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PHASE 2A > Immunology > Flashcards

Immunology Flashcards

1
Q

What must the immune system do in order to be effective?

A

Must discriminate self from non-self

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2
Q

Describe innate immunity

A 
Non-specific
Instinctive 
Present from birth 
First line of defence 
Based on physical and chemical barrier and phagocytosis (No lymphocyte involvement)
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3
Q

Give examples of physical and chemical barriers used in innate immunity

A

Skin, mucociliary escalator, gastric acid, hairs, lysozymes

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4
Q

What is the function of a lysozyme?

A

To destroy bacterial cell walls

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5
Q

Describe adaptive immunity

A 
Specific
Acquired/learned immunity
Requires lymphocytes 
Antibodies 
Memory and quicker response
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6
Q

Name 3 polymorphonuclear leukocytes

A
  1. Neutrophil
  2. Eosinophil
  3. Basophil
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7
Q

Name 3 mononuclear leukocytes

A
  1. Monocytes
  2. T lymphocytes
  3. B lymphocytes
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8
Q

In which primary lymphoid tissue do T cells mature?

A

Thymus

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9
Q

In which primary lymphoid tissue do B cells mature?

A

Bone marrow

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10
Q

How do T cells recognise antigens?

A

Antigens must be displayed by an antigen presenting cell and bound to MHC1/2
(T cells can’t recognise soluble antigens)

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11
Q

What is the function of a T helper 1 (CD4)?

A

Helps immune response against intracellular pathogens

Secretes cytokines

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12
Q

What is the function of a T helper 2 (CD4)?

A

Helps produce antibodies against extracellular pathogens

Secretes cytokines

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13
Q

What is the function of cytotoxic T cell (CD8)?

A

Kills cells directly by binding to antigens - they induce apoptosis

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14
Q

What is the function of T reg?

A

They regulate the immune response

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15
Q

Which cells express MHC 1?

A

All nucleated cells

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16
Q

Which cells express MHC 2?

A

Antigen presenting cells - macrophages, B cells and dendritic cells

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17
Q

Which MHC would an intracellular antigen (endogenous) lead to the expression of?

A

MHC 1

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18
Q

Which MHC would an extracellular antigen (exogenous) lead to the expression of?

A

MHC 2

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19
Q

What type of T cell binds to MCH 1?

A

Cytotoxic T cells (CD8)

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20
Q

What type of T cell binds to MCH 2?

A

Helper T cells (CD4)

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21
Q

What do B cells differentiate into?

A

Plasma cells

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22
Q

What do plasma cells produce?

A

Antibodies

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23
Q

What does a helper T cell bind to?

A

A T cell receptor which is bound to an antigen epitope which Is bound to MHC 2 on an APC

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24
Q

Which interleukin is secreted when a helper T cell is bound to a T cell receptor?

A

IL-2
IL-2 binds to an IL-2 receptor on the T cell and produces positive feedback mechanism leading to division and differentiation

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25
Q

How many antibodies can each B cell make?

A

Only 1 antibody which can only bind to 1 epitope

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26
Q

What happens to B cells that recognise ‘self’?

A

They are killed in bone marrow

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27
Q

Describe the process of a T helper cell binding to a B cell

A

A B cell antibody binds to an antigen
Phagocytosis
Epitope is displayed on the surface of the B cell bound to an MHC 2
TH2 binds to B cells
Cytokine secretion induces B-cell clonal expansion
Differentiation into plasma cells and memory B cells

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28
Q

Give 3 functions of antibodies

A
  1. Neutralise toxins
  2. Opsonisation
  3. Activate classical complement system
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29
Q

Name 5 immunoglobulins

A 
IgG
IgA
IgM
IgD
IgE
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30
Q

What are the 2 most common immunoglobulins?

A

IgG (70-75%) and IgA (15%)

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31
Q

What is an IgE response associated with?

A

Hypersensitivity allergic response and defence against parasitic infections

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32
Q

What is the predominant Ig in mucous secretions?

A

IgA

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33
Q

Which region of an antibody binds to antigens?

A

The Fab region

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34
Q

Which region of an antibody binds to B cells?

