Immunology Polansky Review Flashcards
Acute Phase Reactants
proteins that increase due to infection, injury, trauma (CRP/A1-antitrypsin, fibrinogen..etc)
Alloantibody
ab formed in response to antigen from individuals of the same species
Antigen (Ag)
foreign substance that stimulates ab production. Large complax molcules usally a protein or polysaccharide
Ab (antibody)
ig produced by plasma cells in response to Ag
avidity
strength of bond between ag and ab
chemokines
cytokines that attract cells to a site, important in inflammatory response
CD (cluster of differentiation)
ag feature of
antigenic features of leukocytes
cytokines
chemicals produced by activated immune cells that affect other cells, interferons, TNF, TGF..etc
epitope
determinant site on ag
Hapten
LMW substance that can bind to ab, incapable of immune response unless bound to larger molecule
histamine
vasoactive amine from mast cells and basophils in allergic rxn
hypersensitivity
heightened immune response with tissue damage
inflammation
cellular and humoral mechanisms involed in relation to injury or infection
interferons
cytokines with antiviral properties, active against certain tumors and inflammation
interleukins
cytokines produced by leukocytes that affect inflammatory response through increase in soluble factors
ligand
molecule that binds to another molecule or complementary configuratgion, substance being measured in an immunoassay
Lysozyme
enzyme in tears/saliva that attacks cell walls of microorganism
MHC
genes that control expression of MHC found on all nucleated cells, used to be HLA
monoclonal ab
ab derived from single B clone
opsonin
serum proteins that attach to foreign substance and enhance phagocytosis
polyclonal ab
ab produced by many b cell clones
postzone
how do you fix
reduced complexes due to AG access, false neg in tests for ab, repeat in 1-2 weks
prozone
causes false?
what do you do?
ab excess, false neg tests for ab, dilute and retest
seroconversion
change of sero test from neg to pos due to development of detectable ab
serum sickness
Type III hypersensitivity rxn from build up of ab to animal serum used in passive immunization
thymus
found in throax, t lymph development, primary lymph organ
titer
ab concentration, reciprocal of highest dilution with positive rxn
zone of equivalence
when # of multivalent sites of ab and ag are equal, results in optimal precipitation
Cellular immune system
mediated
defence against
what cells?
cell mediated
defence against virus, mycobact, intracellular path/tumors
T cells and macrophages
examples of cellular immune system
graft vs host, hypersensitivty, tumors
Humoral immune system
antibody mediated
defense against bacteria (extracellular)
B lymphs and plasma
Humoral immune system examples
ab production
Natural/innate immune system components
neuts, macros, APR, complement
aquired immune system components
t/b cells, plasma cells, ab, cytokines
natural acquired active immunity
individual infected with microorganism produces ab
infections
specific, not immediate, long term
artificial acquired active immunity
vaccine exposure to ag
DTaP
speciifc, not immediate, life long
natural aquired passive immunity
individual protected by ab produced by another person
maternal ab that cross placenta, breast milk
specific, immediate, not life long
artifical aquired passive immunity
individual recieves ig containing abs produced by another person
HBIG,
specific, immediate, not long term
Eos
neutralize basos/mast cells
parasites, some phagocytic
Basos
hypersensitivty
histamine, heparin, eos chemotactic factor A
bind IgE
mast cells
hypersensitivity
connective tissue, more granules than basos, bind IgE
Macrophages
elim bacteria, parasites, tumors, secrete mediators, APC
activated by microorgn or cytokines from t lymphs
NK Cells
defence against?
markers?
br
first line of defense against tumors and viruses, no T/B markers
bridge innate and adaptive
Th cells
activate other cells, cell mediated immunity
CD4+, low in AIDS
Tc cells
supressor cells inhibit Th cells
cytotoxic kill others
CD8+
low in AIDS
CD4/CD8 ratio
2:1
Tr cells
supress immune response to self
CD4 CD25
B lymphs
transform to plasma and memory after stimulation
have surface Igs that act as receptors
plasma cells
ab production, in peripheral lymph organs, non dividing
die in a few days
Memory cells
where are they located?
how long?
respond to ag when stim again with increased activty
peripheral lymph organs, live months to years
secondary lymph organs
spleen, lymph nodes, tonsill, appendix, CALT, MALT (peyers patches)
ID of lymphs
flow cytomoetry
Common T cell ag tested in flow
CD2, CD3, CD4, CD7, CD8
common B cell ag tested in flow
CD19, CD20, CD22 surface Ig
basic Ig structure
2 H chains 2 L chains, held by disulfide bonds
Heavy chains
gamma, alpha, delta…etc
determine class (IgG, IgM)
2 H chains in Ig always the same
L chains
free..
