Module 4: Adverse Reactions and Immune Defects Flashcards
Primary immunodeficiency
-congenital
-derived from a genetic or development defect leading to abnormal maturation of immune system
Types of primary immunodeficiency
-b-cell deficiencies
-t-cell deficiencies
-complement deficiencies
-phagocytic deficiencies
-combined T and B cell deficiencies
Secondary immunodeficiencies
-result from environmental factors affecting and compromising the immune system
Types of secondary immunodeficiency
-chemotherapy
-chronic infection
-immunosuppressive medication
-cancer
B-cell deficiency
-dysfunctional B lymphocytes or a decrease in their prevalence
T-cell deficiency
-dysfunctional T lymphocytes or a decrease in prevalence
-increase susceptibility to viruses, protozoans and fungi
Complement deficiency
-intricate regulation of nine components
-prone to frequent severe bacterial infections and complications arising from inability to clear immune complexes
Phagocytic deficiency
-can appear at various stages of the process
-bacterial and fungal infections are frequent and severe
Combined T and B cell deficiency
-dysfunction and/or low numbers of lymphocytes
-infections that cause mild diseases may be life threatening
Secondary immunodeficiency AIDS acquired
-cannot be inherited
Modes of transmission of HIV
-sexual intercourse
-heterosexual sex
-vertical transmission to children
-non-sterile injections of drugs
HIV primary infection
-most people have effective immune response for first couple of weeks and then immune system gets compromised
HIV acute infection
-targets and infects CD4 cells which causes a drastic decrease in level of these and level of virus in blood increases
-2-4 weeks after infection symptoms usually appear
-high transmission risk
HIV chronic infection
-HIV continues to multiply and most people do not experience infection but transmission is still possible
AIDS
-CD4 helper T cells get depleted
-patients are diagnosed with AIDS if there T cell count is below 200 cells/mm3
How long do AIDS patients typically survive for
-3 years
Antiretroviral therapy
-does not kill or cure HIV but prevents it from replicating
-uses panel of antiretroviral to prevent drug resistance
Screening techniques for immunodeficiencies
-complete blood counts
-quantitative serum immunoglobin
Complete blood counts
-show how many of each cell type are present in a small sample of blood which is then compared to healthy range
Quantitative serum immunoglobin
-measures levels of IgG, IgA, and IgM in blood serum and compare them to a control
-urine protein electrophoresis
Autoimmunity
-sometimes immune system initiates a reaction in response to its own cells
Autoimmune disease
-failure of an organ to distinguish self from non self causes the immune system to initiate a response against its own cells and tissues
Organ specific autoimmune diseases
-involve an immune response that is directed to an antigen that is unique to a single organ or gland
Most common organs affected by autoimmune diseases
-thyroid gland
-adrenal gland
-stomach
-pancreas
Graves disease
-autoimmune disease that frequently leads to overactivity of thyroid gland
Systemic autoimmune diseases
-immune response s directed towards a broad range of antigens that are characteristic of a number of organs and tissues
Rheumatoid arthritis
-typically presents as chronic inflammation of joints, other organ systems can also be affected
Immunosuppression
-suppress or reduce the strength of the bodies immune response
Immunosuppresents and organ transplants
-after transplantation the body recognizes the new organ as a foreign object and immune system will initiate a response against it
-used to reduce this risk of rejection
Immunosuppresive drugs
-corticosteroids
-cytotoxic drugs
-immunophilins
-lyphocytes depleting therapies
Corticosteroids action
-anti-inflammatory
-kills T-cells
Corticosteroids example
-prednisone
-provides relief for inflamed areas of the body
Cytotoxic drugs action
-blocks cell division nonspecifically
Cytotoxic drugs example
-cyclophosphamide and methotrexate
-treats cancer by slowing or stopping cell growth
Immunophilins action
-blocks T-cell responses
Immunophilins example
-cyclosporine
-used to prevent rejection in those receiving a transplanted organ
Lymphocyte-depleting therapies action
-kills T cells non-specifically
-kills activated T-cells
Lymphocyte-depleting therapies
-monoclonal antibodies
-used to prevent acute rejection in organ transplantation
Side effects of immunophilin
-nephrotoxicity
-hypertension
-hirsutism
-hypertrichosis
-gingual hyperplasia
Cytotoxic drugs side effects
-nausea
-vomiting
-loss of appetite
-stomach ache
-diarrhea
-darkening of skin/nails
Side effects of methotrexate
-nausea
-vomiting
-hair loss
-tiredness
-dizziness
-chills
-headache
-mouth sores
-sores in lungs
-increased risk of skin infection
Corticosteroids side effects
-osteoporosis
-hirsutism
-hypertrichosis
-diabetogenic
Latent infections most common pathogens
-TB
-HSV1/2
-CMV
-EBV
-VZV
Opportunistic infections
-reactivation of a pathogen that is already present in the host
-can arise from bacteria, viruses, parasites, or fungi
Fungal opportunistic infections
-PCP
-cryptococcosis
-candidiasis
-aspergillosis
Parasitic opportunistic infections
-toxoplasmosis
Bacterial opportunistic infections
-tuberculosis
-MAC
Viral opportunistic infections
-cytomegalovirus
-herpes simplex virus
-varicella zoster virus
-mononucleosis
Type 1 hypersensitivities
-immediate/anaphylactic
-can be immediate and lead to death in as little as a minute
Type 1 primary exposure
-allergen induces humoural immune response where there is an excessive amount of IgE antibodies which bind to mass cells and neutrophils
Type 1 secondary exposure
-membrane-bound IgE cross-links with allergen which initiates the degranulations of basophils and mast cells, releasing vasoactive mediators causing vasodilation and smooth muscle contraction
Clinical manifestation of type 1 hypersensitivity
-allergic rhinitis
-atopic dermatitis
-asthma
-hives
Type 2 hypersensitivity
-antibody mediated cytotoxic hypersensitivity
-takes minutes to hours to develop
Clinical manifestation of type 2 hypersensitivity
-drug induced hemolytic anemia
-transfusion reactions
Type 3 hypersensitivity
-immune-complex mediated hypersensitivity
-takes hours to days or weeks
-inflammatory
Clinical manifestation of type 3 hypersensitivity
-serum sickness
-edema and pain
Type 4 hypersensitivity
-cell-mediated or delayed type hypersensitivity
-takes 2-3 days to develop after exposure
Clinical manifestation of type 4 hypersensitivity
-inflammatory bowel disease
-contact dermatitis
During anaphylaxis, what is secreted by mast cells
-histamines
Autoantibody
-antibody produced by the immune system that is directed against a self antigen
What dysfunction of the immune system includes autoantibodies
-autoimmunity
