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Year 3 > Introduction to Immunology > Flashcards

Introduction to Immunology Flashcards

1
Q

what are the physical barriers to infection?

A

skin and epithelial mucosa
Secretions
normal flora

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2
Q

how does the resp/GI/GU systems prevent infection?

A

Antimicrobial peptides secreted by epithelial cells in resp/ GI/ GU tracts (also secreted by phagocytic cells) – have anti-bacterial properties – inc cecropins, magainins, defensins

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3
Q

how do secretions prevent infection?

A

o Sweat, tears, saliva, gastric acid, sebaceous glands, mucus, breast milk
o Saliva – lysozyme (digests proteoglycan in bacterial cell walls), IgA, IgG and lactoferrin
 IgA prevents attachment of microbes and may neutralise microbes insitu
 Lactoferrin sequesters free iron (used my microbes) and has direct antimicrobial effects – bind to lipopolysaccharide part of bacterial membrane, causes oxidative damage of the membrane, which results in cell lysis.

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4
Q

how does normal flora prevent infection?

A

o Commensal bacteria – compete for nutrients, prevent attachment, release fatty acids, and antibacterial proteins, prevent invasion
o Lactobacilli in vagina – cause acidic pH (4.0-4.5)

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5
Q

what are the physiological defences agains infection?

A

o Temperature (fever), pH, location of immune cells within the bloodstream (can readily attack when and wherever microbes invade)

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6
Q

how do burns allow infection?

A

and dry mouth

allow access and more optimal growing conditions

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7
Q

how does cystic fibrosis lead to increased infection?

A

The increased viscosity of secretions in cystic fibrosis reduce the ability of the cilia to clear infections effectively, leading to repeated infections, and allows damage to the lungs to occur.

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8
Q

how does normal gut bacteria contribute to infection?

A

without normal gut flora keeping gut pathogens under control, other bacteria can increase in number and cause problems, such as a toxic megacolon here as a result of clostridium difficile infection.

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9
Q

name the molecules of the innate immune system

A

complement
interferon
cytokines
acute phase reactants

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10
Q

name the receptors of the innate immune system

A

pattern recognition receptors: toll-like receptors, mannan binding like lectin

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11
Q

name the molecules of the adaptive immune system

A

immunoglobulins

cytokines

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12
Q

name the receptors of the adaptive immune system

A

TCR - t cell receptor
BCR - b cell receptor
MHC/HLA

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13
Q

discuss the innate immune system

A 
•	First line of defence
•	Rapid
•	Already present at birth
•	Some specificity
•	No memory – same response with re-exposure
•	Detects alteration from haemostasis
o	Damage recognition – host
o	Pathogen recognition – pathogen
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14
Q

name the 5 activators of inflammation in the innate system

A 
damage to tissues e.g. burns
microbial infection
complement activation
autoimmunity
allergens
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15
Q

name the mechanism involved in inflammation in the innate immune system: damage to tissues

A

prostaglandin

leukotriene

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16
Q

name the mechanism involved in inflammation in the innate immune system: microbial infection

A

exotoxins, endotoxins
TLRs - macrophages, mase cells
IL-1, IL-6, IL-12, TNF-a
NO

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17
Q

name the mechanism involved in inflammation in the innate immune system: complement activation

A

C3a

C5a

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18
Q

name the mechanism involved in inflammation in the innate immune system: autoimmunity

A

immune complexes
complement
T-cel

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19
Q

name the mechanism involved in inflammation in the innate immune system: allergens

A

mast cell degranulation

histamine

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20
Q

name the stages in the innate immune system

A 
inflammation
recruitment of immune cells
activation of complement 
opsonisation
phagocytosis
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21
Q

what happens as a result of inflammation in the innate immune response?

A 
vasodilation
loosening of endothelial tight junctions
increased cell adhesion molecules
chemotaxis
smooth muscle contraction
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22
Q

with a diagram describe the recruitment of immune cells in the innate response

A

see notes

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23
Q

draw a series of diagrams to show the activation of complement in the innate response

A

see notes

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24
Q

what is opsonisation?

A

to prepare for eating

reduced repellent negative charge of cell membrane to allow phagocyte to come closer

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25
Q

give examples of opsonins

A

complement
antibodies
plasma proteins

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26
Q

use a diagram to describe phagocytosis

A
  1. phagocyte moves towards microbe
  2. phagocyte attaches to microbe via opsonin
  3. endocytosis of microbe within phagosome
  4. phagosome fuses with lysosome
  5. oxygen dependent species result in microbe death
  6. release of microbe products
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27
Q

what is the life span of neutrophils?