K or L, found in all classes of Igs but only 1 type per molecule
Free L chains are bence jones proteins
Fab fragment
fragment antigen binding
1 L chain and 1/2 H chain, bind ag (2 per ig)
Fc fragment
fragment crystaliable
carboxy-term have of 2 H chains, role in opsonization and complement
constant region
aa sequence for….
carboxy term ends of H/L chains where amino acid sequence for all chains is the same for that type
variable region
amino acid sequence varies, antigen recognition unit, responsible for Ig specificity
Hinge region
flexible portion between 1/2nd constant regions, allows molecule to bend so that 2 ag binding sites can operate independently
joining chain
glycoprotein that links Ig monomers in IgM and secretory IgA
IgG role
defense against
neutralizes…
what kind of rxns?
defense against bacteria/virus
neutralizes toxins, opson, passive immune in newborns
precipitation
IgM role
neutralizes toxins, opsonin
first ig produced, ONLY IG PRODUCED IN NEW BORNS
most eff at complement
IgA role
1st line of defense, mucosal surfaces, prevents bacterial adherence
tears, sweat saliva, breast milk
IgD role
located?
b cell maturation, surface of b lymphs
IgE role
allergic rxn, degranulation
type I hypersensitity rxn
classical complement pathway
triggered by ag/ab rxn. IgM most eff.
C1 first to bind
activation C4, C2, C3
alternative complement pathway
activated by?
ab independent, act by bacteria, fungi, tumors..etc
Lectin pathway
non….
def
ab independent, MBL mannose binding lectin, nonspecific region of sugars on microorgn, defence in infancy
highest complement presence in plasma
C3
Inactivation of complement
56 degrees c for 30 min
Type I hypersensitivity
anaphlactic
IgE
release of mediators from basos/mast cells
immediate
anaphylaxis, hay fever, food allergies
Type II hypersensitivity
Cytotoxic
IgG/IgM complement cellular ag
cytolysis due to ab and complement
immediate
transfusion rxn, HDN, AHA
Type III hypersensitivity
immune complex
ag-ab deposits
immediate
arthus rxn. serum sickness, SLE, RA
Type IV hypersensitivty
dependent?
release?
d
types?
T cell dependent
relase cytokines
delayed
contact dermatitis, tuberculin skin test
direct agglutination
nat…..
agglutinate in presence?
example?
natrually occuring ag on particles, agglutinate in pres of ab
typhoid fever, not common in US
hemagglutination
ab-ag rxn that clumps rbcs,
abo slide test
passive agglut
solube ags bound to particles, latex, agglut w ab,
RF or ANA
reverse passive agglut
what is attached
what happens?
ID?
ab attach to carrier, agglut in pres of ag
rapid ID of bacteria
agglut inhibition
comp…
lack
detection of
competitive reagent and specimen, lack of agg is pos
detection of drugs
hemagglut inhibit
detects ab to….
example
dects abs to viruses that agg rbs,
rubella
coaggluation
rgnt ab attached to….s
rgn ab attached to carrier bact (s. aureus most common) protein A binds fc portion
rapid id of bacteria
antiglob mediated agglut
detection of…
detect of nonagglut ab by coupling w 2nd ab
direct and indirect ag tests
precipitation
what kind of complex?
sensitvity?
soluble ag combines with soluble ab to produce visible complex
less sensitve
ouchterloney double diffusion
what diffuses? where? forms?
what ags?
ab/ag diffuse from wells in gel and form preciptin lines
fungal ag, nuclear ag
radial immunodiffision (RID)
ag dif…..p…diameter?
low vol?
ag diff out of well in gel containing ab, precip ring, diameter prop to conc of ab
low vol IgD/IgG
rocket immunoelectrophoresis
what is added to RIF
mig
what shaped band?
examples?
electrical charge added to RIF, migration into agar, rocket shaped band
Igs, complement, AFP
immunoelectrophoresis IEP
what is separated?
dd
replaced?
proetins sep by electrophroresis, double idff
serum proteins , replaced by IFE
immunofix electrophoresis
proteins sep by…
anti….
what precipitates?
