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Immuno Exam 3 > Transplantation Lecture > Flashcards

Transplantation Lecture Flashcards

1
Q

list the 3 problems with organ transplantation

A
  • transplant must be able to maintain normal function
  • health of recipient and transplant must be maintained during surgery
  • the recipient’s immune system must be prevented from responding to the transplant causing rejection
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2
Q

What is autologous transplantation

A

when stem cells are from the patients own body

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3
Q

What is allogeneic transplantation

A

When stem cells are taken from donor to recipient

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4
Q

In order for allogenic transplantation to be successful both donor and recipient must be

A

histocompatible

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5
Q

What does it mean to be histocompatible

A

the donor and recipient have compatible tissue types and can coexist without provoking a strong immune response

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6
Q

Serum of blood group O people have which class of antibodies against A and B antigens

A

IgG

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7
Q 
ABO antigens are present on 
A. Kidneys
B. Erythrocytes
C. Endothelial Cells of blood vessels
D. All of the above
A

D: all of the above

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8
Q

Describe how hyperacute rejection occurs

A

Incompatible tissue between donor and recipient results recipient antibodies that bind the blood vessels of the graft(donor antigen), complement if fixated throughout the vasculature

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9
Q

What procedures can avoid hyperacute rejection

A
  • typing

- cross matching for ABO

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10
Q

Antibodies against donor blood group antigens bind vascular endothelium of graft initiating an inflammatory response that occludes blood vessels describes which process?

A. Acute Rejection
B. Hyperacute Rejection
C. Histocompatibility
D. Graft Versus Host Disease

A

B

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11
Q

Hyperacute rejection is

A. Slow
B. Rapid

A

B

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12
Q

Blood antigen Incompatibility can cause type __ hypersensitivity

A

II

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13
Q

what type of rejection is the most devastating rejection of organs

A

hyperacute

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14
Q

Where and when is HLA I expressed

A

vascular endothelium, constitutively

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15
Q

Where and when is HLA II expressed

A

vascular endothelium when there is infection, inflammation and trauma

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16
Q

What are alloantigens

A

self antigen that vary between members of the same species

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17
Q

Alloreactions are

A

immune responses induced by alloantigens

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18
Q

What is immunogenetics

A

the study of genetics of alloantigens and the impact on the immune system

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19
Q

What are the two types of alloreactions

A
  1. transplant rejection

2. graft versus host disease

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20
Q

What is an autograft

A

when tissue is transplanted from donor to recipient

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21
Q

When tissue or organ is grafted and transferred from one person to another who is genetically identical that is called.

A. Allograft
B. Xenograft
C. Isograft
D. Autograft

A

C

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22
Q

When donor and recipient are of different species, this type of transplant is called

A. Allograft
B. Xenograft
C. Isograft
D. Autograft

A

B

23
Q

What are the effects of hemolytic reactions

A
  • fever
  • chills
  • shock
  • renal failure
  • death
24
Q

HLA class I antibodies react with

A

B cells and T cells

25
Q

HLA class II antibodies react with ____ cells

A

B

26
Q

What are the 3 general steps of hematopoietic stem cells transplantatoin

A
  1. irradiation and chemotherapy to clear recipient stem cells making space for donor cells
  2. hematopoietic cell infusion
  3. patient is healthy
27
Q

What cells are responding in graft vs host disease?

A

T cells

28
Q

Describe what generally happens in Graft Versus Host Disease

A

The donor T cells in the graft attack the recipients healthy tissue

29
Q

What is an autograft?

A

when a patients tissue is transplanted from one area to another

30
Q

What is an isograft?

A

an syngeneic transplant: a transplant between two genetically identical individuals

31
Q

Acute rejection is a type __ hypersensitivity

A

4

32
Q

____ T cells respond to HLA class _

A

CD8, 1

33
Q

_____ T cells respond to HLA class ___

A

CD4, 2

34
Q

Inflamed state of transplanted organ induces

A. Recipient T cells to migrate to secondary lymphoid tissue
B. Donor derived T cells to migrate to secondary lymphoid tissue
C. Donor Derived Dendritic cells to migrate to secondary lymphoid tissue
D. Recipient dendritic cells to migrate to secondary lymphoid tissue

A

C

35
Q

Donor derived dendritic cells present

A. Donor derived antigen to recipient T cells
B. Donor Derived antigen to recipient macrophages
C. Recipient antigen to other donor dendritic cells
D. Recipient antigen to donor B cells

A

A

*slide 16

36
Q

Describe what happens in the direct pathway of allorecognition

A

Recipient T cells are stimulated by a direct interaction between their receptors with allogenic HLA molecules expressed by DONOR cells

37
Q

In the direct path of allorecognition, _____ T cells are stimulated by _____ dendritic cells

A

recipient, donor

38
Q

Describe the direct pathway of allorecognition

A

Donor dendritic cells from transplant activate recipient T cells that go back to the transplant and damage the epithelial cells of the transplant

39
Q

What is used to treat chronic rejection

A

Anti B cell antibody (rituximab)

40
Q

____ antibodies against HLA I form immune complexes that deposit in blood vessels of transplanted organ occurs in _____ rejection

A

IgG, Chronic

41
Q

What is the function of Anti CD52

A

it binds leukocytes and activates complement on the cell to destroy it in preparation for organ transplant to prevent it from initiating an immune response

42
Q

Calcium influx during T cell activation results in the activation of

A. cyclosporin
B. NFAT
C. Tacrolimus
D. Calcineurin

A

D

43
Q

What is calcineurin

A

a phosphatase that activates NFAT

44
Q

What is the role of NFAT in T cell activation

A

it binds AP-1 to form an active transcription factor

45
Q

How does cyclosporin act?

A

it binds calcineurin preventing the binding of NFAT to AP-1 thus inhibiting IL-2 transcription

46
Q

Belatacept binds_____ and prevents engagement of CD28

A

B7

47
Q

Antibodies that bind to pig endothelial cells

A

Xenoantibodies

48
Q

What is the function of belatacept?

A

A drug that binds B7 and prevents B7:CD28 engagement thus preventing the co-stimulatory signal

49
Q

T/F: Anti CD25 engages the low affinity IL-2 receptor ON naive alloreactive T cells

A

False, binds the HIGH affinity IL-2 receptor on ACTIVATED T cells

50
Q

What is the function of Anti CD25

A

to bind high affinity IL-2 receptor on active T cells and prevent the generation of signal 3 of activation of cyclin D

51
Q

Where are the targets for immunosuppressive drugs

A
  1. MHC and TCR binding
  2. B7 and CD28 costimulatory signal
  3. Anti-CD52 to initiate complement on T cell
  4. Calcineurin via Cyclosporin to prevent NFAT activation and blocking IL-2 Transcription
  5. Anti-CD25 to block the IL-2 receptor
52
Q

What is myeloblative therapy?

A

a procedure that cripples the patients immune system and creates space for donor cells

53
Q

The allogenic difference in minor histocompatibility H-Y antigens is due to

A

the bound peptide NOT the MHC molecule

54
Q

What gives rise to minor histocompatibility antigen differences between donor and recipient?

A

polymorphic self proteins that differ sin amino acid sequence between people

Immuno Exam 3 (5 decks)

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