A

few days

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28
Q

what are the main functions of neutrophills?

A

phagocytosis

degranulation

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29
Q

what are the degranulation products in neutrophils?

A

peroxidase
defensins
acid and alkaline phsophatases

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30
Q

what are the main tagetts of neutrophils?

A

bacteria

fungi

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31
Q

name the receptors found on neutrophils

A 
o	Toll like receptors
o	Complement
o	IgG
o	Chemokine IL-8
o	Chemoattractant C5a
o	ICAM + VCAM – adhesion to endothelium
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32
Q

life span of eosinophils

A

8-12 days

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33
Q

function of eosinophils

A

extracellular killing via degranulation

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34
Q

what are the components of eosinophil degranulation?

A

peroxidase
major basic protein
IL-8, cytokine

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35
Q

what induces degranulation of mast cels and basophils?

A

major basic protein

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36
Q

main target for eosinophils

A

parasites

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37
Q

what do IL-5 and IL-3 stimulate?

A

production and release of eosinophils from BM

expression of IgE receptors on eosinophils

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38
Q

life span of basophils

A

few days

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39
Q

where are basophils predominately found?

A

within circulation

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40
Q

main fuction of basophil

A

degranulation

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41
Q

degranulation products of basophils

A

histamine
prostaglandins and leukotrienes
cytokines: IL-4, IL-3

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42
Q

main target of basophils

A

parasites

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43
Q

receptors found on basophils

A

o Surface bound IgE
o C3a, C5a anaphylatoxins
o Toll-like receptors

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44
Q

draw: neutrophil

A

see notes

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45
Q

draw: eosinophil

A

see notes

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46
Q

draw: basophil

A

see notes

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47
Q

draw: mast cell

A

see notes

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48
Q

draw: macrophage

A

see notes

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49
Q

life span of mast cells

A

long

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50
Q

where are mast cells found?

A

present in tissues exposed o external environment e/g/ skin, lung, gut

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51
Q

what is the function of mast cells?

A

degranulation through cross linking of IgE receptors

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52
Q

degranulation products of mast cells

A 
o	Histamine
o	Proteases
o	Reactive oxygen species
o	Cytokines – TNF alpha, IL-4, IL-3 
o	Leukotrienes and prostaglandins
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53
Q

main targets for mast cells

A

parasites

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54
Q

receptors found on mast cells

A 
o	Surface bound IgE
o	C3a and C5a
o	Damage associated molecular patterns
o	Toll like receptors
o	Complement
o	Others: that can bind drugs e.g. opioids and antibiotics
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55
Q

what are macrophages? give examples of where they are found

A 
•	Tissue-based monocytes
o	Kupffer (liver), microglial (brain), mesangial (kidney)
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56
Q

life span of macrophages

A

months to years

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57
Q

main functions of macrophages

A

phagocytosis
antigen presentation to T cells
release TNF-a, IL-2, IL=6

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58
Q

receptors found on macrophages

A

o Toll like receptors
o Fc for IgG and IgA
o C3b
o MHC class I and II

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59
Q

draw: dendtiric cell

A

see notes

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60
Q

draw: NK cell

A

see notes

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61
Q

where are dendritic cells found?

A

tissues exposed to external environment

62
Q

once activated where do dendritic cells migrate to? how?

A

lymphoid tissues

binding to microbes via pattern recognition receptors

63
Q

main functions of dendritic cells

A

o Phagocytosis
o Antigen presentation to CD4+ T cells via MHC II
 Shape enhances activation
o Secrete TNF alpha, IL-12, IL-23

64
Q

discuss follicular dendritic cells

A

o Mesenchymal origin
o Within follicles of lymphoid tissue
o Do not express MHC II but interact with B cells

65
Q

what are NK cells activated by?

A

IFN and macrophage derived cytokines e.g. IL-2

66
Q

main functions of NK cells

A

o Bind to and kill virus-infected and cancerous cells –reduced MHC I expression
o Release of perforin + granzymes from granules
 Perforates cell, inserts proteolytic enzymes, induces apoptosis
o Also induce apoptosis by binding to FasL molecules on virus
o Release IFN gamma and TNF alpha

67
Q

what are NK cells inhibited by?

