immunology Flashcards
What are the 2 types of immunity?
- Innate (natural) immunity
- Acquired (adaptive) immunity
What is innate immunity?
Innate immunity is present continuously, it is a defence mechanism that is present from birth and is generally non-specific (i.e. the same generic response occurs towards many different types of material).
What is acquired immunity?
Acquired immunity is induced by the presence of ‘foreign’ or ‘non-self’ material (including infectious microorrganisms). The response that occurs is (usually) unique to the specific substance or pathogen that induced the response.
Do the innate and acquired immune systems work separately?
No. Both innate and acquired immune systems work closely together to eliminate disease-causing micro-organisms.
What are the 3 types of innate(natural) immunity?
- Natural/physical barriers
- soluble factors
- immune cells
What are the two types of adaptive (acquired) immunity?
- soluble factors
- immune cells
What are the 4 types of soluble factors involved in innate (natural) immunity
- cytokines
- acute phase proteins
- inflammatory mediators
- complement proteins
What are the 4 types of immune cells involved in innate (natural) immunity?
- macrophages
- mast cells
- natural killer cells
- neutrophils
What are the 2 types of soluble factors involved in acquired (adaptive) immunity?
- Cytokines
- Antibodies
What are the 2 types of immune cells involved in acquired (adaptive) immunity?
- B cells
- T cells
What are the two types of intrinsic epithelial barriers to infection?
- skin
- mucous membranes
- respiratory tract
- Gastrointestinal tract
- Urogenital tract
___________ barriers are highly effective at preventing infectious disease. If these defences are _________(e.g. by a wound, a foreign object, a medical device, etc.), __________ diseases can arise. These diseases can be caused by over growth of commensal micro-organisms in an undesireable anatomical location OR by the invasion of pathogenic microorganisms.
- constitutive
- breached
- infectious
What are primary lymphoid tissues?
Anatomical sites where white blood cells (leukocytes) are produced.
What are primary lymphatic organs?
Primary lymphatic organs are where lymphocytes are formed and mature. They provide an environment for haematopoietic stem cells to divide, differentiate and mature into red blood cells (leukocytes) and platelets.
Name the 2 primary lymphatic organs
- red bone marrow
- thymus gland
What is the lymphatic system?
A secondary transport system that protects and maintains the body by producing and filtering lymph. system present throughout the body except cartillage and epidermis.
What is lymph?
A clear fluid that contains white blood cells (also known as leukocytes) and arises from the drainage of fluid from the blood and surrounding tissues.
Where is lymph filtered?
Lymph is filtered at points called lymph nodes, where pathogens are removed before the fluid is returned to venus circultation.
What do lymph nodes do?
Lymph nodes help filter bacteria and other toxins from your body by trapping harmful organisms and using specialized white blood cells (leukocytes) to destroy them.
Lymph vessels are equipped with valves that make sure fluid can be easily transported. How else is lymph fluid transport aided (4 ways)?
- breathing
- muscle contraction
- pulsation in the arteries
- external compression including
- manual lymphatic drainage
- short stretch bandages
- gradient compression garments
What do secondary lymphoid tissues do?
They are arranged as a series of filters monitoring the contents of the extracellular fluids, i.e. lymph, tissue fluid and blood.
- lymphoid tissue filtering each of these fluids is arranged in a different way
- these tissues include: lymph nodes, tonsils, spleen, Peyer’s patches and mucosa associated lymphoid tissue (MALT)
Secondary lymphoid tissues are also where lymphocytes are activated during adaptive immune responses.
- these tissues all share a common feature-distinct zones for different types of lymphocytes (T cells versus B cells)
What do the lymph nodes do in their role as secondary lymphoid tissues?
- small organs that filter for lymph
- removes dead cells, pathogens and antigens uses them to activate adaptive immune responses.
What does the spleen do as a secondary lymphoid tissue?
- serves as a filter for blood
- removes old and damaged RBCs
- removes infectious pathogens and uses them to activate adaptive immune responses.
Name 5 of the secondary lymphoid tissues
- lymph nodes
- tonsils
- spleen
- Peyer’s patches
- mucosa associated lymphoid tissue (MALT)
What is the common feature of all secondary lymphoid tissues?
They have distinct zones for different types of lymphocytes (T cells versus B cells)
Which 3 components of the immune system are found in the blood and recruited into inflamed tissues?
- neutrophils
- eosinophils
- basophils
Which 3 cellular components of the immune system are found in the blood and seconday lymphoid tissues?
