Immunology Flashcards

1
Q

Which form of immunity is described below?

  1. early response, reacts to microbes and products from injured cells (recognizes PAMPs and DAMPs)
  2. repeated exposures demonstrate the same reaction
  3. Involves physical and chemical barriers; neutrophils, macrophages, DCs, NK cells; complement
  4. Inflammatory cells phagocytose microbes and produce ROS/NOS
  5. NK cells target viruses
  6. receptors are encoded within germline
A

Innate

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2
Q

Which form of immunity is described below?

  1. specific for distinct molecules
  2. able to remember and respond more vigorously
  3. evolved to respond to an initial encounter with a variety of foreign pathogens as well as a potential secondary encounter with the same pathogen
  4. receptors are produced by somatic recombination (allows greater diversity)
A

Adaptive

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3
Q

Which form of immunity is described below?

  1. B lymphocytes secrete Ab to eliminate extracellular microbes
  2. The response of B-cells to an Ag requires activating signals from CD4+ cells; some activated B-cells will differentiate into Ab-secreting plasma cells
  3. B-cells also need helper T-cell assistance for class switching and affinity maturation
A

Humoral

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4
Q

Which form of immunity is described below?

CD4+ and CD8+ T cells defense against intracellular microbes, such as viruses and some bacteria

A

Cell-mediated

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5
Q

What are ICAMs and how do they work?
What cells are they expressed on?
What cells and other receptors do they bind to?

A
  1. Member of Ig superfamily involved in Ca-dependent cellular adhesion
  2. ICAM-1 (CD54) is expressed on cytokine-activated endothelial cells and many other cell types
  3. Binds LFA-1 (CD11a/CD18) expressed on leukocytes
  4. LFA-1 and ICAM-1 binding = synapse between CD8+ T cell and its target
  5. Also binds Mac-1 (CD11b/CD18) expressed on monocytes
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6
Q

Answer the following questions regarding IL-12:

  1. IL-12 is produced by what cells?
  2. IL-12 is produced in response to what stimulus?
  3. Once produced IL-12, stimulates the synthesis of what other cytokines by T cells and NK cells?
  4. Enhances cytotoxicity of which cells?
  5. Stimulates CD4+ TCL differentiation into TH1 cells
  6. Activates which TF?
  7. Facilitate what cell differentiation?
A
  1. produced by DCs, macrophages and B cells
  2. in response to IFN-y
  3. Stimulates synthesis of IFN-y and TNF-a by T-cells and NK cells
  4. Enhances CTL and NK cell cytotoxicity
  5. Stimulates CD4+ TCL differentiation into TH1 cells
  6. Activates STAT4
  7. Facilitate CD8+ differentiation – shared process with TH1 cells
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7
Q

Answer the following questions regarding IL-2:

  1. IL-2 is produced by what cells?
  2. When IL-2 is produced by CD4+ TCLs, what does this stimulate to occur?
  3. What regulator protein is induced by IL2 which will lead to synthesis of cyclins and degradation of p27, leading to evasion of apoptosis and continued cell cycling?
  4. IL-2 helps with proliferation and differentiation of which cells?
  5. IL-2 is required for survival and function of which T cell line?
  6. IL-2 induces proliferation and activation of what other non-T cell?
  7. IL-2 enhances cytotoxicity of which cells?
  8. IL-2 activates which cells?
A
  1. produced by T-cells (mainly by activated CD4+, TH1 cells)
  2. Secreted by CD4+ TCLs when activated by an Ag -stimulates clonal expansion
  3. Induces Bcl-2, synthesis of cyclins, and degradation of p27 – evasion of apoptosis and continued cell cycling
  4. Proliferation of T-cells; differentiation into effector and memory cells
  5. Required for survival and function of Tregs (they don’t produce significant IL-2 on their own, so they rely on CD4+ TCLs)
  6. Induces proliferation and activation of NK cells
  7. Enhances CTL and NK cell cytotoxicity, production of LAK cells
  8. Activates DCs, macrophages, and B cells
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8
Q
  1. Which inflammatory cytokine is immunosuppressive?

