Immunology Exam I Flashcards
when either of the three pathways of complement are activated what results…
inflammation
lyse certain infectious agents
opsonize infectious agents
clears immune complexes
what activates the lectin pathway
mannan binding lectin binds CHO on bacteria
what activates the alternative pathway
spontaneous lysis of C3 if binds to bacteria, initiates the pathway
the classical pathway requires what Ig to bind
pentameric IgM or 2 molecules of IgG
what is the molecule that binds to the microbial surface in the complement pathway
C3b
what is opsonization
the coating of molecules with opsonins that help deliver bacteria to the phagocyte for destruction
what molecules aid in opsinization
antibody IgG and complement C4b
what are immune complexes
they are insoluble lattices that trigger inflammation and type III hypersensitivity reactions
What disrupts immune complexes
C3b
anaphylatoxins
cause degranulation of mast cells and basophils WITHOUT IgE
_____________is a major chemotactic protein for inflammation
C5a
What does MAC do ?
forms pores in molecules and lyses the cell
MAC is critical for protection against
Neisseria infections
MAC is not effective against
gram negative because of LPS
deficiencies in the classical pathway c1q, c1r, c1s, c42 and c2 results in
increased immune complex diseases
increased infectious with pyogenic bacteria
Deficiency in the alternative pathway factor B and properdin results in
nessierial infections
deficiency in C3 results in
recurrent bacterial infections, immune complex disease
deficiency in MAC
recurrent meningoccocal and gonococcal infections
Deficiency in C1-INH results in
over missue use of C1,4,2 and presents with edema of mucosal surfaces
what is a cytokine
a chemical messenger of the immune system; a low mw protein secreted by white blood cells in response to a stimulus
autocrine action of cytokine
acts on the cell that secreted it
paracrine action of cytokine
acts on a nearby cell
endocrine
goes through the blood to act on a distant cell
What are the four effects of cytokine signaling
pleiotropy, redundancy, syngergy, and antagnosim
pleiotropy
multiple functions
synnergy
better when together
anatognism
work against eachother
redudndancy
multiple cytokines with similar functions
what is the significant of gamma chian of IL2-R
IL2 and IL4 share the gamma chain of IL2
_______-causes T and B cell proliferation
IL2
_________causes B cells to make different antibodies (class switching)
IL-4
mutations in the gamma chian of IL-2R leads to
SCID
____________is used to treat HBV, HCV, and HHV-8
IFN-alpha
___________is used to treat MS
IFN-beta
_____________are both antiviral
IFN-alpha and beta
____________activates macrophages to stimulate intracellular killing and inhibits the TH2 Response
IFN-gamma
____________-is used to treat chronic granulamatous disease
IFN-gamma
Three actions of IFN-alpha and beta
resistance to viral replication, increase MHC class I expression, activates NK cells to kill virus infected cells
What are the three fever inducing cytokines
IL-1, IL-6 and TNF-alpha
Actions of the pyrogenic cytokines
activation of complement/ opsinization
phagocytosis
decreased viral and bacterial replication, increased ag processing, initiation of adaptive immune response
TNF-alpha is made by
macrophages, T cells and fibroblasts
TNF-beta is made by
actiated T and B cells
______________-can kill tumor cells
TNF-alpha
____________can inhibit TNF-alpha
monoclonal antibodies
____________-is used to treat chronic inflammatory diseases such as RA, chrons, and psoriasis
TNF-alpha inhibitors
what is the side effect of anti-TNF-alpha
increased susceptibility to diease
____________- and __________-are proinflammatory and induce the liver to make acute phase proteins and induce febrile response
IL1-6
______________stimulates hematopoiesis, acts on plasma cells to drive Ab production
IL6
IL-2 is made by
T cells
what type of regulation is IL-2 under
autocrine regulation
_____________stimulates growth and differentiation of T cells , B cells and NK cells
IL-2
_________________ and __________ are directed toward the alpha chain of IL-2R which blocks IL2
basilizimab and daclizumab
___________ has been found to have success of organ transplants and experimental treatment of leukemia and melanomas
IL2 treatment
____________-promotes class swithcing from IGM to IgE and IgG
IL-4
what inhibits IFN-gamma production
IL4
_______promotes class switching to IgA
IL-5
both IL4 and IL5 are made by
Th2 cells
____________induces eosinophil development and differentiation
IL-5
