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Management of Infection > Lecture 6A - Immunity and Response to Infection > Flashcards

Lecture 6A - Immunity and Response to Infection Flashcards

1
Q

What are many new drugs and vaccines aimed at?

A

either diminishing or enhancing the immune response

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2
Q

What are the two types of immunity?

A

specific and non specific

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3
Q

Within the two types of immunity, what are the subdivision?

A

external and internal

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4
Q

What are the gut and interior of the lungs classed as?

A

external as they are lined with epithelial tissues in contact with the outside world

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5
Q

What is non specific immunity?

A

designed to oppose the entry and spread of all pathogens

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6
Q

What is specific immunity?

A

targeted against particular agents causing illness, usually proteins but can be other small molecules as well

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7
Q

External non specific barriers against disease?

A

society

behaviour

social distancing

wearing face covering/masks

safety glasses

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8
Q

How is society an external barrier?

A

clean water and sewage treatment is the single most important factor for increased life span during the last 2 centuries, hygienic food preparation and preservation have also helped

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9
Q

How is behaviour an external barrier?

A

the concept of germs as a transmissible agent of disease has lead to adoption of methods of hygiene such as washing hands, use of condoms, deep cleaning in hospitals

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10
Q

External defences?

A

skin and the mucous membranes of nose, mouth, ears, eyes, gut and urogenital tract are all points of vulnerability through which transmission of disease can occur

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11
Q

What is the skin an example of?

A

an inherent, non-specific physical defence agains disease

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12
Q

Ears?

A

we produce wax

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13
Q

Respiratory tract?

A

mucus, surfactant (contains anti-viral lipoproteins)

alveolar macrophages which resident outside the body

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14
Q

Intestine as defence?

A

pH of 1 in the stomach

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15
Q

pH of urogenital tract?

A

4.5, fights against disease and keeps tract healthy

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16
Q

How do eyes produce defence?

A

through tears

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17
Q

maternal foetal defence?

A

transmission of antibodies across the placenta and through mothers milk

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18
Q

What is our microbiome?

A

a biofilm of healthy bacteria in the gut can help reduce the changes of pathogenic bacteria invading the mucosal epithelium and expanding in number

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19
Q

What does the skin secrete?

A

sebum

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20
Q

What do secretions such as mucus do?

A

traps invaders and is continuously wafted out of the lungs by thousands of cilia

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21
Q

How infections spread?

A

acquisition during foetal life or at birth

contact (usually onto hands)

coughing

faecal

sexual

blood and blood products

insect or animal bites

food/water borne

injury

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22
Q

What can happen if a benign bacterium penetrates the body wall?

A

it can cause severe infection

e.g. appendicitis

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23
Q

Internal non-specific immunity?

A

the second line of defence

phagocytic cells

pyrogens

chemical mediators

complement proteins

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24
Q

What are phagocytic cells?

A

omnivorous scavengers that detect foreign cells, proteins and particles and engulf and phagocytose them

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25
Q

What are pyrogens?

A

peptides secreted by leukocytes and other cells

they act on the hypothalamus to raise body temperature and cause symptoms of fever

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26
Q

What might raised temp do?

A

inhibit iron uptake by the bacteria, which can slow bacterial growth

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27
Q

What are chemical mediators of inflammation?

A

e.g. interferons

interfere with viral replication and are used in multiple sclerosis and have also been tried in COVID-19

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28
Q

What are complement proteins?

A

recognise foreign proteins and cells and trigger their destruction (also part of specific immunity)

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29
Q

What do foreign objects usually have?

A

a set of signals/peptides or proteins which are obviously not part of the body

30
Q

What does the non-specific response begin with?

A

ingestion and digestion of foreign particles and toxins by amoeboid like cells (phagocytosis)

31
Q

What are neutrophils?

A

the first to arrive at the site of infection and destroy bacteria

found in blood and tissue

32
Q

What are ‘roaming’ mononuclear phagocytes?

A

‘monocytes’ in the blood stream differentiate into macrophages in tissues

can move out of the blood stream and into tissue where there is damage and differentiate into phagocytes to help fight infection

33
Q

What are ‘fixed’ organ specific phagocytes?

A

reticular endothelial system - fixed phagocytic cells associated with particular organs (e.g. Kuffper cells in the liver)

these will ingest and destroy any foreign particles and old red/white blood cells they come across

34
Q

What are dendritic cells?

