-sweat, sebum, mucus
some produce secretions that kill/inhibit pathogens
-stomach acid, lysozyme in tears, antibodies in breast milk

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46
Q

phagocytic cells

A

neutrophils and eosinophils
monocytes/macrophages
-migrate towards chemotaxins
-phagocytosis enhanced by opsonins

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47
Q

monocytes/macrophages types and locations

A

free-circulate in blood/lymph
fixed-reside in tissues
-liver-kupffer cells
-CNS-microglia

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48
Q

what is the function of NK lymphocytes?

A

immune survelliance

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49
Q

what do NK cells do?

A

recognize and adhere to abnormal cell surface proteins
expressed by virally-infected cell or some tumor cells
“self” surface proteins prevent NK cell killing

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50
Q

what do NK cells secrete?

A

“perforins”

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51
Q

what do perforins do?

A

result in rupture of abnormal or infected cells

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52
Q

complement system components

A

over 30 plasma proteins

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53
Q

how does the complement system work?

A

plasma proteins react together in chain reactions or “pathways”

  • similar to coagulation pathways
  • some protein fragments have biological activity
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54
Q

classical pathway

A

activated by Ag-Ab complexes (adaptive immunity)

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55
Q

alternate pathway

A

activated by pathogen cell surface proteins (innate immunity)

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56
Q

lectin pathway

A

starts classical pathway in absence of Ag-Ab complexes

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57
Q

what is the endpoint of all complement pathways?

A

cleavage of C3 to C3a and C3b

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58
Q

C3b

A

powerful opsonin-enhances phagocytosis

cleaves C5 to C5a and C5b

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59
Q

C5a

A

chemotaxis-attracts neutrophils

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60
Q

C3a and C5a

A

anaphylatoxins-stimulate histamine release from mast cells and basophils
vasodilation, increased capillary permeability

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61
Q

C5b

A

joins C6-C9 to form membrane attack complex (MAC)

punches holes in pathogen membranes

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62
Q

inflammation

A

localized tissue response to injury or infection

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63
Q

inflammation characteristics

A

red, hot, swollen, painful, plus or minus loss of function

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64
Q

what happens in inflammation?

A

walls off area of injury/infection
removes offending agent and/or devitalized tissue
sets stage for permanent repair (regeneration)

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65
Q

fever

A

body temperature >37.2 C

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66
Q

what happens during fever?

A

accelerates WBC activity

inhibits some viruses and bacteria

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67
Q

fever-inducing agents

A

produced by some pathogens
endogenous pyrogens
interleukin-1 and tumor necrosis factor

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68
Q

treating fever

A

do not treat just to treat, ask why

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69
Q

adaptive immunity

A

AKA “immune response”

results from the coordinated activities of B & T lymphocytes

70
Q

adaptive immunity-2 lines of defense

A

cell-mediated immunity

antibody-mediated (humoral) immunity

71
Q

what is involved in cell-mediated immunity?

A

T cells

most important for intracellular pathogens & abnormal/foreign cells

72
Q

what is involved in antibody-mediated (humoral) immunity?

A

B cells

most important for extracellular pathogens

73
Q

what do both lines of defense (cell mediated and antibody mediated) in adaptive immunity do?

A

both recognize, respond to and remember threats based on specific antigens

74
Q

T cells

A

80% of circulating lymphocytes

75
Q

where do T cells mature

A

mature and acquire specificity for antigen in thymus

76
Q

what dictates T cell specificity?

A

T cell receptor gene rearrangements before birth

77
Q

what distinguishes T cell types?

A

cluster of differentiation (CD) markers on cell surface

78
Q

general T cell markers

A

CD3, CD28

79
Q

what marker denotes cytotoxic T cells or NK cells?

A

CD8 or T8

80
Q

what do T8 cells do?

A

effector cells that directly attack foreign antigens

81
Q

what marker denotes helper T cells?

A

CD4 or T4

82
Q

what do helper T4 cells do?

A

helper T cells are the master regulatory cells of immune response

83
Q

what marker denotes regulatory T cells?

A

CD4, CD25

84
Q

what do regulatory T cells do?

A

suppress immune response

85
Q

B cells

A

15% of circulating lymphocytes

86
Q

where do B cells mature?

A

B cells mature and acquire specificity for antigen in bone marrow

87
Q

what dictates B cell specificity?

A

specificity for antigen dictated by immunoglobulin gene rearrangements before birth

88
Q

what do mature B cells express?

A

mature B cells express immunoglobulin on surface (B cell receptor)

89
Q

what do B cells differentiate into?