monoclonal antibodies against IL-4 are used to treat
serious allergies
______________is made by macrophages
IL10
__________downregulates pro-inflammatory cytokine production
IL-10
_________activates B cells promoting the TH2 response
IL-10
how is IL-12 made
primarily by macrophages
_______________induces differentiation of Th cells into Th1 cells
IL-12
IL-18 with IL-12
induce IFN-gamma from Th1 cells
_________is the first cytokine responsible for stimulating immune response
IL-12
______________-attact leukocytes to the site of inflammation
chemokines
IL8 is a chemokine that attracts
neutrophils
RANTEs atttracts
T cells and monocytes
Eotaxin attracts
eosinophils
____________are growth factors
IL3 and Il7
IL3
growth factor for WBC
IL7
growth factor for lymphocytes (B and T cells)
G-CSF
essential for neutrophils
___________ is used to boost immunity during chemotherapy
GM-CSF
________________is used to boot immunity prior to bone marrow transplant
G-CSF
___________–is used to treat anemia
EPO
What cytokines are secreted by TH1 cells
IL-2,and IFN-gamma
What cytokines are secreted by macrophages
IL-8, 10, 12, TNF-alpha, GCSF, GM-CSF
what cytokines are secreted by Th2
IL4,5,6
what cell funxtions in both adaptive and innate immunity
NK cell
what are three ways why adaptive immunity shows up
physical bariers failed
innate immunity is unable to clear the infection
preventative step
what is the time frame for adaptive immunity
days versus hours for innate immune system
how is specificy generated ?
clonal selection
what is the main antibody for the primary response
IGM and later IgG
what is the main antibody for the secondary response
IgG
passive artifical immunity
transfer of antibodies to a patient
what cells are responsible for the adaptive immune response
small lymphocytes, B lymphocytes, T lymphocytes
CD3 is associated with what cells
T cells and T cell receptor
B cells are responsible for attacking invaders ______-the cells
outside
T cells are responsible for attacking invaders_______inside the cell
inside
what cells are responsible for secreting antibodies
plasma cells
Th1 activates what types of cells
Tc and macrophages
Th2 activates what types of cells
B cells
where does lymph end up going
left subclavian vein
does lymph have valves
yes (one way valves)
is lymph have a pumping system
moves via movement of muscles
What are the two primary lymphoid organs
bone marrow and thymus
what are the secondary lymphoid organs
MALT CALT, spleen and lymph nodes
__________________ is where lymphocyte development and maturation occurs
primary lymphoid organs
______________________is where the lymphocyte interacts with the antigen
secondary lymphoid organ
What occurs in the thymus
T cell development and selection
What is DiGeorge’s syndrome
congenital birth defect, failure of the thymus to develop, absence of circulating T cells, increased # of infections
When is the thymus the largest ?
puberty
____________is the major site of hematopoiesis
bone marrow
where do B cells develop and mature
in the bone marrow
what structure is the first lymph tissue to encounter antigen ?
lymph nodes
What cells are responsible for trapping antigen traveling through the lymph node
phagocytic and dendritic cells
What are the two major parts of the spleen ?
red pulp and white pulp
______________is responsible for trapping blood borne antigens
spleen
____________________is the formation and development of red and white blood cells from stem cells
hematopoeisis
Where does hematopoeisis begin ?
it begins in the yolk sac and then migrates to the fetal liver and spleen
where is the major site of hematopoesis after birth until death
bone marrow
all lymphoid cells are derived from___________
pluripotent hematopoietic stem cells
_____________-cells are resistant to radiation
PHSC
What is important to know before a BM transplant can occur
MHC compatability to prevent graft rejection
Stem cells can be used to treat what two diseases
SCID and ADA deficieny
_________are recognized by monoclonal antiodies
Clutster of differentiations
what is the marker for Th
CD4
what is the marker for TC
CD8
whta is the marker for all T cells
CD3
whatis the marker for macrophages
CD14
What is the markers for NK cells
CD16, CD56
what are the markers for all B cells
CD19, 20, 21
what are the markers for stem cells
Cd34
What are the lymphoid cells /
B T and NK
what are the granulocyte cells
neutrophils, eosinophils, basophils, and mast cells
mononuclear cells inlcude
macrophages
granulocutes
dendritic cells
What cell makes up the majority of adult blood counts ?
