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POD > Immuno > Flashcards

Immuno Flashcards

1
Q

What is the distribution of immune cell composition in healthy humans?

A 
Neutrophil (40-75%)
Lymphocyte (20-50%)
Monocyte (2-10%)
Eosinophil (1-6%)
Basophil (
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2
Q

What is a form of B cell hyperplasia?

A

Multiple Myeloma

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3
Q

What is a form of T cell hyperplasia?

A

Leukemia, lymphoma

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4
Q

What are the functions of the immune system?

A

protection

surveillance

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5
Q

What is the difference between an immunogen and an antigen?

A

immunogen leads to a productive immune response

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6
Q

What are the characteristics of innate immune system?

A

not specific
includes barriers, complement, cytokines
phagocytic
fast-minutes to hours

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7
Q

What are the characteristics of adaptive immune system?

A

variable
days
B and T lymphocytes

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8
Q

Why are infants and the elderly more susceptible to infections?

A

infants-incomplete immune system

elderly-weaker response, no new T cells

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9
Q

How does nutrition impact the immune system?

A

less zinc and iron available

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10
Q

What are some properties of cytokines?

A 
secretion is limited
most paracrine (can be autocrine or juxtacrine)
more than one affect-pleiotropic
overlapping-redundant
antagonistic or synergistic
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11
Q

What are chemokine functions?

A

stimulate directional migration of leukocytes
activate integrins
leukocyte activation
chemotaxis

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12
Q

What are inflammatory chemokines?

A

turned on by infection and stimulate inflammation

examples-IL8, MCP-1, MIP3a, MIP1alpha, IP-10

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13
Q

What are lymphoid chemokines?

A

expressed in lymphoid organs, mediate recirculation, constitutively expressed
examples-SLC, BLC, MIP3alpha, SDF-1

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14
Q

How do cytokine receptors signal?

A

signal mostly through JAK/STAT

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15
Q

What does stem cell factor do?

A

released from bone marrow stroma

renewal and induce differentiation into pluripotent stem cell

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16
Q

What does IL7 do?

A

stimulates lymphoid progenitor

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17
Q

What does IL3 do?

A

induces maturation early in myeloid lineage

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18
Q

What cytokines act on neutrophils to mature?

A

IL3, GM-CSF, G-CSF

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19
Q

What cytokines act on monocytes to mature?

A

IL3, GM-CSF, M-CSF

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20
Q

What activates the classical pathway?

A

antibodies (IgM and IgG)

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21
Q

What are anaphylatoxins and how do they work?

A 
stimulate cellular degradation by acting as a chemotactic for neutrophils
increase vascular permeability
smooth muscle contraction
histamine release from mast cells
C5a phagocytosis via CR1 on macrophages
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22
Q

What is the C3 convertase in the classical pathway?

A

C4b2a

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23
Q

What is the C5 convertase in the classical pathway?

A

C4b2a3b

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24
Q

What activates the alternate pathway?

A

random deposition of C3b

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25
Q

What is the C3 convertase in the alternate pathway?

A

C3bBb

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26
Q

What is the C5 convertase in the alternate pathway?

A

C3bBb3b

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27
Q

What are the cofactors in the alternate pathway?

A

B, D, properdin

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28
Q

What activates the lecithin pathway?

A

Mannose binding lectin or ficolins binding to carbohydrates

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29
Q

What cleaves C2 and C4 in the lecithin pathway?

A

MASP (MBL associated serine protease)

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30
Q

What is opsonization?

A

C3b which is recognized by phagocytes

enhances phagocytosis of microbes

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31
Q

What are the complement receptors on phagocytic cells?

A

1, 3, 4 (kiss of death)

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32
Q

What complement receptor functions as a costimulator of B cells?

A

CR2

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33
Q

What does DAF do?

A

membrane inhibitor

dissociates C4b, C3b

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34
Q

What does MCP do?

A

membrane inhibitor

dissociates C4b, C3b, promotes cleavage by Factor 1

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35
Q

What does C1 inhibitor do?

A

prevents proteolytic activity of C1 complex

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36
Q

What do CD59 and S protein do?

A

prevent assembly of MAC

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37
Q

What is the antigenic determinant?

A

exact area of recognition on antigen

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38
Q

What is the immune system capable of seeing?

A 
chemicals
nucleic acids
carbohydrates
lipids
peptides
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39
Q

How do B and T cells differ in what they can recognize?

A

B-anything
T-peptide
increasing size increases immunogenicity

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40
Q

What is the immunodominant epitope?

