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DMD 5244 (Immunity) > Immunity and Host Defense against Oral Infections (complete) > Flashcards

Immunity and Host Defense against Oral Infections (complete) Flashcards

1
Q

Which two things in the oral cavity acts as a physical barrier that prevents pathogen invasion

A
  1. the integrity of the Oral Mucosa

2. tooth enamel

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2
Q

What are the two types of immunity that you can find in the Oral cavity

A

Non-specific (innate) immunity

Specific (adaptive) immunity

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3
Q

Which type of immunity in the oral cavity is non-specific and continuous
innate or adaptive immunity

A

innate

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4
Q

What triggers the activation of adaptive immunity in the oral cavity

A

a response to specific pathogen/antigen which causes an antigen-specific antibody response or a T-cell response

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5
Q

What things come from gingival crevicular fluid that assist in immunity of the oral cavity

A
  1. Polymorphs (PMNs)
  2. Complement pathway proteins
  3. IgG
  4. IgA
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6
Q

What is the class, function and abundance of Neutrophils

A 
Class = Granulocyte
Function = Phagocyte, innate immunity
Abundance = 62%
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7
Q

What is the class, function, and abundance of lymphocytes

A 
Class = agranulocytes
Function = adaptive immunity
Abundance = 30%
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8
Q

What is the class, function, and abundance of monocytes

A 
Class = agranulocytes
Function = phagocytes (macrophages in the tissues)
Abundance = 5%
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9
Q

What is the class, function and abundance of eosinophils

A 
class = granulocyte
function = removal or hemoliths and Ab/Ag complexes
abundance = 2%
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10
Q

What is the class, function, and abundance of basophils/mast cells

A 
class = granulocytes
function = allergy response, inflammation
abundance =
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11
Q

What are the different soluble mediators of immunity in the oral cavity

A

Antibodies
Complement components
Cytokines

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12
Q

what are the antibodies that are soluble mediators of immunity in the oral cavity

A

sIgA
IgM
IgG

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13
Q

What is the main complement component that is a mediator of immunity in the oral cavity

A

C3

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14
Q

what are the cytokines that are soluble mediators of immunity in the oral cavity

A

IL-1
IL-6
TNF-alpha

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15
Q

From where does sIgA come from

A

saliva

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16
Q

What are the 4 barriers of innate immunity in the oral cavity

A
  1. anatomic barriers
  2. physiologic barriers
  3. phagocytotic barriers
  4. inflammatory barriers
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17
Q

What makes up the anatomic barrier of the oral cavity

A

the epithelial cells of the oral cavity

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18
Q

What are the three ways that epithelial cells of the oral cavity fight infection

A
  1. act as a physical barrier
  2. the production of antibiotics, cytokines, and NO
  3. housing intraepithelial lymphocytes that kill the microbe
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19
Q

How do epithelial cells produce antibiotics, ctyokines, and NO

A

They have TLRs on their surface that recognize PAMPs, the binding of PAMPs by the TLRs signals epithelial cells to produce peptide antibiotics, cytokines, and NO

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20
Q

What are PAMPs

A

they are pathogen associated molecular patterns. (certain molecular patterns that are only found in pathogens)

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21
Q

What are TLRs

A

Toll-Like receptors (receptors on cell surfaces that recognize and bind to PAMPs)

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22
Q

What does TLR-2 bind to

A

Lipoteichoic acid that is found in gram + bacteria

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23
Q

what are two types of gram+bacteria that are bound by TLR-2

A

Actinomyces

Strep

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24
Q

What does TLR-4 bind to

A

lipopolysaccharides (LPS) of gram - bacteria

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25
Q

what is a type of gram - bacteria that TLR-4 binds

A

prevotella

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26
Q

Do oral cavity epithelial cells express receptors for sIgA

A

Yes

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27
Q

how does the swallowing of saliva affect immunity of the Oral cavity

A

it removes microbes from dental plaque and oral mucosa

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28
Q

How do pH and Temperature of the saliva affect immunity of the mouth

A

A rise in pH in gingivitis and periodontal disease favors putative periodontal pathogen growth
A rise in temperaure alters bacterial gene expression, and immune evasion

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29
Q

what is the normal pH in the mouth

A

6.9

30
Q

What things found in saliva are antimicrobial in nature

A 
lactoferrin
lysozyme
Myeloperoxidase system
salivary peroxidase system
antimicrobial peptides
complement
leukocytes
sIgA
31
Q

What is lactoferrin of saliva and what does it do in oral cavity immunity

A

an Iron binding molecule that is bacteriostatic (stops bacteria from reproducing)

32
Q

What is lysozyme of saliva and what does it do in oral cavity immunity

A

it is a basic protein that breaks down bacterial structure

33
Q

what bacteria is the lysozyme of saliva effective against

A

S. mutans

34
Q

what is the Myeloperoxidase system of saliva and what does it do in oral cavity immunity

A

it is a bactericidal generating halide, H2O2 in PMNs migrate to the gingival crevice to start inflammatory response

35
Q

What is the salivary peroxidase system of saliva and what does it do in oral cavity immunity