A

The Fc region

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35
Q

Name 4 types of cytokines

A
  1. Interferons (IFN)
  2. Interleukins (IL)
  3. Colony Stimulating factors
  4. Tumour necrosis factors (TNFa &b)
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36
Q

What is the function of interferons?

A

Produce antiviral proteins

IFNy - released by activated Th1 cells

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37
Q

What is the function of interleukins?

A

Interleukins causes cell division and differentiation

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38
Q

What is the function of colony stimulating factors?

A

CSF causes division and differentiation of bone marrow stem cells

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39
Q

What is the function of tumour necrosis factors?

A

TNF mediates inflammation and cytotoxic reactions

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40
Q

What is the function of chemokines?

A

Chemokines attract leukocytes to the site of infection

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41
Q

Give examples of secondary lymphoid tissue

A

Spleen, lymph nodes, mucosa associated lymphoid tissue (MALT)

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42
Q

Describe the process of phagocytosis

A
  1. Pathogen binds to neutrophil/macrophage
  2. Engulfment of pathogen
  3. Phagosome formation
  4. Lysosome fusion - phagolysosome
  5. Pathogen is destroyed
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43
Q

Give 3 examples of O2 dependent mechanism of killing

A
  1. Killing using reactive oxygen intermediates
  2. Superoxides can be converted to H2O2 and then to hydroxyl free radicals
  3. NO leads to vasodilation and increased extravasation and so more neutrophils etc are in the tissues to destroy pathogens
44
Q

What is the role of NO in killing pathogens?

A

NO leads to vasodilation and increased extravasation

This means that more neutrophils etc are in the tissues to destroy pathogens

45
Q

Why can superoxides be used to destroy pathogens?

A

Superoxides can be converted to H2O2 and then to hydroxyl free radicals
Hydroxyl free radical are highly reactive and can destroy pathogens

46
Q

What mechanisms or cells are involved in O2 independent killing of microbes?

A

Lysozyme, defensives, TNF, pH

47
Q

What are the complement system plasma proteins derived from?

A

Liver

48
Q

What are the 3 main outcomes of complement system activation?

A
  1. Pathogen lysis
  2. Activation of leukocytes
  3. Increased phagocytosis
49
Q

Name the 3 complement activation pathways

A
  1. Classical
  2. Lectin
  3. Alternative
50
Q

What activates the classical complement pathway?

A

Antibodies

51
Q

What activates the Lectin complement pathway?

A

Mannose binding protein

52
Q

What activates the alternative pathway?

A

Bacterial cell walls and endotoxin

53
Q

Describe Th1 (CD4) activation

A

Antigen presenting cell presents antigen with MHC II to a naïve CD4 T-cell
Stimulation with high levels of IL-12 activate naïve cells to CD4 T helper 1 cells
Th1 cells travel to secondary lymphoid tissue
Proliferate (clonal expansion)
Recognise antigen on infected cells with MHC II via T cell receptor (CD4)
Th1 secretes INFy causing apoptosis

54
Q

Describe cytotoxic (CD8) T cell activation

A

Antigen presenting cell presents antigen with MHC 1 to a naive CD8 T cell
Activation to a cytotoxic T cell
Chemokines released –> inflammatory cell recruitment
Proteolytic granules release perforins and granulysin –> apoptosis and killing of pathogen
IFN release –> macrophage activation –> intracellular killing

55
Q

Which complement plasma proteins have opsonic properties when bound to a pathogen?

A

C3b and C4b

56
Q

What is the function of MAC in a pathogens’ membrane?

A

MAC is a leaky pore like channel

Ions and water pass through the channel and disrupt the intracellular microbe environment –> microbe lysis

57
Q

Which complement plasma proteins are pro-inflammatory and cause chemotaxis and activation of neutrophils and monocytes etc?

A

C3a and C5a

58
Q

Name things Th 1 cells do

A

Produce IL-2, IFNy and TNFb
Activate macrophages –> inflammation
Promotes production of cytotoxic T cells
Induce B cells to make IgG antibodies

59
Q

Name things Th 2 cells do

A

Produce IL-4,5,6,10
Activate eosinophils and mast cells
Important in secondary infections and allergy
Induce B cells to make IgE - promotes release of inflammatory mediators

60
Q

Why is innate immunity needed?

