Immunity Flashcards
Antibodies against meningococcus assist ________ cells in destroying the bacteria
phagocytic
Tissue damage causes inflammation and activation of ___________, which help lyse the bacteria.
complement
response that takes longer to produce antibodies
primary
response that produces antibodies quickly
secondary
neutrophils accumulate to kill bacteria in response to ________ signals
chemotactic
when bitten by dog, patient is given _______ to prevent rabies
immunoglobulins
immunoglobulins provide passive immunity for ______ (how long?)
2 months
neonate’s ______ level drop after birth
IgG
neonates lowest level of IgG will be ______ months afer birth
5-6
the spectrum of microorganisms colonized on the body’s surfaces
normal microbiome
the natural epithelial barrier and inflammation that confer innate resistance and protection
innate (natural/native) immunity
process that is initiated by inflammation and results in a long-term and very effective immunity to infecting microorganisms
adaptive (acquired/specific) immunity
type of immunity that is slow to develop but has memory & rapidly targets/eradicates a 2nd infection
adaptive immunity
physical, mechanical, and biochemical barriers at the body’s surfaces that are in place at birth to prevent damage by sunbstances in the environment and thwart infection by pathogenic microorganisms
natural barriers
the second line of defense that is activated if the surface barriers are breached which protects from further injury, prevents infection of injured tissue, and promotes healing
inflammatory response
a rapid activation of of biochemical and cellular processes that is relatively nonspecific
inflammatory response
highly interconnected junctions that prohibit the passage of microorganisms into the underlying tissue
mucosal epithelial cells
mechanical cleansing of body surfaces include…
vomiting and urination
these cells produce mucus that coats the epithelial surface and traps microorganisms that are removed by hairlike cilia that mechanically move the mucus upward to be expelled by coughing or sneezing
goblet cells of the UR tract
substances synthesized and secreted by epithelial surfaces that trap or destroy microorganisms
epithelial-derived chemicals
examples of epithelial-derived chemicals
mucus sweat sliva tears earwax
in the skin, these secrete antibacterial and antifungal fatty acids and lactic acid
sebaceous glands
enzyme in sweat, tears and saliva that attacks the cell walls of gram-positive bacteria
lysozyme
________ create an acidic skin surface (pH 3-5) which is inhospitable for most bacteria
glandular secretions
proteins secreted by epithelial cells that destroy pathogens
antimicrobial peptides
generally positively charged polypeptides of approximately 15-95 amino acids that can be divided into 2 classes
antimicrobial peptides
these can activate cells of innate and adaptive immunity
cathelicidins and defensins
family of glycoproteins produced and secreted by the lungs which include surfactant proteins A-D and mannosebinding lectin
collectins
these react with different affinities to carbohydrates and lipids on the surfaces of a wide array of pathogenic microorganisms
collectins
the process that facilitates recognition of the microorganism by macrophages, enhancing macrophage attachment, phagocytosis and killing
collectin binding
powerful activator of a plasma protein system (complement) that recofnizes a sugar commonly found on the surface of microbes which damages bacteria and increases recognition by macrophages
mannose-binding lectin (MBL)
epithelial antimicrobial found in intestinal goblet cells where it protects against helminth infections
resistin-like molecule beta
epithelial antimicrobial stored in neutrophils and intestinal epithelium that reacts with lipopolysaccharide on the surface of gram-negative nacteria resulting in bacterial lysis
bactericidal/permeability-inducing (BPI) protein
carbohydrates that are found in intestinal epithelium and have activity against gram-positive bacteria
antimicrobial lectins
rapid initiation and interactive system of humoral and cellular systems designed to limit the extent of tissue damage, destroy contaminating infectious microorganisms, initiate the adaptive immune response and begin the healing process
inflammatory response
cellular injury and pathogenic invasion result in…
mast cell degranulation
activation of plasma systems
release of cellular products
inflammatory response occurs in tissues with _______
vascularization (blood supply)
inflammatory response is activated ________ after damage occurs
rapidly (within seconds)
inflammatory response depends on the activity of ___________
cellular and chemical components
inflammatory response is _______
nonspecific
