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Pathophysiology - UT Houston SON Grad School > Module 3: Topic 2: Inflammation / Immune > Flashcards

Module 3: Topic 2: Inflammation / Immune Flashcards

1
Q

Name three types of “first line” defense

A
  1. Physical 2. Mechanical 3. Biochemical
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2
Q

Describe characteristics of “first line” PHYSICAL and MECHANICAL defense

A
  • Anatomical and NON-SPECIFIC - Tightly associated epithelial cells: skin, lining of GI, GU and resp. tracts. - Tight cell junctions prevent microbes from entering -“washing” = normal turnover of the cells i.e. skin cells sloughing off or -mechanical cleansing = vomiting / urinating -Goblet cells producing mucous –> cilia –> coughing -low temp of skin prevents bacteria from growing (prefer 37 C) -skin pH 3-5
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3
Q

Describe characteristics of “first line” BIOCHEMICAL defense

A

-biochemical barriers synthesized and secreted by epithelial cells to trap and destroy micro-organisms. -mucus -perspiration/sweat -saliva -tears -earwax -Sebaceous glands –> antibacterial/anti-fungal fatty acids -lysozyme- attacks gram + cell walls (sweat, tears and saliva)

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4
Q

Biochemical Barriers

A

-Epithelial derived chemicals -Bacteria derived chemicals

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5
Q

Epithelial Derived Chemicals (Biochemical Barrier)

A

Antimicrobial peptides (small molecular weight): -generally positively charged polypeptides (15-95 AAs) -disrupt bacterial cell wall (no cholesterol) Two classes: 1. CATHELICIDINS - linear alpha-helical shape (1 in humans) 2.DEFENSIN- type alpha (need activation) and beta (active) (beta may help defend from HIV) (50 types in humans) Lung produces: COLLECTINS Includes surfactant proteins. Other epithelial antimicrobials: -RESISTIN-LIKE MOLECULE BETA -BACTERICIDAL/PERMEABILITY INDUCING PROTEIN (BPI) -stored in neutrophils and GI epithelium -ANTIMICROBIAL LECTINS - GI carbs work against gram + bac.

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6
Q

Bacterial Derived Chemicals (Biochemical Barrier)

A

-normal microbiome: GI tract/ vaginal tract -aid in multiple ways (digestion, keeping pathogens out)

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7
Q

Commensal organism

A

(to the benefit of one organism without affecting the other)

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8
Q

Mutualistic organism

A

to the benefit of both organisms

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9
Q

Describe “second line” of defense

A

-The inflammatory process -physiologic, internal, NON SPECIFIC -Purpose: isolate, destroy, remove

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10
Q

Describe “third line” of defesne

A

SPECIFIC LONG-TERM CAN BE INDUCED BY VACCINATION EFFECTED ONLY BY

SERUM PROTEINS (IMMUNOGLOBULINS)

ANTIBODIES)

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11
Q

Review this chart

A
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12
Q

ANTIGEN vs. IMMUNOGEN

A

An immunogen refers to a molecule that is capable of eliciting an immune response by an organism’s immune system, whereas an antigen refers to a molecule that is capable of binding to the product of that immune response.

So, an immunogen is necessarily an antigen, but an antigen may not necessarily be an immunogen.

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13
Q

WHAT IS A HAPTEN?

A

Antigens that are too small to be immunogens by themselves but become immunogenic in combination with larger molecules that function as carriers for the hapten.

For example, the antigens of penicillin and poison ivy are haptens, but they initiate allergic responses only after binding to large-molecular-weight proteins in the allergic individual’s blood or skin.

McCance, Kathryn L.; Huether, Sue E. (2015-06-08). Pathophysiology: The Biologic Basis for Disease in Adults and Children (Pathophysiology the Biologic Basis) (Page 229). Elsevier Health Sciences. Kindle Edition.

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14
Q

TYPES OF IMMUNE MODULATORS THAT INCREASE/DECREASE IMMUNE RESPONSE

A

EXTERNAL(EXOGENOUS) AND INTERNAL (ENDOGENOUS)

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15
Q

EXTERNAL/EXOGENOUS IMMUNE MODULATORS

A

Trauma

Disease

Pollution

Radiation

Drugs

UV light

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16
Q

INTERNAL/ENDOGENOUS IMMUNE MODULATORS

A

Age

Sex

Nutritional status

Genetic background

Reproductive status

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17
Q

When is there a need for immunosuppression?