- Natural killer cells
- T cells
- B cells
Which cellular comoponent of the immune system is found in the blood and recruited into normal and inflamed tissues?
Monocyte
Name the three tissue resident cellular components of the immune system
- Mast cells
- macrophage
- dendritic cells
What type of stem cell do all cellular components of the immune system develop from in the bone marrow and foetal liver?
Pluripotent haemotopoietic stem cells
Pluripotent haematopoietic stem cells give rise to cells with progressively more and more limited ______________ potential.
Differentiation
During their first division what are the two potentials of pluripotent haemoptoetic stem cells?
- Myloid/erythroid
- lymphoid potential
Myleoid progenitors give rise to all non-lymphoid lineages, name the two kinds
- Monocytes- which give rise to dendritic cells (DC) and macrophages
- Granulocytes (neutrophils, eosinophils and basophils)
lymphoid progenitors give rise to which 3 types of cells
- T cells
- B cells
- Natural killer (NK) cells
What are the major functions of natural killer cells?
NK cells are large granular lymphocytes that can detect and kill tumour cells and virally infected cells ; they can also kill antibody-bound cells/pathogens
What are the functions of mast cells, eosinophils and basophils?
- pro-inflammatory
- parasitic killing mechanisms
- linked to allergy and asthma
- important in defence against large antibody-coated pathogens that cannot be phagocytosed (e.g. parasites)
What are the functions of monocytes, macrophages and neutrophils?
- phagocytosis- ingest and kill extracellular pathogens as well as dead/dying apoptotic cells and small immune complexes (antigen/antibody complexes)
- important source of cytokines which regulate acute inflammatory responses
- particularly important at sites exposed to the external environment
Monocytes circulate in the blood; some migrate into peripheral tissues where they can differentiate into tissue-resident macrophages. Macrophages have additional functions, including promoting tissue repair and limiting acute inflammatory responses after the invading pathogen has been eliminated from the body.
Neutrophils circulate in the blood but are rapidly recruited into inflamed, damaged and infected tissues.
What is the function of dendritic cells (DC)
- antigen uptake in peripheral sites
- antigen presentation
- Naive T cell activation
- function to phagocytes, process and present antigens on their cell surface to help activate T cells
- present in large no.s in tissues that are in contact with the external environment
Mature T cells and B cells constantly circulate through the blood, _______ and secondary lymphoid tissues; they are inactive until meet a pathogen/________ that they can recognise and respond to; some are very _____ _______ (e.g. memory T cells and memory B cells)
- lymph
- antigen
- long-lived
What do B cells do?
They are responsible for the production and secretion of circulating antibodies
What do CD4+T cells (helper T cells, TH cells) do?
Secrete cytokines that regulate innate and acquired immune responses
What do CD8+T cells (cytotoxic T lymphocytesm CTLs) do?
Kill tumour cells and virally-infected cells.
Name the 3 types of soluble (humoral) components of the immune system
- antigens and antibodies
- complement system proteins
- cytokines
Adaptive immune responses are induced by which specific structures?
Antigens
What is an antigen?
Any substance which can cause an adaptive immune response by activating B cells and T cells.
What is an antibody?
An antibody (also known as an immunoglobulin) is a protein that binds to one specific antigenic epitope.
Why is an antibody produced during acquired immune responses?
It is produced in response to a specific antigen
True or false, Individual antigens do NOT contain many different antigenic epitopes.
False, individual antigens contain many different antigenic epitopes
Are antibodies unique?
Yes, they can only bind to one specific antigenic epitope.
Do different microbial species contain unique or similar sets of antigens.
Unique.
Individual cells/microorganisms contain many different antigens but different microbial species will express a unique set of antigens.
What three things do viruses provide protection against?
- extracellular pathogens
- viruses
- toxins
Can antibody-deficiency diseases be life threatening?
Yes
Describe compliment proteins
- family of approx 30 different proteins
- produced in the liver
- circulate in the blood/tissues as inactive precursor proteins (constitute ~ 10% of serum proteins)
How can compliment proteins be activated?
Directly or indirectly by invading micro-organisms
Compliment proteins can enzymatically cleave and activate other downstream compliment proteins in a __________ ____________.
Biological cascade
What are two critical roles of compliment system proteins
- Promoting inflammation
- defense against extracellular bacterial species
What are cytokines?
A diverse collection of small proteins and peptides
when are cytokines produced?