A

It is a bactericidal generating thiocyanate that produces H2O2

36
Q

What are the main antimicrobial peptides that are found in saliva

A

histatins and defensins (alpha and beta)

they are small cationic peptides with antimicrobial activity

37
Q

what are histatins and what do they do for oral cavity immunity

A

they are histidine rich peptides with broad anti-fungal and anti-bacterial activity

38
Q

what are defensins and what do they do for oral cavity immunity

A

they have broad anti-fungal, bacterial and VIRAL activity

39
Q

what to Beta defensins do specifically

A

protect mucosal surfaces

40
Q

what does the complement from saliva do for oral cavity immunity

A

Breaks down C3 derived from GCF (gingival Crevicular fluid)

41
Q

What do leukocytes from saliva do in oral cavity immunity

A

secrete alpha defensin
phagocytosis
microbial killing

42
Q

what happens to leukocyte activiy in the oral cavity with inflammation

A

it increases

43
Q

What is sIgA from saliva and what does it do in oral cavity immunity

A

it is the major Ab in saliva and it inhibits microbial adherence, agglutinates bacteria, and neutralizes viruses

44
Q

What is the phagocytic barrier involved in immunity of the oral cavity

A

the presence of phagocytes that destroy pathogens

45
Q

how do phagocytes destroy pathogens

A
  1. they bind the pathogen using cell surface receptors
  2. engulf the pathogen in a phagosome
  3. pump in toxic reactive oxygen and nitrogen intermediates to kill the pathogen
46
Q

What are the oxygen-independent methods phagocytes use to kill pathogens

A

Lysozyme
Defensins
Lactoferrin
Proteolytic and hydrolytic enzymes

47
Q

what does lysozyme do

A

breaks down cell wall components

48
Q

what are the oxygen dependent methods phagocytes use to kill pathogens

A 
Hydrogen peroxide
superoxide anion
hydroxyl radical
myeloperoxidase
hypochlorite
hypohalite
Nitric oxide
49
Q

what is CGD

A

chronic granulomatus disorder, a disorder where phagocytes lose their ability to completely eliminate engulfed pathogens.

50
Q

what are the treatments for CGD

A

antibiotics (high dose, long term)

IFN-y injections to activate macrophages

51
Q

what Abs does the Gingival crevicular fluid have

A

IgG, IgA, and IgM

saliva has sIgA

52
Q

What are some key characteristics of IgG

A
  1. monomer
  2. 70% of total Ab
  3. crosses the placenta and protects fetus
  4. activates complement
  5. major opsonizing Ab
  6. protects gingiva and gingival portion of crown
53
Q

What are some key characteristics of IgM

A
  1. Pentamer
  2. 10% of total Ab
  3. first Ab generated against any Ag
  4. predominant Ab produced by the fetus
  5. Ab for carb antigens (ABO)
  6. protects gingiva and gingival portion of the crown
54
Q

What are some key characteristics of IgA

A
  1. in serum as monomer, in secretions as dimer
  2. lines the oral cavity and doesn’t allow pathogens to adhere
  3. mucosal immunity
  4. sIga distinguishes between commensals and pathogenic molecules
55
Q

what is immune exclusion

A

the ability of antibodies (sIgA) to tell between commensal and pathogenic molecules

56
Q

what mediates humoral mucosal immunity

A

sIgA

57
Q

there are two classes of IgA. IgA-1 and IgA-2. what is the difference

A

IgA-1 is more concentrated in plasma (both equal in saliva)
IgA-1 is directed against protein antigens
IgA-2 is directed against carb antigens

58
Q

what does the M-cell of the mucosal immune system do

A

captures the Ag and delivers it to DCs. this signals IELs to migrate to mesenteric lymph nodes

59
Q

what is the main difference between oral and gut mucosal immunity

A

gut has MALT mouth has Oral lymphoid foci

60
Q

what are the two main immunologic functions of the mucosal epithelium

A
  1. provides physical barrier between the body and microbes

2. confers the first line of immune defense against the microbes

61
Q

what type of T-cells are most IEL’s (intraepithelial lymphocytes)

A

CD8+

62
Q

what do DC (dendritic cells) do in oral mucosa

A

sample between epithelial cells for Ags

63
Q

what are the three functions of the oral mucosal immune system

A
  1. respond to harmful organisms
  2. regulate influx of immune cells
  3. prevent inflammatory tissue destruction
64
Q

what happens to commensal bacteria if the homeostasis between them and the mucosal immune system becomes unbalanced

A

they become surrogate pathogens and stimulate a chronic inflammatory response

65
Q

what does dental plaque at the gingival margin result in

A

acute inflammation

66
Q

what does acute inflammation do to GCF

A

it increases the flow of GCF

67
Q

an ecological imbalance between the endogenous flora and host immune response results in

A

dental caries and periodontal disease

68
Q

what causes dental caries

A

frequent consumption of fermentable carbs. which is used by S. mutans and that gives off acid which degrades enamel

69
Q

what do M-cells do the the mouth

A

they capture antigens and deliver them to Dendritic cells, those then cause the secretion of IgA

70
Q

what do mucosal epithelial cells secrete as a non-specific shield to prevent microbe damage

A 
mucins
defensins
trefoil peptides
acquired enamel pellicle
lysozyme 
NO

DMD 5244 (Immunity) (16 decks)

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