A
  • Organ/Tissue Transplant
  • Allergic Reaction
  • Autoimmune Disease
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18
Q

What is natural immunity?

A
  • Not produced by antigen
  • Present at birth
  • Host-dependent
  • The natural epithelial barrier and inflammation confer innate resistance and protection.
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19
Q

What is acquired (adaptive) immunity?

A
  • Results from the immune response
  • Slower than innate system
  • SPECIFIC
  • has “memory”
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20
Q

What is Active Immunity?

A
  • Immune components produced host (antibodies / T-lymphocytes)
  • Either after natural exposure to an antigen or after immunization.
  • Typically “long lived”
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21
Q

What is passive immunity?

A
  • Occurs when preformed antibodies or T lymphocytes are transferred from a donor to the recipient.
  • Immune components produced by donor
  • Temporary immunity b/c donor’s components eventually destroyed by recipient’s system
  • Example: maternal transfer, immune serum transfer (Hep A, Rabies, Sanke bites)
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22
Q

Primary and Secondary Immune Response Graph

A
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23
Q

Primary Immune Response

A
  • Initial antigen exposure → latent/lag phase b/c of B-cell differentiation/proliferation
  • 5-7 days = IgM ab specific to antigen
  • IgM 1st, IgG 2nd
  • IgG will be equal or less than IgM production

If no further exposure to antigen happens - ab are catabolized and quantities fall.

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24
Q

Describe Secondary Immune Response

A
  • Second challenge by same the antigen
  • Rapid response (b/c memory cells are already present and don’t need differentiation)
  • Larger amounts of ab produced
  • IgM in small quantities
  • IgG in GREAT QUANTITIES
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25
Q

What are lymphocytes?

A
  • Primary immunocyte
  • Small, round, WBC
  • Comes from pluripotent stem cell
  • Found in liver, spleen, bone marrow (fetus, child, adult)
  • Need to mature through lymphatic vascular journey
  • Journey through lymph → antibodies; humoral immunity
  • Journey through thymus → sensitized, attack antigens; cell mediated immunity
26
Q

Immune Response Pictograph

A
27
Q

Antigen

A

Reacts with preformed components of the immune system

28
Q

Antigenicity

A

The capacity of a chemical structure (either an antigen or Hapten) to bind specifically with a group of certain products that have adaptive immunity: T cell receptors or antibodies (a.k.a. B cell receptors)

29
Q

Immunogen

A

An antigen that can induce the formation of immune system components.

Is an antigen or any substance that may be specifically bound by components of the immune system (antibody, lymphocytes).

30
Q

Immunogenic

A

Is the ability to initiate the immune response.

Will induce an immune response resulting in the production of antibodies or functional T cells.

31
Q

Characteristics for antigen to be immunogenic:

A

(1) being foreign to the host,

(3) having an adequate chemical
complexity,

(4) being present in a sufficient quantity.

(2) being appropriate in size (large)

32
Q

Describe antigen criteria: foreignness

A
  • Foremost criteria for immunogenicity
  • Tolerance is an active process – distinguishes self from foreign by

–suppressor T cells (T-regulatory cells)

–Ts and anti-idiotypic antibody

McCance, Kathryn L.; Huether, Sue E. (2015-06-08). Pathophysiology: The Biologic Basis for Disease in Adults and Children (Pathophysiology the Biologic Basis) (Page 229). Elsevier Health Sciences. Kindle Edition.

33
Q

Immunogenic Antigen

A

Antigens that are foreign, fat, complex & abundant are immunogenic.

34
Q

Tolerogenic Antigen

A

Self antigens that are fat, complex, and abundant but not foreign are tolerogenic.

