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Blood and Lymph Mine > Unit 3 Immunology > Flashcards

Unit 3 Immunology Flashcards

1
Q

ADCC

A
  • HIV elite controllers may have strong ADCC response
  • in ADCC, Fcgamma receptor on NK cells binds Fc region of IgG antibody that is bound to target cell, NK cell then induces apoptosis
  • is not related to MHC the way CTL is
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2
Q

NK Cells

A
  • cell of innate immune system
  • can attack cells and directly induce apoptosis
  • ADCC also
  • is not MHC related the way CTL is
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3
Q

Flow Cytometry

A
  • test for T cell number and function
  • shows graph of CD4+ vs C8+ cells
  • lasers used to illuminated cells in single file line and quantify them
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4
Q

Test for B Cell Function

A
  • serum protein electrophoresis
  • serum run on gel and stained for protein
  • results show graph with peaks with normal gammaglobulin showing soft peak on right side
  • big, wide peak is polyclonal hypergammaglobulinemia
  • big, narrow peak is monoclonal hypergammaglobulinema (multiple myeloma)
  • no peak is agammaglobulinemia
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5
Q

Test to measure individual immunoglobulin classes or subclasses

A
  • single radial immunodiffusion

- results appear in circles that can be measured

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6
Q

Test for T Cell Function

A
  • skin test

- chest x ray in infants might be helpful to check for thymus (looks like heart)

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7
Q

Tests for Autoimmune Diseases

A
  • antinuclear antibodies
  • rheumatoid factor
  • immune complexes
  • immunofluorescence
  • immunohistochemistry
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8
Q

Tests for Specific Antibody

A
  • precipitation
  • simple ELISA (indirect only)
  • passive agglutination
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9
Q

Tests for Measuring Antigens

A
  • direct ELISA
  • capture ELISA
  • rapid screens
  • reverse passive agglutination
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10
Q

Monoclonal Antibodies

A
  • B cell mixed combined with myeloma cell that produce antibodies to certain inflammatory elements
  • murine (mouse) -omab
  • chimeric (mouse VL and VH domains only) -ximab
  • humanized (mouse CDR only) -zumab
  • human (made in SCID mouse with human organs) -umab
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11
Q

Biological Response Modifiers (BRMs)

A

-some are growth factors that can be used in bone marrow transplant to increase new bone marrow growth

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12
Q

Bispecific T Cell Engager (BiTE)

A

-antibodies (CD19 and CD3) that are coupled together via engineering to bring CTL cell together with B lymphoma cell

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13
Q

Chimerica Antigen Receptor (CAR)

A
  • antibody to CDR of target cell that is attached to antibody for CD3 CTL cell surface molecule
  • no MHC restriction
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14
Q

Passive Antibody Therapy in Cancer

A
  • attach antibody to cancer cell to toxin or T cell

- this allows specific targeting of cancer cells for treatment

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15
Q

ABO (and bombay) Blood Types

A
  • O>A>B>AB
  • bombay- lacks transferase to add final sugar to core, so these people do not express their blood types and appear O
  • bombay can only receive blood from bombay
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16
Q

isohemaglutinins

A
  • IgM antibody to other blood types

- exposed to antigens in environment and do not need to be exposed to other blood types to have reaction

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17
Q

crossmatch test

A
  • done before blood transfusion to test for antibody in recipient to antigens in donor blood
  • donor cells are suspended in saline and plasma of recipient is added
  • mixture is centrifuged and supernatant is checked for redness (hemolysis)
  • pellet is then resuspended and checked for clumps
  • if either test is positive, blood is not used
18
Q

Coomb’s Test (indirect vs direct)

A
  • antiglobulin test (tests for presence of antibody)
  • ex. autoimmune hemolytic anemia
  • direct- is there antibody present on cells that I am interested in? Add antiglobulin to pt’s cells.

-indirect- is there unexpected antibody to donor RBCs in plasma of recipient? Add antiglobulin to mixture of donor’s cells and recipient’s plasma.