neutrophils
what is the term associated a B or T cells have not yet come in contact with antigen
Naive Cells
Th1 cells activate
Tc and Macrophages
Th2 cells activate
B cells
NK cells have receptors for
Ab-ADCC
Chediak-Higashi
no NK cells and have increased incidence of lymphomas
macrophages in the lung are called
alveolar macrophages
macrophages in CT are
histiocytes
macrophages in the liver are called
kupfer cells
macrophages in the kidney are called
mesangial cells
macrophages in the brain are called
microglial cells
activated macrophages have….
increased phagocytic abilities, increased ability to activate Th and high levels of class II MHC on the surface
what cell is first at the site if inflammation
neutrophil
cells that have phagocytic capabilites, play a major role in parsites and secrete granules that damage the parasite membrane
eosinphils
________are non phagocytic and release pharmacoligcally active substances contained within granules and are involved in the allergic response
basophils
______–are precursors formed in the bM during hepatopoeisis and play a role in allergies
mast cells
_______________express high levels of class II MHC and B7
dendritic cells
langerhan cells are found in
epidermis and mucous membranes
interstitial dendritic cells are found in
most organs
interdigitating cells are found in
T cell zones of secondary lymph tissue and thymic medulla
__________-are found in the blood
circulating dendritic cells
_____________are found exclusively in the follicles of the lymph nodes
follicular dendritic cells
characteristics of follicular dendritic cells
don’t express class II MHC, don’t function as APC for Th cell activation, have many receptors and bind Ag-Ab complexes and play a role in the formation of memory b cells
cells of the innate immune system include
phagocytes
cells of the adaptive immune system include
lymphocytes
what cells are concidered phagocytes ?
neutrophils, macrophages, eosinophils, and basophils
what are the receptors on macrophages
CR3, CR4, (complment) and CD14 (LPS receptor), and toll receptors
what are the receptors on neutrophils
toll receptors, CR3,4 (compplement), CD14 and Fmet peptide receptors
phagocytes have receptors for what two things that greatly enhance their phagocytic capability
IgG and C3b
What does NADPH oxidase make
toxic oxygen radicals
what does myeloperoxidase make
hypochlorite (bleach)
Il1-beta
activates endothelium lymphocytes and local tisue destruction and increases access to affector cells, produces systemicaly fever and production of IL-6
Function of IL-6
lymphocyte activation and increased antibody production
cytokines secreted by macrophages
IL-1 Beta, TNF-alpha, IL-6, CXCL8,IL-12
rolling of wbc’s is done by
selectins
tight binding of wbcs in inflammation is done by
integrins
vasciular endothelium receptors for rolling adhesion
p and e selectin
neutrophil receptors for rolling adhesion
sialyl lewis carbohydrates on wbc
vascular endothelium for tight binding
ICAM-1
Neutrophils receptors for tight binding
LFA-1 and CR3
IL-8 and IL-1 are
proinflammatories
_____________ and__________directly inhibit viral replication
IFN-alpha and IFN-beta
________is produced by fibroblasts
IFN-beta
_________is produced by leukocytes
IFN-alpha
Functions of IFN-alpha and IFN-beta
induce resistance to viral replication
increase MHC class I expression
activate NK cells to kill viruses
CD expressed on NK cells
16 and 56
activation of NK cells leads to
degranulation via perforin
NK cells kill what type of cells
have decreaed MHC class I expression on them
the major line of defense against bacteria or extracellular pathogens is
antibodies
three main functions of antibodies
opsonization
neutralization
antibody dependent cellular cytotoxicity (ADCC)
basic structure of the antibody includes how many light chains and how many heavy chains
2 heavy and 2 light
what are the two domains of the light chains
1C and 1V
what are the domains of the heavy chains
1V and 3-4 C
What is the region of the antibody that binds the Ag
variable region (Fab)
how many antigen can the variable region bind
2
What does the constant region of the antibody function in
complement activation
opsonization, and crossing the placenta
what region of the antibody determines its function
Fc or constant region
What type s of bonds hold the antibody chains together
disulfide bonds
heavy chains have how many classes
5
light chains have how many classes
2
what joints to form the heavy chain
V,D, and J
what joints to form the light chains
V and J
which chain rearranges first (heavy or light chain)
heavy chain THEN light chain
what are the genes called that are responsible for DNA rerangement ?