In response to infection, inflammation and tissue damage.
describe the function of cytokines
- modulate behaviour of cells and so play a key role in co-ordinating the immune system
- many have multiple functions
- different cytokines may have overlapping functions
- short half-life
- can act locally and/or systemically
Name 4 cytokines and their functions
- interferons- anti-viral activity
- Tumour necrosis factor alpha (TNFalpha)- a pro-inflammatory cytokine
- chemokines- control and direct cell migration
- interleukins- various functions
Give 2 examples of the various types of signals through which cells communicate
cells communicate via various types of signal (e.g. cytokines or hormones) that travel to target sites (cells) in order to elicit a specific biological response.
cytokines may act on the cells that produce them; on nearby cells or on distant cells. Name and describe these three types of signalling
- autocrine signals are produced by signalling cells that can also bind to the ligand what is released, which means the signalling cell and the target cell can be the same or similar cells.
- Paracrine signalling occurs between local cells where the signals elicit quick responses and last only a short amount of time due to the degradation of the paracrine ligands.
- Endocrine signalling occurs between distant cells and is mediated by hormones and cytokines released from specific cells that travel to target cells, producing a slower, long-lasting response.
Give an overview of the innate immune response
- Inflammation,complement activation, phagocytsosis and destruction of pathogen
- Typical time after infection to start response- minutes
- duration of response- days
Give an overview of the adaptive immune response
- interaction between antigen presenting dendritic cells and antigen specific t cells: recognition of antigen, adhesion, co-stimulation, T-cell proliferation and differentiation.
- activation of antigen-specific B cells
- Formation of effector and memory T cells
- Interaction of T cells with B cells, formation of germinal centres. Formation of effector B cells (plasma cells) and memory B cells. Production of antibody.
- Emigration of effector lymphocytes from peripheral lymphoid organs.
- elimination of pathogen by effector cells and antibody.
Describe the immunological memory
- maintenance of memory B cells and T cells and high serum or mucosal antibody levels. Protection against re-infection
- Typical time after infection to start of response= days to weeks
- duration of response= can be lifelong
List the 6 innate immune system responses
- acute inflammation
- macrophages
- mast cells
- natural killer cells
- neutrophils
- complement
What are the 2 acquired immune system responses?
- B cells, antibodies
- T cells
What does the immune system do?
Identifies and eliminates microorganisms and other harmful substances as well as abnormal cancer cells.
How does the immune system identify and eliminate microorganisms and other harmful substances as well as abnormal cancer cells?
- by distinguishing ‘self’ molecules from ‘non-self’ molecules
- by identifying ‘danger’ signals (e.g. from acute inflammation)
- or via a combination of the two
A balanced immune system provides optimal effectiveness, What are the two components of a balanced immune system?
- protection from pathogens
- rejection of donor tissues
In organ transplantation the new tissue would be recognised as foreign and initiate an immune response. How can this be prevented?
With anti-inflammatory and immunosuppressive drugs to prevent rejection of the tissue
What are the two possibilities if the immune system goes wrong?
- Immune over-reaction
- Immune under-reaction
What are the two ways the immune system can over-react
- Reaction to ‘self’=autoimmunity
- reaction to innocuous substances= allergies
What are the two ways the immune system can under-react?
- Recurrent infections
- Cancer
Which 3 ways can we manipulate the immune system to prevent or treat human diseases?
- Immunization
- anti-inflammatory and immunosuppressive drugs
- Cancer immunotherapy- immunotherapy enables the immune system to recognize, target and eliminate cancer cells, making it a potential ‘universal answer’ to cancer.
What is the first line of defenc against infection?
Natural/physical barriers
What are the 4 points of energy where pathogens can infect the body?
- digestive system
- respiratory system
- urogenital system
- skin damage
What are the two routes of attack for pathogens?
- circulatory system
- lymphatic system
what is the most important barrier to infection?
The skin
How does the skin act as a barrier to infection?
-
Physical barrier
- composed of tightly packed, highly keratinized, multi-layered cells
- constantly undergo renewal and replacement
-
Physiological factors
- Low pH 5.5 (acidic)-most pathogens are intolerant to acidic environments
- low oxygen tension
-
Sebaceous glands
- secrete hydrophobic oils- slippery surface limits physical colonization by pathogens and microorganisms
- lysozyme- destroy the integrity of bacterial cell walls.
- ammonia - “
- antimicrobial proteins
How does secreted mucous act as a constitutive barrier to infection?