19
Q

heterphile antibody

A
  • antibody to disease also happens to bind to another antibody
  • cross reactive antibodies
  • can test for mono or syphilis
20
Q

Hemolytic Disease of Newborn

A
  • severe disease causes high bilirubin that can cross blood brain barrier and lead to brain disease or death
  • sensitization occurs in mother during pregnancy where fetus is Rh+ and mother is Rh-
  • mother then makes IgG than can cross placenta in future pregnancies
  • RhoGAM is IgG to Rh(D) and opsonizes Rh(D) in mother’s blood stream and destroys them before mother can develop response
21
Q

ABO hemolytic disease of newborn

A
  • when mother makes IgG instead of IgM to ABO antigens
  • this can cross placenta and cause disease
  • no treatment available
22
Q

passive aggluination

A
  • serial dilutions of serum (antibodies) mixed with antigen
  • can measure titer amount
  • uses beads to normalize antigen size
23
Q

HIV

A
  • affects Th CD4 cells
  • must be below 200 to have AIDS
  • HIV type 1 is more prevalent than type 2
  • lentivirus- slow progression that leads to death
  • virus from chimps (M), and gorillas (O) and brought to US likely from sex travel in Haiti
  • 35 million people in world have HIV
  • In US, 1,100,000 have HIV, 16% don’t know they have it
  • incidence dec. 33% since 2001
  • virus gp120 binds to CD4 on T cells, causing conformational change in gp120 that puts it in contact with CCR5 (on T cell)
  • second conformational change so that gp41 is exposed on HIV that pokes through T cell membrane and virus enters cells
  • cells infected with HIV can lyse quickly, become chronic, or become latent
  • chronic viral producers have gp120/gp41 on surface and can fuse with other non infected cells, rendering antibodies useless
  • latency is in Tfh cells in lymph node that can suppress DNA replication but cannot get rid of DNA from nucleus
  • pts eventually stop making more T cells
    dx: with ELISA and confirm with western blot
24
Q

Infections Seen in HIV Patients

A

-Candida albicans
-Pneumocystis jirovecii
-Protozoan infections
-CMV
-hepatitis
-HSV
-VZV
TB
-kaposies sarcoma
-T cell mediated diseases

25
Q

HIV long term survivor

A
  • mutation in CCR5 (homozygous delta 32) on Th (CD4) cells

- mutation means no CCR5 receptor is present for HIV to bind to to enter cells

26
Q

HIV elite controller

A
  • associated with HLAB57
  • esp. good at presenting HIV on MHCs
  • infected with HIV but do not progress to AIDS
  • ADCC or CTL response is strong
27
Q

Good Target for HIV Vaccine

A

-target gp120 or gp41 because these portions cannot mutate to maintain function of viruses

28
Q

Immune Surveillance Theory

A
  • T cells and other immune cells may suppress cancer cells

- confirmed by research- immunosuppressed pts have more cancer

29
Q

Immunoediting

A
  • appear to not have tumor, but really have latent tumor cells
  • elimination- immune system attacks cancer or cancer cells die due to overproliferation
  • equilibrium- immune system kills most cancer cells but not all, some survive for many years
  • escape- cancer cells mutate to resist immune system (CTLA-4 and PD1 checkpoint receptors on CTLs are engaged by cancer cells)
  • autoantibodies can be made to block these receptors and prevent activation by tumor cells (PD1= nivolumab, CTLA4= ipilimumab)
30
Q

Tumor Associated Antigens (TAA)

A
  • could be normal but overexpressed
  • could be mutated
  • tumor rejection antigens are subclass
31
Q

Tumor Rejection Antigens (TRA)

A

-subclass of tumor associated antigens that are recognized by immune system and allow us to attack tumor

32
Q

Carcinoembryonic Antigen (CEA)

A
  • normally expressed in bowel of fetus that is also on in colon cancer
  • NOT used as routine screening
  • can use in high index of suspicion or to track dec. levels after resection
33
Q

CTL and Cancer

A
  • recognize TAA on tumor cell MHC and kill tumor cell

- respond when there is high rate of MHC response

34
Q

Th1 and Cancer

A
  • Th1 cells normally recruit M1 macrophages to kill

- cancer cells create environment that is M2 friendly, and this causes tumor growth

35
Q

NK and Cancer

A
  • not MHC dependent
  • can kill via direct binding or ADCC
  • as tumor cells decrease MCH expression, NK cells become more crucial to response
36
Q

Innocent Bystander Killing of Tumor

A
  • inject BCG (TB shot) directly into tumor and T cells respond
  • T cells then also damage surrounding tumor cells
37
Q

Antibody Therapy to Cancer

A
  • attach antibody to toxin or NK cell or radioisotope and target antibody to specifically bind cancer cells
  • costly
38
Q

Adoptive Cellular Transfer Therapy

A
  • tumor infiltrating lymphocytes (TIL) and immune cells that can attack tumor cells are taken from patient and grown in culture
  • pt is immunosuppressed and cells are injected back into patient to kill tumor cells
39
Q

Herceptin

A 
Monoclonal antibody (humanized) that targets HER2
-treats cancer
40
Q

Simple ELISA

A

-tests for antibody

41
Q

Capture ELISA

A
  • tests for antigen

- antigen must have at least two epitopes

Blood and Lymph Mine (7 decks)

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