Robbins Chapter 6 Tables Flashcards
Immediate (Type I) hypersens. immune mechanism
Production of IgE to release vasoactive amines and mast cells
Immediate (Type I) hypersens. histopathologic lesions (6)
vascular dilation, edema, smooth muscle contraction, mucus production, tissue injury, inflammation
Immediate (Type I) hypersens. prototypical disorders (3)
anaphylaxis, allergies, bronchial asthma
Antibody-mediates (Type II) hypersens. immune mechanism
production of IgG and IgM
binds to antigen on cell or tissue
phagocytosis or lysis of target cell by complement or Fc receptor
recruit leukocytes
Antibody-mediates (Type II) hypersens. histopathologic lesions (4)
phagocytosis, lysis of cells, inflammation, potentially no tissue injury
Antibody-mediates (Type II) hypersens. prototypical disorders (2)
autoimmune hemolytic anemia, goodpasture syndrome
Immune complex-mediated (type III) hypersens. immune mechanism
deposition of antigen-antibody complexes
complement activation
recruitment of leukocytes by complement products
release enzymes and toxic molecules
Antibody-mediated (Type II) hypersens. histopathologic lesions (2)
inflammation, necrotizing vasculitis (fibrinoid necrosis)
Antibody-mediates (Type II) hypersens. prototypical disorders (3)
systemic lupus erythematosus, serum sickness, arthus reaction
Cell-mediated (Type IV) hypersens. immune mechanism
activated T lymphocytes
release of cytokines
inflammation and macrophage activation
T cell-mediated cytotoxicity
Cell-mediated (Type IV) hypersens. histopathologic lesion (4)
perivascular cellular infiltrates, edema, granuloma formation, cell destruction
Cell-mediated (Type IV) hypersens. prototypical disorders (4)
contact dermatitis, multiple sclerosis, type 1 diabetes, tuberculosis
Immediate Hypersensitivity Examples (4)
Anaphylaxis, bronchial asthma, allergic rhinitis, food allergies
Clinical and Pathologic Manifestations of Anaphylaxis
fall in blood pressure (shock) caused by vascular dilation, airway obstruction due to laryngeal edema
Clinical and Pathologic Manifestations of bronchial asthma
airway obstruction caused by bronchial smooth muscle hyperactivity, inflammations and tissue injury caused by late-phase reaction
Clinical and Pathologic Manifestations of allergic rhinitis, sinusitis (hay fever)
increased mucus secretion, inflammation of upper airways, sinuses
Clinical and Pathologic Manifestations of Food allergies
increased peristalsis due to contraction of intestinal muscles
Autoimmune hemolytic anemia
target antigen: red cell membrane proteins
mechanism of disease: opsonization and phagocytosis of red cells
manifestation: hemolysis, anemia
Autoimmune thrombocytopenia purpura
target antigen: platelet membrane proteins
mechanism of disease: opsonization and phagocytosis of platelets
manifestation: bleeding
Pemphigus vulgaris
target antigen: proteins in intercellular junctions of epidermal cells
mechanism of disease: antibody-mediated activation of proteases, disruption of intercellular adhesions
manifestation: skin vesicles (bullae)
Vasculitis cause by ANCA
target antigen: neutrophil granule proteins
mechanism of disease: neutrophil degranulation and inflammation
manifestation: vasculitis
Goodpasture syndrome
target antigen: noncollagenous protein in basement membrane of kidney and lung
mechanism of disease: complement and Fc receptor mediated inflammation
manifestation: nephritis, lung hemorrhage
Acute Rheumatic fever
target antigen: streptococcal cell wall antigen
mechanism of disease: inflammation, macrophage activation
manifestation: myocarditis, arthritis
Myasthenia gravis
target antigen: Ach receptor
mechanism of disease: antibody inhibits Ach binding, down modulates receptors
manifestation: muscle weakness, paralysis
Graves disease (hyperthyroidism)
target antigen: TSH receptor
mechanism of disease: antibody-mediated stimulation of TSH receptors
manifestation: Hyperthyroidism
Insulin-resistant diabetes
target antigen: insulin receptor
mechanism of disease: antibody inhibits binding of insulin
manifestation: hyperglycemia, ketoacidosis