2. What other growth factor and cytokines are also immunosuppressive?

A
  1. IL-10
    • IL-10 is produced by macrophages and DCs and serves as negative feedback to inhibit their activity
  2. TGF-B and TNF-a are also immunosuppressive
    • All suppress anti-tumor response and inhibit DC function
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9
Q

Match which MHC I and MHC II interacts with which T cell:
CD4+
CD8+

A

MHC class I, expressed on all cells, recognizes CD8+

MHC class II, expressed only on APCs (DCs, macrophages, B-cells), recognizes CD4+

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10
Q

What happens with APC cell and lymphocyte priming?

A
  1. During priming, a DC acquires Ag and matures at the site of infection and travels to the draining LN where it enters the T cell area and interacts with T cell residents there.
  2. DC and T cells both express CCR7- travel to LN due to CCL19 and 21
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11
Q

What are the three methods of MHC loading?

A

(1) endogenous, (2) exogenous, (3) cross-presentation

all occur before MHC expression on the cell surface

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12
Q

Which MHC loading is being described?

loading MHC class I molecules in APCs – unique to dendritic cells
exogenous proteins can be taken up by DCs and presented on MHC class I molecules. At the same time, these DCs present MHC class II peptides to CD4+ T-cells.
Enables Ag from one cell (virus or tumor-infected cell) to prime/activate T cells specific for these Ag
A

Cross-presentation

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13
Q

Which MHC loading is being described?

loads intrinsic proteins onto class I on most cells – intracellular peptides are combined with class I molecules within the ER

A

Endogenous pathway

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14
Q

Which MHC loading is being described?

loads extracellular peptides class II on APCs – as class II molecules leave the ER in an exocytic vesicle, it fuses with vesicles containing peptides

A

Exogenous pathway

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15
Q

Which of the MHC loading mechanisms is best used for tumor cells? WHY?

A
Cross presentation:
Since tumor cells are typically not derived from APCs, they lack necessary costimulators for T-cell response. Therefore, they are first taken up by APCs and processed with MHC class I molecules; the APC provides the costimulatory signals to initiate a CD8+ T-cell response.
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16
Q

What are the different molecules that help in the
APC/T-cell recognition and activation?

  1. Necessary 1st signal for activation
  2. Second signal for co-stimulation
  3. Third signal for amplification for T cell response
A
  1. recognition of Ag
    o DCs and TCLs express CCR7, which colocalizes to lymphatics and T-cell zones of LNs (CCL19 and CCL21)
    o Initially, DC interact with T-cells via ICAM (on DC) and LFA-1/2 (on TCLs)
     Binding slows movement of DC and brings it in proximity with TCR
  2. CD28 co-stimulatory molecule binds to its ligands, CD80 (B7-1) and CD86 (B7-2), which are present on activated APCs
     Results in (1) IL-2 production, which is critical for TCL proliferation/survival, (2) anti-apoptotic proteins Bcl-2 and Bcl-XL
  3. T cell activation increases surface expression of CD154, which binds CD40 on DCs, macrophages, and B-cells
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17
Q

Which factor would help optimize APC presentation?

a. IL-2
b. IL-12
c. GM-CSF
d. G-CSF)

A

c. GM-CSF

• GM-CSF: produced by T-cells, macrophages, endothelial cells, fibroblasts
o Promotes growth and differentiation of pluripotent progenitor cells
o Stimulates growth of granulocytes, macrophages, and eosinophils
o Activates macrophages and dendritic cells
• GM-CSF used in dendritic cell vaccines to induce differentiation (can also use IL-4)

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18
Q

What is the major difference if B and T cell receptors?

