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MICR2221 - Medical Immunology > L6 - Extracellular pathogens II > Flashcards

L6 - Extracellular pathogens II Flashcards

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USMLE® Step 1 flashcards
1
Q

What are innate host defences of the skin/mucosal surfaces?

A

resistant to infection unless broken

mucociliary escalator

urinary tratcs

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2
Q

What are innate host defences of pH?

A

hostile for fungal growth

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3
Q

What are innate host defences of the antimicrobial secretions

A

active against some fungi

antimicrobial peptides in skin

B-defensins in gut

a-defensins in neutrophils

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4
Q

What are the innate host defences of the complement cascade

A

classical pathway (immune complexes)

lectin pathway (terminal mannose residues)

alternative pathway (LPS, yeast cell wall)

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5
Q

What are the innate host defences of phagocytes?

A

neutrophils
monocytes
macrophages
dendritic cells

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6
Q

What is mucositis?

A

sore inflamattion

occurs are irradiation of cytotoxic drugs when prepare for bone marrow transplant

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7
Q

Can the membrane attack complex cause lysis of fungi?

A

NO - can act as opsonins but does NOT LYSE LIKE IT WOULD BACTERIA

complement binds to outer part of fungi - cause inflammation & phagocytic attack

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8
Q

How does candida interact with the complement cascade?

A

activates all 3 pathways

promotes phagocytosis by macrophages & neutrophils

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9
Q

How does aspergillus interact with the complement cascade?

A

complement deficiency = ^ susceptibility to invasive disease

less C’ deposition on pathogenic species

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10
Q

What is neutropenia?

A

reduce No. of neutrophils

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11
Q

What are predisposing factors for invasive fungal disease?

A

neutropenia

functional problems with neutrophils

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12
Q

What are common fungal PAMPs?

A

chitin
glucans
mannosylated proteins

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13
Q

how many PRRs do PAMPs interact with?

A

sometimes 1

sometimes multiples

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14
Q

How are fungi internalised in phagocytosis?

A

actin dependent process

form phagosome

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15
Q

How does the phagosome mature?

A

fusion with vesicles = phagolysosome

acidification

digest fungi into individual antigens

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16
Q

How does phagocytic killing of fungi by OXIDATIVE mechanisms occur?

A

“respiratory burst”

ROS (candida, aspergillus)

RNI (cryptococcus)

17
Q

How does phagocytic killing of fungi by NON-OXIDATIVE mechanisms occur?

A

Anti-microbial peptides

hydrolases

limitation of nutrients (zinc sequestration)

18
Q

What is the role of Th1 in fungal immunity?

A

protective response

activate phagocytic cells by TNF, IL-12 and IFNy

19
Q

What is the role of Th2 in fungal immunity?

A

harmful in response fungal infection

unfavourable for aspergillus and candida

allergic responses, disease relapse

IL-4, IL-66, IL-13

20
Q

What is the role of Th17 in fungal immunity?

A

induces release of AMPs

favourable with mucocutaneous cadidosis

epithelial expression of chemotactic factors

IL-17, IL-22, IL-23

21
Q

What are immune responses in normal individuals?

A

macrophages/neutrophils recruited

migrate to draining lymph node

APC

Th1 = pro-inflammatory, enhance clearance

Th2 = dampen immune response

22
Q

What are immune defects due to haematological malignancy?

A

decreased No. neutrophils

decreased No. of dendritic cells in ALL

defects in neutrophils in CLL

^ Treg cells in CLL = suppressed function

23
Q

What are immune defects to chemotherapy and HSCT?

A

decreased No. neutrophils

steroids suppress further

chemotherapy impairs dendritic cell function

radiotherapy - lymphopenia

chemotherapy reduces No. B cells & disrupts cytokine networks

24
Q

What are immune defects in HIV/AIDS?

A

abnormal phagocytosis

impaired maturation - bad APCs

T-cells destroyed

deranged cytokine networks

impaired antibody responses

25
Q

Immune defects after solid organ transplantation?

A

doesn’t affect neutrophils

Cyclosporine inhibit activation of CD4 cells and many ILs

Moabs = T-cell depletion

B-cells inhibited by Sirolimus

MICR2221 - Medical Immunology (16 decks)

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