Immunodeficiency Week 10 Flashcards
What is a Immunodeficiency Diseases
Defects in one or more components of the immune system can lead to serious and
often fatal disorders - immunodeficiency diseases
How many groups are immunodeficiencies classified? what are they?
2
Primary
Secondary or Acquired
What is a primary immunodeficiencies
The primary immunodeficiencies are genetic defects that result in an increased
susceptibility to infection that is frequently manifested in infancy and early childhood
but is sometimes first clinically detected later in life
What is a secondary or acquired immunodeficiency?
Secondary, or acquired, immunodeficiencies are not inherited diseases but
develop as a consequence of malnutrition, disseminated cancer, treatment with
immunosuppressive drugs, or infection of cells of the immune system
What is the principal consequence of immunodeficiency
The principal consequence of immunodeficiency
is increased susceptibility to infection
What are the consequences of a deficient humoral immunity?
Deficient humoral immunity usually results in
infection by encapsulated, pus-forming bacteria
and some viruses
What are the defects in cell-mediated immunity?
defects in cell-mediated immunity lead to infection
by viruses and other intracellular microbes or the
reactivation of latent infections
Where do you find combined deficiencies?
Combined deficiencies – all classes of microbes
What are “opportunistic” infections?
Opportunistic infections; susceptible to cancer
Features of Immunodeficiencies affecting T or B Lymphocytes:
Susceptibility to infection in a B cell deficiency includes:
Pyogenic bacteria (otitis, pneumonia, meningitis, osteomyelitis)
enteric bacteria and viruses
some Parasites
Features of Immunodeficiencies affecting T or B Lymphocytes:
Susceptibility to infection in a T cell deficiency includes:
Pneumocystis jiroveci
many viruses
atypical myobacteria
fungi
Features of Immunodeficiencies affecting T or B Lymphocytes:
Serum Immunoglobulin Levels in a B Cell Deficiency are….
reduced
Features of Immunodeficiencies affecting T or B Lymphocytes:
Serum Immunoglobulin Levels in a T Cell Deficiency are….
normal or reduced
Features of Immunodeficiencies affecting T or B Lymphocytes:
DTH reactions to common antigens in B Cell Deficiency are…
Normal
Features of Immunodeficiencies affecting T or B Lymphocytes:
DTH reactions to common antigens in T Cell Deficiency are…
Reduced
Features of Immunodeficiencies affecting T or B Lymphocytes:
Morphology of lymphoid tissues in a B Cell Deficiency are…
Absent or reduced follicles and germinal centers (B cell zones)
Features of Immunodeficiencies affecting T or B Lymphocytes:
Morphology of lymphoid tissues in a T Cell Deficiency are…
Usually normal follicles, may be reduced parafollicular cortical regions (T cell zones)
Primary (Congenital) Immunodeficiencies are…
Primary immunodeficiencies are monogenic diseases caused by germline mutations
in genes that regulate the development or function of the immune system
Most Primary immunodeficiencies exhibit….
the majority of primary immunodeficiencies exhibit an autosomal recessive
inheritance
Autosomal recessive alleles are often seen when?
Autosomal recessive alleles are often seen in consanguineous families when the
same mutation is inherited from both parents
What is the situation when offspring are of NONCONSANGUINEOUS marriages?
in offspring of nonconsanguineous marriages, one defective allele of a specific gene
is inherited from one parent and a different defective mutation in the same gene is
inherited from the other parent
Some primary immunodeficiencies are associated with what?
Some primary immunodeficiencies are associated with autosomal dominant
inheritance
Primary immunodeficiency diseases –> what?
Primary immunodeficiency diseases clinical history of repeated infections
Diagnoses of Primary (Congenital) Immunodeficiencies are quite easily made by what? (3 things)
measurement of serum Ig levels,
flow cytometry of immune cells,
or assessment of neutrophil function in vitro
Diagnoses of Primary (congenital) immunodeficiencies in Primary T cell immunodeficiencies are made by what? (2 things)
reduced numbers of peripheral blood T cells,
low proliferative responses of blood lymphocytes to polyclonal T cell
activators
Primary (Congenital) Immunodeficiencies may result from what types of defects? (2 things) defect in what development and activation and defect in effector mech of what?
defects in lymphocyte development or activation
defects in the effector mechanisms of innate and adaptive immunity
Defects in Innate Immunity are: (define and name)
Defects in NK Cells and Phagocytes -
Defects in Innate IS
Chediak-Higashi syndrome CHC
Who gets it?