RAG 1 and RAG 2
what is the first antibody that is made
IgM
what are some functions of IgG
opsonization
ADCC, activation of classical complement and can cross the placenta
which antibody can cross the placenta
IgG
what antibody is predonimnant antibody in the serum
IgG
What antibody predominates in the secondary immune response
IgG
what is the predominant antibody during the primary immune response
IgM
first antibody made in neonates
IgM
activates classical complement pathway
IgM
pentameric in serum
IgM
high avidity but low affinity
IgM
the predominant antibody in secretion s
IgA
secretion present as a dimer
IgA
protected in secrety by a secreotry piece
IgA
found in low levels in the plasma cells and binds mast cells and basophils
IgE
functions in type I hypersensitivity reactions
Ige
antigen receptor is on B cells
IgD
which two antibodies have the naive B cell Ag receptor
IgM and IgD
which antibody opsonizses
IgG
which antibody functions in ADCC
IgG
which antibody is transported across the placenta
IgG
which antibodys have memory B cell Ag receptot
IgG, IgA and IgE
which antibody triggers mast cell granule release
IgE
if cells in the bone marrow express rag, tdt, MHC II, and CD19, 20,21 and 40 which types of B cells are they
ProB and PreB
Which cells express Tdt
Prob B and Preb B
Cd19, CD20, CD21, and CD40 are expressed on
all developing B cells
memory B cells express ___________ __________ and _____________on their cell surfaces
IgG, IgA, and IgE
what are the 3 important things that happen in the germinal centers ?
class switching, plasma or memory cell formation and somatic hypermutation
_____________interaction is essential for class switching
CD40/CD40L
the second signal in B cell activation includes
helper Th2 cell via the cd40 ligand and cytokines
IL4 is responsible for class swithcing of
IgG and IGE
IL5 is responsible for class swithcing to
IGA
_______is a coreceptor that functions in B cell activation
CD19
Antigen dependent B cell development involves 3 important events
class switching
plasma/memory cell formation
affinity maturation
somatic hypermutations
point mutations, deletions, or insertions into the V,D, or J region of rearranged Ig genes
class I letters
ABC
class II leters
DP, DQ, AND DR
function of HLA
bind antigenic peptides and present them to T cells
HLA class II
extracellular bacteira, exogenous Ag
HLA class I
endogenous antigens (viral)
____________is expressed on all nucleated cells
class I HLA
composition of HLA
3 alpha chian and Beta 2 microglobulin
length of amino acids taht can bind class I HLA
8-10 amino acids in length
_________is required for proper folding of the molecule
B2 microglobulin
what combines to form the antigen binding cleft of HLA 1
alpha 1 and alpha 2
class II HLA expressed on
APCS
APCs consist of
macrophages, dendritic cells and B cells
composition of HLA class II
composed of an alpha and beta chian
size of amino acids in length that bind HLA Class II
12-15 aa
what combines to form the peptide binding cleft
alpha 1 and beta 1
what is responsible for making the viral peptides shorter
proteosomes
what transports the HLA molecules into the cytoplasm
TAP 1 and TAP 2
how do we prevent endogenous peptides from binding into the peptide binding groove of class II
the invariant chain
the majority of diseases associatied with HLA problems are found to be assocaited with
Class II
what viruses can decrease MHC expression
CMV, HBV, and adenovirus
what are the two significant things that distinguishes TCR from BCR
TCR is never secreted and TCR must recognize antigen and MHC and NOT FREE antigen
what does the TCR resemble
FAB fragment
__________is the signaling molecule for T cells
CD3
the cortex of the thymus includes
immature lymphocytes and nurse cells (specilized epithelial cells)
the meduall of the thymus includes
mature thymocytes and cells that survived selection
selection occurs where in the thymus
cortex
in the subcapsular region you find
immature double negative thymocytes
in the cortex you find
immature double positive thymocytes
in the medulla you find
mature thymocytes
positive selection
ensures that the alpha and beta TCR’s expressed in a given individual will bind the self MHC
negative selection
