Immunodeficiency

Question 1

Describe Immunodeficiency

Answer 1

• inadequate immune response
• 1 component or range of components
• primary/secondary
• transient/permanent

Question 2

Describe primary immunodeficiency

Answer 2

• genetic
• immune system is directly affected
• usually permanent - may be amenable to alleviation but gene therapy is the only cure
• very rare

Question 3

What are some examples of primary immunodeficiencies ?

Answer 3

• DiGeorge syndrome
• Secretory IgA deficiency
• Severe combines immunodeficiency disease (SCID)

Question 4

Describe secondary immunodeficiency

Answer 4

• caused by problem outside the immune system itself
• if often transient & amenable to treatment
• common
• 2 main types = biological & iatrogenic

Question 5

Describe Iatrogenic immunosuppression

Answer 5

• can be a side effect ;
• surgical removal of spleen
• prolonged exposure to X-rays
• radiation & cytotoxic drugs in cancer therapy
• control of autoimmunity, allergy, inflammation, transplant rejection

Question 6

What are biological causes of secondary immunoficiency ?

Answer 6

• age
• malnutrition
  -infection
• cancer
• autoimmunity
• blood loss/skin damage
• hormonal changes

Question 7

Describe HIV & AIDs

Answer 7

• Human Immunodeficiency Virus causes Acquired Immunodeficiency syndrome
• an acquired immunodeficiency disease which is permanent & leads to death due to either continuing infection or cancer

Question 8

Describe category A AIDs

Answer 8

• essentially symptom free disease for many years

Question 9

Describe category B AIDs

Answer 9

• AIDs-related complex
• decline in immune effectiveness
• recurrent infections
• opportunistic infections

Question 10

Describe category C AIDs

Answer 10

• full-blown AIDs
• variety of very unpleasant conditions - eg = muscle wasting, neuropathy, loss vision, drug side effects, dementia, drug resistant, infection, aggressive cancers

Question 11

Approaches to Immunodeficiency Therapy

Answer 11

• behavioural change
• prophylaxis, symptomatic relief
• vaccines
• drugs to slow progression - ART

Question 12

Describe ART

Answer 12

Drug combination, attacks different parts of the virus cycle :
- nucleoside analogues & other reverse transcriptase inhibitors
- protease inhibitor
- integrase inhibitor
- fusion inhibitor

Question 13

What are the limitations of ART ?

Answer 13

• cost & accessibility of drugs
• denial of the problem, the authoritarian views, prevalence of myths about the disease
• particularly in the west - belief AIDS is now controllable