IDs mon….b…what adaptation?
proteins sep by electroph, antiserum of gel, ab-ag complex precipitates
ID of monoclonal gam, bence jones, western blot addaptation
nephlometry
examples?
light scatter ag-ab complex
ig complement CRP
nonistopic
immuni assay that uses something else as label, enyzyme ex
completitive
immunoassay in which pt ag and labeled rgnt ag compete for binding sites
noncompetitive
more….than competitive
no competition for binding sites, more sensitive than competitive
heterogeneous immunoassay
has? more…than hommogenous
separation step to remove free from bound analyte, more sensititve than homogenous
homogenous immunoassay
doesnt require?
easier to?
doesnt require separation step, easier to automate
EIA
what is label?
what is added to measure activity?
any immunoassay that uses enzyme as label, substrate added to measure activity
Direct EIA
1st…com
all ?
initial?
1st type developed, competitive, all rct added at the same time
intitial ag-ab rxn has enzyme labeled rgnt
indirect EIA
non
more
known as
non competitive, enzyme labeled rgnt not apart of initial rxn
more sensitive, also known as ELISA
solid phase
bound to
mic
cellu
rgnt ag or ab bound to support medium, microtiter plts, cellulose membrane..etc
EIA description
he…
c/d
heterogenous, competitive direct
ELISA description
heterogenous, noncompetitive, indirect
Rapid ELISA
mem
qu
built in?
membrane based, usually qualitiative, built in control
EMIT
homo lmw
homogenous, LMW analytes
DFA direct flourescnet antibody
glass slide, flourescnem , bacterial or viral ags
infirect flourescnet ab (IFA)
san
ab in?
a/f
glass slide pt serum, sandwich techniquue, ab in serum
FANA, FTA
fluorsc polarization immunoassay (FPIA)
used for t/h
com
labeled ag competes w ab for sites, competitive homogenous automates
theraputic drugs/hormones
VDRL
f
r
c
m
s/c
flocculation
detects reagin
cardiolipin
microclumps
serum/csf
RPR
f
r
ch
mac
s/p
sc
flocculation
reagin
charcoal
MACROAGGLUT
serum/plasma
screening/treatment
FTA-ABS
Ab to t. pallidum
sorbent, flourescence
TP-PA
colored…ag
ab to t pallidum
colored gelatin particles, agglutination, not as sensitive in primary syhpilis
ELISA for syphilis
high sensitivity in primary syphillis decreases in later stages
RPR +
FTA +
pos for syphillis
RPR +
FTA =
neg for syphillis
ELISA +
RPR +
pos for syphillis
ELISA +
RPR =
FTA-ABS
late, latent or previous syphillis
ASO
g
rheu
ne
GAS, Rheumatic fever
nephlemotry
Anti-DNase B
g/gl/i
e/n
highly
GAS, glomerulonephritis, impetigo
EIA, neph
highly speciifc, may be pos when ASO neg
streptozyme
GAS
slide agglut
more false pos and false neg
IM (infectious mononucleosis) sero tests
Heterophile ab, 90% of pts develope
EBV specific antibodies
total anti-HAV
past infection and immunity
HAV RNA
curr
current infection to detect in food and water
HBsAG
cute or chronic, first marker to appear, screen donor blood
HBeAg
acute or chronic indicated high degree of infectivity
total- anti hbc
c/p/c
predom…
current,past or carrier
predom IgG persists for life
IgM anti-Hbc
1st ab to appear, detetcs window period, screen donor blood
Anti-hbe
recovery, reduced infectivity
Anti-Hbs
recovery/immunity, ab that develops following immunization
HIV markers
viral
p
i/ig
Viral RNA detectable within days
p24 ag core coat for nucleic acids
IgM
IgG
HIV confirmatory tests
Western blot
IFA
NAAT
tests to stage/monitor HIV
CD4 tcell count, # declines with disease
HIV-1 viral load, determine when to start antiretroviral therapy
screening tests for SLE
FANA, high sensitivty most test pos, low specificity
EIA-ANA not as sensitivty/specific
easier less expensive
tests for ANA
anti-dsDNA low sensitivty for SLE, high specificity
Anti-sm speckled pattern
antihistone/ENA
serologic tests for RA
RF, autoab IgM against IgG, not specific
Anti-CCP more specific for RA more severe form
