Immunology 3 Flashcards

1
Q

What B cell markers and when?

A

CD 34 from Pro-B cell to large pre-B cell
CD10 from pro-b cell to small Pre-B cell
CD19 from pro-B cell to mature B cell
CD 20 only later, from large pre-B ell to mature B cell

Rag1,2, and TdT are downregulated on successful rearrangement

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2
Q

Role of BAFF (ie target of belimumab in lupus)

A

Promotes survival of naive B cells
During Ag activation upregulates TLR expression, promotes Ig Class switching, induces memory B cell differentiation to plasma cells.

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3
Q

Do memory B cells need T cell help to become activated?

A

minimal if any

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4
Q

What are T cells?

A

Lymphocytes generated in the thymus

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5
Q

What is the role of AIRE?

A

These are genes that control expression of tissue specific antigens in the medullary epithelial cells of the thymus

  • so that there can be deletion of high affinity T cells
  • induction of thymic regulatory T cells
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6
Q

What is APECED? AKA autoimmune polyendocrinopathy type 1

A

Autoimmune polyendocrinopathy with candidiasis and ectodermal dystrophy.

  • failure to express specific T cell Ag in thymus due to AIRE mutation
  • no deletion of self reactive T cells
  • autoimmunity

Get Autoimmune hypoparathyroidism, Addisons, chronic mucocutaneous candidiasis
Candida supression relies on Th17 response

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7
Q

What is foxp3?

A

master regulator of T reg cells

IPEX is a disorder when foxP3 is defective

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8
Q

Name a B7 blocker and an anti-CTLA4 molecule>

A

B7 blocker is Abatacept- used in RA to downreg immune response

Anti CTLA4 is ipilimumab in melanoma, prostate ca- stimulates immune response

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9
Q

Which is the major CK for generation and maintenance of Tregs?

A

IL-2

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10
Q

How do superantigens trigger things off?

A

Link the Vbeta chain of TCR with the MHC II outside the peptide groove (ie bridge the first signal receptors)

eg TSS, staph enterotoxins

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11
Q

Describe how perforin granzmes work?

A
CD8 T cells recognise virus infected cell
Perforins punch holes
Granzymes get in through holes
Induse caspase enzymes in cell targeted
apoptosis
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12
Q

Fas pathway to kill cells- how does it work?

A

FasL on T cell
binds
Fas on target cell
Caspases activated

Apoptosis and cleavage of viral genes

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13
Q

Non cytotoxic innaate lymphoid cells do what?

A

Promote tolerance to intestinal microbiota

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14
Q

HLA-DM role?

Describe MHC1 and 2 methods of Ag presentation

A

In MHC2 antigen presentation, catalyses ripping out of CLIP so that the Ag can bind and be presented on cell surface

MHC1: Proteasomes break down whatever is in the cytoplasm. In the ER, bits of peptide are stuck on to MHC and then vesicles are shuttled to the surface

MHC2: after endocytosis, lysosomes break down contents. Then garbage trucks fuse with vesicles from golgi containing MHC2 (inhibited by clip)- clip displaced and Ag gets in before whole thing sjuttled to surface of cell.

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15
Q

What does dendritic cell stain with?

A

CD1

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16
Q

What do plasmacytoid dendritic cells do?

A

release loads of IFN in response to viral infection

Not so important for antigent presentation and activation of T cells

17
Q

DIfference between humanised and chimeric monoclonals

A

On Chimeric the V domain is mouse the C domain is human eg ritux inflix “xi”
On Humanised both human with just the cap of variable (AB site) mouse “zu”

Fully human is just “u”

18
Q

Why would you make a monoclonal IgG1 or IgG4

A

IgG1 will maximise phago or complement related properties eg ritux
IgG4 will minimise this eg inflix

19
Q

TNF alpha is a major cause of inflammation in what autoimmune disease?

A

RA

Discovered by Australian

20
Q

What is adalimumab?

What is abatacept?

A

Adalimumab is TNF alpha blocker
Abatacept is CTLA4 mimic that binds B7

In RA very similar outcomes except infusion site reaction more on adalimumab

21
Q

When is IL-6 blocker used?

A

RA
JIA
not Ank spond

Tocilizumab

22
Q

What is the problem in familial mediterranean fever?

A

IL-1 beta overproduction

Block with anakinra

23
Q

What are two fancy new drugs in psoriasis?

A

Secukinumab- blocks IL-17A

Ustekinumab0 IL12/23 monoclonal binds to the p40 subunit

24
Q

Ipi vs nivol?

A

Fewer autoimmune side effects with nivol than ipi

25
Q

What is the Ag in pemphigus (autoimmune)

A

desmoglein-3 and desmoglein-1

26
Q

goodpastures target

A

alpha 3 chain of type 4 collagen

27
Q

HLA DR2 effect on DM1

A

protective

28
Q

Drug induced lupus (4)

A

Minocycline
TNF blcokers
procainamide
hydralazine

29
Q

Which TNFs are worse for TB?

A

Inflix
Adalim
worse than etanercept

30
Q

Why is TNF important in TB?

A

IFN needed to maintain an ordered granuloma that sequesters the TB organisms

31
Q

What happens in NO dependent killing?

A

bacteria binds macrophages
produces TNF alpha
this upregulates iNOs
Release of NO which is toxic to infected cells in the vicinity of the macrophage

32
Q

TLR2 recognises

A

Gram pos eg lipoteichoic acid

33
Q

TLR4 recognises

A

Gram neg eg lipopolysacharide

Mutations in this also predispose to severe RSV

34
Q

NK cells look like…

A

large granular lymphocytes