A

normal self signal via MHC I

68
Q

receptors found on NK cells

A 
o	Killer activation receptors
o	Killer inhibitory receptors – recognise MHC class I
o	Toll-like receptors 
o	Fc receptors
o	Adhesion molecules
o	FasL
69
Q

name the common cytokines

A

IL-1, 2, 4, 5, 6, 8, 12

70
Q

what produces IL-1

A

macrophages and epithelial cells

71
Q

what produces IL-2

A

t cells

72
Q

what produces IL-4

A

Th2 cells

mast cells

73
Q

what produces IL-5

A

Th2 cells

mast cells

74
Q

what produces IL-6

A

t cells

macrophages

75
Q

what produces IL-8

A

macrophages
monocytes
keratinocytes
fibroblasts

76
Q

what produces IL-12

A

b cells

macrophages

77
Q

function of IL-1

A 
fever
lymphocyte activation
acute phase proteins
mobilisation of PMNs
activates endothelium
78
Q

function of IL-2

A

induces proliferation of T and NK cells

79
Q

function of IL-4

A

induces B cell activation adn Th2 IgE production

inhibits Th1 response

80
Q

function of IL-5

A

induces eosinophil growth and differentiation

B cell activation and IgA response

81
Q

function of IL-6

A

lymphocte activation, fever, acute phase proteins

82
Q

function of IL-8

A

chemotaxis of PMNs

83
Q

function of IL-12

A

induces Th1 and activates NK cells

inhibits Th2 response

84
Q

what produces TNF-alpha?

A

macrophages

T cells

85
Q

what produces IFN-gamma

A

Th1 cells

NK cells

86
Q

what produces prostaglandins and leukotrienes?

A

chemoattract t cells
eosinophils
mast cells
basophils

87
Q

what produces nitric oxide

A

macrophages

PMNs

88
Q

functions of TNF-a

A

increases vascular permeability

induces fever

89
Q

functions of IFN-gamma

A

activated macrophages and PMNs
Induces Th1
Inhibits Th2

90
Q

functions of histamine

A

increases vascular permeability

smooth muscle contraction

91
Q

functions of prostaglandins and leukotrienes

A

increase vascular permeability
smooth muscle contraction
stimulate mucus secretion

92
Q

functions of nitric oxide

A

vasodilation

smooth muscle relaxation

93
Q

name 2 pattern recognition receptors

A

toll-like receptors

mannose receptor

94
Q

what expresses toll-like receptors?

A

dendritic cells
macrophages
epithelial cells

95
Q

function of toll-like receptors

A

bind lipopeptides, dsDNA, flagellin

96
Q

what expresses mannose receptors

A

macrophages
epithelial cells
dendritic cells

97
Q

function of mannose receptor

A

binds mannose-like carbohydrates (PAMPs) on bacteria, viruses, fungi

98
Q

function of b-cell receptors

A

membrane bound immunoglobulin

recognise antigen directly

99
Q

function of t-cell receptor

A

antigen needs to be processed and presented via MHC I or II before recognition by T cell

100
Q

CRP is produced in the liver is response to what?

A

IL-1
IL-6
TNF

101
Q

function of CRP

A

binds to bacteria

acts as an opsonin for phagocytosis

102
Q

describe the adaptive immune response

A
  • Specificity and memory
  • Delayed response – days to weeks
  • B-cell – antibody mediated
  • T-cell
  • Mucosa associated lymphoid tissues
103
Q

what cells are found in the spleen?

A

lymphoid follicles - b-cells, follicular dendritic cells
macrophages
plasma cells

104
Q

function of the spleen

A

filters blood

traps microbes and immune complexes

105
Q

give 3 examples of mucosa associated lymphoid tissue

A

GALT
BALT - bronchus
NALT

106
Q

what is GALT?

A

o Waldeyer’s ring
o Peyers patches in small intestine
o Appendix
o Lymphoid follicles in large intestine and rectum

107
Q

describe b cell maturation and differentiation

A

see notes

108
Q

draw an IgG, IgE, IgD molecule

A

y shaped

109
Q

draw an IgM molecule

A

round

110
Q

draw an IgA molecule

A

linear

111
Q

when is IgM first produced?

A

as a foetus

112
Q

when is IgG first produced?

A

birth

113
Q

when is IgA first produced?

A

1-2 months after birth

114
Q

what are the functions of antibodies?

A

free antigen neutralisation
opsonisation for phagocytosis
activation of complement
antigen presentation

115
Q

where are antibodies usually cleared from circulation?

A

liver

spleen

116
Q

another name for major histocompatibility complex

A

human leucocyte antigens

117
Q

what is the function of MHC?

