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Immunology (M1) > Immunology Introduction: Immune System, Cells and Molecules > Flashcards

Immunology Introduction: Immune System, Cells and Molecules Flashcards

1
Q

Primary (central or regenerative) immune system tissue: contents and examples

A

Contain developing lymphocytes

Examples: Bone marrow and Thymus

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2
Q

Secondary (peripheral) immune system tissue: contents and examples

A

Contain mature cells, active in host defense

Examples: Spleen, lymph nodes, MALT (mucosal-associated lymphoid tissue; includes tonsils, adenoids, appendix, Peyer’s Patches in GI tract, other mucosal lymphoid tissues)

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3
Q

Bone marrow activity (what happens here)

A

Site of hematopoiesis and B-cell maturation

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4
Q

Hematopoiesis and age

A

As a person ages, most hematopoiesis in flat bones (sternum, vertebrae, ileac, and ribs)

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5
Q

Thymus location and function

A

Bi-lobed organ in upper anterior thorax

Function: maturation and selection of T-cells

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6
Q

Thymus structure

A

Two lobes - each surrounded by capsule

Lobes divided into lobules by fibrous septa

Each lobule has outer cortex and inner medulla

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7
Q

Thymus vascular supply

A

Rich vascular supply

Cells enter thymus via blood, exit via lymphatic vessels or blood

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8
Q

Chest Radiograph

A

Classic “sail sign” of thymus

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9
Q

Spleen location and function

A

Large, vascular organ in left upper quadrant of the abdomen under the diaphragm

Major site of immune responses to pathogens and other foreign substances in the blood

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10
Q

Spleen structure

A

Blood supply from a single artery, divides into smaller arterioles

Two sections:

  1. White pulp: contains lymphocytes; T cells near arterioles in the periarteriolar sheath; B cells are more peripheral
  2. Red pulp: involved with RBC breakdown
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11
Q

Lymph nodes location and function

A

Small nodular aggregates of lymphoid tissue; 500-600 in human body located along lymphatic channels/vessels

Generally the first lymphoid structure to encounter foreign antigens; fluid draining from lymph enriched with antibodies and lymphocytes

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12
Q

Lymph nodes structure

A

Outer fibrous capsule

Multiple afferent lymphatic vessels, one efferent

Three concentric regions: cortex, paracortex, medulla

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13
Q

Lymph node cortex contents

A

Contain follicles (cell aggregates) which may contain germinal centers

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14
Q

Lymph Node diagram

A
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15
Q

Lymph node groups (9)

A
  1. Cervical
  2. Supraclavicular
  3. Axillary
  4. Mediastinal
  5. Supratrochlear
  6. Mesenteric
  7. Inguinal
  8. Femoral
  9. Popliteal

Can someone ask my silly mother if ferrets poop?

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16
Q

Most palpable lymph node groups?

A

Cervical, axillary, and femoral

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17
Q

Cervical LNG: location and site of drainage

A

Location: head and neck

Drainage: scalp, face, nasal cavity, pharynx

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18
Q

Axiallary LNG: location and site of drainage

A

Location: axilla

Drainage: arm, chest wall, breast

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19
Q

Inguinal LNG: location and site of drainage

A

Location: groin

Drainage: genitalia, buttock, anus, abdominal wall, leg

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20
Q

Mediastinal LNG: location and site of drainage

A

Location: In/near mediastinum/central posterier thorax

Drainage: Mid chest, upper abdomen, lungs

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21
Q

Mesenteric LNG: location and site of drainage

A

Location: lower abdomen, near intestine

Drainage: small/large intestine, upper rectum

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22
Q

MALT
Mucosal-Associated Lymphoid Tissue

A

Aggregates of lymphocytes found throughout mucosal surfaces in body (GI, resp, GU tracts)

Large number of Ab-producing cells; crucial pathogen defense

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23
Q

MALT divisions

A
  1. GALT: Gut-Associated Lymphoid Tissue
    • Tonsils, adenoids, appendix, Peyer’s patches
  2. BALT: Bronchial/Tracheal-Associated Lymphoid Tissue
  3. NALT: Nose-Associated Lymphoid Tissue
  4. VALT: Vulvovaginal-Associated Lymphoid Tissue
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24
Q

Mucosal Immune System

A
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25
Q

Lymphatic System and Function

A

Separate vascular system through which the lymph moves

Functions: Collect/drain excess fluid, absorb fat, conduit for immune cells

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26
Q

Lymphatic System/Lymph Structure

A

Branching vessels (not circular)

Lymph fluid: WBC and plasma, no RBCs

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27
Q

Lymphatic drainage: Initiation

A

Initiated by interstitial fluid uptake in lymphatic capillaries

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28
Q

Lymphatic drainage: flow

A

By skeletal muscle contraction, arterial pulsation, unidirectional valves; smooth muscle in walls of larger vessels; NO PUMP