35
Q

Factors Affecting Immunogenicity

A
  • Route of antigen administration:
    • IV, SQ, Intraperitoneal, Intranasal, Oral
  • Each route stimulates different set of lymphocyte-containing tissue → different immune responses (cell mediated vs. humoral)
  • Host’s genetic make up also affects response (genes are on Chromosome 6)
36
Q

Describe features of the Human Leukocyte Antigen (HLA)

A
  • Identical twins have identical HLA
    • (expect the same immune response)
  • Knows the code for recognizing foreigners
  • Proteins found on nearly every cell surface
  • Defend the body against infection
  • Distinguish foreigners from self
  • Produced by genes on the major histocompatibility complex (MHC)
  • Four loci on chromosome 6 (A,B,C,D)
37
Q

Describe Class I Antigens

A

Class I antigens (A, B, & C loci) are on all cells except RBCs

MHC I: graft rejection (guide cytotoxic T cells)

38
Q

Describe Class II Antigens

A

Class II antigens have 3 separate loci (DR, DP, & DQ)

Confined to B cells, macrophages, epithelial cells, and some Ts

MHC II: antigen presentation, graft rejection (Th cells), autoimmune disease

39
Q

What is the location of a gene on a chromosome called?

A

Locus (The location of a gene is stable)

40
Q

How many alleles can each loci have?

A

50-100s

41
Q

What is an allele?

A

A variation of a gene and what it controls.

42
Q

How are MHC genes inherited?

A

As a block.

43
Q

What is a haplotype?

A

All the MHC genes inherited from one parent.

There is 1/4 chance of matching a sibling’s haplotype.

44
Q

Are HLA antigens found in RBCs?

A

No

45
Q

Approximately, how many red cell antigens are on the surface of RBCs?

A

80

46
Q

ABO System Summary

A

Two major antigens A & B

IgM isohemagglutinin : is natural occurring ab

A - A antigen → anti-B antibodies

B - B antigen → anti-A antibodies

AB- A& B antigens → no antibodies = universal recipient

O - no antigens →​ anti A & anti B antibodies = universal donor

47
Q

What type of antigen and antibodies does type A blood have?

A

A Antigen

anti-B Antibodies

48
Q

What type of antigen and antibodies does type B blood have?

A

B Antigen

anti-A antibodies

49
Q

What type of antigen and antibodies does type AB blood have?

A

A and B Antigens

No Antibodies

UNIVERSAL RECIPIENT

50
Q

What blood type is the universal recipient?

A

AB

51
Q

What type of antigen and antibodies does type O blood have?

A

No Antigen

anti-A and anti-B Antibodies

UNIVERSAL DONOR

52
Q

Which blood type is a universal donor?

A

O

53
Q

B Lymphocytes

A

Mature in tissues (human bursal equivalent)

B cell precursors cannot react with antigens

Post bursal B cells produce plasma membrane bound antibodies (IgM) to the 8th power antigenic determinants

54
Q

Clonal Selection

A

–Most accepted theory on antigen recognition

–All generic to begin with

–Plasma cells exposed for first time then become memory cells

55
Q

Clonal Diversity Pictograph

A
56
Q

Immunoglobulins

A

Antibodies produced in response to immunogen

immunoglobulins - generic term

antibodies - specific for a certain antigen

Five Classes of Ig (GAMED)

Ig G

IgA

IgM

IgE

IgD

57
Q

Cytokines

A

Lymphokines -produced by lymphocytes

Monokines - produced by immonocytes/macrophages

Functions of Cytokines:

  • Necessary in immunity
  • Growth & proliferation of cells
  • Growth & development of placenta
58
Q

Interleukin

A

B cell antibody response is controlled by IL-2

IL-2 is secreted by activated (ie. Those having recognized agMHC) Th cell.

59
Q

Fetal & Neonatal Immune Function

A

Deficient

  • antibody production
  • phagocytic activity
  • complement activity

Last trimester can produce primary response (IgM) to CMV, rubella, Toxoplasma gondii

Little IgA or IgG

Active transport passes maternal ab into fetal circulation

At birth maternal ab are catabolized as neonate IgG begins to rise

Protective level 5-6 months

60
Q

Aging

A
  • Thymus decreases in size to only 15% by 45-50 years of age
  • Numbers of T cell do not decrease
  • Function of T cells & macrophages deteriorates
  • May see delayed or decreased hypersensitivity response.
  • Diminished immunity conferred by immunization.

Pathophysiology - UT Houston SON Grad School (5 decks)

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