L5&6- Immunopathology Flashcards

1
Q

general overview of Innate immune system

A

Innate:
-Barrier and chemical mechanisms

  • PRR (Pattern recognition receptor) - proteins expressed by cells to identify two classes of molecular patterns: 1) pathogen-associated molecular patterns (PAMPs), which are associated with microbial pathogens, and 2) damage-associated (DAMPs), which are associated with cell components that are released during cell damage or death.
  • Phagocytes, natural killer cells
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2
Q

General overview of adaptive immune system

A

Humoral

Cellular

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3
Q

Pattern recognition receptors

A

Antigen recognition receptor in innate system

Common theme is recognition of Pathogen-associated Molecular Patterns (PAMPs) but also Danger Associated Molecular Patterns (DAMP’s)

2 groups

  • Cell surface (transmembrane) and intracellular receptors – TLRs, NLRs, RLR’s and CLR’s
  • Fluid-phase soluble molecules
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4
Q

FLUID-PHASE RECOGNITION MOLECULES

A

C-TYPE LECTIN FAMILY

  • COLLECTINS
    • Mannan-binding Lectin
    • Surfactant Protein A & D

Role in neutralisation of pathogen
Role in recruitment of adaptive response

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5
Q

Steps of Classical Pathway

A

Antigen+Antibody Complex –> c1, c4, c2 —> C3 convertase

From C3 convertase can go 3 ways:
1) c3a, c5a –> peptide mediators of inflammation, phagocyte recruitment

2) c3b –> binds to complement receptor on phagocyte —>opsonisation of pathogens —> removal of immune complexes
3) c3b —> c5b, c6, c7 ,c8 ,c9 —> Membrane attack complex, lysis of certain pathogens and cell

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6
Q

What is opsonization

A

An immune process where particles such as bacteria are targeted for destruction by an immune cell known as a phagocyte .

The process of opsonization is a means of identifying the invading particle to the phagocyte

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7
Q

Function of macrophages

A

Phagocytose and kill bacteria; produce antimicrobial peptides; bind (LPS); produce inflammatory cytokines

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8
Q

Function of Plasmacytoid dendritic cells (DCs)

A

Produce large amounts of interferon- (IFN-) which has antitumor and antiviral activity, and are found in T cell zones of lymphoid organs; they circulate in blood.

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9
Q

Function of Myeloid dendritic cells

A

Interstitial DCs are strong producers of IL-12 and IL-10

Langerhans DCs are strong producers of IL-12

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10
Q

function of Natural killer (NK)

A

Kill foreign and host cells that have low levels of MHC+ self peptides. Express NK receptors that inhibit NK function in the presence of high expression of self-MHC

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11
Q

Function of NK-T cells

A

Lymphocytes with both T cell and NK surface markers that recognize lipid antigens of intracellular bacteria such as M. tuberculosis by CD1 molecules and kill host cells infected with intracellular bacteria.

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12
Q

Function of Neutrophils

A

Phagocytose and kill bacteria, produce antimicrobial peptides

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13
Q

Function of Mast cells and basophils

A

Release TNF-, IL-6, IFN- in response to a variety of bacterial PAMPs

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14
Q

Function of Epithelial cells

A

Produce anti-microbial peptides; tissue specific epithelia produce mediator of local innate immunity, e.g. lung epithelial cells produce surfactant proteins (proteins within the collectin family) that bind and promote clearance of lung invading microbes

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15
Q

ADAPTIVE IMMUNE RESPONSE

A

Evolution in response to changing pathogen structures

In response to infection this lymphocyte undergoes CLONAL expansion

High degree of specificity

VDJ recombination enables multiple immunoglobulin structures

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16
Q

Mechanism of antigen presentation

A

Antigens are internalised

Broken down to peptides

Peptides associate with newly synthesised Class 2 molecules and are brought to the cell surface.

If the peptides are foreign they are recognised by helper T cells which are then activated.

Helper T cells produce cytokines needed by B cells, T cells , etc.

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17
Q

FUNCTIONS OF CLASS 1 MHC

A

The function of these proteins is to present antigenic peptides to T cells- T cells only see antigen in association with MHC Proteins.

MHC class 1 proteins present peptides to cytotoxic T cells

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18
Q

FUNCTIONS OF CLASS 2 MHC

A

The function of these proteins is to present antigenic peptides to T cells- T cells only see antigen in association with MHC Proteins.

MHC Class 2 proteins present peptides to helper T cells

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19
Q

Lymphocytes-function: B lymphocytes

A

develop potential to secrete antibodies: humoral immunity

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20
Q

Lymphocytes-function: T lymphocytes

A

Killer or cytotoxic T lymphocytes are able to kill. Cellular immunity

Helper T lymphocytes secrete growth factors (cytokines) which control immune response: Help B lymphocytes and T lymphocytes (Helper T cells are target of HIV)

Suppressor T lymphocytes may damp down immune response

21
Q

Binding of antibodies to antigens inactivates the antigens by…?

A

Neutralization (blocks binding sites, coats bacteria)

Agglutination of microbes

—> Phagocytosis

Activation of complement —> cell lysis

22
Q

What happens when cytotoxic t cell binds to foreign antigen?

A

Recognises non self antigen –> binds to infected cell –> Releases Perforin (hole forming) enzyme that can promote apoptosis –> infected cell destroyed

23
Q

IL2

A

T cell growth factor (and IL 15)

24
Q

Do we need to know the different cytokines for adaptive and innate immunity?