A

dominate over others in the elicitation of immune responses

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41
Q

What is cross reactivity?

A

recognizing ligand will see antigen but may also see an unrelated antigen
example-M cells after strep infection

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42
Q

What is a hapten and how does it cause anemia?

A

hapten-non immunogenic but can interact with a carrier protein to become immunogenic
example-penicillin binding to RBC–>causes anemia

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43
Q

What is the purpose of a booster vaccine?

A

memory response to maintain level of antibody

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44
Q

What is passive immunization?

A

immunoglobulin

maternal to fetal transmission

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45
Q

What is active immunization?

A

live attenuated
inactivated or killed
nucleic acid

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46
Q

What is antigenic sin?

A

immunodominant epitope dominate the response and mask the new epitopes that on their own might elicit a response

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47
Q

What are the two forms of antibodies?

A

B cell receptor

secreted antibodies

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48
Q

What are the functions of antibodies?

A

neutralize toxins
prevent entry and spread of pathogens
eliminate microbes

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49
Q

What is the constant region?

A

little genetic variation
imparts function of antibody
defines isotype

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50
Q

What is the variable region?

A

determines binding of antigen

ratio of kappa to lambda is 2:1

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51
Q

What is the hypervariable region?

A

forms the antigenic determinant

also called the complimentary determining regions

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52
Q

What is the importance of the hinge region?

A

flexibility

important in B cell activation-crosslinking

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53
Q

What is the difference between affinity and avidity?

A

affinity-single Ab-Ag complex

avidity-overall strength of attachment

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54
Q

What is significant about IgG?

A

activates complement
crosses placenta
osponization
sensitize NK cells

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55
Q

What is significant about IgM?

A

heaviest-pentamer
can neutralize
activates complement

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56
Q

What is significant about IgA?

A

dimeric-cross via an accessory Poly Ig receptor

can cross epithelium

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57
Q

What is significant about IgE?

A

short half life

coat mast cells, allow release of granules upon allergic binding

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58
Q

What is the difference between the primary and secondary response?

A

antibodies initially IgM
switch to IgG
second response-higher concentration, shorter time, increased affinity

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59
Q

How are monoclonal antibodies formed?

A

collect B cells and place in myeloma and then look for antibodies

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60
Q

What is isotype?

A

epitopes on constant region and show no variation within a species

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61
Q

What is allotype?

A

epitopes in constant region that show variation within a species

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62
Q

What is idiotype?

A

epitopes in variable region that show variation within the same individual (IgM for different pathogens)

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63
Q

How is MHC I organized in humans genetically?

A

set of 3 genes (A, B, C)

located on chromosomes 6

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64
Q

How is MHC II organized in humans genetically?

A

set of 3 genes (DP, DQ, DR)

located on chromosome 6

65
Q

What factors contribute to variation in MHC?

A 
co-dominance-both parental alleles equally represented
polymorphism-different alleles
polygenic-can express all 3 class I and up to 4 class II
66
Q

What is the structure of MHC I?

A

peptide bonding at alpha 1 and alpha 2
alpha 3 recognizes CD8
beta 2 microglobulin is conserved portion

67
Q

What is the structure of MHC II?

A

peptide bonding at alpha 1 and beta 1

68
Q

Where is MHC I expressed?

A

all nucleated cells

69
Q

Where is MHC II expressed?

A

only professional APCs (dendritic cells, macrophages, B cells)

70
Q

What polymorphism is associated with New Guinea?

A

HLA-A11

impacts EBV

71
Q

What polymorphism is associated with West Africa?

A

HLA-B53

associated with recovery from malaria

72
Q

What happens in Bare Lymphocyte syndrome I?

A

missing MHC I

leads to bacterial infections but no problem with viral infections

73
Q

What happens in Bare Lymphocyte syndrome II?

A

missing MHC II
leads to impaired CD4 development
fatal unless bone marrow transplant

74
Q

What innate immune cells are located in the tissue?

A

macrophage
dendritic
mast cell

75
Q

What innate immune cells are located in the blood?

A

eosinophils
basophils
neutrophils

76
Q

What do pattern recognition receptors do? What are some specific examples of what they recognize?

A 
recognize patterns in PAMPs or DAMPs
viral-dsRNA, ssRNA
bacteria-LPS, flagellin
fungal-mannoproteins
parasite-glycosylinositol
77
Q

How do toll like receptors work?

A

signal through MyD88

activate NFKB

78
Q

What are NOD receptors?