A

TCR only recognizes peptide fragments bound to MHC (not unprocessed Ag)

BCR can bind to Ag in their native form and can detect unprocessed Ag

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19
Q

This card is just for review of the T-cell receptor

A
  • TCR genes only undergo recombination (not somatic mutation or conversion)
  • TCR complex = TCR, CD3 and zeta proteins
  • When TCR recognizes MHC-peptide complex, it forms an immunologic synapse (aka SMAC), which contains the TCR complex, CD4 or CD8 coreceptors, costimulatory molecules, and adaptor proteins
  • TCR signaling activates NFAT, AP-1, and NF-KB
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20
Q

This card is just for review of the B-cell receptor

A
  • BCR: membrane-bound form of Ig
  • Only 2 ITAMs (TCR has 10), but this number increases with cross-linking
  • BCR genes can generate diversity through recombination, somatic mutation, or gene conversion
  • Transcription factors = Fos, JunB, NF-KB
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21
Q

Which part of the antibody has the effector action?

A
• C region of heavy chain – this is also what determines the Ab isotype
      o Less specifically, the Fc region has effector 
         function and the Fab region binds Ag

• Since Ab function is determined by binding of the Fc region to the Fc receptor on different cells, each Ab isotype performs different effector functions

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22
Q

Cell type: Th1

  1. Activation is caused by what cytokines?
  2. Which cytokines or product is produced by Th1 cells after activation?
  3. What is the main purpose or MOA of these cells?
A
  1. Activation:
    IL-12 (produced by macs, DCs, B-cells, neuts)
    IL-18
    IFN-y
2. Product:
TNF-α and TNF-B
IFN-γ
IL-2 (neg on Th2 response)
IL-10 (neg feedback)
TF= T-BET
  1. Purpose:
    Cell mediated immunity–> activation of CD8+ CTLs, NK cells, complement fixing IgG
    Induce IL-12 production by APCs (activates macrophages)
23
Q

Cell type: Th2

  1. Activation is caused by what cytokines?
  2. Which cytokines or product is produced by Th1 cells after activation?
  3. What is the main purpose or MOA of these cells?
A
  1. Activation:
    IL-4 (produced by MCs and other innate cells)
2. Product:
IL-4
IL-5
IL-6
IL-10
IL-13
TF= GATA-3
  1. Purpose:
    Humoral immunity–> B lymphs and plasma cells–>Abs (IgE)
    Mast cell and eosinophil activation
    Alternative M2 activation
    Impt. in allergy, hypersensitivity, parasite
24
Q

Cell type: Th17

  1. Activation is caused by what cytokines?
  2. Which cytokines or product is produced by Th1 cells after activation?
  3. What is the main purpose or MOA of these cells?
A
  1. Activation:
    IL-1, IL-6, IL-23 + TGF-B (when paired with the others)
  2. Product:
    IL-17
    IL-22
    TF= RORyt
  3. Purpose:
    Granulocytes and macs–> fungal infections
25
Q

Cell type: T regs

  1. Activation is caused by what cytokines?
  2. Which cytokines or product is produced by Th1 cells after activation?
  3. What is the main purpose or MOA of these cells?
A
  1. Activation:
    TGF-β, IL-10
  2. Product:
    TGF-β, IL-10
    TF= FOXP3
  3. Purpose:
    Suppresses active immune responses
26
Q

Which cytokines produced by innate immune cells aid in adaptive immunity?

A

o IL-12 –> TH1
o IL-1, IL-6, IL-24 –> TH17
o IL-6 –> promotes Ab production by activated B-cells
o IL-15 –> survival of memory CD8+ cells

27
Q

CTLA-4 (aka CD152) is expressed on activated T cells and Tregs. What is it’s primary MOA?

A
  1. Competes w/ CD28 (and has a higher affinity) for binding to CD80 and CD86 on DCs
  2. Signaling leads to activation of indoleamine 2,3-deoxygenase (IDO), which metabolizes tryptophan and inhibits T-cell proliferation
  3. Recruits SHP-1, which interrupts the TCR signal (does this through recruiting Src homology domain)
28
Q
  1. T/F: Blockage of CTLA-4 induces tumor regression?

2. What does this inhibit or prevent from occuring in regards to the T cell?

A
  1. True
    either through “releasing the breaks” on effector T cells or inhibiting Tregs
  2. May prevent interaction with CD80 and CD86 -> allows CD28 to bind to CD80/86
    May inhibit the negative intracellular signals that shut down effector T cells
29
Q

What is CTLA-4 blockade used for clinically?