A

I don’t know? :s

25
Immunosuppression
A natural or artificial process which turns off the immune response, partially or fully, accidentally or on purpose Uses: Transplant rejection Autoimmune diseases Lymphoproliferative diseases
26
Immunodeficiency
the lack of an efficient immune system-susceptibility to infections
27
What pathogen can affect PRR (e.g TLR)?
Pneumococcus | HSV
28
What pathogen can affect the Complement pathway?
Meningococcus
29
What disorder can affect white blood cells or cause the absence of them?
SCID | Opportunistic infections
30
What would affect release of cytokines?
Mycobacterium
31
What type of infections what result in poor antibody response?
Recurrent Sino-pulmonary infections
32
Hypersensitivity
Undesirable, damaging, discomfort-producing and sometimes fatal reactions produced by the normal immune system (directed against innocuous antigens) in a pre-sensitized (immune) host
33
HYPERSENSITIVITY TYPES
TYPES I - IV I - IgE MEDIATED REACTION II - CYTOTOXIC REACTION III - IMMUNE COMPLEX REACTION IV - CELL MEDIATED REACTION (DTH)
34
Type I (anaphylactic) Hypersensitvity
Immunopathogenesis: IgE Ab mediated mast cell and basophil degranulation- release of preformed and inflammatory mediators Clinical features: Fast onset (15-30 min) Weal and flare Early phase and late phase Common antigens: Pollen, bee venom, animal dander Associated diseases: Hay fever, allergic asthma
35
IMMUNOGLOBULIN E
Produced by plasma cells from class-switched B cells under the control of IL-4 and CD40L - CD40 interaction Extremely low serum levels BUT High affinity receptor for IgE (FceRI) on mast cells and basophils Permits stable binding over long periods
36
PRE-FORMED MEDIATORS
HISTAMINE Stimulation of irritant nerve receptors Smooth muscle contraction Increase in vascular permeability KALLIKREIN Activates bradykinin - similar actions to histamine
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LIPID MEDIATORS
ARACHIDONIC ACID DERIVATIVES Arachidonic acid --> (Lipoxygenase) -->Leukotrienes Arachidonic acid--> (cycloxygenase) -->Prostaglandins (e.g:PROSTACYLINE, THROMBOXANE )
38
Late phase responses Type 1 hypersensitivity
BASOPHILS Similar properties to mast cells over longer time scale EOSINOPHILS GRANULES contain cytotoxic proteins (e.g. Eosinophil Cationic Protein) Attracted to sites of allergic inflammation by CHEMOKINES (e.g. Eotaxin 1/2)
39
Late phase responses Type 2 hypersensitivity
T CELL RESPONSES -Involved in both EARLY and LATE response to allergen -Cytokine production by activated T cells critical in ongoing response CYTOKINE-DRIVEN ACTIVITY is the major source of PATHOGENESIS in allergic responses
40
EXAMPLES OF ALLERGIC DISEASES
ASTHMA RHINITIS DERMATITIS FOOD ALLERGY
41
What happens in HYPERSENSITIVITY - TYPE II
Antibody-mediated cytotoxic reactions Binding of antibody to target antigen on cell membrane results in:- -Activation of the complement cascade resulting in cell lysis -Aggregation of Fc portions of immunoglobulin/C3b with binding to FcRs/C3bR resulting in opsonisation, phagocytosis & destruction
42
Causes of HYPSERSENSITIVITY - TYPE II
Initiated by IgM or complement-binding IgG IgM >> IgG1 & IgG3 IgM most efficient since pentavalent IgG requires multiple binding Cells usually affected are haematopoietic cells e.g: - Blood group incompatibility - Autoimmune haemolytic anaemias - Affecting neutrophils - Affecting platelets
43
HYPERSENSITIVITY - TYPE III
IMMUNE COMPLEX REACTIONS 1. IgG + Ag = AgAb complex 2. FcR in complex bind C1q 3. Complement activation leads to generation of activated complement fragments 4a. C5a - attractant for neutrophils 4b. C3b - Opsonin 5. Attempted phagocytosis of complexes - release of enzymes, oxygen radicals 6. Consequence is tissue damage
44
Examples of HYPERSENSITIVITY - TYPE III
Vasculitis Nephritis Arthritis Farmer's lungs
45
OTHER ANTIBODY-MEDIATED IMMUNOPATHOLOGY
Inactivation: - Direct e. g. to Intrinsic factor - B12 deficiency -Indirect binding to e.g. hormone results in clearance of AgAb complex - Receptor blockade e. g. To AChR in Myasthenia Gravis
46
HYPERSENSITIVITY - TYPE IV
T cell mediated - CD4+ cells (MHC class II) - Delayed type e.g. Tuberculin skin reaction - Initially perivascular infiltration of lymphocytes & monocytes - LANGERHAN’S cells present neo-antigen to T cells - Ag-specific T cells release cytokines - recruitment of macrophages (non Ag-specific) - Activated macrophages cause tissue damage - Requires previous exposure to antigen
47
OTHER CELL-MEDIATED IMMUNOPATHOLOGY
T cell-mediated cytotoxicity CD8+ T cells (MHC Class I) Contact dermatitis e.g. Nickel, poison Ivy Combination of DTH and cytotoxic reaction Nickel acts as hapten with epidermal proteins Antigen presentation by APC Keratinocytes may present to CTL precursors
48
GRANULOMATOUS REACTIONS
Granulomas: - Focal collections of inflammatory cells in tissues - Macrophages - Epithelioid cells (phagocytic cells containing foreign material) - Giant cells - Lymphocytes T cells are Th1-type - secrete IL2 & IFNg Release of IL-12 by macrophages critical in initiation of response
49
GRANULOMATOUS DISEASES
Infections: - Mycobacterial - Tuberculosis - Atypical mycobacteria - Leprosy - Tuberculoid - Th1 - Protective - Lepromatous Th2 - Non-protective Unknown aetiology: - Sarcoidosis - Wegener’s Granulomatosis - Crohn’s disease