A

To handle pathogens we need a rapid response to

61
Q

What are pattern recognition receptors (PRRs) a receptor for?

A

Pathogen-associated molecular pattern molecules (PAMPs)

62
Q

Name 3 receptors that make up the PRR family

A
  1. Toll-like receptors (TLR)
  2. Nod-like receptors (NLR)
  3. Rig-like receptors (RLR)
63
Q

What is the main function of TLR’s?

A

Send signals to the nucleus to secrete cytokines and interferons –> initiate tissue repair
Enhanced TLR signalling = improved immune response

64
Q

What is the main function of NLR’s?

A

Detect intracellular microbial pathogens

Release cytokines and can cause apoptosis if the cell is infected

65
Q

What disease could be caused by a non-functioning mutation of NOD2?

A

Crohn’s disease

66
Q

What is the main function of RLR’s?

A

Detect intracellular double stranded RNA

Triggers interferon production –> antiviral response

67
Q

TLR’s are adapted to recognise damage molecules. What characteristic do the damaged molecules often have in common?

A

Often hydrophobic

68
Q

What kind of TLR’s can be used in vaccine adjuvants?

A

TLR4 agonists

69
Q

Give examples of diseases that can be caused by PRR’s failings to recognise pathogens

A

Atherosclerosis
COPD
Arthritis

70
Q

Give 3 examples of extracellular PRRs

A
  1. Mannose receptors
  2. Scavenger receptors
  3. TLR’s
71
Q

What is the function of mannose and scavenger extracellular receptors?

A

Induce pathogen engulfment

72
Q

Give an example of an intracellular PRR

A

NLR

73
Q

What are circulating PRRs secreted from?

A

Epithelia, phagocytes and the liver

74
Q

What happens when PAMP binds to a PRR?

A

The innate immune response and inflammatory response is triggered

75
Q

What is extravasation?

A

Leukocyte migration across the endothelium

76
Q

What do macrophages at the tissues secrete to initiate extravasation?

A

TNF alpha (pro inflammatory molecule)

77
Q

Describe the process of extravasation

A
  1. Macrophages at tissues release TNF alpha
  2. The endothelium is stimulated to express adhesion molecules and to stimulate chemokines
  3. Neutrophils bind to adhesion molecules; they roll, slow down and become stuck to the endothelium
  4. Neutrophils are activated by chemokines
  5. Neutrophils pass through the endothelium to the tissue to help fight infection
78
Q

Give 3 advantages of active immunity

A
  1. Induces immunological memory
  2. Produces high affinity antibodies
  3. Produces a persistent protective response against pathogens
79
Q

Give 2 advantages of passive immunity

A
  1. Immediate effect

2. Useful treatment for acute dangers (e.g. snake venom)

80
Q

Give 3 disadvantages of passive immunity

A
  1. Short term
  2. No immunological memory produced
  3. Reaction is possible
81
Q

Describe the first immune response to initial exposure

A
  1. Innate immune response
  2. IgM predominated
  3. Low affinity
82
Q

Describe the second immune response following exposure to a pathogen encountered before

A
  1. Rapid and larger than the first
  2. High affinity IgG
  3. Adaptive immunity, T cell help
83
Q

Give 3 advantages of live vaccines

A
  1. Very effective, prolonged and comprehensive
  2. Immunological memory produced
  3. Often only 1 vaccine is needed
84
Q

Give 2 disadvantages of live vaccines

A
  1. Immunocompromised patients may become ill

2. Vaccines often need to be refrigerated which can be a problem in remote areas

85
Q

Give 2 advantages of inactivated vaccines

A
  1. There is no risk of infection

2. Storage is less critical

86
Q

Give 3 disadvantages of inactivated vaccines

A
  1. Inactivated vaccines tend to only activate the humoral response; there is a lack of T cell involvement
  2. The response is often weak
  3. Boosters are needed and so patient compliance may be poor
87
Q

What is the role of an adjuvant?

A

It is a substance added to a vaccination to stimulate an immune response - convince immune system you are infected

88
Q

What can be used as an adjuvant?