arteriole inflammatory response includes…
aterilor constriction
transudate production
mast cell degranulation
capillary inflammatory response includes…
emigration of neutrophils spillage of erythrocytes leukocyte (platelet adhesion) platelet aggregation endothelial cell contraction increased vascular permeability chemotaxis for neutrophils
venule inflammatory response includes…
emigration of neutrophils
macrophage infiltration
mediators
fibrin deposition= fibrosis
Inflammatory Phases (Acute)
Cellular Injury
Acute Inflammation
Healing or Chronic Inflammation
Inflammatory Phases (Chronic)
Cellular Injury
Chronic Inflammation
Healing or Granuloma Formation
the 3 plasma protein systems
complement system
clotting system
kinin system
enzymes that are inactive froms of proteins
proenzymes
system athat produces several factors that can destroy pathogens directly and can activate or collaborate with other components of the innate and adaptive immune response
complement system
completement system pathway activated by proteins of the adaptive immune system (antibodies bound to their specific targets (antigens)
classical pathway
completement system pathway activated by mannose-containing bacterial carbohydrates
lectin pathway
completement system pathway activated by gram-negative nacterial and fungal cell wall polysaccharides
alternative pathway
early systemic response to inflammation which is partially induced by specific cytokines released from neutrophils and macrophages
fever
fever-causing cytokines
endogenous pyrogens
portion of the brain that controles the body’s temperature
hypothalamus
pyrogens act directly on the ________
hypothalamus
3 cardinal signs of inflammation
fever
leukocytosis
plasma protein synthesis
increase in the number white blood cells (>11K)
leukocytosis
more immature forms of neutrophils present in relatively greater than normal proportions than mature neutrophils
leukocytosis with left shift
process of plasma proteins, mostly products of the liver, increased during inflammation
plasma protein synthesis
local manifestation of inflammation
vasodilation
increased capillary permeability
systemic manifestations of inflammation
fever
leukocytosis
plasma protein synthesis
cellular products of inflammation response
transudate leukocytes endothelial cell adhesion molecule neutrophils erythrocytes macrophages fibrin
watery exudate in early or mild inflammation with very few plasma proteins or leukocytes
serous
thick and clotted exudate in severe or advanced inflammation
fibrinous exudate
exudate that consists of pus caused by large amount of accumulated leukocytes in persistent bacterial infections
purulent (supparative) exudate
purulent (supparative) exudate is characteristic of …
walled-off lesions (cysts or abscesses)
exudate that includes bleeding and filled with erythrocytes
hemorrhagic exudate
first step in initiation of immune response that presents foreign fragments to immune system
macrophages ingest, process, and display antigen fragments on their cell surface
antigen presenting cells (APC)
cells that present and process antigens
antigen presenting cells (APC)
these are needed to start an immune response
antigen presenting cells (APC)
What are displayed on the surface of APCs?
macrophages with antigen fragments
What do macrophages with antigen fragments interact with?
T-helper cells that recognize the same antigen
macrophage + T-helper cell interaction releases _______ which stimulates _______
macrophage - chemical alarm system called IL-1 stimulates T-helper cells to secrete IL-2
IL-2 causes proliferation (rapid increase) in…
cytotoxic T cells + B cells
proliferation of cytotoxic T cells and B cells triggers…
cell-mediated and humoral immune response
cells that present and process antigens require a variety of cells in the __________ system
lymphoid (lymph nodes + spleen)
antigen processing is done by _________ cells
phagocytic (mostly dendritic)
the processed antigen is on the surface of the cells and recognized by the lymphocytes
antigen presentation
a molecule that can react with antibodies or antigen receptors on B and T cells
antigen
most antigens are _________
immunogens (will induce an immune response)
most important criteria for antigen to induce an immune response
antigen is foreign to the host
_______ antigens are the most immunogenic
large
criteria for antigen to induce immune response
- foreign to the host
- large
- adequate chemical complexity
- sufficient quantity
- route / vehicle of entry
- genetic make-up of host
glycoproteins found in all human cells except RBC
major histocompatibility complexes (MHC)
these carry identification or codes that help distinguish tissue from the tissue of others and from antigens or foreign substances.
