TOPIC 2 - P2 Flashcards
(IMMUNE RESPONSE) latency, preseroconversion, or window period: ________
lag phase
(IMMUNE RESPONSE) antibody cannot be detected with __________
serologic testing
(IMMUNE RESPONSE) ________ are very active in processing antigen and initiating the primary response to the antigen
T and B cells
primary antibodies: __________________
immunoglobulin M (IgM) subclass
immune maturation, primary antibodies..
there is a period when it overlaps with the production of _________ at the beginning of the ___________
IgG antibodies ; secondary response
Many of the antigens that stimulate the primary response have multiple repeating _______ (polysaccharides) and therefore are good immune stimulators at lower concentrations
epitopes
secondary response antibodies: _____________________
immunoglobulin G (IgG) subclass
immune maturation, secondary response antibodies…
made in great quantities have a _______ for antigen and can be produced by much __________ of antigen
higher avidity ; lower concentrations
immune maturation, secondary response antibodies…
can usually be measured within __ to __ days
1 to 2
(IMMUNE MATURATION) After the antigen is cleared, ______ are stored in immune organs of the host
memory cells
Cell Lineages and Markers..
________: classified by complex in vitro testing using monoclonal antibodies
CD markers
specify cellular definitions and functions, including maturation levels and lineage specificity
CD markers
CELL LINEAGES AND MARKERS..
All immune cells originate from ___________ (CD34-positive cells)
pluripotent hematopoietic progenitors
CELL LINEAGES AND MARKERS
________ are responsible for differentiating and maturing stem cells into the many different cells of the IS
growth factors
allow progenitor stem cells to reproduce and differentiate
growth factors
____ part of the antibody receptor and the complement receptor ____ are used by phagocytes during opsonization
FC ; CR1
_____ all have granules in their cytoplasm (neutral/ basic/acidic)
Granulocytes
granulocytes main role: _______; function primarily in ___________-
phagocytosis ; acute inflammatory responses
granulocytes have ______ that allow them to destroy engulfed pathogens
enzymes
possess receptors for the Fc portion of _____ and complement receptors _____, ______ and ______
IgG (CD16) ; C5a, CR1(CD35), and CR3(CD11b)
_______ process antigens for acquired immunity and can directly kill many pathogens such as bacteria and fungi as part of innate immunity
Phagocytic cells
_________ present antigen to lymphocytes and interact with other immune cells via cell membrane receptors_
MPS cells
monocytes encounter antigen, they can differentiate into ________
tissue macrophages
________ possess low-affinity Fc receptors for IgE and therefore play a critical role in allergic reactions and inflammation in parasitic infections
eosinophils
_________ and _______ (a type of tissue basophil) possess high-affinity FC immunoglobulin E (IgE) receptors, are powerful effectors of inflammation and allergic reactions, and can cause the release of localized histamine
Basophils and mast cells ;
__________ are generated in the thymus or bone marrow
Lymphocytic cells
acquire ______ that enable them to interact with antigens and to differentiate between __________ antigens, a very critical part of lymphocyte maturation and the acquired IS in general
receptors ; self and nonself
Then travel through the circulatory system to the ________ and _______, where they mature and differentiate
lymph nodes and spleen
Provided with a _________ environment in which immune responses are exchanged and made specific
highly interactive
___ and ___ cells, and these similar-looking cells can be distinguished by the presence of specific cell markers
T and B
cell lineages and markers.
Specific to the ____
T cell
__________: in proximity to and usually identified with the CD3 complex
T-cell receptor (TCR)
TCR associates in cell-to-cell contacts and interacts with both _______ and _________
antigenic determinants and MHC proteins
_____ and _____: involved in cell adhesion
CD2 & CD3 marker
_____: has the unique ability to bind with sheep erythrocytes in vitro
CD2
_______: Th cells; recognize antigen together with the MHC class II molecules
CD4 marker
________: Tc cells and interact with MHC class I molecules
CD8 marker
______ is a reversal of the typical CD4 to CD8 ratio
AIDS
________: can stimulate multiple T cells, causing them to release large amounts of cytokines; can lead to lethal reactions in the host if the immune system is overstimulated
superantigens
_____: possess MHC class II antigens (antigen presentation), complement receptors CD35 and CD21; FC receptors for IgG
B cells
CD markers used to identify B cells: _____, _____ and ______
CD19, CD20, and CD22 markers
__________ may act as an antigen receptor for binding simple structural antigens or antigens with multiple repeating determinants (referred to as T cell–independent antigens, meaning they do not require the intervention of T-cell help)
Membrane-bound immunoglobulin
When _____ become activated, they mature and develop into plasma cells
B cells
______, are sometimes referred to as third population cells; also referred to as large granular lymphocytes
NK cells
NK cells do not have ______ or do they have _____
surface Ig ; antigen receptors
NK cells have the _____ and _____ markers
CD56 and CD16
NK cells are ______-independent and are able to lyse virally infected cells and tumor cells directly in a process known as ________________ by anchoring immunoglobulin to the cell surface membrane through an FC receptor
thymus ; antibody-dependent cell mediated cytotoxicity (ADCC)
_____ are soluble protein or peptide molecules that function as powerful mediators of the immune response
Cytokines
Cytokines function in a complex manner by _________, _______, and differentiation of _______.