A

Toxoids, proteins, chemicals

89
Q

What are 5 features of an ideal vaccine

A
  1. Safe
  2. Induces a suitable immune response
  3. Shouldn’t require repeated boosters
  4. Generates immunological memory
  5. Stable and easy to transport
90
Q

Which cells express high affinity IgE receptors?

A

Mast cells, basophils and eosinophils

91
Q

Give 5 examples PAMPs

A
  1. Lipopolysaccharides
  2. Endotoxins
  3. Bacterial flagellin
  4. Peptidoglycans
  5. Double stranded RNA
92
Q

Give examples of inactivated vaccines

A

Polio (viral)
Hep A (viral)
Rabies (viral)
Pertussis (bacterial)

93
Q

Give example of live attenuated vaccines

A

MMR (viral)
Rotavirus (viral)
BCG (bacterial)

94
Q

Name other forms of vaccine

A
  1. Recombinant proteins
  2. Synthetic proteins
  3. DNA vaccines
  4. Polysaccharide-protein conjugates
95
Q

Activation of naïve T cells is better achieved by which antigen presenting cells?

a) Neutrophil
b) Mast cells
c) Macrophages
d) Dendritic cells

A

d) Dendritic Cells

96
Q 
What cell type is described below? 
Located exclusively in tissues, has an important role in both the innate and adaptive immune system, are antigen presenting cells and have phagocytic properties
a)	Macrophage
b)	Neutrophil
c)	Eosinophil
d)	Mast cell
e)	Fibroblast
A

a) Macrophage

97
Q

Which of the following is not involved in innate immune mechanisms?

a) Anatomic barriers
b) Phagocytic
c) Inflammatory mechanisms
d) Antibody production
e) Skin

A

d) Antibody production

98
Q

T cells recognise antigen…

a) In solution in plasma
b) When presented on red blood cells
c) Following presentation on antigen presenting cells
d) In a 3-dimensional form
e) Following presentation on pattern recognition receptors

A

c) Following presentation on antigen presenting cells

99
Q

Influenza vaccine is targeted towards ‘at risk’ groups in the UK. Which of the following are classified as ‘at risk’?

a) Over 65 years
b) 16 years old
c) The obese of any age
d) Teenagers
e) Under 2 years old

A

a) Over 65 years
AND
e) Under 2 years old

100
Q

Which of the following is administered as a live attenuated vaccine in the UK

a) Hepatitis A
b) Measles, Mumps, Rubella
c) Tetanus
d) Flu
e) Polio

A

b) Measles, Mumps and Rubella

101
Q

Complements are the proteins that are involved in the clearance of antigen/bacteria. Which of the following is not part of the Elimination phase of complement activation?

a) Opsonisation
b) Target cell lysis
c) Chemoattraction of leukocytes
d) Production of interferons
e) Phagocytosis

A

d) Production of interferons

102
Q

Which of the following is a polysaccharide vaccine?

a) Anthrax vaccine
b) Hib vaccine (Haemophilus influenza type b)
c) Rabies vaccine
d) Hepatitis A

A

b) Hib vaccine

103
Q

Which of the following are features of the adaptive immune response?

a) Does not require prior contact with the pathogen
b) It works with B and T lymphocytes
c) Lacks specificity
d) Distinguishes “self” from “non-self”
e) Enhanced by complement

A

b) It works with B and T lymphocytes

104
Q

What are the two types of immune response in humans?

a) Immunological tolerance
b) Immune surveillance
c) Innate and acquired
d) Intrinsic and extrinsic
e) Overt and covert

A

c) Innate and acquired

105
Q

Which of the following is not an organ-specific auto-immune disease?

a) Ulcerative colitis
b) Type 1 diabetes mellitus
c) Graves disease
d) Hashimoto’s thyroiditis
e) Sjogren’s syndrome

A

a) Ulcerative colitis

106
Q

Which of the following is not a classical PAMP?

a) Peptidoglycan, found in bacterial cell walls
b) Flagellin, a protein found in bacterial flagella
c) Lipopolysaccharide (LPS) from the outer membrane of gram-negative bacteria
d) Interleukin 12
e) Nucleic acids such as viral DNA or RNA

A

d) Interleukin 12

PHASE 2A (16 decks)

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