ensures that thymocytes bearing high affinity for self MHC or self ag+ self MHC are removed from the repertoire
what cells constitutiely express B7
dendritic cells
macrophages can expres B7 if
activated by IFN-gamma
B7 on the APC interacts with
CD28 on the helper T cell
what is the function of CTLA-4
it downregulates B7-CD28
macrophages secrete
IL1-6 and tNF-alpha
Th cells express____that alters gene expression
IL2 receptor
super antigens
viral or bacterial proteins that bind particular Vbeta regions of TCR and alpha regions of MHC OUTSIDE of the peptide binding cleft
__________inhibits the Th2 response
IFN-gamma
__________inhibits the TH1 response
IL-4 and IL-10
what cells are often the targets for infection with intracellular pathogens
macrophages
interaction between Fas and Fas L causes
apoptosis
CD markers for CTL
TCR, Cd2,3,and 8
effector molecules of CTL
perforin, granzymes, TNF-beta, and IFN-gamma
primary lymphoid organs are ?
bone marrow and the thymus
cell name that is the only cell capable of activating the naive T cells
interdigitating dendritic cells
do FDC’s express MHC class II
NO!
what is the function of FDC’s
retain immune complexes and help in the formation of immune complexes
can FDC’s present and process Ag
NO!
What are the two receptors on FDC’s
complement and Antibody receptors
if Ag enters the GI or respiratory tract the Ag will be cleared by
MALT
if Ag enters the blood the Ag will be cleared by
spleen
if Ag enters the tissue the Ag will be cleared by
lymph nodes
the T cells are found in what compartment of the lymph node
paracortex
the B cells are found in what compartment of the lymph node
cortex
composition of germinal centers
FDC’s and dividing B cells
where are plasma cells and memory cells generated
germinal centers
what is the name of the artery that carries Ag to spleen
splenic artery
Where are B cells found in the spleen
marginal zone arranged in follicles
Where are T cells found in the spleen
surround the artery in the periarteriolar lymphoid sheath (PALS)
the flow of B and T cells through the secondary lymphoid tissues is directed by cell adhesion molecules (CAMS’s and
specialized endothelial cells called High endothelial venules (HEV’s)
___________use HEV to recirculate through the secondary lymphoid tissues
Naive lymphocytes
what is the cell marker that the lymphocyte binds to on the vascular endothelium /
CD34
When lymphocyte binds Cd34 what does it activate
Beta 2 integrins which change the conformation, bind ICAM
what happens when your missing CD18
you get LAD
LAD is characterisized by
recurrent bacterial infections and impaired wound healing
primary immunodeficiencies are
inherited
__________is the primary means for removal of extracellullar bacteria from the body
phagocytosis
what is the happmakr of phagocyticic deficiencies
recurrent bacterial or fungal infections (s. aureus, pneumoniae, ecoli, pseudomonas, candida, aspergillus)
________is a mutation in NADPH oxidase
chronic granulmatous diseaes
hallmarks of CGD
severe and recurrent infections with Catalase positive organisms
infections if unresolved in CGD result in
granulomas
CGD is treated with
antibiotics and IFN-gamma
what is NTR test
tests for active NADPH oxidase (negative in CGD)
______is results in the absence of CD18
leukocyte adhesion deficiency
hallmarks of LAD
chronic bacterial infections no abscess and no pus formation, severe gum inflammation
treatment for LAD
bone marrow transplant, antibiotics, and IFN-gamma
_______________ affects the synthesis and maintenance of storage granules in many cell types including neutrophils, melanocytes, monocytes and NK cells
chediak higashi
what is the result of chediak higashi syndrome
phagocytosed material is NOT delivered to the lysosomes because of fusion defect
Halkmarks of CH syndrome
recurrent bacteirial
no NK activity
albinism because of melanocytes
treatment for CH
BMT and high dose of gamma globulins IgG’s
Job Syndrome
TH1 cells can’t make IFN-gamma, PMN’s don’t respond to chemotactic stimuli; course facies, cold abscess, retain primary teeth, increaed IgE
C3 deficiency
defects in opsonization, chemotaxis, clearance of immune complexes and lysis, increased susceptiblity and severity to pyogenic bacteria