regulating growth ; mobility ; leukocytes
One cytokine may act by _____ or together with other cytokines.
itself
Other cytokines oppose the actions of one or more cytokines and function to quantitatively increase or decrease a particular _______
immune reaction
Some cytokines are ______ and need each other to have their full effect
synergistic
The effects of cytokines can be in the _______ of their release, or they can travel through the ____ to affect distant cells and tissues
immediate area ; plasma
(CYTOKINES AND IMMUNOREGULATORY MOLECULES) Major classes: ________, _______, _______ and ______
interleukins (IL), interferons (IFN), tumor necrosis factors (TNF), and colony stimulating factors (CSF)
_____ act by binding to specific target cell receptors.
Then, the number of receptors is often _____ as the cell is stimulated.
Cytokines ; increased
both the receptor and the cytokine become internalized, which induces the target cell to _________ and _______.
grow and differentiate
Immune cells and other host cells respond to cytokines and can react with __________, as well as _______, ______, and _________
chemoattraction ; antiviral, antiproliferation, and immunomodulation processes.
Cytokines fine-tune the IS and also function as ___________
typically communicate between cells through the _____
critical cell activators ; plasma
______ are attractant molecules that interact between cells, immunoglobulins, and complement proteins and are important in destroying pathogens
Chemokines
__________ and __________ play a role in inflammation, a process that recruits appropriate cells to an immune site and modifies the vascular system
Acute phase proteins and fibrinolytic proteins
some cytokines are _____________
immunosuppressive
(Immune System Genetics) not all transfusion recipients make ________ to alloantigens on transfused RBCs
antibodies
(Immune System Genetics) ________: people who have a tendency based on their inheritance to make antibodies
Responders
(Immune System Genetics) ________ and _______ describe individual responses to antigen challenges
high responders and low responders
(Immune System Genetics) ________ is the region of the genome that encodes the human leukocyte antigen (HLA) proteins
major histocompatibility complex (MHC)
(Immune System Genetics) critical in ______ and ___________ in cell-to-cell interactions, transplantation, paternity testing, and specific HLA patterns
immune recognition and regulation of antigen presentation
Class I molecules are found on all nucleated cells except _____
play a key role in __________ function
trophoblasts ; cytotoxic T-cell
________ are found on antigen-presenting cells
Class II molecules
Class II molecules on APCs are essential for presenting processed antigen to _____ and are necessary for ______ and _______
CD4 T cells ; T-cell functions and B-cell help
Class III molecules that encode complement components such as ___, ____, and ______
C2, C4, and factor B
_____ aka antibody
Immunoglobulins
complex protein with specificity to antigens (or immunogens) that stimulate their production
Immunoglobulins
bind antigen, fix complement, facilitate phagocytosis, and neutralize toxic substances in the circulation
Immunoglobulins
Characteristics of Immunoglobulins
_____: most concentrated in serum approximately 80% of the total serum Ig;
IgG
Characteristics of Immunoglobulins…
___, at about 13% (although it is the major Ig found in body secretions)
IgA
Characteristics of Immunoglobulins
___ is 6%;
IgM
Characteristics of Immunoglobulins
IgD is ___
1%
Characteristics of Immunoglobulins
____ is the least common
IgE
WHAT IMMUNOGLOBULIN IS..
Heavy Chain Type: Alpha
Sedimentation Coefficient: 7 to 15*
Molecular Weight: 160 to 500
Biologic half-life: 5.8
Carbohydrate content: 7.5 to 9
Placental transfer: No
Complement fixation: No
Agglutination in saline: +
Heavy chain allotypes: Am
Proportion of total immunoglobulin: 13
IgA
WHAT IMMUNOGLOBULIN IS..
