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CPR > Renal Immunity > Flashcards

Renal Immunity Flashcards

1
Q

What is a major Acute Kidney Injury (AKI) cause?

A

Sterile inflammation

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2
Q

An AKI can lead to renal failure. Renal failure is abrupt ____ in kidney function

A

Decrease

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3
Q

When a normal cell dies by injury, what does it release?

A

DAMPs

- Damage - Associated Molecular Patterns

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4
Q

DAMPs are usually released due to?

A

ECM degradation

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5
Q

What 2 things can bind DAMPs released from dying cells?

A
  1. C-reactive protein

2. Toll-like receptors

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6
Q

When C-reactive protein binds DAMPs, what does that activate?

A

Classical complement pathway

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7
Q

When Toll-like receptors bind DAMPs, what does that cause?

A

Renal inflammation

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8
Q

_____ activate immune mechanism of an AKI

A

DAMPs

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9
Q

Once the complement pathway is activated, what chemoattractants are generated?

A

C3a and C5a

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10
Q

What do C3a and C5a induce?

A
  1. Leukocyte filtration

2. Membrane Attack Complex activation

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11
Q

C3a and C5a cause leukocyte filtration and MAC activation. What leukocytes infiltrate?

A

Neutrophils

Monocytes

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12
Q

What do Neutrophils release to cause tissue damage?

A

Proteases and Free radicals

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13
Q

What do Monocytes differentiate into?

A

M1 Macrophages

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14
Q

With an Early AKI, what inflammatory mediators dominate?

A

Th17 and Th1

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15
Q

With a Late AKI, what inflammatory mediator dominates?

A

Th1

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16
Q

What does Th17 secrete?

A

IL-17 (pro-inflammation)

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17
Q

IL-17 induces expression of what chemokine?

A

CCL20

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18
Q

What cells does IL-17 then keep recruiting?

A

Neutrophils
Monocytes
Th17
Th1

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19
Q

What does Th1 secrete?

A

IFN - gamma

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20
Q

IFN - gamma secreted by Th1 cells activates?

A

M1 macrophages

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21
Q

What do M1 macrophages release to cause more inflammation?

A

IL-6 and TNF-alpha

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22
Q

What antibody does IFN-gamma also activate?

A

IgG

23
Q

TRegs ____ AKI progression

A

Prevent!

24
Q

Why is the kidney susceptible to complement-induced damage?

A

Its high filtration rate favors deposition of immune complexes

25
Q

What is a major barrier of successful kidney implantation?

A

Genetic Incompatibility

26
Q

What antigens are the targets for transplant rejection?

A

HLA

27
Q

What are the 2 reasons transplants can be rejected?

A
  1. Host Versus Graft Disease (HVGD)

2. Graft Versus Host Disease (GVHD)

28
Q

Host Versus Graft Disease

A

Host’s immune system attacks the graft

29
Q

Graft Versus Host Disease

A

Graft’s immune cells attack recipient

30
Q

Autografts

A

Grafts from own person’s body

31
Q

Isografts

A

Grafts between identical twins

32
Q

Allografts

A

Grafts between same species

33
Q

Xenografts

A

Grafts between different species

34
Q

Which type of graft is the most susceptible to rapid attack?

A

Xenografts

35
Q

4 key concepts in Kidney Transplantation

A
  1. Condition of Allograft
  2. Donor-host Antigenic disparity
  3. Strength of host Anti-donor response
  4. Applied immunosuppression
36
Q

If the Allograft is damaged, what can it release and cause?

A

Releases DAMPs – causes clots and tissue damage

37
Q

A RBC type A has A antigens on its surface. What antibodies does it have?

A

Anti-B

38
Q

ABO matching is NOT important for what 3 things?

A
  1. Cornea transplant
  2. Heart valve transplant
  3. Bone and tendon grafts
39
Q

Describe how they test for Class I HLA compatibility

A
  1. Add a specific HLA antibody to donor and recipient
  2. Add complement
  3. Add dye
  4. If the dye is inside the cell, that HLA antigen is present!!!!
    = You want this response for both donor and recipient for each specific HLA antigen
40
Q

What are the 3 types of HVGD rejections?

A
  1. Hyperacute
  2. Acute
  3. Chronic
41
Q

How soon will a Hyperacute graft rejection occur?

A

Within minutes

42
Q

What causes a Hyperacute graft rejection?

A

Pre-existing antibodies and complement activation

43
Q

How soon will an Acute graft rejection occur?

A

Within days to weeks

44
Q

What causes an Acute graft rejection?

A

Cytotoxic T cells activated by APCs

- Also can be triggered by donor DCs -

45
Q

How soon will a Chronic Graft rejection occur?

A

Months to years

46
Q

What causes a Chronic graft rejection?

A 
Vascular injury (ischemia)
Macrophages
47
Q

What usually causes a GVHD rejection?

A

The DONOR T cells are activated in the new tissue!

48
Q

What antigens do the donor T cells attack with a GVHD?

A

Minor H antigens because the HLA ones are matched

49
Q

What symptoms may a GVHD rejection include?

A

Jaundice, rash, diarrhea

50
Q

With a HVGD, both innate and adaptive immune response become active. Which is the strongest?

A

Adaptive

51
Q

Hyperacute rejection is what type of sensitivity?

A

Type 2

52
Q

Acute rejection is what type of sensitivity?

A

Type 4

53
Q

Chronic rejection is what type of sensitivity?

A

Type 3 and 4

54
Q

Graft versus Host rejection is what type of sensitivity?

A

Type 4

CPR (48 decks)

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