major histocompatibility complexes (MHC)
these distinguish self from non-self
major histocompatibility complexes (MHC)
T lymphocytes cannot recognize foreign bodies unless they are displayed on the surface of…
MHC proteins on the cell
this is an important consideration for tissue and organ transplants
matching of the MHC gene expression
MHC are divided into _______
human leukocyte antigens (HLAs) that code for MHC
the 3 types of MHC are derived genetically from _____
the long arm of chromosome 6
types of MHC that codes for proteins that display/present antigens on the surface cells
Class I and II
type of MHC that codes for a variety of proteins important in the inflammatory reaction
Class III
type of immunity that consists of lymphocytes and surface proteins called antibodies
Adaptive (acquired) Immunity
Adaptive (acquired) Immunity is specific to ______ and produces ______
certain antigen
long-term protection
Adaptive (acquired) Immunity has a _____ system
memory
Adaptive (acquired) Immunity produces a ______ response if the antigen presents for a second time
secondary
Adaptive (acquired) Immunity is ______ meaning it does not pre-exist but will be produced in reponse to infection
inducible
cells found in blood, tissues and organs and defend against intracellular pathogens by attacking the antigen directly
effector T cells
cell that may produce cytokines or develop into T-cytotoxic cells (Tc cells) or T helper cells
T cells
regulatory cells that control both cell-mediated and humoral responses
T helper cells
type of immunity that is controlled by T cells and is responsible for some viruses, tumors and cancers
cell-mediated immunity
cells that divide into plasma cells (factories for antibodies) and circulate in blood and secretions and defends against extracellular microbes by binding to the antigen
B cells
B cells need _____ to activate
T helper cells
type of immunity that can result in direct inactivation of the microorganism or activation of inflammatory mediators (phagocytes) that will destroy the pathogen
Humoral Immunity
type of immunity that can result in direct inactivation of the microorganism or activation of the inflammatory mediators (phagocytes) that will destroy the pathogen
humoral immunity
type of immunity that is primarily responsible for protection against bacteria and viruses
humoral immunity
______ reduce the IgG that will recognize a specific antigen that has been presented previously and provides immunity
B cells
process of antibodies or immunoglobulins manufactured to a specific antigen
humoral response
functions of humoral response
precipitation agglunation neutralization compliment activation opsonization
class of immunoglobulins that is most abundant, most protective, and smallest that cross the placenta to fetus
IgG
class of immunoglobulins that is the largest, first to respond because it increases first
IgM
class of immunoglobulins that is found in body secretions (i.e. breastmilk)
IgA
class of immunoglobulins that is a mediator in allergic reactions and defends against parasitic infections
IgE
class of immunoglobulins that is least abundant and acts as an antigen receptor on the surface of early B cells
IgD
adaptive immunity occurs in ___ phases
two
phase of adaptive immunity that occurs in the fetus where lymphocytes undergo extensive differentation and proliferation in the thymus and bone marrow developing origin-specific cell surface proteins
generation of clonal diversity
T lymphocytes (T cells) are derived from…
thymus
B lymphocytes (B cells) are derived from…
bone marrow
_____ and ______ develop surface antigen receptors
T cells and B cells
lymphocytes coming out of clonal diversity are immunocompetent but naive meaning….
they have the ability to respond to an antigen but have not encountered one yet
phase of adaptive immunity that is initiated by exposure to a foreign antigen related to infection
clonal selection
in clonal selection, antigen reacts with B and T cells that have…
surface receptors against that specific antigen
in clonal selection, when the B and T cell clones encounter an antigen, they form…
mature effector cells
B cells become…
plasma cells, antibody and memory cells
T cells become…
T cytotoxic cells, T helper cells, T regulatory cells, and memory cells
T helper cells help the _____ process
clonal selection
T cytotoxic cells kill _____
target cell
T regulatory cells suppress _____
the immune response
memory cells illicit ______
a secondary response
immunity that is created by the transfer of plasma containing antibodies against a specific antigen from an immunized person OR
from someone who has had the disease and became immune to an individual who needs to be protected because this person has not been immunized or previously exposed
passive immunity
_____ immunity does not involve the host’s immune response at all
passive
______ immunity is temporary
passive
modes of transmission of passive immunity
injection of performed antibodies
passage from mother to fetus (IgG)
breastmilk to newborn (Ig G and IgA)