Heavy Chain Type: Delta
Sedimentation Coefficient: 7
Molecular Weight: 180
Biologic half-life: 2.8
Carbohydrate content: 10 to 13
Placental transfer: No
Complement fixation: No
Agglutination in saline: 0
Heavy chain allotypes: None
Proportion of total immunoglobulin: 1
IgD
WHAT IMMUNOGLOBULIN IS..
Heavy Chain Type: Epsilon
Sedimentation Coefficient: 8
Molecular Weight: 196
Biologic half-life: 2.3
Carbohydrate content: 11 to 12
Placental transfer: No
Complement fixation: No
Agglutination in saline: 0
Heavy chain allotypes: None
Proportion of total immunoglobulin: 0.002
IgE
WHAT IMMUNOGLOBULIN IS..
Heavy Chain Type: Gamma
Sedimentation Coefficient: 6.7
Molecular Weight: 150
Biologic half-life: 21
Carbohydrate content: 2.2 to 3.5
Placental transfer: Yes
Complement fixation: +
Agglutination in saline: ±
Heavy chain allotypes: Gm
Proportion of total immunoglobulin: 80
IgG
WHAT IMMUNOGLOBULIN IS..
Heavy Chain Type: Mu
Sedimentation Coefficient: 19
Molecular Weight: 900
Biologic half-life: 5.1
Carbohydrate content: 7 to 14
Placental transfer: No
Complement fixation: +++
Agglutination in saline: ++++
Heavy chain allotypes: None
Proportion of total immunoglobulin: 6
IgM
___, ___, and ___ have the most significance for the blood bank
IgG, IgM, and IgA
Most clinically significant antibodies that react at body temperature (37°C) are ____ and capable of destroying transfused antigen-positive RBCs, causing ____ and ______
IgG isotype ; anemia and transfusion reactions
______ are most commonly encountered as naturally occurring antibodies in the ABO system that react best at _____
IgM antibodies ; ambient temperature (22°C to 24°C)
IgG antibodies are important in _______, because antibodies can be formed in response against alloantigens on fetal RBCs that enter the mother’s circulation, usually during delivery
hemolytic disease of the newborn (HDN)
____ is important in immunohematology: ____ of anti-A and anti-B antibodies
IgA ; 30%
anti-IgA antibodies can cause severe ______ if IgA are transfused in plasma products to patients who are deficient in IgA
anaphylaxis
IgA can increase the effect of ________-
IgG-induced RBC hemolysis
_____: important in allergic reactions
IgE
(IgE) FC portion of the IgE molecule attaches to _____ and ______ and facilitates histamine release when an allergen binds to the Fab portion of the molecule
basophils and mast cells
(IgE) ______ is critical for bringing about an allergic reaction
Histamine
BIOLOGICAL PROPERTIES OF IgG SUBCLASSES
Proportion of total serum IgG (%): 65 to 70
Complement Fixation: ++
Binding to macrophage Fc receptors: +++
Ability to cross placenta: +
dominant antibody activities
Anti Rh: ++
Anti-factor VII: 0
Anti-dextran: 0
Anti-kell: +
Anti-duffy: +
Anti-platelet: 0
Biological half-life (days): 21
IgG1
BIOLOGICAL PROPERTIES OF IgG SUBCLASSES
Proportion of total serum IgG (%): 23 to 28
Complement Fixation: +
Binding to macrophage Fc receptors: ++
Ability to cross placenta: ±
dominant antibody activities
Anti Rh: 0
Anti-factor VII: 0
Anti-dextran: +
Anti-kell: 0
Anti-duffy: 0
Anti-platelet: 0
Biological half-life (days): 21
IgG2
BIOLOGICAL PROPERTIES OF IgG SUBCLASSES
Proportion of total serum IgG (%): 4 to 7
Complement Fixation: +++
Binding to macrophage Fc receptors: +
Ability to cross placenta: +
dominant antibody activities
Anti Rh: +
Anti-factor VII: 0
Anti-dextran: 0
Anti-kell: 0
Anti-duffy: 0
Anti-platelet: +
Biological half-life (days): 7 to 8
IgG3
BIOLOGICAL PROPERTIES OF IgG SUBCLASSES
Proportion of total serum IgG (%): 3 to 4
Complement Fixation: 0
Binding to macrophage Fc receptors: ±
Ability to cross placenta: +
dominant antibody activities
Anti Rh: ±
Anti-factor VII: +
Anti-dextran: 0
Anti-kell: 0
Anti-duffy: 0
Anti-platelet: 0
Biological half-life (days): 21
IgG4
_____ have functions that deal primarily with maturation of B cells into plasma cells usually bound to the membrane of ______
IgD ; immature B cells
IMMUNOGLOBULIN VARIATIONS…
______ refers to variants present in all members of a species, including the different heavy and light chains and the different subclasses
Isotype variation
IMMUNOGLOBULIN VARIATIONS…
______ is present primarily in the constant region; not all variants occur in all members of a species
can occur during ______, from multiple transfusions of blood
Allotypic variation ; pregnancy
IMMUNOGLOBULIN VARIATIONS…
