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Patho II > Immunity > Flashcards

Immunity Flashcards

1
Q

Types of blood cells [review]

A
  • Monocytes/macrophages
  • Lymphocytes: B cells and T cells
  • Polymorphonuclear leukocytes: (granulocytes) neutrophils, eosinophils, Basophils => mast cells
  • RBCs
  • Platelets
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2
Q

Blood cell progenitor line

A
  • all come from a hematopoietic stem cell
    differentiates into
  • the lymphoid progenitor line (B and T cells),
  • the myeloid progenitor line (other WBCs, megakaryoctyes, erythroblasts)
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3
Q

Host defense systems

A

Physical & chemical barriers to infection:

  • Skin
  • Mucous membranes & secretions

Inflammatory response (innate: non-specific)

  • Occurs after tissue injury or infection
  • Fever & inflammation
  • Phagocytic WBCs, antimicrobial substances, natural killer cells

Immune response (adaptive: specific)

  • Identifies self from non-self (host vs. foreign)
  • Recognizes & eliminates altered host cells
  • Antigen-Antibody response
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4
Q

What is an antigen?

A

[remember: antibody-generator]
An antigen is an immunogen, any molecule that can stimulate an immune response
- usually a progein or large CHO

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5
Q

Epitope

A

antigenic determinant- the part of an antigen molecule to which an antibody attaches itself.

  • an antigen can have several epitopes
  • each can stimulate a distinct clone of lymphocytes
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6
Q

Hapten & Hapten-carrier complex

A

compound that can combine with protein molecules to act as an antigen
ie plasma proteins bind with penicillin– generally too small to act on its own

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7
Q

Lymphocyte roles

A

REGULATORY: speed up or slow down immune response
- T4/ Helper T cells (CD4 marker)
- the “quarterback”
EFFECTOR: final stake of the immune response
- T8/ Killer or cytotoxic T cells (CD8 marker)
- “Rambo”
- ensure removal of foreign invader

B- LYMPHOCYTES (10-20%) - Mature in BBBone marrow, humoral/AB immunity
T-LYMPHOCYTES (60-70%) - Mature in TTThymus - cell mediated immunity

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8
Q

MHC

A

Major Histocompatibility Complex recognizes self from non-self
- AKA human leukocyte antigen (HLA)

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9
Q

MHC I

A

HLA-A, B, C

  • present on cell membranes of ALL nucleated cells
  • Present processed antigen to T8 cells
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10
Q

MHC II

A

HLA- DR, DP, DQ

  • primarily on B-cells, macrophages, dendritic cells
  • aka APC: antigen-presenting cells (phagocytic cells)
  • present processed antigen to T4 cells
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11
Q

Cell mediated immunity

A

No antibodies involved–occurs once the problem is already inside the cell

T cells respond directly to antigens
(Killer, Helper, Suppressor, Memory)
- Involves destruction of target cells through secretion of lymphokines - e.g., organ transplant rejection

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12
Q

Humoral immunity

A

AKA immunoglobulin or antibody mediated immunity

  • B cells mature into plasma cells that produce specific antibodies
  • Provides for elimination of bacteria, neutralization of bacterial toxins, & prevention of viral infection
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13
Q

Role of T lymphocytes

A
  • Activating other T-cells & B-cells
  • Controlling viral infections
  • Rejecting foreign tissue grafts
  • Delayed hypersensitivity
  • Regulating & amplifying T- & B-cell response
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14
Q

Types of T-Lymphocytes

A
  • Cytotoxic (CD8+): Bind to surface of invading cells, disrupt cell membrane & release toxic chemicals

Helper (CD4+)

  • Secrete cytokines
  • Stimulate B-cells to proliferate & mature into plasma cells
  • Facilitate cell-mediated response