Flow through multiple lymph nodes before entering circulation in blood

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29
Q

Lymphatic drainage system

A

2 separate, asymmetric systems

Upper right areas (right side of head, heart, lungs): right lymphatic duct –> right subclavian vein

Rest of body: thoracic duct –> left subclavian vein

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30
Q

Contents of lymph fluid and changes throughout flow

A
  1. Phagocytic cells & antigens may be in lymph entering lymph node
  2. Initiation of an immune response, processing of foreign antigens
  3. Fluid exiting nodes with higher number of immune cells and antibodies
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31
Q

Virchow’s node

A

left supraclavicular node

enlargement implies inflammation or infection in left chest/abdomen—could be malignant

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32
Q

Lymphedema Definition

A

Interstitial collection of lymph due to disruption of lymphatic flow

Usually progressive, can lead to tissue hypertrophy & fibrosis

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33
Q

Lymphedema symptoms and complications

A

Symptoms: Swelling, skin changes, pain, restricted range of motion, and nonpitting edema

Complications: skin infections, malignancy; reduced quality of life including aspects of emotional, physical and social well being

34
Q

Primary Lymphedema

A

Associated with genetic or inherited conditions

Associated with lymphatic disruption; can present at any age

35
Q

Secondary lymphedema

A

Due to underlying disease or is a consequence of prior treatment

Etiology: obstruction of lymphatic vessels or nodes (compression by a tumor) or infiltration of the vessels by tumor cells; most common -breast cancer

In US, most due to malignancy or cancer therapy

36
Q

Filariasis

A

Most common cause of secondary lymphedema worldwide; due to infection by the nematode Wuchereria bancrofti

Transmitted by mosquitoes; 20 neglected tropical diseases

adult worms reside predominantly in the lymphatic vessels and nodes, especially legs; scrotum top site in post-pubertal males

37
Q

Filariasis mosquito and human stages

A
38
Q

Filariasis Diagnosis

A

The standard method for diagnosing active infection is the identification of microfilariae on a thick smear of blood

  1. Blood draw at night (10 PM–2 AM), the time period when organisms are in peripheral blood
  2. Serologic enzyme immunoassay tests (alternative test)
39
Q

Filariasis Treatment

A

The main goal of treatment to kill the adult worm

  1. Diethylcarbamazine citrate (DEC) is both microfilaricidal and active against the adult worm; this is drug of choice for lymphatic filariasis
  2. Lymphedema and elephantiasis are not indications for DEC treatment; most people with lymphedema are not actively infected with the filarial parasite
40
Q

Lymphangitis (with site and common pathogen)

A

Inflammation or infection of the lymph vessels

Site of infection: distal to affected blood vessel

Most common pathogen: Streptococcus pyogenes (Group A Strep)

41
Q

Chylothorax

A

Accumulation of lymph in the thorax; often consequence of severing the thoracic duct during surgery

42
Q

Lymphadenopathy

A

Enlargement (< 1 cm) of one or more lymph nodes

Localized (only 1 body area) vs. Generalized (≥ 2 body areas)

Can be associated with infection, inflammatory disorders (e.g. autoimmune diseases), malignancy, etc.

43
Q

Lymphadenitis

A

Lymphadenopathy with pain and/or signs of inflammation (eg, redness, tenderness)

Usually associated with active infection

44
Q

Lymphoma

A

Type of cancer / malignancy of varied cells of the immune system

45
Q

Three lines of immune system defense

A
  1. Intact skin and mucous membranes
  2. Innate/natural
  3. Adaptive/acquired
    1. Cell-mediated
    2. Antibody-mediated (humoral)
46
Q

Innate immune response (what is involved?)

A
  1. Epithelial barriers
  2. Phagocytic cells
    • neutrophils, macrophages, and dendritic cells
  3. Cells that release inflammatory mediators
    • basophils, mast cells, and eosinophils
  4. Natural killer cells
47
Q

Adaptive immune responses

A
  1. Proliferation of antigen-specific B- and T-cells, which occurs when the surface receptor of these cells binds to an antigen
    • Antigen-presenting cells: display antigen to lymphocytes and collaborate with them in the response to antigen
48
Q

Two key features of adaptive immunity that lymphocytes are responsible for:

A

Specificity and memory

49
Q

Innate immunity cells

A
  1. Neutrophil
  2. Monocyte/macrophage
  3. Eosinophil
  4. Basophil
  5. Mast cell
  6. Natural Killer
50
Q

Neutrophil type of cell and function

A
  1. WBC Granulocyte
  2. Engulf bacteria and fungi, oxidative burst
51
Q

Monocyte/Macrophage type of cell and function

A
  1. WBC Mononuclear; monocyte –> macrophage
  2. Engulf bacteria, fungi, and cellular debris; produce cytokines; antigen processing
52
Q

