Immunological Tolerance Flashcards

1
Q

Immunological Tolerance

A

A state of unresponsiveness for a particular antigen
– LEARNED, very specific and induced by prior exposure to antigen
– Includes tolerance to non-self antigen

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2
Q

• Self tolerance – physiological state in which the

A

immune system does not react destructively against self tissue

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3
Q

Self-tolerance may be induced in

A

immature self-reactive lymphocytes in generative lymphoid organs (central tolerance), or in mature lymphocytes in peripheral sites (peripheral tolerance)

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4
Q

Central Tolerance-

A

occurs in generative lymphoid organs (bone marrow/thymus) involving immature self-reactive lymphocytes recognizing self antigen

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5
Q

Peripheral Tolerance-

A

in peripheral sites involving mature self-reactive lymphocytes encountering self antigen

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6
Q
  • Immunological tolerance is NOT simply a failure to recognize an
A

antigen

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7
Q

Immunological tolerance is

A

ItISanactiveresponsetoaparticularepitope and is just as specific as an immune response

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8
Q

Tolerancecanbe

A

natural(selftolerance,oral tolerance)…or induced (e.g.- prevent allergies, graft rejection or autoimmunity)

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9
Q

Reactivity is prevented by

A

y processes that occur during development rather than being genetically pre- programmed.

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10
Q

• The most important aspect of tolerance is

A

self tolerance, which prevents the body from mounting an immune attack against its own tissues.

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11
Q

Those lymphocytes that do not bind MHC through their TCR are destined to

A

die by apoptosis.

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12
Q

• During maturation in the thymus, most immature T cells that recognize antigens with high avidity are

A

deleted

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13
Q

Some self-reactive CD4+ T cells that see self antigens in the thymus are not

A

deleted but instead

differentiate into regulatory T cells

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14
Q

choice between lymphocyte activation and tolerance is determined by:

A

the properties of the antigens
– state of maturation of the antigen-specific lymphocytes
– types of stimuli received when these lymphocytes encounter self antigens

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15
Q

Central tolerance in B cells: Occurs in

A

immature B cells in the bone marrow

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16
Q

Potentially autoreactive cells can be

A

eliminated or inactivated by contact with self Ag

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17
Q

• Nature and concentration of the self Ag

determine the fate of

A

B cells

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18
Q

Multivalent Ag (membrane associated proteins) induce

A

B cell death

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19
Q

– High concentrations of Ag induce

A

B cell death

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20
Q

Lower concentrations of small, soluble self Ag induce

A

functional anergy

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21
Q

Peripheral tolerance is the mechanism by which

A

mature T cells that recognize self antigens in peripheral tissues become incapable of responding to these antigens

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22
Q

PT: Clonal deletion/apoptosis-

A

Actual elimination from the cellular repertoire by activation induced cell death

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23
Q

PT: Clonal anergy-

A

mature cell is present but is functionally inactivated (can be reversed)

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24
Q

PT Suppression- i

A

inhibition of cellular activity through interaction with other cells
– T regs (CD4+/CD25+ T cells, TGF-β or IL-10 secreting reg T cells)

