Immunology w/ DIT Flashcards
chemotactic factors for neutrophils (4)
Il-8 and C5a, LTB4, Kallikrein
Granuloma formation -
2 cells involved and cytokines (2)
Th1 secretes in IFN gamma activating macrophages.
TNF alpha from macrophages induce and maintain ganulomas
C3b
opsonization w/ IgG
also clears immune complexes
b binds
anaphylaxis complement products
C3a and C5a
Acute inflammation mediated by what cell
Neutrophil
Chonic inflammation medicated by what cell
Monocytes-> macrophages
Acute phase of inflammation initiated by what 3 cytokines
IL1
IL6
TNF alpha
Granuloma formation is dependent on this cell and its secreted cytokine
Macrophage and TNF alpha
4 Steps of Leukocyte extravasation
mediated by what receptors
Rolling - E selection on endothelial cells (P selection and L selection in leukocytes)
Tight binding - ICAM1 on endothelial cells and LFA1 (integrins)on PMNs
Diapedesis - PECAM on both cells
Migration - no recptors, follow chemotactic signals
Whole process enhanced by platelet activating factor
Patient presents w. delayed separation of the umbilicus and has recurrent bacteria infections is suffering from what ?
deficient in what?
Leukocyte adhesion deficiency syndrome
deficient in integrins
cells that activate macrophages and cytokine
Th1 release IFN gamma to activate macrophages and granuloma formation
Granuloma diseases(11)
TB Fungal trepona palliudum M leprae Bartenlla henslae (cat scratch fever) Sarcoidosis Crohn's disease wegeners Beryllosis, silicosis Foreign body disease
C reactive phase vs sed rate
both non specific election in inflammation -
Sed rate is fibrinogen coated RBC settle faster
- > increased Sed rate (helpful in osteomyolytis) infection, inflame, CA, pregnancy, SLE, RA
- low in Sickle cell and polycythema
C reactive protein is an acute phase reactant made in the hepatocyte
Vasodialation and vascular permeabilty in inflammation due to (3)
Histamine
serotonin
bradykinin
Fibroblasts needs what to lay down collagen
Vit C needed for fibrosis
Tissue remodeling needs what dietary molecule
Zinc
- done by metalloproteinases
12-24 hrs post wound see
what changes 2 days later
acute inflammation and PMN -increase vessel permeation
Macrophages come in and assess
- fibroblast, myfibroblast and endothelial cells and epithelilaization (skin and wound coverage for 28Hrs)
Remodeling of the wound occurs when and what is done
1 week after and fibroblasts change type III (granulation tissue) collagen to Type I (scar)
B cells are located where in the lymph node?
in the follicles located in the cortex - B cell localization and proliferation
T cells are located where in the lymph node
What else is located here
in the paracortex
The high endothelial venules (HEV) are also located here where T and B cells enter from the blood
What is located in the medulla of the lymph node (2)
Medullary cords - mature lymphocytes and plasma cells
Medulary sinuses w/ macrophages
What region of the lymph node expands greatly during a viral infection?
What congenital deformity inhibits this?
T cells in the PARACORTEX
DiGeorge -> lack of thymus -> lack of t cells
Functions of the lymph node?(3)
filtration w/ macrophages
storage and activation of B and T cells
Antibody production
secondary lymphoid organs (4)
vs primary (2)
lymph node, spleen, MALT and cutaneous lymph tissue
Thymus and bone marrow
MALT tissue is located (4)
lamnia propia of the intestine -GALT
adenoids/tonsils (o-malt)
upper airways (BALT)
nose associated lymph
Payers Patches differ from lymph nodes in that?
Located where?
they are unencapsulated and located in the lamina and sub mucosa of the illiim of the smallintestine
M cells function in peters patches
flattened areas that take up antigen, transcytosis it, allows APCs to take up to the geminal centers deeper and allow IgA to be made in prevention of disease
Right lymphatic duct drains?
vs Thoracic Duct
R arm
R chest
R half of face
Drains everything else located at the L subclavian and internal jugular vein
Extremities Lymph Drainage
Lateral side of dorsum of the foot drains?
Thigh drains?
Upper limb and lateral chest
Lat foot drains to popliteal
Thigh drains to superficial inguinal
Upper limb and Lat chest drains to axilla (next is parasternal/mammary nodes)
GI Lymph drainage
Stomach drains to ?
Duodeum/ illium?
Sigmoid Colon?
Stomach -> celiac
Duodeum and illieum -> superior mesenteric
Sigmoid colon -> colon-> inferior mesenteric
Inguinal/Rectal lymph drainage
Rectum drains?