C1inh deficiency that leads to uncontrolled activation of the classical pathway, overproduction of C2 (vasoactive)-edema
hereditary angioedema
B cells deficiencies are characterized by
recurrent bacterial infections with normal immunity to virus and fungal parasites
results in NO B cells and is a mutation in a tyrosine kinase
X linked Agammaglobulinemia
patients with X linkged agammaglobulinemia have difficulty qith
encapsulated bacteria like the flu
———-results when there is a mutation in CD40L on T cells
Hyper IgM syndrome (HIM)
what Immunoglobulins are missing in HIM
IgA, G and E
presents in late teens and early 20’s, can’t differentiate into plasma cells, patients presentwith recurrent bacteiral infections
common arialbe immunodeficieincy
_______________is delyaed onset of normal IgG synthesis usually seen in the 5th or 6th month of life, pts have recurrent respiraotry infections
transient hypogammaglobulinemia of infancy
what is the most common immunodeficiency
selective IgA deficiency
what is the deficiency in bruton X linked hypo-gamma globulinemia
deficiency of a tyrosine kinase blocks B cell maturation
deficiency of X linked hyper IgM syndrome
deficiency of Cd40 L
in _______________there is absence of thymus, cardiovascular abnormlaities, and characteristic facial features recurrent infections with intracellular pathogens
DiGeorge’s syndrome
_______is an autosomal recessive mutation that prohibits the expressionof class II MHC therefore TH cells can’t develop
Bare lymphocyte syndrome
what is MHC class I deficiency
failure of TAP1 molecules to transport peptides to the ER
__________is a defect in the common gamma of IL-2 receptor or Adenosine deaminase that results in chronic diarrhea, skin mouth and throat lesions, opportunistic infections and cells unresponsie to mitoens
SCID
one does deficiency in Rag 1 or Rag 2 result in
SCID
__________is a mutation in leukosialin (CD43) responsible for actin filament assembly and cytoskeletal rearrangemnt necessary for T cell signaling resulting in THROMBOCYTOPENIA, ECZEMA, AND IMMUNODEFICIENCY
wISCOTT alDRISH SYNDROME
____________________ is a mutation in a cell cycle kinase resulting in broken capillaries of the eye and difficulting maintaining balance
ataxia telangiesctasia
people with ataxia telangiestsa have deficiencies in
IgA and IgE
vaccination
to induce a protective immune response against an infectious agent without causing harm to the patient
________-is to induce Ab and activated T cells to protect the those from FUTURE infection
memory
what is used for killed and inactivated vaccines
formalin or heat
advantages of killed and inactivated vaccines
safe
disadvatnages of killed/inactivated vaccines
needs large amounts, not as strong of an immune response and will probably need boosters
what is a live attentuated vaccine
genetic mutations are induced, grown in non-human animal hosts
advantages of live attenutaetd vaccine
capable of replication, reach the anatomical site, strongly immunogenic
disadvatnage of live attenuated vaccine
revert back to virulent form, contraindicated for immunodeficient population
what type of vaccine requires boosters
killed or inactivated
which vaccine can revert
attenuated
type of immunity that is induced for attenuated
humoral and cell mediated
type of immunity that is induced for killed
humoral
________________utilizes an antigenic portion of the organism
subunit
______-are inactivated toxins
toxoids
__________outer surface protein vaccine such as for Hep B
surface antigen
what is a subunit capsule vaccine
polysaccharide conjugated to a protein
____________is a substance that is found to Ag to illicit a stronger immuune response
adjuvant
what is the adjuant commonly used for humans
alum
what are the four routes for vaccine delivery
oral, intranasal, subcutaneous, and intramuscular
adenovirus affects _________ and the type of vaccine given is __________ and commonly given to
respiratory infection
oral live attenuated
military personel
hepatits A and B is a ________ and the type of vaccine is a __________
hepatitis
subunit surface antigen
HPV type of vaccine is
subunit outer coat protein
influenza type of vaccine is
Nasal- live attenuated or Intramuscular- killed