A

cytoplasmic

79
Q

What are RIG like receptors?

A

cytoplasmic, recognize virus

80
Q

What are scavenger receptors?

A

recognize phosphatidylserine

sign of cell damage for apoptosis

81
Q

What is the local effect of TNF alpha?

A

inflammation

82
Q

What are the systemic effects of TNF alpha?

A

brain-fever
liver-acute phase protein synthesis
low output for heart
thrombosis and coagulation

83
Q

What can lead to septic shock?

A

IL 1,6, TNF alpha

84
Q

What is the timeline of reaction to a viral infection and how does this happen?

A

secretion of IL12, TNF alpha/beta, IFN beta
NK responds to 12/alpha
in return they upregulate MHC I expression
NK starts the killing and cytotoxic T cells mediate the final killing

85
Q

What do neutrophils do?

A

short half life
migrate to sites due to recruitment by macrophages
killing through ROS, NO, defensins, enzymes
end in formation of NETS (neutrophil extracellular traps) to immobilize pathogen

86
Q

What do eosinophils do?

A

fight parasitic infection
active in allergic responses
recognized via FcR, trigger IgE response

87
Q

How is MHC I processed?

A 
cytosolic
broken by proteases
calnexin binds MHC in ER
next complex calreticulin/ERp57/Tapsin
peptide enters by TAP and bind in ER
88
Q

How is MHC II processed?

A 
extracellular
degraded by cathepsin
MHC I in ER binds invariant
CLIP remains, CLIP degraded by HLA-DM
endosomes meet and binding can occur
89
Q

What is expressed to change an immature DC into a mature DC?

A

expression of CCR7

now it goes to the lymph node

90
Q

What are characteristics of a plasmocytoid dendritic cell?

A

B220
antiviral
secrete INF-1

91
Q

What are characteristics of a conventional dendritic cell?

A

CD11
good for tissue immunity
secrete IL6, IL12, TNF

92
Q

What is cross presentation?

A

extracellular that is presented via CD8/MHCI

helpful with viruses so that they do not infect the dendritic cells

93
Q

What are the components of the TCR?

A

alpha/beta chains with CD3
co-receptor of CD4 or CD8
contain ITAMS for downstream signaling

94
Q

What is MHC restriction? What is allorecognition?

A

MHC-bias to self MHC set in thymus
normally won’t see foreign MHC
can if there is allorecognition

95
Q

What are the costimulatory signals for TCR?

A

CD28 and B7

96
Q

What adhesion molecules are necessary for TCR?

A

LFA-1 and ICAM (on APC)

97
Q

What two events does DAG participate in during the signal transduction?

A

PKC–>NKFbeta

Activate Ras–>AP-1

98
Q

What does IP3 cause in signal transduction?

A

Increase in Ca

Calcinerin activation–>NFAT

99
Q

What does B7 on the APC bind to and what is the result?

A

CD28 on T cell, signal leads to IL2R on T cell
DC produces IL2 to have T cell divide
clonally divide

100
Q

What changes occur as a cell goes from a naive T cell to an effector T cell?

A

Loss of L selectin
Gain VLA4
Increase LFA1

101
Q

What signal and transcription factor for Treg cells? What do they produce?

A

TGFbeta via FOXP3

produce TGFbeta and IL10

102
Q

What signal and transcription factor for Th17 cells? What do they produce?

A

TGFbeta and IL6 via RORyT (Irish man with liver issues-acute phase also)
produce IL6 and IL17

103
Q

What signal and transcription factor for Th1 cells? What do they produce?

A

IL12 and IFN gamma via Tbet

produce IL2 and IFN gamma

104
Q

What signal and transcription factor for Th2 cells? What do they produce?

A

IL4 via GATA3

produce IL4 and IL5

105
Q

How does Th1 cell function?

A

macrophage activation requiring IFN gamma and IL 12
induces expression of CD40L
converts macrophage into better phagocyte by secreting IL1, IL12

106
Q

What do Th17 cells do?

A

secrete inflammatory chemokines that recruit and activate neutrophils
important in IBS, psoriasis, multiple sclerosis, arthritis

107
Q

What is perforin?

A

aids in delivering granzymes

108
Q

What are granzymes?

A

serine proteases which activate apoptosis

109
Q

What is Fas?

A

FasL expression leads to Fas/FasL interaction leading to activation of apoptosis

110
Q

How are memory cells formed?

A

Rely on IL7, 15 for survival and MHC peptide

111
Q

How is the T cell response terminated?