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25
Ignorance- co-existence of
self-reactive clones and antigen; cells do not respond to antigen
26
Peripheral tolerance in B cells- Not all potentially reactive cells are
eliminated or inactivated and enter peripheral circulation
27
• TWO SIGNAL HYPOTHESIS - how T cells affect B cell activation
Signal one: Generated through the Ag receptor Signal two: mediated by CD40 and CD40L B cell anergy results if one of the signals is mis
28
Anergic cells show a block in
TCR-induced signal transduction - Lack of costimulation by B7/B72 - costimulation by inhibitory receptors - e.g. CTLA-4
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-CTLA-4 competes with CD28 for
B71 and B72 -binds with higher affinity than CD28
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-CTLA-4 keeps T cells in
check
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-knockout mice lacking CTLA-4 develop
- uncontrolled lymphocyte activation - massively enlarged lymph nodes and spleen - fatal multiorgan lymphocytic infiltrates (suggestive of systemic autoimmunity)
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-- Activation in the absence of IL-2 can lead to
death
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Self-reactive cells may be ‘deleted’ from the repertoire.
Activation in the absence of IL-2 can lead to death -- Persistent Ag -- Activation-induced cell death
34
The state of tolerance may be maintained by
immune regulation
35
How does ignorance happen?
Antigen is expressed in a privileged site/sequestered. - - T cells cannot get to the antigen across an endothelial barrier - - Perhaps the antigen is not expressed in the context of MHC molecules.
36
• Foreign antigens may be administered in ways that preferentially
induce tolerance rather than immune responses
37
protein antigens administered subcutaneously or intradermally with adjuvants
favor immunity
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high doses of antigens administered systemically without adjuvants tend to
induce tolerance
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• Oral administration of Ag favors
tolerance induction
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• A state of immune hyporesponsiveness follows
oral administration of an antigen
41
Oral tolerace is
Responsible for maintenance of homeostasis | – No immune response to food antigens
42
Human disease trials utilizing fed proteins to abrogate autoimmune disease
lack of toxicity, ease of administration over time, and antigen-specific mechanism of action • MS (glatiramer acetate/cop1 - resembles human myelin (4 a.a) • Uveitis (peptide B27PD – resembles retinal autoantigen protein) • Type 1 Diabetes (Human insulin)
43
• T cells (Cell mediated responses)–
Recognize processed antigen in the context of MHC to irradicate infection – Effector functions include cytokine production and release of cytotoxic factors
44
B cells (Humoral responses)-
Recognize free antigen via Ig receptor to irradicate infection Effector functions include antibody mediated destruction of antigen
45
What is Autoimmune Disease?
Group of more than 80 serious, chronic illnesses/syndromes that can involve almost every organ system – includes diseases of the nervous, gastrointestinal, and endocrine systems as well as skin and other connective tissues, eyes, blood, and vasculature. • Occurs when the immune system becomes dysregulated and attacks the very organs it was designed to protect
46
* AUTOIMMUNITY RESULTS WHEN CENTRAL AND PERIPHERAL TOLERANCE IS
broken
47
Mechanisms that lead to autoimmunity
remain unclear
48
Genetic Factors: •Autoimmune diseases tend to occur in
families and this concordance is largely genetic. •Greater concordance between identical twins for some diseases. •Strong HLA/MHC association.
49
Many autoimmune diseases affect
women much more commonly than men
50
Severity/course of autoimmune disease may also differ between
sexes
51
Rheumatoid arthritis is typically more aggressive in
females
52
Multiple Sclerosis can differ in clinical course between females and males
* Females tend to have a relapsing-remitting disease course | * Males tend to exhibit a chronic progressive disease course
53
What initiates an autoimmune response???
Incomplete deletion of self reactive cells • Aberrant stimulation of “normally” anergic self reactive cells • Altered regulation of anergic self reactive cells
54
Systemic
Immune cells target multiple organ systems and tissues | – Thought to be due to aberrant regulation of many clones of lymphocytes
55
Organ Specific
Immune cells target specific organs or tissue – Thought to be due to failure of self tolerance in only a few clones of cells which react to a limited number of antigens
56
Systemic Lupus Erythematosus (SLE) –
A systemic disorder in which a variety of autoantibodies (DNA, nucleoproteins, platelets, lymphocytes) can cause multisystem damage
57
Multiple Sclerosis (MS) –
Immune System targets Central Nervous System via myelin specific T cells
58
SLE Clinical Features
``` • Multisystem disorder characterized by a variety of autoantibodies • Increased risk associated with HLA DR2 and HLA DR3 • Female/male predominance 10:1 • Initial onset of symptoms typically occurs between 15-25 years of age • Typical symptoms include – Fatigue – Fever – Alopecia – Mucosal ulceration – Butterfly rash – Joint and muscle pain • Severe complications – Kidney, Heart, lung, CNS ```
59
SLE Pathogenesis
Immune complex disease (type III hypersensitivity)
60
Large amounts of autoantibodies produced against SLE pathogenesis
self antigens – DNA – Nucleoproteins – Platelets – Lymphocytes
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SLE pathogenesis: • Immune complexes deposit in
kidneys, joints and vessel walls
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Nonsteroidal anti-inflammatory drugs (NSAIDS) are used to treat
arthritic symptoms of lupus
63
• Corticosteroid creams are used to treat
skin rashes
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Antimalarial drugs sometimes used for
skin and arthritis symptoms.
65
Corticosteroid therapy or cytotoxic (anti-proliferative) drugs may be used in
severe or life-threatening manifestations of the disease
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• Kidney transplant indicated for
advanced Lupus nephritis
67
MS Clinical Features
The most common inflammatory disorder of the central nervous system • Increased risk associated mainly with HLA DR2 • Female/male predominance is 3:2 • Those affected can exhibit a relapsing-remitting or a chronic progressive disease • Pathologic hallmark is the CNS plaque with loss of myelin and depletion of oligodendrocytes with or without axon loss • Typical onset – women of childbearing years – In men onset is typically >40 years of age • Symptoms include – Impaired vision (optic neuritis) – Ataxia – Spasticity – Bladder dysfunction – Weakness/Paralysis of one or more limbs – Sensitivity to temperature – Cognitive impairment
68
MS Pathogenesis
• T cell mediated autoimmune disease in which T cells are specific for components of the myelin sheath
69
MS: Also evidence of macrophage and microglial cell involvement in
myelin degradation
70
MS: • Damage to/loss of myelin impairs
nerve conduction
71
MS Treatments
Immunomodulatory Drugs • Corticosteroids | • Immunosupressive therapy