Testes drain?
Scrotum drains?
Rectum above the pactinate line -> internal iliac
Rectum below drains to superficial inguinal (epithelial derived)
Testes drain to pre-aortic*
- (back to where derived)
Scrotum drains superficial inguinal
Innate immune response consists of? (8)
neutrophils macrophages, NK cells - lymphoid derived* Dendritic Mast cells eosinophils basophils
Complement protein (MAC)
Adaptive immune system response consists of ? (3)
B cells
T cells
Circulating antibody
CD 3
cell marker on all T cells (helper and cytotoxic)
the majority of lymphocytes in circulation (80%) are
T cells
Also refers to B cells
MHC Class I is recognized by?
- binds to?(2)
Made from what genes?
CD8 Cytotoxic T cells
- TCR and CD8
- Viral and CA immunity
HLA - A, HLA - B, HLA-C
MHC class II is recognized by - binds to ? (2)
Made from what genes?
CD4 helper t cells
- TCR and CD4
- Extracellular antigen response
HLA - D
- DR or DP or DQ
MHC I is expressed on
All cells in the body except RBCs
MHC II is expressed on
APCs (3)
Dendrites
Macrophages
B cells
HLA - B27 assoicated w PAIR
Psoriasis
Ankylosing spodylitis
IBD
Reiters Syndrome
DM and graves and DM and RA is associated w/ what HLA type?
DR3
DR4
Dendritic cells have 4 receptors on them
MHC I - all Cells
MHC II - APC
B 7 (CD80 or 86) - co stim
CD40 - activated by T cells
Dendritic cells are located (2 locations)
Langerhorns - in the skin
interstitial dendritic cells - minus the brain
Dendritic cells sample for antigens via (3)
phagocytosis
pinocytosis
receptor mediated endocytosis (clathrin mediated)
Birbeck granule
Cells expired what tumor markers? (2)
tennis racket shape langerhan cell implicated in langerhan cell histiocytosis
S-100 - nueral crest cell origin
CD1a
Kid presents w/ a lytic bone lesions and a skin rash - biopsy shows cells that normally express B7, CD40, MHC 1 and MHC 2 markers
What is expected on EM
langerhans cell histiocytosis - a bunch of dendritic cells that do not work
- now expressing S-100(nueral crest cell origin) and CD1a
see birbeck cells, tennis rackets on EM
Immature T cells are found where?
What do they undergo to become mature T cells
in the cortex of the thymus
Undergo + selection in the cortex and - selection in the medulla as they make their way to the medulla of the thymus
cells in the cortex of the thymus express what markers (3)
CD3, CD4 and CD8
positive selection means what for a T Cell
When CD8 and CD 4 receptors are both expressed and binding to a antigen presented by the thymic cortex leads to differentiation
CD8 selected if bound to MHCI
CD4 if bound to MHCII
Negative selection for a T cell means
in the medulla T cells that bind to tightly to self antigen are selected against for apoptosis
During a viral infection what cytokine is present in the lymph node that will lead a nieve T helper cell down a particular path?
IL12 leads to Th1 cell differentiation and further activation of Cytotoxic T cells and Macrophages through IL 2 and IFN gamma
IL 12 comes from macrophages
During an extracellular attack what cytokine released leads to a nieve helper T cell become a helpful cell in the attack
IL4 leads to Th2 differentiation and further activation of B cells through the release of IL2, IL4, IL5, and IL10
Th1 is suppressed by what cytokine
IL10
also blocks macophage activation
Th2 is suppressed by what cytokine?
IFN gamma
also activates macrophages
IL 2 role in infection
released by both Th1 and Th2 and leads to T cell proliferation
Th1 and CD8 in cell mediated or Th2 in humoral
2 Signals needed to activate nieve T cell
- MHC class II to TCR on CD4 Th1 or Th2
- CD28 w/ B7 (CD80 or 86)
-leads to IL2 and monoclonal T cell proliferation
1.*MHC I if activating a CD8
and 2. CD 28 w/ B7(CD 80 or 86)
CD 28
Co stimulatory factor found on T cells that are activated / B 7 (CD80 or 86) from an APC
B cell Activation signals (2)
MHC II on B cell goes to a Th2 cell and presents as APC
CD40 L on Th2 binds w/ CD40 on B cell to co-stimulate and activate the B cell
- Cytokines IL4 or IL5 class switch the B cell appropriately
Th1 secretes (2)
IL 2 - t cell prolif
IFN gamma - negative feedback on Th2 and activates macrophages
Th2 secretes (4)
IL-2 - t cell proliferation
IL 4 - class switch and + feed on Th2
IL 5 - class switch
IL10 - neg feedback on macrophage and Th1
Cytotoxic T cells kills cells by (2)
Releasing perforin and granzyme
-also done by NK cells
Binding FAS L w/ target FAS receptor
Induing apoptosis
CD8 cells have a role in defense against (3)
Viral
CA
transplants
-faulty MHC I presentations
Regulatory cells release?(2)
Gene expression and associated receptor
Anti inflammatories and IL10 and TGF beta
FOXP3 -> CD25
also has CD3 and CD4
NK cells activity normally is?