Suppressor: Reduce the humoral response

Memory: Remain dormant until second exposure

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15
Q

Natural Killer cells

A

Large granular lymphocytes with CD16 and CD56 cell markers

  • are non-specific effector cells that kill tumor cells & virus infected cells
  • Programmed killing is inhibited by contact with MHC self molecules
  • Activity depends on production of perforins, enzymes & toxic cytokines
  • Activity enhanced by IL-2
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16
Q

Role of macrophages and dendritic cells

A
  • Both work as bridges between innate and adaptive immunity
  • Release chemical signals that activate T- lymphocyte function in adaptive immunity
  • Function as antigen presenting cells to modulate the immune response
  • Dendritic cells are found mainly in lymphoid tissue of the respiratory and GI systems
  • Responsible for processing and presenting antigen to lymphocytes, which results in macrophage activation
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17
Q

Macrophages

A
  • Lack surface receptors for specific antigens
  • Have receptors for Fc (constant) region and for complement
  • Like dendritic cells, they ingest and process antigen & deposit it on its own surface – and then present to T-lymphocytes, which activates them
  • Secrete cytokines: tumor necrosis factor (TNF), interleukin-1 (IL-1) which produces fever
  • Phagocytic effector cells in both humoral & cell-mediated responses
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18
Q

Cytokines (role)

A
  • Small hormone-like polypeptides
  • Act predominantly on immune cells to regulate inflammatory responses including: movement, proliferation & differentiation of leukocytes and other cells
  • Named for the cell that produced them, with international nomenclature, or for the bio property assigned to them (ie interferon)
  • know interleukins, interferons, TNF, CSF
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19
Q

Interleukins

A

Activates t-cells;
co-factor for hematopoiesis;
induces fever, sleep, ACTH release;
stimulates synthesis of cytokines, collagen & collagenases;
activates endothelial cells and macrophages;
mediates inflammation, catabolic process & nonspecific resistance to infection

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20
Q

Interferons (interferon gamma)

A

Induces MHC I & II and other surface antigens on variety of cells;
activates macrophages and endothelial cells, augments or inhibits other cytokine activities;
augments NK cell activity;
exerts antiviral activity
INTERFERes with viral replication

21
Q

TNF (tumor necrosis factor)

A

~pro inflammatory cytokine~
Induces MHC I & II and other surface antigens on variety of cells;
activates macrophages and endothelial cells, augments or inhibits other cytokine activities;
augments NK cell activity;
exerts antiviral activity

22
Q

CSF (colony stimulating factor)

A

~promotes cell differentiation and proliferation~
Promote neutrophilic, eosinophilic, and macrophage bone marrow colonies;
activates mature granulocytes

23
Q

Reticuloendothelial system

A

Tissue macrophages:

  • Lung: alveolar macrophages
  • Liver: Kupffer’s cells
  • Spleen
  • Lymph nodes
  • Intestine: Peyer’s patches
  • CNS: microglial cells
  • Skin: Langerhans’ cells
  • Connective tissue: histiocytes
24
Q

Structure of immune system [review]

A
  • Lymph nodes:
    Distribute along lymphatic vessels
    Filter lymph fluid & remove bacteria & toxins from circulation
    Proliferation of immune cells
  • Thymus:
    Located in mediastinum
    Produces T-lymphocytes
  • Spleen:
    Largest lymph organ
    Reservoir for blood
    Macrophages clear cellular debris & process hemoglobin
  • Tonsils:
    Produce lymphocytes
    Guard against airborne and ingested pathogens
25
Q

Structure of a lymph node

A

Lymph flows in through afferent lymph vessels (2) and out through the hilus, where the artery and vein are.