What responses have been noted?

A

• Used for patients with metastatic melanoma:
o Tremelimumab: fully human IgG2 antibody
o Ipilimumab: fully human IgG1 antibody
o May induce unconventional response patterns, such as progression followed by regression or mixed responses in different lesions with an overall decrease in tumor burden

30
Q

What are the anti-tumor effects of IFNa?

A

Anti-tumor effects:

(1) Inhibits proliferation of tumor cells
(2) Downregulates expression of oncogenes
(3) Induces expression of TSGs
(4) Antiangiogenic
(5) Upregulates MHC class I and contributes to DC maturation– increases the probability of recognition by CD8+ cells
(6) Promotes CD8+ T cell survival
(7) Enhances migration of T cells to tissues

• Type I IFNs interact with c-myc and Rb, induce apoptosis, via Bcl-2/BaTNF/Fas. They also have anti-angiogenic properties (down regulation of VEGF and bFGF)

31
Q

High dose therapy of IFNa is associated with what side effects?

A

associated with severe toxicity: hypotension, vomiting, fever, diarrhea

32
Q
  1. Why is IL-2 not an ideal therapy for cancer therapy?

2. High dose therapy of IL-2 is associated with what side effects?

A
  1. May not be an ideal anti-tumor agent as it can also promote the expansion of Tregs
  2. arrhythmias, capillary leak syndrome, CNS toxicity, diarrhea
33
Q
  1. Why is IL-15 similar to IL-2?

2. Why would IL-15 be different than IL-2 in therapy?

A
  1. IL-15- similar to IL-2, stimulates NK cells and promotes proliferation of T cells
  2. Does not cause activation-induced cell death of CD4+ T cells following long periods of exposure
34
Q

What cells produce it and what is the main job if IFNy?

A

Produced by TH1 cells, CD8+ T-cells, and NK cells

the main activating cytokine for classical macrophages

35
Q

What is the most prevalent blood cell in circulating blood?

a. NK
b. dendritic cell
c. CD8
d. CD4

A

d. CD4+

36
Q

What are the membranous markers for Tregs? What about the intracellular?

A

Treg markers – FoxP3, CD4, CD25

  • Cytoplasmic: CD3, CD4, CD25, CTLA-4, GITR, Lag3, FR-4
  • Intracellular: foxp3
37
Q

Choose the correct answer to complete this sentence:
NK cells are…………

a. innate cytotoxic cells
b. cytotoxic T cells

A

NK cells are innate cytotoxic cells

• NK cells are innate lymphoid cells (type 1 subtype)
o Involved in the innate immune response to virus-infected cells, tumor cells, stressed cells, and some bacteria (1st line of defense for viruses)

38
Q

Which of the following would be markers for NK cells?

CD3, CD4, CD5, CD8, CD16, CD56

A

CD3+/-, CD5 (lo), CD16, CD56

o Low expression of CD5
o Activated NK cells= CD3+
• Three NK cell receptor families: kill cell Ig-like receptor (KIR aka CD158) and two families of C-type lectin receptors (Ly49 and NKG2D) – both have inhibitory and activating receptors

Just as a side note- Nicola Mason resident review lecture stated the following:
o Human NK cells: CD3-, CD56+ (plus activation receptors eg. NKG2D and NKp46)
o Canine NK cells: CD3+/-, CD5 (lo), CD8+ and NKp46

39
Q

What are the different types of monoclonal antibodies that have developed and changed over the years?

A

Chimeric, humanized (caninized)

40
Q

Which MOAb type is below:

Contain the variable region from a mouse Ab + human Fc regions

A

Chimeric antibodies

41
Q

Which MOAb type is below:
Contain the hypervariable regions of the variable antigen-binding domain (Fv) from a mouse Ab; the rest of the Fv and the entire Fc region is human

A

Humanized antibodies

42
Q

To completely circumvent neutralizing Ab, many current therapeutic Ab are what form?