A

B cells differentiate into plasma cells upon activation

90
Q

what do plasma cells do?

A

produce immunoglobulins (antibodies)

91
Q

antigens (foreign)

A

molecules that elicit an immune response

92
Q

types of antigens

A

pathogen cell surface proteins
toxins
abnormal/foreign cell surface proteins
etc

93
Q

where do T and B cells bind

A

a specific portion of an antigen known as epitope

94
Q

specificity of T and B cells

A

each T or B cell is specific to one antigen only

95
Q

haptens

A

atoms or small molecules that act as antigens only when bound to larger protein

96
Q

examples of haptens

A

nickel atoms binding to skin keratin
poison ivy wax binding to skin keratin
most idiosyncratic drug reactions

97
Q

what activates the cell?

A

antigen/hapten binding to T or B cell receptor

98
Q

what do activated lymphocytes do?

A

multiply to form clones

99
Q

four properties of adaptive immunity

A

specificity
versatility
memory
tolerance

100
Q

specificity

A

each T or B cell responds to only one specific antigen

101
Q

versatility

A

many different lymphocytes with limitless receptor specificities are produced
if activated will clone to combat a specific antigen

102
Q

memory

A

some activated lymphocytes (memory cells) remain in circulation
provide more rapid defense against subsequent exposure

103
Q

tolerance

A

immune system ignores “normal” antigens (self-antigens)

104
Q

what are major histocompatibility complex (MHC) molecules?

A

“self” antigens encoded by MHC genes on chromosome 6

128 genes divided into 3 classes

105
Q

class I and II MHCs

A

code for human leukocyte antigens (HLA)

106
Q

class I MHCs code for _____

A

HLA-A, HLA-B, and HLA-C antigens

107
Q

class II MHCs code for _____

A

HLA-DQ, HLA-DP, HLA-DR antigens

108
Q

what determines tissue “type” used in transplantation matching?

A

6 antigens: HLA A, B, C, DQ, DP, DR

109
Q

what can different HLA antigens also indicate?

A

predisposal to various diseases

110
Q

what antigen is related to ankylosing spondylitis?

A

HLA-B27

111
Q

what antigen is related to Graves’ disease?

A

HLA-DR3

112
Q

what do MHC I and II proteins allow?

A

lymphocytes to distinguish between foreign and “self” antigens

113
Q

MHC I proteins

A 
MHC I proteins present on ALL nucleated cells
function to transport foreign molecules (antigens) to cell surface
114
Q

how do CD8 cytotoxic T cells see antigen?

A

only when complexed with MHC I

115
Q

what happens after CD8 cytotoxic T cell sees antigen?

A

kills cell bearing foreign antigen

116
Q

what kind of cells do cytotoxic T cells kill?

A

virally-infected cells

some cancer cells have MHC I that T cells “see” as foreign

117
Q

MHC II proteins present on

A

only macrophages and B cells

118
Q

function of MHC II proteins

A

transport fragments of engulfed molecules (antigens) to cell surface

119
Q

function of MHC I proteins

A

transport foreign molecules (antigens) to cell surface

120
Q

how do CD4 helper T cells see antigen?

A

only when complexed with MHC II

121
Q

what does helper T cell do after it sees antigen?

A

secretes cytokines to activate immune response

122
Q

cell mediated immunity cytotoxic T cells activated

A

inactive Tc cells activated by binding of TCR to MHC-I antigen complex

123
Q

what happens after Tc cell activated?

A

Tc cell divides

124
Q

what do Tc cells divide into?

A

Tc cells specific to same antigen
memory Tc cells
regulatory T cells (later)

125
Q

how to Tc cells kill infected/cancerous cell?

A

secretion of toxins

126
Q

what toxins do T3 cells secrete?

A

perforin
lymphotoxin
cytokines that trigger apoptosis

127
Q

memory Tc cells

A

produced with cytotoxic T cells
stay in circulation
immediately form cytotoxic T cells if same antigen reencountered

128
Q

regulatory T cells

A

produced late
secrete suppression factors
inhibit responses of T and B cells
limit immune response to single stimulus

129
Q

T helper cell activation

A

Inactive Th cells activated by binding of TCR to MHC II-antigen complex

130
Q

what does T helper cell activation require?

A

antigen-presenting cell

131
Q

what happens after T helper cell is activated?

A

Th cell divides

132
Q

what do Th cells divide into?

A

Th cells specific to same antigen

memory Th cells

133
Q

what do Th cells secrete?

