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Pathological Mechanisms > Immunopathology > Flashcards

Immunopathology Flashcards

1
Q

Which wing of the immune system is involved in hypersensitivity reactions?

A

Adaptive immune system

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2
Q

Why can hypersensitivity reactions not occur on the first exposure to a pathogen?

A

Sensitisation must occur first

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3
Q

Which cell / antibody principally mediates type 1 hypersensitivity?

A

IgE

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4
Q

Which cell / antibody principally mediates type 2 hypersensitivity?

A

IgM or IgG bound to a cell or antigen matrix

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5
Q

Which cell / antibody principally mediates type 3 hypersensitivity?

A

IgM or IgG bound to soluble antigen

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6
Q

Which cell / antibody principally mediates type 4 hypersensitivity?

A

T cells

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7
Q

How quickly do type 1 hypersensitivity reactions occur?

A

Immediately

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8
Q

Type 1 hypersensitivity reactions increase in severity with repeated challenges. T/F?

A

True

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9
Q

What type of hypersensitivity is responsible for most allergies?

A

Type 1

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10
Q

Describe the pathophysiology of type 1 hypersensitivity.

A

Sensitisation where there is priming of mast cells as IgE binds to the mast cells
Re-exposure to the antigen causes binding of the antigen to the IgE resulting in degranulation of mast cells
Resultant release of toxins, tryptase, pro-inflammatory cytokines, chemokine, prostaglandins and leukotrienes

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11
Q

How are future type 1 hypersensitivity reactions amplified?

A

Each reaction is a pro-inflammatory process in which the inflammation caused by the rection increases production of IgE and mast cells leading to a bigger response in the next reaction

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12
Q

There is often an initial period of recovery followed by further worsening of symptoms in type 1 hypersensitivity reactions. T/F?

A

True

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13
Q

Type 1 hypersensitive reactions cause smooth muscle contraction and increased vascular permeability. The release of which substance is largely responsible for this?

A

Histamine

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14
Q

Severe type 1 hypersensitive reactions cause massively increased vascular permeability. What are the implications of this?

A

Anaphylaxis:
soft tissue swelling which threatens the airway
loss of circulatory volume causing shock

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15
Q

Describe the pathophysiology of type 2 hypersensitivity reactions.

A

Type II hypersensitivity binds with sensitization which causes opsonisation of cells, this leads to cytotoxicity where there is complement activation, inflammation and tissue destruction

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16
Q

In type 3 hypersensitivity reactions large immune complexes bound to a soluble antigen form. These complexes are large and aggregate in small blood vessels. What are the implications of this?

A

direct occlusion of vessels
complement activation
perivascular inflammation

17
Q

In what type of hypersensitivity is the reaction delayed?

A

Type 4

18
Q

Describe the pathophysiology of a type 4 hypersensitivity reaction where there is a contract-sensitising agent

A

The contact sensitising agent penetrates the skin and binds to self-proteins, altering these proteins in such a way that they are then taken up by langerhans cells (APCs) and presented to lymphocytes in lymph nodes, initiating an immune response

19
Q

What is autoimmune disease?

A

A harmful inflammatory response directed against ‘self’ tissue by the adaptive immune system

20
Q

Autoimmune diseases usually encompass several types of hypersensitivity. T/F?

A

True

21
Q

Several organ-specific autoimmune diseases rarely co-exist within the same patient. T/F?

A

False - Organ specific autoimmune diseases often co-exist within the same patient

22
Q

Type 1 diabetes is a selective autoimmune destruction of the beta cells of the pancreas. What types of hypersensitivity reactions are at play here?

A

Type 2 and 4

23
Q

Myasthenia gravis is a syndrome of fatiguable muscle weakness, Which parts of the body are particularly affected by this?

A

Limbs
Respiratory tract
Head and neck

24
Q

What is the cause of myasthenia gravis?

A

IgG antibodies target the ACh receptor of the neuromuscular junction, blocking the receptor and preventing signal transduction

25
Q

Give examples of systemic autoimmune diseases.

A 
Rheumatoid arthritis
systemic lucid erythematosus
inflammatory bowel disease
connective tissue disease
systemic vasculitis
26
Q

What are some of the characteristic systemic signs of rheumatoid arthritis?

A 
Pulmonary nodules and fibrosis
pericarditis and valvular inflammation
small vessel vasculitis
soft tissue nodules
skin inflammation
weight loss
anaemia
27
Q

What is rheumatoid factor?

A

A large immune complex formed by the targeting of IgG antibodies by IgM and IgA antibodies

28
Q

In which area of the body can rheumatoid factor be found in high concentrations in RA patients?

A

Synovial fluid

29
Q

The presence of rheumatoid factor is not specific to RA. The presence of what other protein is more specific to RA?

A

Anti-Citrullinated protein antibodies

30
Q

Historically, autoimmune disease has been treated by systemic immunosuppression. What types of drugs are used for this?

A

Steroids
inhibitors of metabolism
inhibitors of T cell function

31
Q

Biologic therapy in RA has many benefits, however there is an increased risk of infection particularly…?

A

Tuberculosis

32
Q

Describe the general pathogenesis of autoimmune disease

A

The pathogenesis of autoimmune disease involves a combination of genetic predisposition and environmental factors leading to a recognition of self antigens by the immune system as foreign and a persistence of the inflammatory response leading to chronic disease

33
Q

Describe the genes commonly involved in genetic predisposition for autoimmune diseases

A

MHC 1 AND 2 genes
Cytokines and cytokine receptor genes
transcription factors and cell adhesion molecules

34
Q

Give examples of environmental factors which could influence the development of autoimmune disease.

A

Infection resulting in Molecular mimicry or tissue damage exposing self antigens
geographical factors (e.g. vit D and MS)
Modifiable personal risk factors such as smoking

Pathological Mechanisms (10 decks)

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