A

fully human

o Can be isolated from mice that have been engineered to express only human Ab

43
Q

What is the phage display approach to monoclonal antibodies?

A

libraries of random recombination of human Ab genes are expressed in bacteriophages
the Ab-expressing phages are then screened for the ability to bind the target protein

44
Q

TGF-B

  1. Produced by what cells?
  2. Immunosuppressive effects on what cells?
  3. Downregulates which cellular markers on DC cells?
  4. Inhibits which pro-inflammatory cytokines in DCs?
  5. In cytotoxic T cells, suppresses which serine proteases and ligand?
A
  1. Produced by tumor-associated macrophages, tumor cells, and Tregs
  2. Immunosuppressive effects on DCs and effector T cells
    In DCs – induces a tolerogenic phenotype
  3. Downregulates MHC class II, CD40, CD80/86
  4. Inhibits proinflammatory cytokines: IL-12, IFN-α, and TNF-α
  5. In cytotoxic T cells
    • Suppresses Granzyme A and B
    • Downregulates FAS ligand
    o Also induces differentiation of Tregs
45
Q

How do NK cells recognize tumor cells?

A

(a) absence of MHC class I
(b) detection of stress-associated proteins.
Killing is most efficient when both conditions are met.

46
Q

What receptors on NK cells recognize MHC I?

A

Inhibitory receptors (i.e., killer inhibitory receptor [KIR]) = recognize MHC class I to avoid killing

47
Q

Which NK receptor recognizes stress-associated proteins secreted by cancer cells?

A

NKG2D receptor, which recognizes stress-associated proteins such as MICA, MICB, Rae1, and ULBP4
These are secreted by cancer cells due to hyperactivation of PI3K or DNA damage.

48
Q

Cancer cells avoid NK cell killing by which two ways?

A
  1. Forced down-regulation of NKG2D expression

2. Release of stress-associated proteins into the surrounding environment (decoy effect)

49
Q

What are passive mechanisms used by cancer cells to avoid the immune system?

A

(1) Become less immunogenic
(2) Express co-inhibitory proteins (PD-L1, CD73, etc.) to block T cell activation
(3) Become impervious to immune system-altered IFN-y signaling
(4) Downregulate MHC class I via epigenetic mechanisms
(5) Repress gene transcription, absent B-2 microglobulin, defective TAP proteins

50
Q

What are active mechanisms used by cancer cells to avoid the immune system?

A

Active mechanisms:
(1) Manipulate immune cells
 NK cells: some subsets can promote Treg production
 Monocytes/macrophages: promote tumor angiogenesis, growth, and metastasis
 Neutrophils: promote tumor growth
 DCs: suppress tumor immunity and induce Tregs
• Also reduces circulating myeloid DCs and increases immature DCs (reduced ability at Ag presentation, instead induces T cell tolerance)

(2) Secrete suppressive molecules (TGF-B, IL-10, TNF-a)
(3) Secrete molecules that recruit or expand suppressive cells such as myeloid suppressors and Tregs (S100, CSF-1, CCL22, CCL2)

51
Q

What are the three types of immunotherapy?

A

(1) Nonspecific: strategies that augment general T cell responses in a nonspecific or polyclonal manner
Ex: cytokines (INF-α, IL-2), immunological adjuvants (Imiquimod), and agents that target immunomodulatory molecules (anti-CTLA-4 Ab)

(2) Specific: activates/enhances the T cells that can recognize TAAs by using vaccines
Ex: xenogeneic DNA vaccine

(3) Adoptive cell therapy: autologous immune cells such as DCs and T cells are manipulated ex vivo and then reinfused into the patient

52
Q

Which immunotherapy is specific and direct?

a. INF-α,
b. xenogenic DNA vaccine
c. IL-2
d. anti-CTLA-4 Ab
e. autologous T cell therapy

A

b. xenogenic DNA vaccine

53
Q

What is MAGE?

A

Cancer-testis tumor-associated antigen (TAA), a subtype of oncofetal Ag

• Protein restricted to tumor cells

o Others include BAGE, GAGE, and NY-ESO-1