A

cytokines that stimulate both cell-mediated and antibody-mediated immune responses

134
Q

cytokines

A

signaling molecules used by immune cells

135
Q

how can cytokines act?

A

locally and/or systematically
approx 20 are well characterized
perennial research targets for biological therapies

136
Q

cytokines worth knowing

A 
interleukin 1 (IL-1)
interleukin 2 (IL-2, T cell growth factor)
interleukin 5
interleukin 8
interferons
tumor necrosis factor (TNF, cachectin)
137
Q

what is interleukin 1 IL-1 produced by?

A

produced by macrophages that are eating

138
Q

what does interleukin 1 IL-1 do?

A

causes T cell division
causes increase in circulating neutrophils
causes the acute phase reaction
acts on the hypothalamus to cause fever and fatigue
attracts macrophages for granuloma formation

139
Q

what is interleukin 2 (IL-2, T cell growth factor) produced by?

A

activated Th cells

140
Q

what does interleukin 2 (IL-2, T cell growth factor) do?

A

causes T cell division

141
Q

what is interleukin 5 produced by?

A

activated Th cells

142
Q

what does interleukin 5 do?

A

causes increase in eosinophils-important in allergies and parasitic infestations

143
Q

what is interleukin 8 produced by?

A

macrophages

144
Q

what does interleukin 8 do?

A

chemotactic for neutrophils

145
Q

what are interferons produced by?

A

some are produced by T cells

146
Q

what do interferons do?

A

“interfere” with viruses and many other activities

147
Q

what does beta interferon do?

A

transforms B cells into plasma cells

148
Q

what does gamma interferon do?

A

activates macrophages and increases MHC II expression

149
Q

what is tumor necrosis factor (TNF, cachectin) produced by?

A

produced by T cells, macrophages

150
Q

what does tumor necrosis factor (TNF, cachectin) do?

A

causes inflammation
causes the acute phase reaction
acts on the hypothalamus to cause fever
induces apoptosis

151
Q

what happens in B cell sensitization in antibody mediated immunity?

A

inactive B cells “sensitized” by binding of BCR to antigen
antigen taken into B cell
antigen expressed on B cell surface with MHC II
now recognizable by Th cell

152
Q

what happens when Th cell binds in antibody mediated immunity?

A

Th cell binds to MHC-II-antigen complex

secrete cytokines that “activate” B cell

153
Q

what happens once B cell is activated?

A

activated B cell clones

154
Q

what does an activated B cell clone into?

A

plasma cells

memory B cells

155
Q

what do plasma cells do?

A

produce and secrete antibodies

156
Q

what do memory B cells do?

A

stay in circulation

immediately form plasma cells if same antigen reencountered

157
Q

what are antibodies (immunoglobulins)?

A

soluble proteins in plasma

158
Q

what are antibodies (immunoglobulins) made of?

A

two pairs of amino acid chains

heavy and light

159
Q

what does each chain on an antibody consist of?

A

constant and variable segments

160
Q

antibody (immunoglobulin) constant segments

A 
determine Ig class 
5 classes
161
Q

antibody (immunoglobulin) variable segments

A

determine Ig specificity to antigen

Antigen-binding site

162
Q

IgM

A

first antibody secreted after B cell activation
short-lived
circulate as five-antibody starburst (pentamer)
responsible for rapid destruction of incompatible blood types

163
Q

IgG

A

second antibody secreted after B cell activation
80% of plasma antibodies
long-lasting, monomer
responsible for resistance against many pathogens and toxins

164
Q

can IgG cross placenta?

A

yes

maternal IgG provies passive immunity to fetus and newborn

165
Q

IgA

A

produced as dimer
found primarily in glandular secretions
glandular cells absorb from plasma and secrete them onto apical surface
bind pathogens before they enter body

166
Q

what kinds of glandular secretions are IgA found in?

A

mucus, tears, saliva, breast milk

167
Q

IgD

A

acts as B cell receptor

binding of antigen sensitizes B cell

168
Q

IgE

A

on surfaces of basophils and mast cells
Ag binding stimulates release of histamine to initiate inflammation
also important in allergic response

169
Q

actions of antibodies

A 
precipitation and agglutination
-formation of immune complexes
activation of complement system
stimulation of phagocytes
-opsonization
inciting inflammation
prevention of bacterial and viral adhesion
170
Q

first antigen exposure

A 
produces primary response
develops slowly, transient
-illness occurs
-antigens activate B cells to form plasma cells
-antibody production slow
171
Q

subsequent antigen exposures

A

produces secondary response
more rapid, extensive and prolonged
no illness
memory cells already primed

Pathophysiology I (10 decks)

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