What is it?
How does it behave:
What happens?
Inherited disease of Hereford, Japanese Black, and Brangus cattle; mink, persian cats, white tigers, humans, etc.
it is a RARE AUTOSOMAL RECESSIVE DISORDER which results in recurrent infections by pyogenic bacT, albinism, excessive bleeding etc.
mutation in the lysosomal trafficking regulator (LYST)
Neutrophils, monocytes, lymphocytes–>GIANT LYSOMES–>rupture–>tissue damage
CD8 t cells and NK cells CANNOT EXCREETE THEIR GRANZYME-RICH GRANULES
PARIENTS WILL BE MORE SUSEPTIBLE TO RESPITORY INFECTIONS AND TUMORS
Autoimmunity: what occurs with random gen of AG binding receptors?
Random gen of AG binding receptors –> makes lymphocytes capable of binding and responding to self-AG.
Autoimmune DZ–>develop spontaneously.
2 major catagories include :
*Normal IR to Unusual AG
*Abnormal IR to normal AG
Autoimmunity stems from 2 sources:
Hormonal influences and Genetic predisposition
Normal immune response is divided into 2 subsets:
Previously hidden antigens and Molecular Mimicry
Abnormal immune response results in:
failure of regulatory control
Autoimmunity, a normal immune response and previous hidden antigens; they can be found in 3 subsets… what are they
Tissue Damage–>intracellular molecules
Molecular structural
alterations
Newly-synthesized antigens
Autoimmunity, a normal immune response and molecular mimicry what is the subset?
Microbial cross-reactions
Autoimmunity, abnormal immune response and failure to regulate what are the 3 subsets?
Failure to apoptosis
virus infections
microchimerism
Autoimmunity
normal IR
Explain:
IR to an AG that has been previously hidden (ex:sperm) OR a result of cross reactivity between an infectious agent and a normal body component
Normal IR
Do we have naturally occurring auto AB? why?
to allow for homeostasis and regulation (IgM/IgG) AB against protein fragments or proteins that are damaged due to oxidation (ROS)
Keep in mind some autoimmune responses have a physiological function
Normal IR
What is Cryptic AG?
-Nontolerant T Cells meet previously hidden autoAG
–T cells are only tolerant if they are first exposed to these AutoAG (AIRE GENE!!)
–Ex: testes injury–>may allow for the proteins to reach the BS–>then come in contact with AG-sensitive cells –>autoimmune response
–EX: heart attack–>AutoAB will be produced against the mitochondria of the myocardiocytes
Normal IR
-AG generated due to molecular changes: how can it be triggered?
can be triggered by the development of completely new epitopes on normal proteins.
POP QUIZ: what is an epitope?
A: the specific target against which an individual antibody binds. When an antibody binds to a protein, it isn’t binding to the entire full-length protein. it is binding to a segment of the protein known as an epitope. Another word for epitope is antigenic determinant–part of the antigen that is recognized by the immune system, specifically by antibodies, b cells or t cells,
EX. Rheumatoid factors (RFs) and immunocongluttins (IK)
Normal IR
RF: autoAB against immunoglobulins. Explain:
Produced when large amounts of immune complexes are generated–>autoimmune dz
–Rheumatoid arthritis, systemic lupus erythematosus
Normal IR
IK: autoAB directed against the complement components c2, c4, c3 explain:
occurs whenever these factors =activated
Normal IR
Receptor Editing explain:
REMEMBER B AND T CELLS ARE SPECIAL AND UNDERGO RANDOM GENE REARRANGEMENT.
*Do NK cells do this too? y/n
As a result autoreactive AG receptors can be created :(
Immature B cell–>produces a receptor that binds to selfAG–>B cell will fail to continue to develop–>light chain receptor will undergo recombination–>no longer self reactive.
**REMEMBER B CELLS GET A 2 CHANCE
This does not occur in mature B cells–>these cells –>apoptosis