Immunology Flashcards
What is the immune system?
A network of specialised cells, tissues and soluble factors that co-operate to kill and eliminate disease causing pathogens and cancer cells
What are the 4 key features of the immune system?
1) Specifically identify and respond to ‘non-self’ or ‘abnormal self’
2) Modify response to eliminate different pathogens effectively
3) Promote active tissue repair and healing
4) Immunological memory
What can happen with an immune over reaction?
Allergy or auto immune disease
What can happen with an immune under reaction?
Cancer and infection
What is a constituative barrier and what are the 3 main ones found in the body?
A protective barrier formed by the body.
1) Skin
2) Mucus
3) Commensal bacterial
What are the adaptations of the skin to protect the body from infection?
1) Physical barrier - tightly packed, highly keratinised, multi layered cells that constantly undergo renewal and replacement
2) Low pH (5.5) and low oxygen tension (bacteria prefer a neutral/basic pH and aerobic conditions
3) Sebaceous glands which secrete hydrophobic oils, lysozyme, ammonia and antimicrobial peptides
What are the adaptations of mucus to protect the body from infection?
1) Mucus membranes line all body cavities that come int contact with the environment and they can trap invading pathogens
2) Secretory IgA prevents bacteria and virus form attaching and penetrating epithilial cells
3) Contains enzymes (lysozymes, defensins and antimicrobial peptides) which kill invading pathogens
4) Cillia directly trap pathogens and contribute to the removal of mucus assisted by sneezing etc
What does lactoferrin (found in mucus) do?
Starve invading bacteria of iron
What are the adaptations of commensal bacteria to prevent the body from infection?
1) Symbiotic relationship with host and reduce pH in colon
2) Produce bactericidins which influence other bacteria
3) compete with pathogens for nutrients
4) Synthesis vitamins (vitamin K and B12)
5) Produce antimicrobial short chain fatty acids
eradication of commensal bacteria with broad spectrum antibiotics can result in opportunistic infections. T or F?
True
Candidiasis is common
What is a primary lymphiod tissue and where are they found
Site of leukocyte development
Thymus gland and bone marrow
What is a secondary lympoid tissue and where are they found?
SIte where T and B cells are activated by antigens
Lymph nodes, spleen, adenoid (glands in roof of mouth), tonsils, peyer’s patch on small and large intestine.
What are the causes of lymphoedema and why does this increase infection risk?
Genetics, cancer treatment (removal of nodes), paracites
Pathogens are trapped in poorly draining lymph which does not pass through lymph nodes to generate an immune response
What are the 3 types of infection?
1) Acute/Limited = rapidly cleared by the immune system giving lasting immunological memory
2) Latent = controlled by the immune system but periodic episodes of pathogen reactivation and replication
3) Chronic = immune response fails (immunodefficiency) giving ongoing pathogen replication.
What is direct and indirect communication in the immune system?
Direct = receptor:ligand interactions Indirect = production and secretion of cytokines by injured or activated immune cells (autocrine, paracrine and endocrine signaling)
What is C reactive protein CRP?
Major acute phase protein in humans used as a key diagnostic marker in blood test.
Where is CRP produced and how long does it circulate for?
Rapid production in the liver
Short half life
What are the functions of CRP?
Activate the compliment system
Enhance phagocytosis by opsinisation
*Diagnosis- different serum levels are associated with different levels of inflammation
What characterises the innate immune response?
Generic and rapid
How does the innate immune system recognise a pathogen?
Pathogens express PAMPs (pathogen associated molecular patterns)
Innate immune cells express receptors for PAMPs. These are pattern recognition receptors PPR
Where are PRRs foundas part of innate immune cells?
In the cytoplasm and on the cell surface for detection of intra and extracellular pathogens
What type of leukocyte are macrophages?
Phagocyte
What type of leukocyte are natural killer cells?
Lymphocyte
What type of leukocyte are Neutrophils?
Phagocyte
Where to macrophages reside?
Epithilial tissue eg skin, lungs and intestine
What are the 5 functions of macrophages?