enhanced by?
killing of cells w/out MHC I through perforin and granzyme
lymphocyte origin*
Activity enhanced by IL2, IL12, IFN beta and IFN alpha
IFN alpha and Beta in a viral infection
warns nearby cells to shut down viral producing products and up regulates MHC I expression
differs from IFN gamma
CD16
found on NK cells, macrophages, and PMNs,
Recognizes Fc component of antibodies and used in antibody dependent cell mediated cytotoxicity (ADCC) - opsonization
CD56
cell marker for NK cells
Also has CD 16
Only lymphocyte of the innate immune system?
NK cells
B cell Surface Markers (8)
CD19
CD 20
CD 21 - EBV
CD 40 - T cell gives permission to activate
MHC II - APC
B7 - Co-stim B activates T cell
IgM
IgD
Heavy Chain of Antibody chains in an Antibody important in determining what?
Isotype of the antibody
IgM - mu IgG -gamma IgA - alpha IgE - epsilon IgD - delta
2 ways to describe an antibody
Light Chain/Heavy chain
or Fab and Fc portion
Light chain of antibody is important in determining what?
A part of the Fab portion that leads to a unique antigenic pocket (idiotype)
2 types Kappa and lambda;
2:1 ratio normally- multiple myeloma if not
What ratio is kappa light chin suppose to be to lambda light chain?
2:1
multiple myeloma if not
example should be gamma 2 lambda 2
Fab portion of the antibody is important for?
Determining the idiotype - unique
Antibody light chain and heavy chains are held together by
di sulfide bonds
Fc portion of the antibody is important for (2)
Constant portion
complement binding - At Ch2 (IgM and IgG)
Determining the isotope
What initiates recombination of the V(D)J sequence
Gene sequence recognized?
Recombination Activating Gene complexes (Rag 1 and 2 ) recognize Recombination Signal Sequences (RSSs) that flank V(D)J coding sequences and result in breaks of dsDNA and antigenic uniqueness from somatic hypermutation
Mutations in RAG genes results in what
Inability to initiate antigenic reombination sequences of the VDJ sequence
Can’t recognize the RSSs
Antibodies have 3 roles in the body
Obsonization - (phagocytosis)
Neutralization - (toxin or bacteria itself)
Complement activation - MAC
Fc of an antibody determines the?
isotype
Fab of an antibody determines the
idiotype
Mature B cells express on their surface what Igs?
IgM and IgD
Main secondary antibody found evenly distributed in the intravascular and extrvascular pools
IgG
4 jobs of IgG
fixes complement
Crosses the placenta to provide passive immunity
opsinizes bacteria
neutralize bacterial toxin/viruses
-mediates cell mediated cytotoxicity
Antibody that crosses epithelial cells by transcytosis?
Covered by what?
IgA
Covered by secretory component,
Found in secretions (tears, saliva, mucus) and breast milk
IgA exists in 2 forms
monomer in circulation
dimer in secretion _ attached at Fc part
IgE is assocaited w/ 2 processes
- Immunity from worms w/ activation of esinophils
2. binding to mast cells and predisposing for hypersensitivity type 1 reactions through histamine release
Antibody produced in immediate response to an antigen
Exists in 2 states
IgM
Pentomer in circulatory -> wheel (too big to cross the placenta)
monomer on surface of B cell
2 antibodies that can fix complement
IgG and IgM
B cells are encouraged to class switch with what 2 signals
Cytokine IL 4 or 5
CD 40 stim from CD40 L (T cell)
Be wary of giving the following 2 vaccines to someone with an egg allergy
Yellow fever
Influenza
Examples of live attenuated vaccines (6)
Induces what kind of response?
Measles Mumps Rubella Varciella Polio - Sabin (oral) Yellow Fever Intranasal flu
Induces a cellular response w/ cytotoxic t cells - actually infects the cell and leads to memory cells