26
Q

B- Lymphocytes

A
  • Basis of humoral (antibody) immunity
  • Antigen binds with receptor, differentiates into plasma cell and secretes immunoglobulins
  • Also function as APCs: Ingest and process antigen & deposit it on its own surface in association with MHC II; activate T-lymphocytes to secrete cytokines
  • Regulated by T-lymphocytes & cytokines
  • Memory B cells: Circulate indefinitely & become active on repeat exposure
27
Q

Antibody structure

A
  • Fc (constant fragment): non-specific activator, identical for all antibodies of a class
  • Fab (antigen binding fragment): specific for each antibody, contains specific antigen binding site
  • binding to the Fab portion activates (“lights up”) the Fc portion which leads to the destruction of the microorganism
28
Q

IgG Immunoglobulins

A
  • Most abundant in the blood (75%)
  • Appears in all body fluids & crosses placenta
  • Major antibacterial & antiviral antibody
  • Second antibody produced during an immune response; greater on second exposure [GGGreater later??]
29
Q

IgM IGs

A
  • First antibody produced on initial exposure [e-M-s always first on the scene]
  • Very large; usually only present in vascular system b/c can’t cross barriers
  • responsible for natural immunity in species (?)
  • activates complement
  • 10% of all iGs
30
Q

IgA IGs

A
  • Found mainly in body secretions (e.g., saliva, sweat, tears, mucus, bile, colostrum)
    [say AAAAAAH]
  • Defends against pathogens on body surfaces esp. respiratory and GI tracts – acts locally vs. systemic
  • Accounts for 15% of all immunoglobulins
31
Q

IgD Immunoglobulins

A 
rare 
- Present in plasma & easily broken down
- Predominant antibody on the surface of B cells & is mainly an antigen receptor
- Needed for maturation of B-lymphocytes
Accounts for <1% of all immunoglobulins
32
Q

IgE IGs

A
  • Antibody involved in immediate hypersensitivity reactions or allergic reactions that develop within minutes of exposure to an antigen
  • Binds to mast cells & basophils
    Stimulates the release of mast cell granules, which contain histamine and heparin
    Involved in parasitic infections
  • Accounts for <1% of all immunoglobulins
    [igEmergency]
33
Q

Natural immunity

A

Innate resistance

Factors: heredity, age, health, species, race, sex

34
Q

Active Immunity

A

Acquired through immunization OR having the disease - producing our own antibodies

Inactivated vaccines (killed viruses):

  • Not capable of replicating in the host
  • present little risk to recipient.
  • Maintenance of lifelong immunity requires multiple doses

Live vaccines (attenuated):

  • Most involve use of live virus with altered virulence
  • Does not require use of multiple doses

Active immunization

  • Use of a modified product of an organism such as a toxoid
  • Maintenance of protective titers requires periodic boosters
35
Q

Active immunity examples

A 
Hepatitis B vaccine
Diphtheria Pertussis & Tetanus (DPT)
Haemophilus influenzae B vaccine
Poliovirus vaccine
Rotavirus vaccine
Measles, Mumps, and Rubella vaccine (MMR)
Varicella virus vaccine
Influenza virus vaccine
Pneumococcal polysaccharide vaccine
36
Q

Passive Immunity

A

Antibodies are given to us
- can be natural (through placenta or breast feeding) or through injection of gamma globulins

components:

  • Immunizing agent: active component
  • Suspending fluid: sterile water, saline, complex tissue culture fluid
  • Preservatives: stabilizers or antibiotics to prevent bacterial overgrowth
  • Adjuvants: aluminum based compound to enhance immunogenicity & prolong stimulatory effect
37
Q

Passive Immunity examples

A 
Hepatitis B immune globulin
Diphtheria antitoxin
Tetanus immune globulin
Varicella zoster immune globulin
Rabies immune globulin
38
Q

Humoral Immunity

A

Depends on maturation of B-cells into plasma cells & secretion of antibodies

Effector responses:

  • Precipitation of antigen-antibody complexes
  • Agglutination or clumping of cells
  • Neutralization of bacterial toxins & viruses
  • Lysis & destruction of pathogens or cells
  • Adherence of antigen to immune cells
  • Facilitation of phagocytosis
  • Activation of complement

