Module 5 Flashcards

1
Q

how many complement pathways are there

A

alternative pathway

classical pathway

lectin pathway

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2
Q

what are the initators for the 3 pathways

classic

alternate

mannose binding lectin

A

classic - immune complexes, apoptotic cells, certain viruses and GN bacteria, CRP bound to ligand

Alternate- bacteria, fungi, viruses, tumor cells,

microbes with terminal mannose groups

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3
Q

classical pathway stage 1 and stage 2

A

antibody mediated pathway
stage 1 is recognition

-C1 (qrs) recognizes IgM or 2 IgG
-C1q binds Fc portion of IgG or IgM
-C1r and C1s attach forming C1- first enzyme of the pathway
-C1 - now active splits C4 into C4a and C4b, C2 into C2A and C2b
-C4b binds to proteins and carbs on antigen surface and C2a FORMS c4B2a known as C3 convertase - NOW ACTIVATED

Stage 2 - amplification or proteolytic complement cascade
-now C3 convertase splits molecules of C3 into C3a and C3b

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4
Q

stage 3 of classical pathway

A

MAC ATTACK

-C3b binds C4b2a to make C4b2a3b (C5 convertase)
-C5 convertase splits C5 into C5a and C5b
-C5b binds C6, C7, C8 and C9 to make c5b6789 (MAC)
-C5bC6C7C8 polymerizes C9 to form a tube that allows ions to flow into and out of cells. Causes cell to burst due to Na and H2O coming

CELL LYSIS

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5
Q

example of classical pathway

A
  • transfusion of group O blood
    C9 forms a pore in the donor RBC causing them to burst causing agglutination reactions
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6
Q

alternative pathway stages

A
  • non antibody initiated pathway
    -activated by microbial/mammalian cell surfaces (plants, yeast, bac)
    -C1, C2 and C4 do not participate
    STEP 1 -other serum proteins are converted causing C3 to activate
    STEP 2-c3b and factor B combine to form C3b,B = C3 convertase

Regulation
- Factor H prevents C3b and Factor B from getting close it competes for a binding site on C3b eventually leading to C3 inactivation

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7
Q

mannose binding lectin pathway stages

A

1)-homologous to c1q structure
-calcium dependent lectins: collectins (collagenous lectins)
2)-MASP enzymes activate complement by interacting with two serine proteases called MASP1 MASP2 which then activates C4 and C2

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8
Q

FUNCTIONS OF PATHWAYS

A

1- cell lysis by MAC which leads to osmotic lysis of a cell

2-participate in immunity or other functions

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9
Q

when the host defends against infections what complement proteins are responsible for what

opsonization

chemotaxis and leukocyte activation

lysis of bacterial and mammalian cells

A

opsonization - covalent bonds between C3 and C4

chemotaxis and leukocyte activation - C3a, C4a, and C5a- anaphylatoxin receptors

lysis of bacterial and mammalian cells C5-C9 MAC

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10
Q

where there is interface between innate and adaptive immunity what complement proteins are responsible for what

antibody augmentation

responses

immunological memory enchantment

A

antibody augmentation - C3b and C4b bound to immune complexes and AG

responses - C3 receptors on B cells and AG presenting cells

immunological memory enchantment C3b and C4b bound to immune complexes and AG, C3 receptors on follicular dendritic cells

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11
Q

during disposal of waste what complement proteins are responsible for what

clearance of immune complexes from tissues

clearance of apoptotic cells

A

C1q - bonded bits of C3 and C4

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12
Q

what happens if there are abnormal changes in the complements

A
  • cause tissue damage
    -intravascular thrombosis
    -abnormal levels in RA, lupusw
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13
Q

what can cause elevated complement levels

A

-inflammatory conditions
trauma myocardial infraction

testing is of limited significance

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14
Q

what can cause decreased complement levels

A

-if the complement was already recently activated
-if the complement is being consumed
-if there is a component of the pathway that is absent (opsonic , lytic activities)

patient is more susceptible to infection

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15
Q

what are other soluble immune response mediators

A

known as biological response modifiers - modulate your own immune response

there are four main sources of brms secreted by mononuclear leukocytes
-b lymph secrete AB
-t lymph secret soluble mediators
-nk cell secrete IFN ALPHA
-monocyte/macrophages secrete interferons, interleukins,

they have therapeutic uses
active - microbial or chemical to modulate - vaccinate

adoptive - using soluble mediators

passive - transfer of pre form antibodies

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16
Q

what are cytokines

A

mediators of immune response
-synthesized or secreted by cells of innate or adaptive immunity
-transmit signals between cells

-INNATE
-mediate early inflammatory reactions
-stimulate adaptive immune response

ADAPTIVE
-stimulate prolif/diff of AG-stimulated lymph
-active effector cells like macrophages

17
Q

what are interleukins

A

mediators of immune response
-type of cytokine
-made by and act on lymphocytes

-function to mediate interactions between leukocytes but dont bind AG
-modulate inflammation and immunity by regulating growth, mobility, and lymphoid cell differentiation

18
Q

what are interferons

A

mediators of immune response
-interfere with viral response and keep them from multiplying

-natural defense to microbes, tumors and AG
-signal neighboring UNINFECTED cells to destroy RNA and reduce protein synthesis and tell INFECTED cells to undergo apoptosis

-enhance gene expression
-inhibit cell proliferation
-increase immune effector cell

clinical use
-antiviral agents
-immunomodulators
-antineoplastic agents

19
Q

what are type 1 interferons

A
  • early innate immune response to viral infections
    -IFN ALPHA AND BETA

GAMMA
-principle macrophage activating cytokine
-stimulates MHC class 1/2
-promotes differentiation of CD4+ to helper T cell type
-acts on B cells to switch IgG subclasses
-activates neutrophils
-stimulates NK cell activity

-used in clinical to increase cytokines

20
Q

What is tumor necrosis factor

A

Mediators of the Immune Response
-principle mediator of acute inflammatory response to GN bacteria
-induces apoptosis and gene transcription
-actively recruits neuts and monocytes to infection sites and get rid of bacteria

-if TNF is low - acute inflammation is induced using leuko and endothelium

if middle level of TNF - inflammation is mediated

if increased TNF - severe disease state (septic shock from GN)

21
Q

what are chemokines

A

Mediators of the Immune Response
-family of cytokines
-stimulates leukocyte movement from blood to tissue at site of infection
-regulates migration of PMNs in tissues

22
Q

what are Hematopoietic Stimulator

A

Mediators of the Immune Response
-stem cell factor: acts on immature stem cells in bone marrow and thymus to promote proliferation

23
Q

what are acute phase proteins

A
  • produced by innate immune system
    -NONSPECIFIC INDICATOR of inflammatory process
24
Q

importance of CRP

A

-differentiates between bacterial (high crp) and viral infection
-good for treatment monitoring
-can reflect long or short term disease activity and response to drugs

in cardiovascular disease - crp and ldl are high
CRP is a better predictor of cardiovascular events than ldl