IgA gives newborn protection against ______
GI infections
injections give individual protection for ______
2 months
type of immunity that is long-lived and occurs when the body mounts and immune response to and builds up antibodies against the disease or immunization
active immunity
active immunity requires ___ cells
memory B cells
modes of transmission of active immunity
natural exposure after immunization
in the 3rd trimester, the fetus mounts a ________
primary immune response
IgG is the lowest in infants at ____ months
5-6
decrease in immune function with aging is due to ________ and ________
decreased T cell activity
decreased circulating memory B cells
aging decreases changes the _______ of T cell subtypes
population
increased risk for autoimmune disorders occurs with aging due to ______
increase in circulating autoantibodies
increased risk for immune complex disorders occurs with aging due to ______
increase in circulating immune complexes
normal immune response that is either inappropriately triggered, excessive, or produces undesirable effects on the body
hypersensitivity
hypersensitivity usually does not occur with ______
first exposure
this type of hypersensitivity respons is antibody mediated, specifically IgE and the products of tissue mast cells and mediated release of histamine from mast cell
Type I: Immediate
this type of hypersensitivity response is antibody mediated, specifically IgG and IgM
Type II: Tissue-Specific/ Cytotoxic/Cytolytic
this type of hypersensitivity response is antibody mediated, specifically IgG and IgM but is NOT TISSUE SPECIFIC
forms large, sticky molecules
Type III: Immune Complex Reaction
Type III Immune Complex Reaction hypersensitivity response results in…
failure to remove antigen-antibody immune complexes causing INFLAMMATION
The most complex type of hypersensitivity response is
Type III: Immune Complex Reaction
this type of hypersensitivity response is cell mediated, specifically T cells, and causes a localized inflammatory reaction
Type IV: Delayed-cell mediated
the type of hypersensitivity response that has no antibody involvement, only T cells
Type IV: Delayed-cell mediated
this type of hypersensitivity is caused by antibodies attacking antigens on the surface of specific cells or tissues which causes them to malfunction or be destroyed
Type II: Tissue-Specific/ Cytotoxic/Cytolytic
this type of hypersensitivity is caused by recent hx of infection or persistent low grade infection; exposure to molds, plants or animal allergens that are inhaled; OR as autoimmune process
Type III: Immune Complex Reaction
this type of hypersensitivity is caused by tissue damage resulting from a delayed cellular reaction to antigen
Type IV: Delayed-cell mediated
this type of hypersensitivity occurs immediately 15-30 min after exposure; could be anaphylaxis
Type I: Immediate
this type of hypersensitivity occurs often immediately (15-30 min) but can occur over time
Type II: Tissue-Specific/ Cytotoxic/Cytolytic
this type of hypersensitivity occurs over several hours or longer and is usually ongoing; “self sustaining inflammation”
Type III: Immune Complex Reaction
this type of hypersensitivity occurs when the exposure precedes the rash by 48 hours or more
Type IV: Delayed-cell mediated
Examples of Type ______ Hypersensitivity
Atopic conditions: asthma, hay fever, dermatitis
Drug, food, insect venom allergies
Reactions to inhaled or environmental allergens
Type I: Immediate
Examples of Type ______ Hypersensitivity
- Transfusion reaction.
- celiac’s disease
- Hemolytic disease of the newborn
- Grave’s Disease
- Transplant rejection
- Autoimmune hemolytic anemia
Type II: Tissue-Specific/ Cytotoxic/Cytolytic
Examples of Type ______ Hypersensitivity
- SLE (Lupus)
- immune complex glomerulonephritis (kidney)
Type III: Immune Complex Reaction
Examples of Type ______ Hypersensitivity
- graft rejection (transplant rejection)
- photoallergic sensitivity
- TB skin test
- -poison ivy rash*
- metal skin reaction (nickel)
Type IV: Delayed-cell mediated
_________ can cause vasodilation, capillary leak which leads to hives, anaphylaxis, and shock due to BP decrease
Histamines
key difference between Type I and Type II Hypersensitivity reaction is…
location of antigen mechanism on injury
type of hypersensitivity that is located on tissue-specific antigen on the cell surface
Type II: Tissue-Specific/ Cytotoxic/Cytolytic
type of hypersensitivity that is located on an antigen from an antigen antibody complex that precipitates out of the blood or fluid and are deposited into tissues
Type III: Immune Complex Reaction
type of hypersensitivity that results in direct cell death or malfunction
Type II: Tissue-Specific/ Cytotoxic/Cytolytic
excessive immune response; when the immune system recognizes self-tissue as foreign, tolerance of self-antigen breaks down
Autoimmunity
the most widely accepted theory of autoimmunity that states response is caused by foreign antigens sharing similar sequences with self-antigens
Antigenic Mimicry Theory
Release of sequestered antigens theory