japanense encephalitis type of accine
killed, given to travelers
measels, mumps and rubella type of vaccine and important notes
live attenuated and contraindicated in pregnany women, and AIDS patients
Polio vaccine
OPV-live attenuated
SALK IPV-killed *US
rabies vaccine
killed vacine; only given to at risk individuals
rotavirus results in _________ and is a ______type of vaccine
diarrhea
oral live attenuated
shingles
live attenuated , adults greater than 60 years old
small pox
live attenuated
varicella
live attenuated contraindicated in pregnant women and AIDS patients
yellow fever
live attenuated given to travelres
what is herd immunity
when the majority of the population has immunity and thus protects the minority of the population that is NOT immune
what is a definition of hypersensitivity
failure of the immune system that are unwarranted and harmful to the host
What is the effector cell in type I hypersensitivty
IgE
wwhat is the effector cells in type II and type III hypersentiivty
IgM and IgG
what are the effector cells in type IV hypersensitivity
T cells (48 hours) delyaed type hypersensitivyt
what distinguishes a type 1 HS reaction from a NORMAL IR
the secretion of IgE from plasma cells
when does degranulation occur in a type I hypersensitivity reaction /
after cross linking but that only occurs after a 2nd exposure
what is the significant of IGE bound to FcR
it can remain stable for weeks to months as opposed to 2-3 days when not bound
where are mast cells found
mucosa and epithelial surfaces lining body surfaces
what is the response when APCc present allergen to Th cells
Th2 response and eleated IgE
what two cytokines are responsible for stimulating the B cell to produce IgE
Il-4 and Il-13
What does the granules consist of in mast cells
HISTAMINE, heparin, TNF-alpha, proteases, degradative enzymes and ECF and NCF (recruits the eosinophils and neutrophils)
what is the action of histamine
induces vascular permeability and evenutally causes inflammation and causes smooth muscle contraction (constricts airways and increases secretions of mucus)
what are some secondary meidators of type I
platelt activating factor IL4 prostaglandins leuotrienes effects of these are more potent and longer lasting
what is the function of PAF
chemotactic for leukocytes and activates neutrophils, eosinphils, and platelets
what is heparin
anticoagulant
action of porstaglandin
increased smooth muscle contraction and vascular permeability
leukotriene
increased smooth muscle contraction and permeability
leukotriene
chemotactic for neutrophils
systemic anaphylaxis
occurs when allergens enter the blood
organ specific anaphylazis
occursn when allergens affect target organs
What happens when you have systemic anaphylaxis
wide spread MAST cell activation increased VP constriction of SM drop in BP organ systems damaged mortality usually from airway constriction and epiglottal swelling
what is the most common allergen associated with systemic anaphylazis
peniciliin (although insect stings peanuts and brazil nuts are also common)
What does epinephrine do
stimulates reformation of tight junctions reduces permeability prevents fluid loss in blood decreases swellin increass BP
difference between type II and type III hypersensitivities
type II antivodies binding to cells or tissues
type III immune complex mediated destruction of tissues
which hypersensitivty is associated with a ribbon like or linear deposition of antibodies
type II
which hypersensitivity is associated with a granular or lumpy bumpy kidney
type III
type II hypersensitivity causes
local complement activation
influx of leukocytes
tissue destruction via ADCC and degrantion and oxygen radicals
examples of type II HS
drugs, transfusion reactions, erythroblastosis fetalis graft rejection, grave’s disease and myasthenia gravis
what is graves diseases
IgG autoantibodies are formed against the TSH receptor, uregulated production of thyroid hormones
__________is caused by high levels of circulating immune complexes
type III hypersensitivity
the common subunit associated with Gm-CSF is
beta subunit
the common subunit associated with IL-6 is
gp130 subunit
common subunit of IL-2 is
common gamma subunit
mutations in the gamma chain if IL-2 results in