Mucous membranes line all body cavities that come into contact with the environment.
- respiratory
- Gastrointestinal
- Urogenital tract
The mucous traps bacteria which are subsequently removed by ciliated cells.
Mucous also contain specialised chemicals that can have anti-microbial properties.
How do commensal bacteria act as a constitutive barrier to infection?
- “friendly” bacteria which exists in the gut, skin, etc
- either have no deleterious effect on the host or sometimes live symbiotically
- can compete with bad bacteria
- can contain chemicals which kill pathogenic microorganisms
- 100 trillion bacteria normally reside at epithelial surfaces amongst mucus and epithelial cells
- > 500 different microbial species
- symbiotic relationship with the host
Provide a brief summary on the 5 natural barriers to infection
- Physical barrier- skin & mucous membranes lining digestive, urinary, respiratory & reproductive systems
- Traps - mucous, cilia (in nose & trachea), hair (covering body & in nose/ears), earwax
- Elimination- coughing, sneezing, urination, diarrhea
- unfavourable pH- stomach acid, sweat, saliva, urine
- Lysozyme enzyme-in tears, sweat; digests bacterial cell walls
What are the fundemental properties of adaptive (acquired) immunity?
- specificity
- adaptiveness
- discrimination between self and non-self
- memory
Describe innate immunity
- innate immunity is present continuously, it is a defence mechanism that is present from birth
- the same generic response occurs to many different microbial species
- rapid response (mins-hours)
- NO immunological memory
- non-specific
- can distinguish SELF from NON-SELF ad should only react against non-self
Decribe acquired (adaptive) immunity
- acquired (adaptive) immunity is induced by the presence of foreign materials
- a unique response is generated to each individual pathogen
- slow response (days), lag time from exposure to the response
- Immunological memory thus subsequent responses are faster and more powerful; basis for protective vaccination against infectious disease
- specific for each antigen encountered
- self-regulating through regulatory T cells
- can distinguish SELF from NON-SELF and should only react against non-self
What do tissue-resident innate immune cells such as macrophages and mast cells, and the complement system lead to?
- Pathogen killing
- acute, local inflammation
What happens when physical (natural) barriers are breached?
- pathogens invade
- innate immune responses initiated
Which tissue-resident innate immune cells recognise pathogens as ‘non-self’ and dangerous?
- Phagocytic (‘eating’ cells) - macrophages and dendritic cells (DCs)
- other cells- mast cells
What are the 3 modes of ingestion by macrophages?
- Pinocytosis
- Receptor-mediated endocytosis
- Phagocytosis
What is pinocytosis?
Ingestion of the fluid surrounding cells
What is receptor-mediated endocytosis?
- molecules bound to membrane receptors is internalized
- an important step in the generation of adaptive immunity
What is phagocytosis?
- intact particles (e.g. bacteria) are internalized whole
- these are facilitated by opsonisation
What are the 7 steps of phagocytosis?
- macrophages express a set of ‘PRR’s’
- Receptor binding to ‘PAMPs’ signals the formation of a phagocytic cup.
- cup extends around the target and pinches off, forming a phagosome.
- fusion with lysosomes to form a phagolysosome- killing of pathogens and degradation of contents (acidification, lysosomal hydrolases)
- debris (including antigens) is released into extracellular fluid.
- pathogen-derived peptides are expressed on special cell surface receptors (MHC-II molecules)
- Pro-inflammatory mediators are released (e.g. TNFa)
Phagocytosis is a specific form of _____________ by which cells internalise solid matter, including apoptotic cells and microbial pathogens.
While most cells are capable of phagocytosis, it is the professional phagocytes of the immune system, including ____________, neutrophils and immature __________ cells, that truly excell in this process.
- endocytosis
- macrophages
- dendritic
What does the phagolysosome contain and what are their roles?
- Highly acidic pH- has bacteriostatic or bactericidal effects
- lactoferrin- prevents further microbial proliferation in the phagolysosome
What is the definition of opsonisation?
The coating of pathogens by soluble factors (opsonins) to enhance phagocytosis.
What are opsonins?
Soluble factors that bind to pathogens and enhance phagocytosis, they allow faster and better recognition.
Provide 3 examples of opsonins
- C3b
- C-reactive protein (CRP)
- IgG/IgM
Can largeextracellular parasites be phagocytosed?
No, extracellular bacterial pathogens do not invade cells and proliferate instead in the extracellular environment which is enriched with body fluids.