A

presentation of antigens to T cells

118
Q

where are MHC I found?

A

all nucleated cells

119
Q

what does MHC I bind to?

A

CD8+ T cells

120
Q

where are MHCII found?

A

antigen presenting cells: dendritic cells, macrophages, B cells

121
Q

what does MHC II bind to?

A

CD4+ T cells

122
Q

using a diagram show the pathways of antigen processing for MHC

A

see notes

123
Q

name the CD4+ T cells

A

Th1
Th2
Th17
T regs

124
Q

draw a diagram to show T cell maturation

A

see notes

125
Q

function of Th1 CD4+

A

protection against intracellular pathogens

autoimmunity

126
Q

function of Th2 CD4+

A

protection against extracellular pathogens

allergy, asthma

127
Q

function of Th17 CD4+

A

protection against extracellular pathogens

autoimmunity

128
Q

with the help of a diagram show b cell activation by T helper cells

A

see notes

129
Q

what does class switching between IgM and IgM require?

A

stimulaiton of the B cell by a t helper cell

130
Q

with the help of a diagram show CD8+ T cell perforin induced apoptosis

A

see notes

131
Q

describe Fas-Mediated apoptosis of CD8+ T cells

A
  • Nucleated cells infected with some viruses upregulate fas expression (CD95)
  • When fas antigens present with MHC I molecules to CD8+, this causes the CD8+ cell to express a fasL receptor on their cell membrane
  • Binding of fas with fasL causes target cell apoptosis
132
Q

name the intracellular pathogens invoking an immune response

A

mycobacterium
viruses
protozoa

133
Q

name the surface pathogens invoking an immune response

A

helminths

arthropods

134
Q

name the extracellular pathogens invoking an immune response

A

bacteria

fungi

135
Q

name the innate molecules involved in the immune response in intracellular pathogens

A

IFN
macrophages
NK cells
dendritic cells

136
Q

name the innate molecules involved in the immune response in surface pathogens

A

mast cells

eosinophils

137
Q

name the innate molecules involved in the immune response in extracellular pathogens

A

neutrophils

138
Q

name the adaptive molecules involved in the immune response in intracellular pathogens

A

Th1, CD4+
cytotoxic CD8+
IgM, IgG, IgA

139
Q

name the adaptive molecules involved in the immune response in surface pathogens

A

Th2, CD4+

IgE

140
Q

name the adaptive molecules involved in the immune response in extracellular pathogens

A

Th17, CD4+

141
Q

describe how immune function varies in the elderly

A

 Thymic involution
 Fewer naïve T cells – dependent on memory T cells
 Reduced ability for T cell expansion
 Reduced B cell development and diversity
• Diminished response to vaccination
 More dependent on innate immunity
• But reduced function of pattern recognition receptors and superoxide killing

142
Q

how can gender affect immune function?

A

oestrogen vs progesterone and testosterone

143
Q

what may cause immune deficiency?

A

genetic cause
other diseases
drugs
environment/iatrogenic insults

144
Q

secondary causes of immune deficiency: environmental

A

malnutrition
trauma
burns

145
Q

secondary causes of immune deficiency: disease

A 
infection HIV
diabetes
renal failure
asplenia
malignancy - CLL, myeloma, lymphoma
146
Q

secondary causes of immune deficiency: drugs

A

immunosuppressive
antirheumatic
antiepileptic

147
Q

how does malnutrition cause immune deficiency? protein-calorie mal

A

immune defences require energy

proteins: cytokines, acute phase proteins, chemokines etc

148
Q

how does malnutrition cause immune deficiency? zinc

A

essential for proliferating cells

deficiency: PMN, NK, monocyte, B and T cell impaired function

149
Q

how does malnutrition cause immune deficiency? iron

A

enzymes within cellular function and metabolic pathways

deficiency = impaired innate immune function - toxic oxygen species

150
Q

how do glucocorticoids cause immune deficiency?

A

o Anti-inflammatory –
 Activate lipocortins: reduce phospholipase A2 and arachidonic acid release
 Alter transcription of enzymes needed for inflammation

151
Q

how does ciclosporin cause immune deficiency?

A

o Calcineurin inhibitor

o Reduced inflammatory cytokine release from T cells

152
Q

how does rituximab cause immune deficiency?

A

o Binds to CD20 (B lymphocytes)

o Allows NK and complement mediated apoptosis

Year 3 (164 decks)

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