T-cell theory
B-cell theory
Mast cell theory
Theories of Autoimmunity
______ are at greater risk to have more autoantibody production compared
Women
______ plus _______ increases risk of Type I DM
genetics plus autoantibodies
enviromental triggers for autoimmunity include…
viruses (Epstein-Barr, cytomegalovirus)
bacteria (h pylori)
stress
stress can trigger autoimmunity because increased stress levels increases production of _______
proinflammatory cytokines
individuals of the same species have incompatible antigens, preventing them from receiving an organ from each other
Alloimmunity/Isoiummunity
transfusion reactions, graft rejections, and transplant rejections are caused by the two individuals having ______
unmatched HLAs
most common cause of infections
viruses
stage of clinical infectious disease process that lasts from initial exposure to onset of first symptom (hours- years)
Incubation Period
stage of clinical infectious disease process that involves the occurence of S/S (mild, discomfort, tiredness)
Prodromal Period
stage of clinical infectious disease process in which the pathogen is multiplying rapidly, immune/inflammatory responses have been activated, S/S may be pathogen-specific or just an inflammatory response (fever)
Invasion Period
stage of clinical infectious disease process where, in most cases, S/S decline and infectious agent is removed (could be fatal or enter latency phase)
Convalescence Period
first line of defense against infection consisting of physical and biochemical agents)
innate resistance
second line of defense against infection that is non-specific
inflammation
3 purposes of inflammation
- Neutralize and destroy invading and harmful agents
- Limit spread to other tissues
- Prepare for repair
functional decrease in one or more components of the immune system
immune deficiency
type of immune deficiency that is congenital, rare, often X-linked, and suspected with severe and recurrent infections
primary immune deficiency
type of immune deficiency that is caused by system disorders, something that secondarily affects the immune system (ex: HIV)
secondary immune deficiency
the chracteristic vascular changes at the site of an injury produce…
increased permeability and leakage
two lines of defense that compose innate immunity
physical/mechanical/biochemical barriers
inflammation
clinical manifestations of inflammation
pain, fever, edema, redness, pus p. 194
pathogenesis of pain
exudate accumulation, chemical mediators, nerve endings
pathogenesis of edema
increased vascular permeability, vasodilation
fluid that leaks out when capillary permeability increases
WBC, neutrophils, macrophages
pathogenesis of erythema
increased blood flow, vasodilation
pathogenesis of exudate
neutrophils, collection of dead cells
B lymphocytes create ________ in response to encountering an antigen
antibodies
antibodies turn into _______
plasma cells
B lymphocytes are responsible for ______ immunity
humoral
T lymphocytes are responsbile for _______ immunity
cell-mediated
most protective, most abundant, smallest immunoglobulin
IgG
immunoglobulin passed through placenta
IgG
IgG passing through breastmilk is ______ immunity
passive
IgA is found in _______
secretions (mucosa, breastmilk)
the largest and the first responder immunoglobulin
IgM
the least abundant immunoglobulin that acts as an antigen receptor on the surface of early B cells
IgD
immunoglobulin that is mediator of allergic responses and acts to defend against parasitic infections
IgE
IgG and _____ increase early in presentation of infection
IgM
T lymphocytes (cell mediated immunity) turn into
thousands of T helper cells, memory cells and T cytotoxic cells
Cell-mediated immunity (T lymphocytes) protects us from _______
tumors, viruses, hard to kill pathogens
In a secondary immune response, _____ is significantly increased.
IgG
passive immunity can be passed from ____ to _____
donor to recipient
What causes bronchospasm during a Type I Hypersensitivity reaction?
histamine release from mast cells that binds with H1 receptors
Histamine causes ______
vasodilation which drops BP
Examples of Autoimmune Disorders
Graves Disease Lupus Hashimotos Type I DM RA Pernicious Anemia
Examples of Alloimmunity
hemolytic disease of the NB
transfusion reaction
graft rejection
Primary Effector Cells of Hypersensitivity Type I: Immediate
mast cells bind to IgE and release histamine which increases chemotaxis of eosinophils
Primary Effector Cells of Hypersensitivity Type II: Tissue-Specific/Cytotoxic
IgG and IgM
reaction mediated by eosinophils, macrophages, and complement
Primary Effector Cells of Hypersensitivity Type III: Immune Complex Response
IgG and IgM and neutrophils
mediated by complement
Primary Effector Cells of Hypersensitivity Type IV: Delayed Cell Mediated
only by T cells
increased ESR (sed rate) would be increased in someone with infection due to
increased plasma protein synthesis (systemic manifestation of inflammation)
phagocytes
WBC, leukocytes, macrophages
lymphocytes
T cells, B cells