A secondary response will occur faster

39
Q

Cell-mediated immunity

A

Cell to cell or cell to virus

  • protection against viruses or cancerous cells
  • action of T-lymphs and macrophages mostly
  • Macrophages process the antigen and present it to Tcells
40
Q

Complement

A

Consists of 20 proteins circulating as functionally inactive molecules

Causes inflammation by increasing:

  • Vascular permeability
  • Chemostasis - chemical equilibrium
  • Phagocytosis - engulfing of foreign particles by phagocytes
  • Lysis of foreign cell

Usually requires antigen-antibody (IgG or IgM) reaction to activate complement system

41
Q

Complement Cascade

A

Two pathways

Classic Pathway

  • Initial step is activation of C1
  • Activation: Fc portion of IgG or IgM antibody is turned on after antigen binds to the Fab portion

Alternate (Properdin) Pathway

  • Initial step is activation of C3
  • Activation: by pieces of bacterial or fungal wall released during phagocytosis

C1-C5: stimulate mast cell degranulation, WBC chemotaxis, & opsonization of bacteria
C6-10: bacterial cell lysis by making cell wall “leaky”

42
Q

Complement-mediated immune responses

A
  • Cytolysis: destruction of cell membranes (body cells or pathogens)
  • Adherence: adhesion of Ag-Ab complexes to surfaces
  • Chemotaxis: chemical attraction of phagocytes
  • Anaphylaxis: degranulation of mast cells; can cause shock.
  • Opsonization (w/adherence: targeting antigen and making it yummy so that it can be engulfed and digested by macrophages
43
Q

Autoimmune disorder

A

Immune response against self, ie rheumatoid arthritis

44
Q

Immunodeficiency disorder

A

Anergic; absent or depressed immune system, eg AIDS

45
Q

Type I Hypersensitivity

A

immediate, mediated by IgE
- Binding of antigens to IgE antibodies on the surface of mast cells triggers release of allergic mediators that cause vasodilation, increased capillary permeability, smooth muscle contraction, & eosinophilia
- Chemical mediators: histamine, prostaglandins, leukotrienes, cytokines
can be Anaphylactic

EXAMPLES: 
extrinsic asthma
seasonal allergic rhinitis
systemic anaphylaxis
reactions to insect stings

[ONE sting is bad enough]

46
Q

Anaphylaxis

A

Systemic response to the inflammatory mediators released in type I hypersensitivity [ONE sting is bad enough]

  • Histamine, acetylcholine, kinins, leukotrienes, and prostaglandins all cause vasodilation
  • Acetylcholine, kinins, leukotrienes, and prostaglandins all can cause bronchoconstriction
47
Q

Type II Hypersensitivity

A
  • Cytotoxic – cytolytic, complement-dependent
  • Binding of IgG or IgM antibodies to cellular or exogenous antigens activates the complement cascade; results in phagocytosis or cytolysis

EXAMPLES:
Goodpasture’s syndrome (glomerulonephritis)
Erythroblastosis fetalis (hemolytic disease of the newborn) - need RhoGAM
Autoimmune hemolytic anemia
Hemolytic transfusion reactions

48
Q

Type III Hypersensitivity

A
  • Immune complex disease reaction
  • Activation of complement by immune complexes causes infiltration of PMNs & release of lysosomal enzymes & permeability factors
    • produces inflammatory response

EXAMPLES:
Serum sickness (Penicillin most common cause)
Post-streptococcal glomerulonephritis
Autoimmune vasculitis

49
Q

Type IV Hypersensitivity

A

T-cells only

  • Delayed (cell-mediated)
  • APC presents antigen to T-cells in association with MHC; T-cells release lymphokines that stimulate macrophages
    • lysozymes released and damage surrounding tissue
EXAMPLES:
Contact dermatitis
HVGD & GVHD (tissue plant rejection)
Allograft rejection
Tb test (don't produce antibodies)

Patho II (12 decks)

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