What happens when parasites are too large to be phagocytosed?
Mast cells step in…
- resident all the time in tissues
- very rapid resonse
- second wave of mast cell responses is due to gene expression
Describe the mode of action of mast cells
- Mast cells contain granules
- Danger signals from damaged cells reach the mast cells
- mast cells become activated by binding of a pathogen to PRRs on their surface and degranulate
- degranulation is the release of pre-formed pro- inflammatory substances
- the mast cells express genes which lead to the production of new pro-inflammatory substances.
Name 4 pro-inflammatory mediators released in the innate immune response
- nitric oxide
- prostaglandins/leukotrienes
- histamines
- pro-inflammatory cytokines (TNFa)
Provide a brief summary of the early innate immune response
- pathogens which display PAMPs and injured tissue cells which produce ‘danger’ signals activate macrophages and mast cells
- pathogens and infected cells are killed
- pro-inflammatory mediators are produced
- leads to localised, acute inflammation
Why is acute inflammation an important response to cellular injury or infection?
- it has both a rapid innate phase as well as a prolonged phase that is an important component of acquired immunity.
- immediately after injury or infection a number of proteins are released. These lead to the physiological characteristics of inflammation: swelling, redness, heat and pain.
What are the local physiological signs of acute inflammation caused by TNFa, histamine, C3a and C5a and their symptoms?
- dilation of small blood vessels; increased blood flow; cell accumulation; increased cell metabolism- redness(rubor) and heat (calor)
- increased permeability of post-capillary venules; fluid accumulates in extra-vascular spaces- swelling (tumour)
- stimulation of nerve endings- pain (dolor)
- swelling/pain- loss of function (functio laesa)
Name the 5 natural (anatomical/chemical) barriers
- Physical barrier: skin and mucous membranes lining digestive, respiratory and reproductive systems
- Tranps: mucous, cilia (in nose and trachea), hair (covering body and in nose/ears), earwax
- Elimination: coughing, sneezing, urination, diarrhea
- Unfavourable pH: stomach acid, sweat, saliva, urine
- lysozyme enzyme: in tears, sweat, digests bacterial cell walls
Which tissue-resident innate immune cells recognise invading pathogens as ‘non-self’ and dangerous
- phagocytic (‘eating’) cells
- macrophages and dendritic cells (DCs)
- Other cells- mast cells
Pathogens express ‘signature’ not found on/in human cells, what are these called?
Pathogen associated molecular patterns (PAMPs)
common to many different pathogenic species
Innate immune cells (and some other cell types) express partner receptors for PAMPs, what are these called?
Pattern Recognition Receptors (PRRs)
Found on the cell surface and in the cytosol for detection of extracellular and intracellular pathogens, respectively.
Which 2 types of cells express pattern recognition receptors?
- Mast cells
- macrophages
Non-immune cells also express _______________ PRRs in order to recognise that they have been infected by intracellular pathogens such as viruses.
Intracellular
Low levels of ___________ complement system proteins are found in extracellular fluids normally.
inactive
The complement system, when activated, creates a cascade of chemical reactions which promotes which 4 things?
- opsonization of pathogens
- direct pathogen killing
- acute inflammation
- leukocyte recruitment
Name the 3 pathways for the complement system
- Classical pathway
- Mannose-binding lectin pathway
- Alternative pathway
What do all 3 pathways which activate the complement system lead to?
Activation of downstream complement proteins
What does healthy tissue look like in relation to inflammatory mediators and immune cells/vasculature?
- no inflammatory mediators
- normal vasculature
- circulating neutrophils
What two things does inflammation promote?
- vascular changes
- rectruitment and activation of neutrophils (transendothelial migration)
What 3 things does changes in the local vasculature due to pro-inflammatory mediators and chemokines in infected and damaged tissue lead to?
- vasodilation and increased blood flow (redness)
- increased vascular permeability (swelling/oedema)
- expression of specific adhesion molecules on the surface of the endothelial cells and activation of adhesion molecule receptors on circulating neutrophils
- can include selectins or interleukins
what are the 5 steps of transendothelial migration?
- Margination of neutrophils to the endothelium near sites of tissue damage/infection
- binding of neutrophils to adhesion molecules (selectins, ICAM-1) on the endothelial cells
- Migration of neutrophils across the epithelium, via the process of diapedesis
- movement of neutrophils within the tissue via chemotaxis
- activation of neutrophil by PAMPs and TNFa