Eosinophil type of cell and function

A
  1. WBC granulocyte
  2. Associated with allergic response and parasitic infection
53
Q

Basophil type of cell and function

A
  1. WBC granulocyte
  2. Associated with hypersensitivity and release histamine
54
Q

Mast Cell type of cell and function

A
  1. Bone marrow derived cell
  2. Granules contain vasoactive amines like histamine, proteases kill bacteria
55
Q

Natural Killer type of cell and function

A
  1. WBC lymphocyte
  2. Recognizes stressed or infected cells and kills them by secreting macrophage-activating cytokine INF-γ
56
Q

Innate Immunity: Phagocytic cells

A
  1. Neutrophils
  2. Macrophages
  3. Dendridic cells
57
Q

Name the cells

A

Neutrophils/PMNs

58
Q

Name the cells

A

Eosinophils

59
Q

Name the cells

A

Mast cells

60
Q

Monocyte progression

A

Bone marrow stem cell –> Blood monocyte –> tissue macrophage –>

  1. Differentiation (CNS, liver, lung, bone)
  2. Activation
61
Q

Adaptive response immune cells + type of cells

A
  1. B-cell (Plasma cell, memory)
  2. T-cell (helper, cytotoxic, regulatory, memory)

Both are WBC lymphocytes

62
Q

B-cell functions

A

Specific recognition of antigens as mediator of humoral immunity

63
Q

T-cell function

A

Specific recognition of antigens as mediator of cell-mediated immunity

64
Q

Maturation of Lymphocytes (B and T)

A

B: common lymphoid precursor -> immature B lymphocytes -> mature B lymphocytes

T: common lymphoid precursor -> mature naive T lymphocytes -> mature T lymphocytes

65
Q

Antigen-presenting cells

A
  1. Macrophage
  2. Dendritic
  3. Follicular dendritic
66
Q

Cytokines

A

Proteins produced & secreted by immune and non-immune cells - act as intercellular mediators to alter biological responses

67
Q

3 types of cytockine action

A
  1. Autocrine: acts on the same cell that secretes it
  2. Paracrine: acts on an adjacent or nearby cell
  3. Endocrine: acts at a distance to stimulate cells
68
Q

Cytokine binding

A
  1. Bind to specific cytokine receptors expressed by target cells
  2. Typically induce signal transduction
69
Q

Cytokine receptors

A

Specific; homodimers or heterodimers that become phosphorylated and activate signaling molecules

70
Q

JAK-STAT signaling pathway

A

Major signaling pathway involved in immune regulation

JAK: Janus Kinase

STAT: Signal Transducer and Activator of Transcription (moves into the nucleus, binds promoters, induces gene transcription)

Cytokines -> receptor -> activates JAK -> activates others (STAT)

71
Q

Important cytokines: innate immunity

A
  1. TNF-α
  2. IL-1
  3. IL-6
  4. IL-12
  5. IFN-α/IFN-β (Type I IFNs)
  6. IFN-γ (Type II IFN)
72
Q

Important cytokines: Adaptive immunity

A

Th-1 cells:

  1. IL-2
  2. IL-3
  3. IFN-γ

Th-2 cells:

  1. IL-4
  2. IL-5
  3. IL-6
  4. IL-10
  5. TGF-β
73
Q

Proinflammatory cytokines

A
  1. TNF-α
  2. IL-1
  3. IL-6
  4. (and others)
74
Q

Important cytokines: Hematopoiesis

A
  1. IL-3
  2. IL-7
  3. M-CSF
  4. G-CSF
  5. GM-CSF
75
Q

Chemokines

A

Small chemo-attractant molecules that cause cells to migrate towards a concentration gradient of the chemokine

76
Q

What cells express chemokine receptors?

A

Target/responding cells

77
Q

Chemokine activation signals what?

A
  1. cytoskeleton rearrangement
    • cell moves to areas with highest chemokine concentration
78
Q

Four categories of chemokines and basis

A

Based on position or arrangement of cysteine(s)

  1. CC
  2. CXC
  3. C
  4. CXXXC
79
Q

Coagulation System of Immune System

A

Cascade of plasma enzymes + platelets:

  1. help form clots
  2. provide prostaglandins, hydrolytic enzymes, and growth factors (facilitate antimicrobial defense/wound healing)
80
Q

Kinin System

A

Second enzyme cascade triggered by tissue damage

81
Q

Protease Inhibitors

A

Enzymes that cleave proteins and breakdown inhibitors

82
Q

Defensins

A

Antimicrobial peptides produced by a variety of cell types that can penetrate microbial membranes and destroy bacteria, fungi and enveloped viruses

Immunology (M1) (11 decks)

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