immunology review Flashcards
3 things immune cells do when active?
- Proliferate 2. Cytokine production 3. Adhesion molecules and trafficking
Cytokines do what
Make TF that enters nucleus affect gene transcription profile of cell
4 compartments of immune system
- Complement - land mines
- Phagocytes- the marines (neutrophils and macrophages)
- B cells - Air Force make deploy missile
- T cells - the generals, assasians, the psychologists
Complement immune system 3 pathways
- Classical (immune)
- lectin (pathogen)
- alternative (pathogen)
- All Activate c3 and form membrane attack complex (MAC)
Encapsulated organism infections, or lupus or lupus like glomerulonephritis
Classical pathway early defect
Invasive infections with neisserial species
Late complement pathway defect
How test complement pathway of immune system, how treat?
- Measure number by serum c3 and c4
- measure function ch50 test (defect - absent response)
- treatment- fresh frozen plasma, Eculizumab (HUS, hemolytic uremic syndrome)
C1q absent leads to?
- lupus 90% time
- early complement defect
- made in bone marrow, so bone marrow transplant cure
Delayed separation umbilical cord
Leukocyte adhesion deficiency
Phagocyte deficiency-chronic granulomatus disease commonly present with?
- Catalase + organism infections
- Staph aureus, serratia marcesans, aspergillus
- lack oxidative burst
Absent CD18 means
Leukocyte adhesion deficiency
Neutrophil oxidative burst absent means what
Patient has chronic granulomatous disease (phagocyte deficiency)
Treatment that target neutrophils
- Colchicine- target microtubule formation
- treat gout and rheumatism
- Infection with no pus (clear weepy fluid)
- very high circulating neutrophils (trapped can’t get out)
Leukocyte adhesion deficiency
Patient has recurrent bacterial sinopulmonary infection (ear and sinus infection, bronchitis)
B cell pathology
- 5 year old boy history of ear infections and diffuse bronchiectasis (scarring)
- labs: normal T cells, low B cells, low IgG, low IgM, low IgA
- X Linked Agammaglobulinemia
- BTK gene mutation, block B cell development
8 year old boy with chronic cough and bronchoscopy show pneumocystis jirovecii
labs: normal T and Bcell count, low IgG, high IgM, low IgA
X linked hyper IgM syndrome (CD40 ligand deficiency)
- 17 year old female with recurrent sinusitis 2-3 sinus infections per year for 3 years, 2 bacterial pneumonias last 3 years. Has chronic cough and exercise intolerance. Feels tired all the time.
- CXR show ground glass appearance in R lower lobe. Enlarged lymph nodes mediastinum
- normal T cell count, low B cell, low IgG, normal IgM, low IgA, low vaccine response
Common variable immunodeficiency
- 7 month old boy episodic Otis media since 2 months, failure to thrive, now worsening respiratory status
- CXR patchy infiltrates
- Lab:lymphopneia, low T cell, normal B cell, low NK, Iow IgG, normal IgM, low IgG
Severe Combined Immune Deficiency (SCID)
- 5 month old boy with petechiae since 3 months, has thrombocytopenia (low platelets) 14000-32000, prolonged bleeding for 24 hours after circumcision, wheezing, recurrent Otis media
- Mild eczema face
- Labs: normal IgG, IgM and IgA
Wiskott-Aldrich Syndrome
Inflammatory cytokines
TNF-alpha, IL-1, IL-6
Cytokine growth factors
- T cell: IL-2 and IL-7
- B cell: IL-4 and IL-5
- NK cells: IL-15
- Neutrophils: G-CSF
- Macrophages: GM-CSF
- erythocytes
What immune system defect can cause virus infections?
Tydpe 1 interferons (IFN-alpha, beta), and type II interferon (IFN-gamma), they generate in response to viral infection
What defect in immune system would cause myobacteria infections?
IL-12, and interferon gamma
Recurrent candida infections on skin caused by defect in what immune cytokines?
IL-17, Th17, and IL -23
