Pathology Flashcards
What is Lysozyme?
antibacterial factor
Enzyme present at mucosal surfaces
Active in breaking down the Gram-positive cell wall
reduces the chance of symptomatic gram-positive infections
What is Lactoferrin?
antibacterial factor
Protein found at mucosal surfaces
Chelates iron and therefore reduces soluble iron in the GI/respiratory tract
Inhibits the growth of bacteria as they do not have access to iron
What are the three different pathways of activating complement:
Classical pathway: Ag-Ab complex can bind to and activate complement
Alternative pathway: complement is activated directly by pathogen surfaces
Mannose-binding Lectin pathway: activation of complement by specific sugar residues on pathogen surface
Roles of complement
Killing of pathogens by membrane attack complex (direct lysis via MAC)
Recruitment of inflammatory cells
Opsonization of pathogens (makes them more palatable for phagocytosis)
Which WBC are important in the immune response to parasites?
Eosinophils
They are also involved in allergy responses
Functions of antibodies
1) Opsonise for phagocytosis
2) Activate Complement for lysis
3) Neutralise toxins and pathogen binding sites
What is Central tolerance?
process whereby immature T and B cells acquire tolerance to self-antigens during
maturation within the primary lymphoid organs.
It involves the elimination of cells with receptors for
self-antigens = NEGATIVE SELECTION
What is Clonal deletion?
mechanism that causes elimination of self-reactive lymphocytes on contact with self-antigens.
Explain positive and negative selection in relation to T cell development.
T cells expressing receptors with weak binding to MHC I and II antigens are permitted to survive –
they are POSITIVELY SELECTED
If the T cell receptor binds strongly to MHC alone or MHC carrying self peptide in the thymus, T cells are
induced to die by apoptosis – NEGATIVE SELECTION
What is Peripheral tolerance?
Peripheral T cells are made unresponsive (anergic) through the absence of the second signal,
which is essential for T cell activation
Peripheral B cells are made unresponsive by the absence of co-stimulatory signals from T cells
What do Th1 cells predominantly produce and what is their role?
IFN-gamma
Important in the defence against intracellular microbes
What do Th2 cells predominantly produce and what is their role?
IL-4 (IL-5, IL-13)
Important in the defence against parasites
What do Th17 cells predominantly produce and what is their role?
IL-17
Important in the defence against some bacteria
Hypersensitivity
a heightened immune response to an offending agent with subsequent clinical symptoms.
Tissue damaging reactions may occur to innocuous agents.
Classified into 4 types based on the mechanism leading to tissue damage
Hypersensitivity reactions are antigen specific, and occur after the immune system has already responded to an antigen (i.e. the immune system has been primed)
Type I Hypersensitivity
Immediate (2-30 minutes)
most common type
IgE mediated - result from antigen cross-linking to mast cell-bound IgE
can be systemic or localised, mild or life threatening
e.g. allergic dermatitis, asthma, eczema, hayfever
tends to increase in severity with repeated challenges
Type II Hypersensitivity
5-8 hours
Cytotoxic, antibody dependent
IgG or IgM mediated (reacts to cell-bound antigen)
induces lysis through complement activation
e.g. Rh disease of the newborn
blood transfusion reactions, AIHA, rheumatic heart disease
Type III Hypersensitivity
2-8 hours
Immune complex formation
IgG or IgM bound to soluble antigen
complexes aggregate in small blood vessels, causing occlusion, inflammation and complement activation
complement recruits PMNs, which release tissue-damaging enzymes
systemic complex deposition causes vasculitis
Type IV Hypersensitivity
delayed - 24-72 hours
Cell mediated T cells (CD4 + & CD8 + )
Can be granulomatous
e.g. TB, contact dermatitis