Immunomodulators, Immunohematology, Immunodiagnosis, AIDS, and Tumor Immunology Flashcards
_____ have receptors for the Fc of IgG (FcγR), such that they interact with antibody on the targeted tumor cells in ADCC
NK cells
______ (anti-____) and ________ (anti-____) inhibit downregulators of CTL activity
Nivolumab (PD-1), Ipilimimab (CTLA-4)
______ phenotype individuals do not have H antigen on the core sugar chain
Bombay
_______ formation: virus makes _______ that inserts into the host cell membrane, which enables fusion of nearby uninfected CD4 cells
Syncytia; gp120/gp41
________ occurs in Rh(D)+ fetuses that are born to Rh(D)- mothers that have made anti-Rh(D) antibodies
Hemolytic Disease of the Newborn (HDN)
__% of individuals in the US living with AIDS have not been diagnosed
16
2/3 of Elite Controllers have the _____ allele.
HLA-B27
A subclass of TAAs that can be recognized by the immune system and used to clear the tumor
Tumor Rejection Antigens
Activated ______ allows virus to bind a co-receptor: _______ (chemokine receptors)
gp120; CCR5 or CXCR4
Activated TAA-specific ____ kill tumor cells by inducing apoptosis via perforin or Fas-mediated pathways
CTLs
Advantages of Passive Agglutination over Simple Precipitation
Determination of antibody titer, More sensitive (larger effective size of antigen)
Antibodies against TNF-alpha
infliximab, adalimumab, certolizumab pegol
Antibodies to one antigen that bind to another (cross-reactive antibodies)
Heterophiles
Antibody Source: -omab
Murine
Antibody Source: -umab
Fully Human
Antibody Source: -ximab
Chimeric (Mouse variable, Human constant)
Antibody Source: -zumab
Humanized (Mouse CDRs)
Antibody Technique: coupled antibodies that are anti-CD19 (on CD19+ B cell lymphoma cells) and anti-CD3
Bispecific T cell engager (BiTE)
Antibody Technique: high affinity antibody CDRs coupled to a transmembrane domain that has a T-cell intracellular signaling molecule
Chimeric Antigen Receptor (CAR)
Antigen used in monitoring therapy of colon cancer but not in diagnostic screening
Carcinoembryonic Antigen (CEA)
Antigens made in normal fetal tissue, not normally made in adults but may be re-expressed in a tumor
Oncofetal antigens
Antigens that are expressed uniquely on the malignant clone
Clonal antigens
Antigens that are overexpressed or abnormally expressed by tumor cells
Tumor Associated Antigens
Cell type: down-regulated if the target cell expresses Class I MHC
NK cells
Cell type: recognize stress-related markers on tumor cells, using a small number of innate receptors
NK cells
Cell type: recognize TAA presented by MHC Class I
CTLs
Cell type: recognize tumor antigens, make lymphokines, and attract M1 macrophages
Th1
Cross-reactive antibodies with phospholipids in beef heart enable diagnostic screening for ______.
Treponema Pallidum
CTLs have two checkpoint inhibitor surface receptors (_______) which can be engaged to downregulation cytotoxic activity
CTLA-4 and PD-1
Diagnostic Technique: add fluoroscein-labeled goat anti-human IgG to patient serum/sample, observe for fluorescence
Direct Immunofluorescence
Diagnostic Technique: add known antigen and patient serum to plate, add fluoroscein-labeled goat anti-human IgG, observe for fluorescence
Indirect Immunofluorescence
Diagnostic Technique: Adhere an anti-human antibody to a plate, add patient serum, wash, add another anti-human antibody (peroxidase labeled) that will bind another epitope on the particle of interest, observe for colorimetric result
Sandwich ELISA
Diagnostic Technique: take cells in suspension and pump them through a small orifice, such that cells emerge single file in a fine stream; lasers illuminate cells and light emitted or scattered is collected by photomultipliers
Flow Cytometry
Diagnostic Technique: couple antigen to a plate, add test serum, wash, add enzyme-coupled anti-human antibody, observe for enzymatic activity
Simple ELISA
Diagnostic Technique: couple antigens to RBCs or latex beads, add dilution of patient serum, observe for agglutination to determine antibody titer
Passive Agglutination
Diagnostic technique: inject common antigens to which most people will have Delayed Type Hypersensitivity, observe at 24-48 hours
Skin Test
