Transplant immunology Flashcards

1
Q

What are the organs of the immune system?

A

Lymph nodes
Spleen
Thymus

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2
Q

What does MHA stand for?

A

Major histocompatibility antigen

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3
Q

What does MHC stand for?

A

Major histocompatibility complex

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4
Q

What is MHC?

A

A set of cell surface proteins essential for the adaptive immune system to recognise foreign molecules in vertebrates, which in turn determines histocompatibility.

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5
Q

What does HLA stand for?

A

Human Leucocyte Antigen

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6
Q

What is HLA?

A

Another name for MHC

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7
Q

What do MH proteins do?

A

They take samples from within infected cells to present on the cell surface so that T cells can see that the cell is infected.

Once they see this they can trigger the correct immune response

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8
Q

What are the two classes of MHC?

A

MHC I

MHC II

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9
Q

Which class of MHC displays antigens to CD8+ve cells?

A

MHC I

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10
Q

Which class of MHC displays antigens to CD4+ve cells?

A

MHC II

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11
Q

Which cells do MHC I present antigens to?

A

CD8+ve

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12
Q

Which cells do MHC II present antigens to?

A

CD4+ve

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13
Q

What are CD8+ve cells?

A

Cytotoxic T cells

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14
Q

What are CD4+ve cells?

A

T helper cells

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15
Q

What happens when an MHC protein presents an antigen to a T cell?

A

The T cell recognises a peptide bound to the MHC which activates the T cell

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16
Q

What do activated CD8+ve cells do?

A

T cytotoxic cells

Induce apoptosis of infected cell

17
Q

What do activated CD4+ve cells do?

A

T helper cells

They help B cells make antibodies and produce cytokines

18
Q

What do B cells do when they come across the transplanted organ? (if immunosuppressants were not being taken)

A

They internalise the non-self antigens on the transplanted cells and present them to the T cells

They also form immunological memory against these antigens

19
Q

What do you need to ensure is matched before doing an organ transplant?

A

Blood group

MHC/HLA

20
Q

What is cytotoxicity?

A

Killing/damaging/attacking the graft

21
Q

List the responses that will occur against the transplant antigen.
(if immunosuppressants were not being taken)

A
  1. Innate immune response
  2. T cell mediated cytotoxicity
  3. Antibody mediated cytotoxicity
  4. ADCC
  5. Delayed type hypersensitivity
22
Q

What is ADCC?

A

Antibody dependent cell-mediated cytotoxicity

Target cell is coated with antibody

Lymphocytes and lyse the antibody coated pathogen via the Fc regions binding with Fc receptors

Generally mediated by natural killer cells, but monocytes and eosinophils can also mediate ADCC

23
Q

What are the 3 types of rejection?

A
  1. Hyperacute rejection
  2. Acute rejection
  3. Chronic rejection
24
Q

In what cases would Hyperacute rejection take place? Why?

A

In ABO incompatibility and xeno-transplant

Because the person has pre-formed antibodies against the antigens in the graft

25
Q

How quickly does Hyperacute rejection occur?

A

5 minutes after transplant

26
Q

What does Hyperacute rejection do to the organ?

A

Damage and necrosis of tissue/organ

27
Q

Which part of the immune system causes Hyperacute rejection?

A

Complement system

28
Q

Why does acute rejection occur?

A

T cell mediated cytotoxicity: lymphocytes working against the MHC of the donor graft

Antibody mediated cytotoxicity

29
Q

How quickly does acute rejection occur?

A

Weeks to months after transplant

30
Q

What are the symptoms of acute rejection?

A

Fever
Graft tenderness
Declining renal function

31
Q

How quickly does chronic rejection occur?

A

6 months post transplant

32
Q

What are the symptoms of chronic rejection?

A

Progressive renal failure:

proteinuria & hypertension