SCID
What is the common factor in IL-2 and IL-4
the share the gamma chain of IL-2R
the pyogenic cytokines have what effect on the liver
induces the liver to produce acute phase proteins which help in activation of complement and opsonization
the pyogenic cytokines have what effect on the bone marrow epithelium
neutrophil mobilization
the pyogenic cytokines have what effect on the hypothalamus
increased body temperature resulting in decreased viral and bacterial replication, increased ag processing
the pyogenic cytokines have what effect on fat and muscle
protein and energy mobilization to generate increased body temperature resulting in decreased viral and bacterial repication and increased ag processing
what is the effect of TNF-alpha on dendritic cells
stimulates the migration to lymph nodes and maturation
what are the target cells or tisues for IL-1
Th cells, hepatocytes and hypothalamus
what are the target cells or tissues for IL-6
b cells
hepatocyes
hypothalamus
IFN alpha and beta are secreted by
leukocytes and fibroblasts
anti IL6 receptor is used to treat
Rheumatoid arthritis
IL1 is secreted by
monocytes
macrophages
dendritic cells and endothelial cells
total magnification=
objective times ocular lens
does brightfield microscopy show viruses ?
NO but shows most bacteria
dark field microscopy is used for
thin bacteria (spirochetes) such as treponema pallidum, borrelia, leptospira spp.
phase contrast microscopy
shows internal details of the microbes (CD image)
what type of microscopy is used for viral particles
Electron microscopy
TEM
electrons pass through specimen
SEM
electrons boundce off surface for #d image
_____________detect, locate, quantify specific nucleic acid sequences in clinical specimens
DNA probes
DNA probes are currently used to diagnose what things
CMV, chlyamydia, gonorrhoea, trichomonas, yeast TB
what is the technique used for dagnosing cancer and typing HLA’s
DNA probes
how do you calculate PCR amplication
2 to the n
what is the diagnostic test for HIV
RT-PCR
which test is more sensitive than DNA probes
PCR
PCr is mainly used for
HIV, HSV, HPV and Hantaviruses and MRSA
What is RFLP used for
helps identify the spread of pathogens between pts. and distinguish HSV1 from HSV2
_________is used to identify specific protein in a mixture
western blotting
What is THE definitive test to confirm diagnosis of HIV
western blot
________________is used to detect changes in protein concentration
western blot densitometry (it is more qualitative than quantitative)
____________can test or screen for large number of organisms
microarrays
precipitation reactions test for
immune complexes
agglutination reactions test for
clumping
RBC’s and latex beads is an example of
agglutination reactions
RBC agglutination is used to test for
EBC and ABO blood groups
Latex beads agglutination is used for
diagnosis of CSF infections
what is important in precipitation reactions
ab must be bivalent and Ag must be bipolyvalent, cause type III hypersensitivity reactions
_______-is the inverse of greatest dilution of pt serium that retains activity
titer (1:64- titer of 64)
in precpiptation reactions what is held constant
antibody
excess ______________inhibits agglutination reactions
ab
flow cytommetry used in
typing HLA, cancer detection and immune disorder screening
bacillus anthracis causes ______- and the type of vaccine is
antrax, subunit toxoid
corynebacterium diptheria causes ____-and the type of vaccine is
diptheria, subunit toxoid
H influenxae type V causes _______- and the type of vaccine is
meningitis, subunit capsule
neisseria meningitidis causes _________and the type of vaccine is
meningitis, subunit capsule
B pertussus causes ________and the type of baccine is
whooping cough, subunit toxoid, fimbriae
S. pneumoniae type of baccine
subunit capsule
clostridium tetani
subunit toxoi
S. tymphi causes ________– and the type of vaccine is
subunit-capsule
oral live, attenuated (given to travelers)
mycobacterium tuberculosis
live attenuated BCG
if you lose the beta subunit what cytokines do you lose
Gm-CSF, IL3 and IL6
v cholerae
subunit toxoid
if you lose the g130 subunit you lose
Il-6 and IL11
if you lose the gamma subunit
you lose IL2,5,7,9 and 4
