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MIIM30003 > Immune System in Disease > Flashcards

Immune System in Disease Flashcards

1
Q

What are the 4 types of hypersensitivity?

A

type 1: immediate - allerg
type 2: antibody mediated
type 3: immune complex
type 4: delayed type

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2
Q

What is type 1 immediate hypersensitivity mediated by?

A

IgE, mast cells, lipid mediators

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3
Q

What is type 4 delayed type hypersensitivity mediated by?

A

CD4 T cell mediated

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4
Q

What response do allergens induce?

A

Th2 reponse
low dose, mucosal location

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5
Q

What are 3 properties of allergens?

A
  1. very stable
  2. high solubility in bodily fluids
  3. introduced in low doses
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6
Q

What are 4 allergic reactions?

A
  1. systemic anaphylaxis
  2. allergy rhinitis
  3. asthma
  4. food allergiesW
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7
Q

What are the 2 phases of type 1 immediate?

A
  1. sensitisation
  2. response (local or systemic)
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8
Q

What are the 3 steps in sensitisation?

A
  1. allergen cleaves occluding in tight junctions, entering mucosa
  2. DC primes T cell in lymph node
  3. plasma cell travels back to mucosa and produces IgE specific Ab
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9
Q

What is the response step?

A

allergen-specific IgE binds to mast cell, triggering degranulation

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10
Q

What are 3 results of mast cell activation?

A
  1. secretion of preformed mediators
  2. synthesis and secretion of lipid mediators
  3. synthesis and section of cytokines
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11
Q

What are 2 physiological effects of mast cell degranulation in the GI tract?

A
  1. increased fluid secretion and peristalsis
  2. diarrhoea, vomiting
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12
Q

What are 2 physiological effects of mast cell degranulation in the airways?

A

decreased diameter, more mucus
wheezing, coughing, phlegm

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13
Q

What are 2 physiological effects of mast cell degranulation in the blood vesesls?

A

more blood flow and perm
more fluid to tissues, lymph flow and effector response

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14
Q

What happens during the immediate phase?

A

wheal and flare
blood vessels dilate, leak plasma
more swelling around site of challenge (wheal)
blood vessels further dilate (flare)

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15
Q

What happens in the late phase?

A

involve cell infiltrates and sustained edema and/or smooth muscle contraction

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16
Q

What are the 2 outcome of type 2 hypersensitivity?

A
  1. injury dur to activation of effector mechanisms
  2. abnormal physiological response (graves, MG)
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17
Q

What causes type 3 hypersensitivity?

A

occurs if complexes are excessively produced and inefficiently cleared

18
Q

What are 4 results of immune complex mediated damage?

A
  1. immune complexes deposit on basement membranes and blood vessel walls
  2. vasculitis
  3. glomerulonephritis
  4. arthritis
19
Q

what elicits type 4 hypersensitivity?

A
  1. microbial infection
  2. intradermal injection of protein antigens
  3. contact with chemicals
20
Q

What are the two phases of type 4 hypersensitivity?

A
  1. sensitisation
    2 response
21
Q

explain sensitisation in type 4

A

allergen penetrates skin and is taken up by local antigen
DC primes T cell in LN

22
Q

explain response in type 4

A

re-exposure to antigen: Th1 recognises antigen and releases cytokines
recruitment and activation of phagocytes

23
Q

What is the Mantoux test?

A

inject PPD to detect presence of Mtb-specific CD4 T cells

24
Q

Why does gluten cause celiac?

A

gluten is a mix of glutamine and proline rich proteins
tTg converts glutamine into glutamic acid
gliding bind w high affinity to HLA-DQ2/8 resulting in T cell activation

25
Q

Why are autoreactive cells not always activated?

A
  1. antigen not available
  2. absence of signal 2
  3. aitoreactive B cells don’t have auto reactive CD4+ T cells
26
Q

Response to type 2/3

A

B cell production of auto antibodies

27
Q

CD4 and CD8 T cells

A

DTH responses (TH1 activation of macrophages, cytokine production, pro-inflammatory mediator disease
CTL killing of stromal cells
provision of B cell help

28
Q

macrophages

A

nitric oxide, proteases, oxidative radicals

29
Q

Summary of normal pituitary

A

pituitary gland releases TSH which acts on thyroid to release thyroid hormones

thyroid hormones act on pituitary gland to shut down production of TSH, suppressing thyroid hormone synthesis

30
Q

What happens in graves?

A

autoantibodies bind to TSH receptor on thyroid cels
stimulates receptor so enhanced production of thyroid hormones

31
Q

What is lupus?

A

unknown trigger
many auto antigens
B cell hyperactivity
presence of anti-DNA autoantibodies and immune complex deposition in kidney

32
Q

What are 2 examples of t cell mediated autoimmunity?

A
  1. insulin dependent diabetes mellitus (IDDM)
  2. MS
33
Q

IDDM

A

organ spec., T cell med (CD4/CD8)
destruction of pancreatic beta cells which produce insulin
infiltration of lymphocytes, weak autoantibody response, T cell reactivity to islet proteins
loss of insulin secretion, resultant insulin dependence

34
Q

MS

A

polygenic degenerative disorder of CNS which results in paralysis episodes while forming, and then chronic paralysis in late stages

35
Q

What T cells for MS

A

CD4 T cells specific for myelin antigens promote an inflammatory response and degrade myelin sheath
Th1 nd Th17 responses = bad
Th2 responses = remission

36
Q

2 categories of immunodeficiency?

A
  1. primary immunodeficiency disorders (inherited)
    - gene mutations = immune system failure
    - X-linked, autosomal recessive
  2. secondly immunodeficiency disorders (acquired)
    - infection, cancer, chemo, organ transplant
    - suppression of immune responses
37
Q

Treatment of immunodeficiencies

A
  1. antibiotics
  2. IVIG
  3. enzyme replacement
  4. bone marrow transplant
38
Q

XLA

A

mutation in gene for Btk
Btw needed for signal transduction via pre-BCR
failure to make complete BCR leads to pre-B cell apoptosis

39
Q

hyper IgM (x-linked)

A

x-linked hyper IgM syndrome is caused by mutations in CD40L = Defective CD40 signalling

40
Q
A

MIIM30003 (5 decks)

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