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Dermatology > Skin immunology > Flashcards

Skin immunology Flashcards

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Dermatology Board Prep flashcards
1
Q

What is the immune function of keratinocytes?

A

Sense pathogens via cell surface receptors and help mediate an immune response

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2
Q

What can activate keratinocytes?

A

UV (sunlight) and sensitizers (allergic contact dermatitis)

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3
Q

What AMPs can the epidermis produce?

A

Defensins and cathelicidins

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4
Q

In what disease process are AMPs in high levels?

A

Psoriasis

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5
Q

What is the main immunce cell present in the epidermis?

A

Langerhans cells

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6
Q

What type of cell is a langerhans cell?

A

Dendritic cell that can intersperse with keratinocytes in the epidermis

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7
Q

How do langerhans cells act as immune cells?

A

They act as sentinels in the epidermis and process lipid antigens and microbial fragments and present them to effector T cells to activate them
They have birbeck granules

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8
Q

Where can T cells be found in the skin?

A

In high numbers in the epidermis and dermis

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9
Q

What type of T cell is found in the epidermis?

A

CD8+ cells

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10
Q

What type of T cell is found in the dermis?

A

CD4+ and CD8+ cells

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11
Q

What is Th1 associated with?

A

Psoariasis

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12
Q

What is TH2 associated with?

A

Atopic dermatitis

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13
Q

What is TH17 associated with?

A

Psoriasis and atopic dermatitis

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14
Q

Where are T cells produced?

A

Bone marrow and sensitised in the thymus

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15
Q

What does Th1 do?

A

Activates macrophages to destroy microorganisms and produces IL2 and IFN-gamma

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16
Q

What does TH2 do?

A

Helps B cells make antibodies

Producecs IL4, IL5 and IL^

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17
Q

What do CD8+ cells do?

A

Kill infected cells directly

Protect against viruses and cancer

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18
Q

What dendritic cells are found within the dermis?

A

Dermal dendiritc cell

Plasmacytoid dendritic cell

19
Q

What is the function of dermal DC?

A

Involved in antigen presentation and secreting cytokines and chemokines

20
Q

What is the function of plasmacytoid DC?

A

To produce IFN-alpha

Found in diseased skin

21
Q

What immune cells are found in the dermis?

A

Macrophages, neutrophils, mast cells

22
Q

What is the function of neutrophils?

A

Circulating leukocytes attracted to tissue by chemokines

23
Q

What is the function of mast cells?

A

Tend to be found in barriers
Effectors of IgE mediated immune response (allergy)
Binding of IgE causes activation of the mast cell and release of inflammatory mediators

24
Q

Where are MHC1 found?

A

On all cells

Present antigens to cytotoxic T cells

25
Q

What is an endogenous Ag?

A

Endogenous antigens are generated within normal cells as a result of normal cell metabolism, or because of viral or intracellular bacterial infection. The fragments are then presented on the cell surface in the complex with MHC class I molecules.

26
Q

Where are MHC2 found?

A

Found on antigen presenting cells (B cells and macrophages)

Present to Th cells

27
Q

What is an exogenous Ag?

A

By endocytosis or phagocytosis, exogenous antigens are taken into the antigen-presenting cells (APCs) and processed into fragments. APCs then present the fragments to T helper cells (CD4+) by the use of class II histocompatibility molecules on their surface

28
Q

What chromosome codes for MHC molecules?

A

Chromosome 6

29
Q

What skin conditions are associated with an inappropriate immune response/ inflammation?

A 
Psoriasis 
Atopic dermatitis
Bullous pemphigoid
Contact dermatitis
Morphea
Urticaria
SLE
Skin infections
Skin tumours
30
Q

What is the hallmark of psoriasis?

A

Inflammation

There is a non-ending accelerated phase 2 wound response

31
Q

What skin appendages can psoriasis affect?

A

Nails and joints

32
Q

What are the symptoms of psoriasis?

A

Erythema
Itchy plaques
Bleeding of lesions
Arthritis

33
Q

What can cause the onset or exacerbation of psoriasis?

A 
Bacterial pharyngitis (gram +ve) 
Mild trauma of skin (koebner phenomenom) 
HIV infection 
Stress
B-blockers or lithium 
Genetic
34
Q

What is the immunopathogenesis of psoriasis?

A

KC under stress releases factors to produce IFN-alpha
Chemical signals activate DC which migrate to skin draining lymph nodes to present to and activate T cells Th1 and Th17
T cells attracted to dermis by chemokiles where they secrete interleukins causing KC proliferation, AMP release and neurtrophil attracting chemokines

35
Q

How can atopic eczema occur?

A

Mutations in filaggrin gene
Decrease in AMP in skin
T cells (Th2), DC, KC, macrophages and mast cells are involved

36
Q

What skin conditions are autoimmune?

A

Psoriasis
Vitiligo
SLE - fault apoptosis causing lots of DNA to accumulate in the blood and therefore the body starts to form auto-antibodies to its own DNA

37
Q

What is type 1 hypersensitivity?

A

Antibody mediated IgE

38
Q

What is the pathogenesis of type 1 hypersensitivity?

A

Early exposure to allergen causes the production of IgE which binds to the IgE receptor on mast cell. Later exposure causes rapid crosslinking of the receptors, signal transduction and degranulation of the mast cell

39
Q

What is type 2 hypersensitivity?

A

Antibody mediated: IgG and IgM

Important in autoimmunity and transplantation

40
Q

What are some common disaeses via type 2 hypersensitivity?

A

Haemolytic disease of the newborn

Blood transfusion recipients

41
Q

What is type 4 hypersensitvity?

A

Cell mediated: Th1

Delayed type hypersensitivity is based on T-cell mediated response

42
Q

What are some examples of type 4 hypersensitivity reactions?

A

Tuberculin reaction
Contact allergy
Metals - nickel and chromate

43
Q

What cell types are involved in skin immunity in the epidermis?

A

Keratinocytes
Langerhans
CD8+ T cells
Melanocytes

44
Q

What cell types are involved in skin immunity in the dermis?

A 
DC cells
Macrophages
CD4+ and CD8+ T cells 
NK cells
Fibroblasts
Lymph/ vasculature

Dermatology (24 decks)

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