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IIH > The Immune System in Early Life > Flashcards

The Immune System in Early Life Flashcards

1
Q

List 8 characteristics of the immune system at birth.

A

1 - Immune responses to protein antigens is almost normal.

2 - Opsonic activity and complement is reduced to 65% of normal levels.

3 - Phagocyte function is reduced.

4 - Monocyte motility is reduced.

5 - There are higher numbers, but poorer function, of lymphocytes.

6 - Antigen presenting cell function is reduced.

7 - B cell activation is poor.

8 - Epithelial and mucosal surfaces are the first lines of defence.

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2
Q

Why does the immune system at birth have higher numbers, but poorer function, of lymphocytes?

A

Due to:

1 - Low levels of IL-2, IL-4, IL-5, IL-12 and IFN-g.

2 - Reduced activation of the humoral immune response.

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3
Q

To which other organ systems is immune development linked?

A

Cardiovascular and bone marrow development.

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4
Q

List 3 anatomical sites at which haematopoietic stem cells form during embryogenesis.

A

1 - The yolk sac.

2 - The aorta-gonad mesonephros region (AGM).

3 - The placenta.

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5
Q

At which stage in life do haematopoietic stem cells colonise the bone marrow?

A

At birth.

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6
Q

At which stage in life do macrophages start to develop?

A

At 3 weeks of gestation.

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7
Q

At which stage in life do thymocytes start to develop?

A

At 7 weeks of gestation.

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8
Q

At which stage in life do follicular dendritic cells start to develop?

A

At 17 weeks of gestation.

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9
Q

At which stage in life do follicular B cells start to develop in the spleen?

A

At 19 weeks of gestation.

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10
Q

At which stage in life do T regulatory cells start to develop?

A

At 14 weeks of gestation.

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11
Q

At which stage in life do B regulatory cells start to develop?

A

At 24 weeks of gestation.

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12
Q

At which stage in life do neutrophils start to develop?

A

At 30 weeks of gestation.

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13
Q

How do the numbers of NK cells change with age from gestation to adulthood?

A
  • NK cells increase with gestational age.
  • After birth they are higher than at any subsequent time in life but have reduced cytotoxicity.
  • Numbers reduce to normal adult levels by 5 years of age.
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14
Q

At which age are complement levels normal?

A

By the first few years of age.

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15
Q

At which stage in life does the spleen develop?

A

At 5 weeks of gestation.

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16
Q

From which anatomical site do the cells required for the haemopoietic function of the spleen arise?

A

The yolk sac wall.

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17
Q

At which stage in life does the spleen generate both red and white cells?

A

The 2nd trimester of gestation.

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18
Q

At which stage in life do haematopoietic stem cells migrate to the foetal liver?

A

At 5 weeks of gestation.

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19
Q

At which stage in life are B cells present in the liver?

A

At 12 weeks of gestation.

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20
Q

From which anatomical structure does the thymic epithelium develop?

A

The 3rd pharyngeal arch.

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21
Q

At which stage in life does the thymic epithelium develop?

A

At 6 weeks of gestation.

22
Q

From which embryological tissue layers do the cortex and medulla of the thymus develop?

A
  • The cortex develops from the ectoderm.

- The medulla develops from the endoderm.

23
Q

At which stage in life do lymphocytes migrate to the thymus?

A

At 8-9 weeks of gestation.

24
Q

At which stage in life is positive and negative thymic selection possible?

A

Very early in utero.

25
Q

How does the mass of the thymus change with age?

A
  • At birth, it is 10-15g.
  • It grows to 30-40g by the age of puberty.
  • After puberty, involution occurs and it is replaced by adipose tissue such that by middle age, it is approximately 10g.
26
Q

What is DiGeorge syndrome?

A

A heterozygous chromosomal deletion which causes a defective development of the pharyngeal pouches and a subsequent T cell deficit due to a reduced size of the thymus.

27
Q

What might be found on a full blood count of a person with DiGeorge syndrome?

A

A range from slightly reduced T cell numbers to severe combined immunodeficiency.

28
Q

Give an example of an organ other than the thymus that reduces in size due to DiGeorge syndrome.