A

expression of CTLA4 to compete with binding for B7

112
Q

Where does antigen independent B cell maturation occur?

A

bone marrow

113
Q

What is characteristic of Pro B cells?

A

CD19 expression
growth by IL7
heavy chain VDJ recombination

114
Q

What is characteristic of Pre B cells?

A

surrogate light chain

VJ recombination

115
Q

What is VDJ recombinaton?

A

mediated by VDJ recombinase activating RAG1/RAG2

116
Q

What Immunoglobulin is formed first?

A

IgM

117
Q

Which light chain is formed first?

A

kappa

118
Q

What is characteristic of immature B cells?

A

has IgM

undergoes negative selection-exposed to self antigens–>die if they recognize

119
Q

Where does the antigen dependent phase occur?

A

lymph node

120
Q

What is characteristic of a mature B cell?

A

IgM and IgD

naive until they see an antigen and undergo clonal selection

121
Q

What is characteristic of a pro T cell?

A

no CD8, CD4 or TCR
proliferate with IL7
beta chain recombination

122
Q

What is characteristic of a pre T cell

A

beta chain present and CD3

VJ recombination

123
Q

What is characteristic of a double positive T cell?

A

complete T cell receptor

positive and negative selection will occur

124
Q

What is positive selection for a T cell?

A

must be able to recognize MHC

125
Q

What is negative selection for a T cell?

A

exposed to macrophages (if bind with high affinity they die)

126
Q

What happens to a single positive T cell?

A

leave thymus and enter circulation

clonal selection when they encounter an antigen

127
Q

What is the order of maturation in the thymus?

A

cortex to medulla

128
Q

What is combinatorial diversity?

A

different combinations of VDJ

129
Q

What is junctional diversity?

A

different nucleotides added by TdT

130
Q

What causes X linked agammaglobulinemia?

A

BTK defect

131
Q

What is missing in Di George syndrome?

A

thymus so no T cells

132
Q

What is missing in X linked SCID?

A

no gamma gene so IL7 is defective

T cells do not develop

133
Q

What does the BCR require?

A

Ig alpha beta coreceptors

134
Q

What is part of the coreceptor complex?

A

CD19, CD21, CD81

135
Q

What is important about T independent B cell antigens?

A

little B cell memory

136
Q

Where does the B cell pick up its antigen?

A

follicular dendritic cell

137
Q

What happens in the interaction between B cell and Th2 cell?

A

meet at para-cortical junction
T cell makes CD40L
produce IL4,5,6
B cell moves into follicle–>germinal center for proliferation and differentiation

138
Q

How does IgG form?

A

IFN gamma

139
Q

How does IgA form?

A

TGF beta

140
Q

How does IgE form?

A

IL-4

141
Q

How does IgM form?

A

IL 2

142
Q

What is somatic hypermutation?

A

mutations in CDR3 to incrase affinity

143
Q

What are memory B cells?

A

leave germinal center

144
Q

What keeps a germinal center from dying?

A

CD40L from follicular Th cells

145
Q

What is neutralization?

A

block toxin
blocks virus
against adhesins to block colonization

146
Q

What is ADCC?

A

Fc receptors on NK cells recognize antibody and crosslink

IgG helps with apoptosis

147
Q

What is necessary for eosinophil activation?

A

IgE for IL5

148
Q

What is important about a polysaccharide vaccination?

A

activating Th and B when a protein is added to a polysaccharide

149
Q

What does a paneth cell do?

A

secrete antimicrobial defensins

150
Q

What does the epithelial cell do?

A

secrete defensins, mobilize pathogens with cilia

151
Q

What do goblet cells do?

A

secrete mucus

152
Q

What takes up antigens and where are they presented?

A

M cells take up antigen and present them to Peyers Patches to activate lymphocytes

153
Q

How doe a lymphocyte home to blood vessel?

A

alpha4beta7 binding to MADCAM1

154
Q

How does a lymphocyte home to gut epithelium (lamina propria)?

A

CCR9 binding to CCL25

155
Q

How does a lymphocyte home to gut epithelium?

A

alphaEbeta7 binding to E-cadherin

156
Q

How does mucosal tolerance occur?

A

Treg cells secrete IL10 to make sure T cells do not over react to commensal bacteria

157
Q

What is an oral vaccine?

A

rotavirus to increase IgA in GI

158
Q

What is an intranasal vaccine?

A

influenza to secrete IgA in upper airway

POD (4 decks)

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