A

share the same cell lineage as monocytes in the bone marrow and can differentiate from them

often found in tissues in contact with the external environment, but some reside in lymph also derived from monocytes

35
Q

What do dendritic cells play a major role in?

A

antigen presentation

36
Q

What are dendritic cells important for?

A

major part of the early warning system for the onset of disease, they constantly sample the environment for abnormal proteins, taking them up and digesting them

they present peptide fragments of the digested proteins to immune cells

37
Q

Where do dendritic cells travel through?

A

the lymph nodes to present antigens to other cells

38
Q

Neutrophils locations?

A

blood and all tissues

39
Q

Monocytes locations?

A

blood and all tissues

40
Q

Tissue macrophages locations?

A

all tissues (including spleen (histiocytes), lymph nodes, bone marrow)

41
Q

Kuffper cells locations?

A

liver

42
Q

Alveolar macrophages locations?

A

lungs

43
Q

Microglia locations?

A

central nervous systems

44
Q

Dendritic cells locations?

A

blood, lymph and tissues

45
Q

What does the hepatic portal vein branch out to?

A

numerous tubular channels called sinusoids

similar structure is found in the spleen

46
Q

What are the fixed endothelial cells of the liver?

A

phagocytic and will ingest and destroy any foreign particles and old red or white blood cells

47
Q

What are the phagocytes of the liver?

A

Kuffper cells

48
Q

What is the collective name for the tissue specific phagocytes?

A

the reticular endothelial system

49
Q

What are the liver and spleen particularly effective at?

A

cleansing blood

50
Q

What are examples of other fixed cells?

A

alveolar macrophages, microglia in the CNS and osteoclasts in bone

51
Q

How do phagocytic cells get to the site of injury?

A

some are already there but when injury occurs we need additional phagocytic cells out of the bloodstream and into the injured tissue

52
Q

What attracts additional neutrophils and monocytes from the bloodstream?

A

chemical attractants from invading bacteria and tissue leukocytes

53
Q

Where is histamine released from?

A

mast cells and basophils

54
Q

What does histamine do?

A

makes the gaps in the endothelial wall of the blood vessel more leaky, allowing the cells to squeeze through

(diapedesis)

55
Q

What is chemotaxis?

A

the leukocytes (WBC) are attracted down a concentration gradient of chemical attractants produced by the invading bacteria and by the leukocytes immediately on hand

56
Q

What is chemotaxis triggered by?

A

chemicals recognised as foreign potentially leaking from the pathogen and these track along the chemotactic gradient towards the invading bacteria and engulf it and destroy it

WBC can also move from the blood stream through gaps in the endothelial cells into tissue

57
Q

What is diapedesis?

A

squeezing out of the blood stream through the wall of the blood vessel into surrounding tissue

58
Q

What happens once phagocytic cell arrives at site?

A

it engulfs the foreign particle and digests it

59
Q

Where can lysozymes escape to?

A

interstitial fluid, which adds to inflammation in the region and can harm healthy tissue

60
Q

When is diapedesis good?

A

when it only attacks the bacteria

61
Q

What is an important step for macrophage to be activated?

A

recognise the chemicals released by the unwanted organism or present on its surface as being a foreign particle or sugar

62
Q

What can macrophages also release?

A

chemical mediators such as tumour necrosis factor and nitric oxide

63
Q

What can the chemical mediators do?

A

trigger programmed cell death from outside (such as cancer cells)

64
Q

What else can macrophages release?

A

chemicals to attract and activate additional phagocytic cells to assist in the neutralisation of any infectious or harmful agent

65
Q

What do macrophages do when they sense a foreign cell?

A

ingest the harmful agent and destroy it

66
Q

What are dendritic cells as a response?

A

specialist macrophages and early warning cells

67
Q

Where are dendritic cells derived from?

A

circulating monocytes in the blood

68
Q

Where are dendritic cells often found?

A

in tissues in contact with the external environment, but some reside in lymph and also derived from monocytes

69
Q

What do dendritic cells do?

A

constantly sample their milieu for the presence of foreign chemical signatures

70
Q

What do dendritic cells to do antigens?

A

the digest trapped antigens, present them to other cells in the immune system, triggering a specific response

Management of Infection (36 decks)

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