Lec16 Immunodeficiency Flashcards

1
Q

8 Main Types of Primary immune Defects

A
  • combined defects
  • antibody defects
  • phagocyte defects
  • complement defects
  • well-defined systemic defects
  • immune dysregulation
  • defects of innate immunity
  • auto inflammatory defects
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2
Q

What is a combined defect?

A
  • Defect in both T and B cells

- usually with lymphoid stem cells

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3
Q

What is pneumocystis carinii pneumonia a sign of?

A
  • Common disease in infants with immunodeficiency / serious T cell defects
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4
Q

What is typical clinical phenotype of severe combined immunodeficiency?

A
  • onset in first year of life
  • serious infections: pneumonia, sepsis, meningitis, viral + fungal infections
  • failure to thrive [poor growth]
  • diarrhea, skin rashes [thrush]
  • many different causes
  • have very few lymphocytes
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5
Q

What is X linked SCID?

A
  • mutation in x-linked gene for common gamma chain that is used in cytokine receptors
  • in IL-2, IL-4, IL-7, IL-9, IL-15, IL-21
  • if altered or lacking don’t get any of these cytokines
  • treatment: get bone marrow transplant
  • have no T cells or NK cells, and have B cells that are just not functional
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6
Q

What is effect of adenosine deaminase deficiency?

A
  • get no T, B, or BK
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7
Q

What is IL-7Ra chainIL7RA mutation?

A
  • get N T and have B and NK deficiency
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8
Q

What is recombinase activating gene [RAG] 1/2?

A
  • get no lymphocytes [T or B], do get NK cells
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9
Q

What are TRECS?

A
  • T cell receptor excision circles that are created in new T cells as they rearrange their T cell receptor [TCR]
  • still persists in cell and get diluted
  • can test newborn blood for TRECs to see if have T cells [look for SCID]
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10
Q

What is bare lymphocyte syndrome?

A
  • deficiency in MHC II
  • still have T cells [unlike in traditional SCID] but have very few CD4 and few gammaglobulins
  • autosomal recessive
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11
Q

What are common antibody defects?

A
  • XLA

- Hyper IgM

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12
Q

What is XLA?

A

X-linked agammaglobulinemia

  • molecular defect Btk [b cell cytoplasmic tyrosine kinase]
  • BCR activation signal can’t happen

clinical

  • affects males
  • severe infections in first year of life
  • low serum IgG, IgA, IgM, no antibody production
  • tiny tonsils [tonsils normally B cells]
  • normal lymphocyte numbers but few B cells
  • pre-B cells in bone marrow but few mature [plasma cells]
  • get chronic sino-pulmonary infections, respiratory failure

treat: life long gamma globulin therapy

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13
Q

What disease: 3 year old boy, failure to thrive, pneumonia, low IgA/IgG, normal IgM, normal B/T/etc cells

A
  • low IgG so think XLA but you see normal B cell quantities
  • possible: CD40L deficiency so B cells never get info to switch
  • basically hyper IgM but without the high IgM
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14
Q

What does AID deficiency cause?

A
  • AID = activation induced cytidine deaminase

- deficiency means can’t get class switching of antibodies so have just IgM not IgG/IgA/IgE

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15
Q

What are common neutrophil defects

A
  • neutropenia = too few neutrophils
  • defect in function
  • – adhesion
  • – locomotion
  • – killing
  • – abnormal structure
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16
Q

What is chronic granulomatous disease?

A
  • defect causes difficulty reducing oxygen
  • prevent phagocytosis from occuring
  • get granulomata formation: necrotizing granulomas surrounded by neutrophil cell infiltrate, neutrophils come there but can’t digest
  • x linked or autosomal
  • clinical: cervical lymphadenitis, hepatosplenomegaly, eczema
17
Q

What genes cause chronic granulomatous disease?

A

autosomal
- p47phox, p67phox, p22phox
x-linked
- gp91phox

18
Q

What is wiskott aldrich syndrome

A
  • type of well-defined defect
  • x linked recessive disease
  • due to auto-inhibited WASP [ a cytoskeletal protein]
  • Can’t respond to cytokine receptors
  • get small platelets that dont work very well
    clinical
  • petechiae [red dots on skin], eczema, pneumonia, B cell lymphoma,low platelet count, bloody diarrhea
19
Q

what is job’s syndrome

A
  • type of well-defined defect
  • hyper IgE
  • clinical: eczema, skiny boild, pneumonia, lung cyst, cnadida on fingertip, delayed shedding primary teeth
20
Q

What is stat 3?

A
  • imporant in lots of cytokines
  • deficiency is autosomal dominant disease
  • looks like systemic illness
21
Q

Treatment for severe cellular defect?

A
  • stem cell or bone marrow transplant
22
Q

Treatment for antibody defect?

A
  • immune globulin replacement
23
Q

Cohn-Oncley isolation of IgG

A
  • isolate IgG from blood and put intso solution

-

24
Q

Illnesses associated with B cell/complement

A
  • otitis media
  • bronchitis
  • bacterial penumonia
  • meningitis
  • cellulitis
25
Q

illnesses associated with neutrophils

A
  • organ abcesses

- osteomyelitis

26
Q

illnesses associated with T cells

A
  • thrush
  • lymphopenia
  • herpes zoster
  • mycobacteria infection
27
Q

Which genes associated with invasive pneumococcla disease

A
  • IRAK4
  • MyD88
  • others in toll receptor path
28
Q

What genes associated with warts

A

CXCR4

29
Q

What genes associated with herpes simplex encephalitis

A
  • toll like receptor 3 and pathway members
  • UNC93B
  • TRAF3
30
Q

What genes associated with chronic candidiasis

A
  • dectin 1
  • card9
  • stat1
31
Q

What genes associated with herpes simplex encephalitis

A
  • IL-12
  • IL23
  • IFN-gamma receptor
  • STAT1
    macrophage gp91
  • IRF8
32
Q

What is effect of IL-2 receptor deficiency?

A

IL-2 receptor = common gamma chain

deficiency –> x linked SCID

33
Q

Most common immunoglobulin deficiency in population

A

IgA