_____ determines the antigen-binding specificity of antibodies and T-cell receptors
Idiotypic variation
found only in the variable (and hypervariable) regions and is specific for each antibody molecule
Idiotypic variation
can be seen as nonself because they are often present at concentrations too low to induce self-tolerance
Idiotypic variation
(Characteristics of Antigens)
- _____ (initiates formation of and reacts with an antibody)
antigen
(Characteristics of Antigens)
- ______ (initiates an immune response)
immunogen
(Characteristics of Antigens)
- Properties such as _____, _____, _____, _____, ______, ______, _______, and _________ influence the amount and type of immune response
size, complexity, conformation, charge, accessibility, solubility, digestibility, and biochemical composition
(Characteristics of Antigens)
- proteins (___, ____, and ____ blood group substances)
Rh, M, and N
(Characteristics of Antigens)
- _____ (ABH, Lewis, Ii, and P blood group substances)
glycolipids
(Characteristics of Antigens)
- Human leukocyte antigens (HLAs) are ______
glycoproteins
(Characteristics of Blood Group Antibodies)
it is the _____ and not the entire antigen that a B cell is stimulated to produce antibody against
epitopes
(Characteristics of Blood Group Antibodies)
_________: produced in response to a single antigen with more than one epitope
needed to give immunity against an entire antigen, such as a ________
polyclonal or serum antibodies ; pathogen
(Characteristics of Blood Group Antibodies)
__________ produced by isolating individual B cells from a polyclonal population and propagating them in cell culture with hybridoma technology
monoclonal antibodies
monoclonal antibodies are preferred in testing because they are _______, _______ and _________
highly specific, well characterized, and uniformly reactive
___________ considered naturally occurring when they are found in the serum of individuals who have never been previously exposed to RBC antigens by transfusion, injection, or pregnancy
(Naturally Occurring) RBC antibodies
The common occurrence of naturally occurring antibodies suggests that their antigens are widely found in _______ and have a ______ pattern.
nature ; repetitive complex
Most naturally occurring antibodies are _________, which react best at room temperature or lower, activate complement, and may be hemolytic when active at 37°C
IgM cold agglutinins
In blood banking, the common naturally occurring antibodies react with antigens of the _____, ____, ___, ___, ___, and __ blood group systems.
ABH, Hh, Ii, Lewis, MN, and P
RBC antibodies are considered ______ when found in the serum of individuals who have been transfused or who are pregnant.
immune
IMMUNE ANTIBODIES
- have a _______ that is unique to human RBCs
- ____ antibodies
- require the use of ________ for detection
- react with the _____, ____, ____, ____, and ___ blood group systems
- molecular makeup
- IgG
- antihuman globulin sera (Coombs’ sera)
- Rh, Kell, Duffy, Kidd, and Ss
(Unexpected Antibodies)
All other antibodies directed against RBC antigen are considered _______ and must be detected and identified before blood can be safely transfused
unexpected
(Unexpected Antibodies)
either isotype ___ or ____; rarely, both may be present
IgM or IgG
(Unexpected Antibodies)
in vitro analysis of unexpected antibodies involves the use of ___________ to optimize antigen-antibody reactions
antibody screening procedures
(Antibody Properties)
______, which is used to express the binding strength of a multivalent antigen with antisera produced in an immunized individual
avidity
(Antibody Properties)
The _______ of an antiserum (or antibody) is one of its most important characteristics and is related to its relative avidity for antigen.
specificity
(Antibody Properties)
______; it is often defined as the strength of a single antigen-antibody bond produced by the summation of attractive and repulsive forces
affinity
(Antibody Properties)
A specific reaction implies reaction between ______.
similar epitopes
(Antibody Properties)
A ______ results when certain epitopes of one antigen are shared by another antigen and the same antibody can react with both antigens.
cross-reaction
(Antibody Properties)
No reaction occurs when there are no _______.
shared epitopes
lack of an immune response or an active immunosuppressive response
Tolerance
______ to an antigen during fetal life usually produces tolerance to that antigen
Exposure