Pernicious anemia
target antigen: intrinsic factor of gastric parietal cells
mechanism of disease: neutralization of intrinsic factor
manifestation: anemia and abnormal erythropoiesis
Systemic Lupus Erythematosus
antigen involved: nuclear antigens
manifestations: nephritis, skin lesions, arthritis
Poststreptococcal glomerulonephritis
antigen involved: streptococcal cell wall antigens
manifestations: nephritis
Polyarteritis nodosa
antigen involved: Hepatitis B virus
manifestations: systemic vasculitis
Reactive arthritis
antigen involved: bacterial antigen
manifestations: acute arthritis
Serum Sickness
antigen involved: proteins
manifestations: arthritis, vasculitis, nephritis
T Cell-Mediated Diseases (6)
Rheumatoid arthritis Multiple Sclerosis Type 1 Diabetes Mellitus Inflammatory Bowel Disease Psoriasis Contact Sensitivity
Rheumatoid arthritis
Specificity: collagen
Mechanism of tissue injury: Th17
Manifestations: chronic arthritis with inflammation
Multiple Sclerosis
Specificity: myelin
Mechanism of tissue injury: Th1 and Th17
Manifestations: demyelination in CNS and paralysis
Type 1 Diabetes
Specificity: panceatic islet b cells
Mechanism of tissue injury: T cell mediated inflammation, destruction by CTLs
Manifestations: Insulitis
Inflammatory Bowel Disease
Specificity: enteric bacteria
Mechanism of tissue injury: Th1 and Th17
Manifestations: chronic intestinal inflammation and obstruction
Psoriasis
Mechanism of tissue injury: Th17
Manifestations: destructive plaques in the skin
Contact sensitivity
Specificity: environmental chemicals ex. urushiol from poison ivy
Mechanism of tissue injury: Th1
Manifestations: epidermal necrosis, dermal inflammation causing rash and blisters
Organ Specific Diseases Mediated by Antibodies (6)
Autoimmune hemolytic anemia Autoimmune thrombocytopenia Autoimmune atrophic gastritis of pernicious anemia Myasthenia gravis Graves Disease Goodpasture syndrome
Systemic Diseases Mediated by Antibodies (1)
Systemic Lupus Erythematosus
Organ Specific Diseases Mediated by T Cells (2)
Type 1 Diabetes
Multiple Sclerosis
Systemic Diseases Mediated by T cells (2)
Rheumatoid Arthritis
Systemic Sclerosis
Organ Specific Diseases Autoimmune (1)
Inflammatory Bowel Diseases (Crohns)
Criteria for Classification of Systemic Lupus Erythematosus (11)
Malar rash Discoid rash Photosensitivity Oral Ulcers Arthritis Serositis Renal Disorder Neurologic disorder Hematologic disorder Immunologic disorder Antinuclear antibody
Leukocyte adhesion deficiency 1
defective leukocyte adhesion
mutation in b chain of CD11/CD18 integrins
Leukocyte adhesion deficiency 2
defective leukocyte adhesion
mutation in fucosyl transferase required for sialyl-lewis-X
What is the defect in Chediak-Higashi syndrome
decreased leukocyte functions
mutations affecting protein involved in lysosomal membrane traffic
What is the defect in chronic granulomatous disease
decreased oxidative burst
X linked defect in leukocyte function
phaogocyte oxidase (membrane component)
Autosomal recessive defect in leukocyte function
phagocyte oxidase (cytoplasmic component)
Myeloperoxidase deficiency defect in leukocyte function
decreased microbial killing because of defect MPO-H2O2 system
C2 and C4 deficiency
defective classical pathway activation
reduced resistance to infection
reduced clearance of immune complexes
C3 deficiency
defects in all complement functions
Deficiency of complement regulatory proteins
excessive complement activation
Human immunodeficiency virus infection
secondary (acquired) immunodeficiency
depletion of CD4+ helper T cells
Irradiation and chemotherapy treatments for cancer
secondary (acquired) immunodeficiency
decreased bone marrow precursors for all leukocytes
Involvement of bone marrow by cancers
secondary (acquired) immunodeficiency
reduced site of leukocyte development
Protein-calorie malnutrition
secondary (acquired) immunodeficiency
metabolic derangements inhibit lymphocyte maturation and function
Removal of Spleen
secondary (acquired) immunodeficiency
decreased phagocytosis of microbes
