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Week 2 Flashcards

1
Q

Infection, chemo, steroids, malignancy and malnutrition all cause what type of immune deficiency?

A

Secondary immune defic

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2
Q

Define granuloma

A

Organised collection of activated macrophages and T lymphocytes
- non spec inflam response triggered by antigens or foreign materials

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3
Q

Result of failure of removal of stimulus on granuloma

A

Persistent production of activated cytokines
End result is organised collection of persistently activated cells

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4
Q

Causes of lung granuloma

A

Sarcoidosis
Mycobacterial disease, e.g. Tuberculosis, leprosy
Leprosy (some forms)
Berylliosis, silicosis and other dust diseases
Chronic stage of hypersensitivity pneumonitis
Foreign bodies

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5
Q

How might an antibody deficiency present?

A

recurrent bacterial infection
- e.g. URTI, GI
antibody mediated AI disease
- ITP, AHA

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6
Q

Give an example of primary antibody deficiency

A

Common variable immune deficiency (CVID)
- Low IgG, IgA and IgM

Selective IgA deficiency
- Most people are asymptomatic

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7
Q

DDx of recurrent bacterial infection

A

Antibody deficiency

Secondary causes
- protein loss e.g. nephrotic syndrome
- failure of protein synthesis e.g. LP disease

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8
Q

WHat is complement?

A

Proteins secreted by liver to act as sticky coat for intruders in order to turbo-boost immediate mmune respnse
- better klling by phagocytosis
- deficiency predisposes to bacterial infection

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9
Q

What are NK cells?

A

Killer cells that lack MHC surface molecules
They don’t need antigen specificity and have no long term memory

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10
Q

NK cells defic prodispose to which problems…..

A

VZV, HSV, CMV, HPV

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11
Q

Innate immunity feature of NK cells means they can eliminate….

A

Cancer cells

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12
Q

What molecules are responsible for innate recognition of invaders?

A

Toll like receptors (TLRs)
- essentially built in burglar alarm for microbes

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13
Q

What are PAMPs?

A

Pathogen associated molecular patterns
- what the TLR burglar alarm senses

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14
Q

What happens when TLRs are activated?

A

Pro-inflammatory cytokines and type 1 Interferon secretion

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15
Q

Result of TLR dysfunction

A

Either immunodefic or autoimmunity
- too little or too much

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16
Q

What are TLR activators?

A

Boost immunity
e.g. anti skin cancer creams, imiquimod (TLR7/8)

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17
Q

What is TNF alpha?

A

immediate-early ‘fire alarm’ signal in response to many stressors (microbes, stress, chemicals, etc.)

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18
Q

WHat common drugs target the TNF?

A

biologics
- antibodies blocking TNF
- e.g. infliximab

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19
Q

Function of iNF inhibitors

A

Block pro inflammatory cytokines

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20
Q

Are biologics renal/hepatotoxic?

A

No
- they’re just normal protein and their metaolism is not depedent on above systems

21
Q

What is the main problem with biologics (other than cost)?

A

Body can form antibodies against them

22
Q

Describe adalimumab

A

Anti TNF
Anti inflam
Often used in rheumatic and inflam disease

23
Q

Describe pembrolizumab

A

Anti PD1
Activates T cells
Used in cancer treatment

24
Q

Describe secukinumab

A

Anti IL17
Blocks one inflam pathway
Used in psoriasis, arthritis, MS

25
4 key types of transplant rejection
Hyperacute Acute cellular Acute vascular Chronic allograft
26
Describe hyperacute transplant rejection
Happens in mins/hours Caused by thrombosis/necrosis and type II hypersensitivity - preformed Ab and complement fixation No treatment
27
Describe acute cellular rejection of transplant
Happens 5-30 days Caused by cellular infiltration and type IV hypersensitivity - CD4/8 and T cells Treat with immunosuppression
28
Describe acute vascular rejection of transplant
Happens 5-30 days Caused by vasculitis and type II hypersensitivity - de novo Ab and complemetn fixation Treat with immunosupression
29
describe chronic allograft failure of transplant
Happens after 30 days Caused by fibrosis and scarring - immune and non immune mechs Treat by minismising drug toxicity, HT and hyperlipidaemia
30
How do vaccines work?
Long-lived Memory B cells are generated during primary immune responses that can survive for many years even after the antigen has been eliminated
31
How does vaccine memory work when the person comes into contact with the pathogen ?
Memory B cells rapidly re-activate in response to a second encounter with that specific antigen - Clonal expansion, differentiation into plasma cells, antibody production
32
How does vaccine affect T cells?
Simulates a rare naive T cells Induces a strong T cell response in 2-3weeks Some of these become effector T cells which - either die byt apoptosis if antigen is absent - become memory T cell and maintained at low frequency
33
Levels of antibody at primary infection
IgM has inital peak and then decr shortly after (essentially the incubation period) IgG slowly peaks and slowly decr (the peak of IgM matches symptom onset)
34
Levels of antibody at secondary infection
IgG and IgM peak early IgG slowly decreases over time whereas IgM decr v quickly
35
Pros of inactivated vaccines
Quick and easy - prevents epidemics, good ab response easy to store, mostly safe
36
Cons of inactivated vaccines
Not v potent - killed orgs don't stimuate a v good immune response - no clonal expansion of B and T cells, abs diminish over time, req multiple injections/boosters
37
Inactivated vaccine examples
Whole cell - polio, hep A, rabies, cholera Fractional - hep B, flu, pertussis, HPV - toxoids e.g. diptheria and tetanus - pure PS e.g. haemophilus B
38
Pros of live attenuated vaccines
Elicits all relevant effector mechanisms, Ab and activated T cells Local and strong response Only one dose req
39
Cons of live attenuated vaccines
Safety - can revert to virulence - can infect immunocompromised hosts Fragile and need stored and handled differently, depending on cold chain
40
Examples of live attenuated vaccines
Viral - MMR, chickenpox, rotavirus, small pox Bacterial - BCG, oral typhoid
41
What are DNA/RNA vaccines?
DNA or RNA which directs the assembly of the antigenic protein inside the host cell Either given as the naked DNA/RNA or packaged into virus that infects host cells and instructs cells t build this specific antigenic protein ^How mad is that btw
42
Pros of DNA/RNA vaccines
Potent Easier to make than protein vax Applied to target mutated proteins found in cancer
43
Cons of DNA/RNA vaccines
May req complex cold chains No long term knowledge about their prospects
44
Examples of DNA/RNA vaccines
COVID-19
45
What are VLP vaccines?
Virus like particles Empty shells (capsids) made from viruses that look like the virus but have no DNA or RNA
46
Pros of VLP vaccines
Non infectious V potent, only need one dose Activated B and T cell response
47
Cons of VLP vaccines
Complex to manufacture Fragile, depends on cold chains
48
Examples of VLP vaccines
Papillomavirus assoc cancer e.g. cervrix, gardasil Against hep B e.g. engerix
49

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