1) Ingest and kill extracellular pathogens by phaocytosis
2) Clear debris from dead and dying tissue- apoptosis
3) Regulate inflammatory response by secreting pro/anti inflammatory cytokines
4) Promote tissue repair and wound healing
5) Antigen presenting cells
Which pro inflammatory mediators are commonly produced by macrophages?
IFN gamma and LPS
Which bacteria can evade phagosomal killing by macrophages?
Salmonella, mycobacterium, Staph aureus
Some bacteria can evade phagosomal killing by macrophages. How can macrophages kill these bacteria?
NK cells secrete pro inflammatory cytokines eg IFN gamma which ACTIVATES macrophages so the produce ROS/RNS and can present antigens.
How can macrophages clear dead and dying cells by apoptosis?
They have receptors that identify apoptotic cells and when the receptor binds the macrophage is activated => phagocytosis and digestion.
Anti-inflammatory cytokines are released to prevent inflammation as no pathogen is present. This promotes healing and repair.
What cells do NK cells kill?
Infected cells and abnormal cancer cells
Do NK cells express PRR on their surface?
Yes
How do NK cells identify self from non self?
Healthy cells express MHC class 1 proteins containing a self peptide. This binds to an inhibatory protein on NK cells and is identified as self. Infected or abnormal cancer cells express do not express self peptides in MHC class 1 and are therefore killed
NK cells release granules from there cytoplasm. What do these contain and how do they kill infected cells?
Perforin and granzymes.
Perforin forms pores in the membrane of the target cell through which granzymes enter and induce apoptosis
How are NK cells activated?
In respose to interferons released from infective/cancer cell (direct activation) or by macrophage derived cytokines
What do virally infected cells produce and release and how does this protect the immune system from viral spread?
Interferon alpha and beta
1) Signals unifected cells to destroy RNA and reduce protein synthesis
2) Signals infected cells to undergo apoptosis (reduces resovior)
3) Activates NK cells
What is the systemic response of acute inflammation?
Change in plasma concentration of specific proteins due to altered protein synthesis in the liver. Driven by cytokines produced during the local inflammatory response.
Give examples of pro-inflamatory mediators?
Histamine, leukotrienes, nitric acid, prostaglandins (and proinflamatory cytokines)
What is the function of proinflamatory cytokines?
Stimulate the bone marrow to increase immune cell production
CRP, SAP and compliment proteins are examples of acute phase proteins, what is the role of these molecules?
Prevent the spread of infection
*used as a diagnostic marker
Fibrinogen is an example of an acute phase protein, what is the role of this molecule?
Wound healing and coagulation
CRP, haptoglobin, manganese superoxide dismutase and protease inhibators are examples of acute phase proteins, what is the role of these molecules?
Prevent systemic inflammation
What are the local effects of acute inflammation?
Rubor, calor, tumor and dolor
Production of proinflamatory mediators, proinflamatory cytokines and chemokines.
What are the functions of: a) Proinflamatory mediators b) proinflamatory cytokines c) chemokines as local effects of acute inflammation?
a) Proinflamatory mediators- vasodilators, ^vascular permeability, ^smooth muscle contraction and pain
b) proinflamatory cytokines- ^vascular permeability and endothilial cell activation
c) chemokines- leukocyte (neutrophil) recruitment and activation
Where does transendothilial migration take place?
Post capillary venuoles
Describe transendothilial migration for a neutrophil. Pro inflammatory cytokines and chemokines are released by macrophages and mast cells…
1) ^vascular permeability. Gap junctions are effected and endothilial cells contract making them leaky. Fluid is lost and viscosity increased at the endothilial layer => decreased blood flow and cell margination.
2) Vasodilation and increased blood flow to the site of infection
3) Endothilial cell activation. Activated endothilial cells express Selectins and ICAM proteins on their membrane
4) Neutrophils bind weakly to selectins using carbohydrate molecules (low affinity => selectin mediated rolling), Neutrophils bind strongly to VCAM/ICAM as they express integrins => stable adhesion and aggregation. Neurophils sqeeze between epithilial cells. DIAPEDESIS
5) Chemotaxis of neutrophils to the site of inflammation. due to chemokines
Where do neutrophils reside?
