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Renal Exam 2 > Immunological Aspects Of The Renal System > Flashcards

Immunological Aspects Of The Renal System Flashcards

1
Q

What are DAMPs and what are some of them?

A

Molecular patterns/alarmins that induce sterile renal inflammation

HMGB1, uric acid, HSPs, S100 protein, hyaluronans

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2
Q

What are the receptors that respond to PAMPs and DAMPs?

A

Toll-like receptors, NOD-like receptors, and C-type lectin

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3
Q

What inflammatory response predominates in renal tissue injury in the early stages?

A

Th17 cells

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4
Q

What inflammatory response predominates in renal tissue injury in the later stages?

A

Th1 cells

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5
Q

What are M1 macrophages induced by?

A

PAMPs and DAMPs

IFN-gamma promote differentiation

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6
Q

What induces alternatively activated M2 macrophages?

A

IL-4 and IL-13

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7
Q

What causes fibrosis and stenosis in chronic states?

A

M2 cells

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8
Q

What cytokines induce Th17 cells?

A

TGF beta and IL-6

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9
Q

What cytokine do Th17 cells produce and what is its effect?

A

IL-17

Tissue inflammation

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10
Q

What are seen in biopsies from patients with glomerulonephritis

A

Complement proteins

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11
Q

What type 2 hypersensitivity reactions lead to kidney injury?

A

Patients with anti-glomerular basement membrane (GBM) antibody mediated GN

(Upon damage, positively charged Ags can be planted into the negatively-charged GBM regions)

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12
Q

What are type 3 hypersensitivity reactions that lead to kidney injury?

A

Post-streptococcal glomerulonephritis, rheumatoid arthritis, and SLE

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13
Q

What occurs downstream of type 2 and 3 hypersensitivity reactions?

A

Complement activation

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14
Q

What’s the difference between type 2 and type 3 hypersensitivity reactions?

A

Type 2 = cell-bound antigen

Type 3 = soluble antigen

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15
Q

How quickly does hyperacute rejection occur?

A

Immediately and caused by antibodies

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16
Q

How quickly does acute rejection occur?

A

Days to weeks after transplantation and caused by T cells

17
Q

How quickly does chronic rejection occur?

A

Months or years after transplantation and caused by vascular trauma, inflammatory products of T cells, Abs

18
Q

What is an autograft?

A

Grafts exchanged from one part to another part of the same individual

19
Q

What is an isograft?

A

Grafts exchanged between different individuals of identical genetic constitutions (e.g. identical twins)

20
Q

What is an allograft?

A

Grafts exchanged between nonidentical members of the sam species

21
Q

What is a xenograft?

A

Graft exchanged between members of different species (from animals)

22
Q

What variables determine transplant outcome?

A
  1. The condition of the allograft (better from a live donor)
  2. Donor-host antigenic disparity
  3. Strength of host anti-donor response (older recipient is better because weaker immune response)
  4. Immunosuppressive regimen
23
Q

What can cause hyperacute allograft rejection?

A

Mechanical trauma and/or ischemia-reperfusion injury

They can release proinflammatory responses that would damage the graft

24
Q

What is ABO matching not important for?

A

Non-vascularized tissues like the cornea, heart valves, and bone/tendon grafts

25
Q

What antibodies do group A blood types have?

A

Anti-b

26
Q

What antibodies do group O blood types have?

A

Anti-A and anti-B

27
Q

Are class I or class II HLA Ags a stronger barrier to transplantation?

A

Class I

28
Q

What are the immune events in allograft rejection?

A
  1. APCs trigger CD4+ and CD8+ T cells
  2. Both a local and systemic immune response develop
  3. Cytokines recruit and activate immune cells
  4. Development of specific T cells, NK cells, or Macrophage-mediated cytotoxicity
  5. Allograft rejection
29
Q

What is the difference between host v graft disease and graft v host disease?

A

Host v. Graft: a kidney is transplanted and the recipient’s T cells attack the transplant

Graft v. Host: bone marrow is transplanted the T cells in the transplant attack the recipient’s tissues

30
Q

What type of hypersensitivity is hyperacute host vs. graft disease?

A

Type 2

31
Q

What type of hypersensitivity is acute host vs. graft disease?

A

Type 4

32
Q

What type of hypersensitivity is chronic host vs. graft disease?

A

Type 4

33
Q

Why does chronic graft rejection occur?

A

Due to the occlusion of blood vessels and subsequent ischemia of the organ

Does not respond to immunosuppresive therapy

34
Q

What kind of hypersensitivity is Graft vs. Host disease?

A

Type 4

Renal Exam 2 (7 decks)

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