A

The parathyroid gland.

29
Q

What causes the initiation of expression of toll-like receptors in the intestines?

A

The gut microbiome bacteria stimulating gut lymphoid tissue.

30
Q

List 7 anatomical sites in which intraepithelial lymphocytes can be found.

A

1 - The intestines.

2 - The biliary tract.

3 - The oral cavity.

4 - The lung.

5 - The upper respiratory tract.

6 - The reproductive tract.

7 - The skin.

31
Q

How do levels of intraepithelial lymphocytes change?

A
  • Greatest at birth.

- Slowly decreases with age until old age.

32
Q

What is the primary function of intraepithelial lymphocytes?

A

They play an important role in gut tolerance of food and the microbiota.

33
Q

List 3 immunological causes of miscarriage.

A

1 - Systemic lupus erythematosus (due to autoantibodies).

2 - Thyroid disease (due to autoantibodies).

3 - NK cell abnormalities.

34
Q

List 3 maternal immune cells that are present at the endometrium.

A

1 - NK cells.

2 - Macrophages.

3 - T regulatory cells.

35
Q

List 5 processes that allow the foetus to tolerate the maternal immune system.

A

1 - Synthesis of immunosuppressive molecules by the placenta.

2 - Downregulation of MHC class I to reduce cytotoxic responses.

3 - Repression of paternal MHC class II in trophoblast cells.

4 - Depletion of tryptophan by IDO and subsequent inactivation of T cells.

5 - Downregulation of TNF superfamily.

36
Q

List 6 immunosuppressive molecules produced by the placenta.

A

1 - Progesterone.

2 - PGE2.

3 - Anti-inflammatory cytokines.

4 - IL-4.

5 - IL-10.

6 - Complement regulatory proteins.

37
Q

List 3 main immunological defence mechanisms of newborn children.

A

1 - Innate immune system.

2 - Mucosal immunity by colonisation of the gut by commensal bacteria.

3 - Passively acquired transplacental antibodies.

38
Q

Which antibody crosses the placenta?

A

IgG.

39
Q

What is the half-life of IgG?

A

21 days.

40
Q

What is hypogammaglobulinaemia of infancy?

A

An immune immaturity of IgG (gamma globulin) as levels come up more slowly during gestation.

41
Q

What causes haemolytic disease of the newborn?

A

Where a foetus has both a different blood type and Rh factor (a surface protein on erythrocytes).

42
Q

Which disease occurs due to differing Rh factor between a mother and a foetus?

A

Rhesus incompatibility.

43
Q

What proportion of pregnancies involve rhesus incompatibility?

A

10%.

44
Q

List 4 signs of haemolytic disease of the newborn.

A

1 - Haemolysis.

2 - Jaundice.

3 - Swollen liver.

4 - Liver failure.

45
Q

How is neonatal lupus caused?

A

When maternal IgG antibodies cross the placenta and attack the myocardial conduction system.

46
Q

List 3 signs and symptoms of neonatal lupus.

A

1 - Skin rash.

2 - Hepatitis.

3 - Thrombocytopenia.

47
Q

List 3 signs of transplacental toxoplasmosis (a parasitic disease).

A

1 - Chorioretinitis (inflammation of the choroid and retina).

2 - Intracranial calcifications.

3 - Hydrocephalus.

48
Q

List 5 signs of transplacental rubella infection.

A

1 - Deafness.

2 - Cataracts.

3 - Heart defects.

4 - Intellectual disabilities.

5 - Liver damage.

49
Q

List 3 signs of transplacental cytomegalovirus infection.

A

1 - Low birth weight.

2 - Jaundice.

3 - Enlarged liver.

50
Q

List 3 immune characteristics of breast milk.

A

1 - Antimicrobial.

2 - Anti-inflammatory.

3 - Immune-modulatory.

51
Q

List 3 antibodies that are transferred in breast milk.

A

1 - IgG.

2 - IgA.

3 - IgM.

52
Q

Give an example of a bactericidal protein that is transferred in breast milk.

A

Lactoferrin.

IIH (26 decks)

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