Blood
Which cells lives longer, neutrophils or macrophages?
Macrophages
Histologically, how are neutrophils identified?
Intracellular granules and a multilobed nucleus
What are the functions of neutrophils?
1) Kill extra cellular pathogens- recognition using PRR:PAMPs
2) Produce more pro-inflamatory cytokines which reinforce inflamation
What are the 3 mechanisms of killing by a neutrophil?
1) Phagocytosis
2) Degranulation
3) Neutrophil extracellular traps (NETs)
Neutrophil phagocytosis: once encapsulated, neutrophils kill pathogens in 2 ways. What are these?
1) Antimicrobial proteins and enzymes
2) Reactive oxygen species
How does a neutrophil phagocytose using antimicrobial proteins and enzymes?
1) Phagosome fuses with azurophilic and specific granules
2) pH rises and the antimicrobial response is activated and the bacterium killed
3) pH decreased and fusion with a lysozyme allows acidic hydrolyases to degrade the bacterium
How does a neutrophil [hagocytose using reactive oxygen species?
1) Assembly of the NADPH oxidase complex
2) production and release of ROS into phagosome
How does a neutrophil kill by degranulation?
Release if antibacterial proteins from neutrophil granules into the extracellular environment
=> direct killing of extracellular killing of extracelluar bacteria and fungi
=> Tissue damage and potential systemic inflammation. This is non specific and can damage host tissue resulting in sepsis
Neutrophil degranulation can damage host tissue resulting in sepsis. How is this response regulated?
Increased expression of protease inhibators (acute phase protein) by hepatocytes- try to limit damage to host cells.
Macrophages promote rear and healing following the infection
How does a neutrophil kill by Neutrophil extracellular traps (NETs)?
1) Activated neutrophils release intracellular structures into the extra cellular environment. NETosis- neutrophils lyse their cell and nuclear membrane to commit suicide
2) NETs immobilise pathogens to prevent spread and this facilitates their phagocytosis.
NB: Proinflamatory cytocines are signaling the bone marrow to produce more neutrophils
What is the compliment system?
A family of 30 proteins produced in the liver and circulating in the blood. (10% of serum protein)
How is the compliment system activated?
Directly or indirectly by pathogens.
1) Classical pathway
2) Alternative pathway
3) Mannose binding lectin pathway
What are the functions of the complement system?
Pathogen killing
Pathogen opsinisation
Leukocyte recruitment and inflammation
Removal of immune complexes
How does the mannose binding lectin pathway work?
1) Cirtain bacterial species express mannose on their surface- mammals do not
2) MBL is an acute phase protein
3) When MBL binds to mannose on bacteria it causes cleaving of C3 to C3a and C3b
How does the alternative pathway work?
1) There is always a very low level of inactive C3 in the blood and over time it breaks down in the absence of an activator.
2) C3b is normally rapidly degraded but if it binds to a bacterial protein or carbohydrate, it is stabalised
3) C3b will then activate the amplification loop to cleave more C3 protein => activation of the compliment cascade
Human cells express proteins and carbohydrates which C3b can bind to but you do not want to activate the compliment system without a pathogen. How is this overcome?
Human cells have an inhibitory protein that will result in degradation of any bound C3b
How does the classical pathway work?
1) Activated by IgM and IgG binding to antigens.
2) This induces a confomational change in Ig mew and Ig gamma heavy chains which expose multiple binding sites for C1, the first component of the classical activation pathway.
NB: IgM is secreted as a planar structure but when bound to antigens becomes a crab like structure
How does the compliment system kill pathogens?
Production of the membrane attack complex MAC
1) In the presence of C3b, C5 –> C5a + C5b
2) C5b generates MAC which creates pores in the pathogen membrane => osmotic lysis
How are encapsulated bacteria killed?
Activation of the complement system, production of MAC and osmotic lysis