Diagnostic Technique: often fluorescent-tagged antibodies to CD-3, CD-4, and CD-8 are used to determine the number, maturation, and type of T cell
Flow Cytometry
Diagnostic Technique: paint dinitrofluorobenze on skin to cause sensitization
Challenge DTH test
Diagnostic Technique: tools to evaluate T cell competence (3)
Skin Test, Challenge DTH test, Chest x-ray in infants
Evidence for Immune Surveillance Theory
Higher incidence of tumors in immuodeficient patients, Activated T cells can recognize tumor-associated antigens, some tumors spontaneously regress (immune response decline?)
HIV binds its _______ to _______ on the surface of Th cells, causing a conformational change in _____
envelope glycoprotein gp120; CD4; gp120
HIV Common Infections: Fungal
Candida, pneumocystis jirovecii
HIV Common Infections: Intracellular
mycobacterium, m. tuberculosis
HIV Common Infections: Protozoa
toxoplasma, cryptosporidium, isospora
HIV Common Infections: Viral
CMV, Hepatitis, HSV, zoster
HIV has a mean incubation period ___ years
9.5
HIV has development of high blood virus levels that peak at __ weeks and antibodies that peak at __ weeks
6; 9
HIV is a type of _______ (virus that causes slow ultimately fatal illness)
lentivirus
HIV is characterized by a falling _____ ratio.
CD4/CD8
HIV persistence is characterized by remaining in _____ cells
memory Tfh
HIV-infected cells may: _______ (3)
Die rapidly, Become persistence virus producers, enter latency
Hypothesis: Adaptive immune response evolved to detect changes in body’s own cell surfaces
Immune Surveillance Theory
IgG antibody to Rh(D) that is administered to Rh(D)- mothers
RhoGAM
In the _____ immunofluorescence test, fluorescence is positive for presence of antibody
Indirect
In the _____ immunofluorescence test, fluorescence is positive for presence of antigen
Direct
Individuals that are infected with HIV but do not progress to AIDs
Elite Controllers
Infection of macrophages and microglia with HIV virus, leading to consequential cytokine release
AIDS dementia complex
Lab Diagnosis of AIDS
ELISA, followed by Western Blot
Lab Monitoring of HIV disease progression
PCR of virus RNA
Large granular lymphocytes that recognize molecules on the surface of stressed or dysregulated cells
NK cells
Least frequent blood type in the US
AB
Limitations of Immune Surveillance Theory
Tumors that immunodeficient and immunosuppressed patients get are not a random sample of all tumors; Nude mice do not get tumors readily
Lineage-specific tumor-associated antigens (most frequently identified TAA)
Differentiation Antigens
Mix normal human RBCs with patient plasma, add anti-human IgG
Indirect Antiglobulin Test
Most ABO isohemagglutinins are Ig___.
M
Most frequent blood type in the US
O
Number of AIDS cases in the US
1.1 million
Patients that have antibodies to HIV in their serum
HIV-seropositive
Reason for the apparent ineffectiveness of antibody in HIV infection
Syncytia formation
Recipient plasma is mixed with red cells from the prospective donor
Major Cross-match
Responds to a viral antigen and horse red blood cells, such that Monospot test can be used to diagnose _______ by mixing serum with horse RBCs
Infectious Mononucleosis
Symptoms of opportunistic infections, Kaposi’s sarcoma, or Th cells <200/μL of blood
AIDS
Treatment strategy: BCG injection directly into tumor, used for superficial bladder carcinoma
Innocent Bystander Killing
Treatment: cells that can fight the tumor are isolated, cultured outside the body, and reintroduced
Adoptive Cellular Transfer Therapy
Treatment: fusion protein with prostate cancer TAA prostatic acid phosphatase and dendritic cells (treat prostate cancer)
Provenge
Tumor cells create an environment in which __ macrophages are favored
M2
Tumor decrease in Class I may increase ___ response
NK
Viral DNA migrates to the nucleus where it is inserted into the host DNA by a ______
viral integrase
Wash patient RBCs and add anti-human IgG
Direct Antiglobulin Test
With administration of _______, antibodies combine with fetal RBCs and destroy them before they are exposed to the mother to allow immunization against Rh(D)
RhoGAM

Normal

Agammaglobulinemia

Hypergammaglobulinemia

Monoclonal Hyperglobulinemia

Multiple Myeloma