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Block 6: Immunology and Inflammation > Week 4 > Flashcards

Week 4 Flashcards

1
Q

steps in leukocyte extravasion

A

rolling activation arrest/adhesion Transendothelial migration

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2
Q

BCG

A

bovine strain of mycobacteria that is a good Tb vaccine

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3
Q

adjuvants

A

substance that boosts immune response

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4
Q

cell mediated immune deficiency tx

A

cytokine therapy such as IFN alpha and GM-CSF to do immunostimulation

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5
Q

what is the TL;DR of corticosteroids

A

stop activation of immune system

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6
Q

mechanism of action of corticosteroids (5)

A
  1. decr size of lymph nodes and spleen 2. interfere with cell cycle of activated lymphoid cells 3. induce T cell death indirectly by inhibiting growth factor 4.suppress ab formation prostaglandins and leukotriene synthesis 5. decr production of cytokines that are needed for t cell maturation
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7
Q

what is the dose for immunosuppression of corticosteroids

A

10-100mg orally/day

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8
Q

does cyclosporin affect suppressor T cells or B cells?

A

no! it is not cytotoxic for T cells; it inhibits Thelper cells making Il2

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9
Q

what is azathioprine metabolized to

A

mercaptopurine

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10
Q

what is mercaptopurine deactivated by

A

xanthine oxidase

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11
Q

what is the most potent immunosuppressnat

A

cyclophosphamide ; not selective! prodrug is converted in liver to a metabolite; metabolite crosslinks DNA and when DNA is cross linked, it cannot be trancribed

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12
Q

what is the dosage for cyclophosphamide

A

one single large dose

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13
Q

what kind of drug is cyclophosphamide

A

alkylating agent; most potent synthetic immunosuppressive drug that is converted in live to active metabolites

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14
Q

in type I hypersensitivity what is mediator release associated with?

A

fall in cAMP therefore treat with agents that incr cAMP

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15
Q

tx for type II hypersensitivity

A

corticosteroids with azathioprine or methotrexate

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16
Q

what are the key components of sIgA

A

J chain Secretory component IgA dimer

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17
Q

secretory component

A

makes IgA more resistant to acid; this is advantages in the GI tract;

it is the remaingin part of the polyIg receptor that brought the secretory IgA from the basolateral side to the apical side

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18
Q

M cells

A

above the peyers patch, sample whats in gut; not as exclusionary as the epithelia

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19
Q

what produces J chain

A

plasma cell

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20
Q

colostrum

A

first breast milk that comes out; rich in sIgA and passively protects infant intestinal tract

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21
Q

functions of IgA

A
  • inhibit microbial attachemt at mucosa
  • neutralize viuses and toxins (block adherence)
  • contain normal microbes in the gut
  • inhibit absorption of foreign antigens that arent digested
  • breast milk/colostrum passive immunity to infant
22
Q

IgA deficiency

A

most common single immunoglobulin deficiency

  • recurrent infections –> tend to be at mucosal surfaces
  • not lethal
    • some compensation by IgM and IgG
23
Q

IgA 2

A

missing 13 amino acid proline rich sequene in hinge region

24
Q

what kind of IgA subclass predominates in human blood

A

IgA1

25
Q

what kind of IgA subclass predominates in small intestine and vaginal tract?

A

IgA2 (this is the one missing the 13aa proline rich sequence in hinge region)

26
Q

IgA proteases are common in

A

hemophilus influenzae

neisseria gonorrhea

nisseria meningitidis

(note- strep sanguinis and pneumonia have metalloproteases)

27
Q

sphingosine-1-phosphate

A

T cell egress from lymph node s

28
Q

what does IV, intraperitoneally, subq, IM or intradermal injection induce?

A

induce serum IgG or IgM

do not induce sIgA

29
Q

what are the inductive sites for production of IgA committed B cells?

A

peyer’s patch

30
Q

describe path from gut lumen to LP

A

M cell –> Peyers patch –> mesenteric lymph node –> lymph –> thoracic duct –> venous blood –> heart –> arterial circulation –> capillaries and afferent lymphatics to lamina propira

31
Q

do peyers patches have afferent lyphatics?

A

no, they get all their info from m cells

32
Q

is the B cell class switch in peyers patch T cell dependent or independent?

A

T cell dependent

33
Q

home molecules for GI tract

A

integrin a4b7

chemokine receptor CCR9

34
Q

CCL25

A

a ligand for CCR9 (expressed by B cells) that is secreted by gut epithelial cells; helps B cells that need to be in mucosal sites get where they need to be

35
Q

MAdCAM-1

A

adhesion molecule expressed by capillary high endothelial venule cells; binds a4b7 which is expressed by B cells; helps B cells that need to be in mucosal sites get where they need to be

36
Q

can IgA traffic to other mucosal sites?

A

yes but frequently the heterologous distal response is not as robust as site of induction

37
Q

major switch factor for sIgA

A

TGF beta

38
Q

what interleukins are imp for IgA production

A

Il5 and Il6

39
Q

Is sIgA production to indigenous flora of the gut T cell dependent or T cell indiependent ?

A

T cel independent; special class of B cells mediate this (B1)

40
Q

intraepithelial lymphocytes

A
  • greater than90% are CD8+
  • distributed between epithelial cells that line small and large intesting
  • many have NK receptors and NK like cytotokic activity; many make TGF beta and IL 10
    • therefore, can contribute to both host defense and tolerance
41
Q

what kind of T cells are in the lamina propria and mesenteric lymph nodes?

A

CD4+ (help B cells secrete IgA via IL5&6)

Tregs (tolerance)

42
Q

what is the significance of cytomegalovirus

A

76% transmission rate through breast milke

43
Q

what kind of B cells in peyers patch

A

B2 (conventional B cells, T cell dependent)

44
Q

where do sIgA B cells differentiate into plasma cells?

A

LP

45
Q

Ceftriaxone

A

common antibiotic

46
Q

confounding factor

A
  • is a risk factor for the disease in the unexposed population
  • is not in the causal pathway
  • associated with the exposure
47
Q

genotype for Rh+

A

Dd or DD

48
Q

genotype for Rh-

A

dd

49
Q

tx for HDNB

A

exchange transfusion

bili light

50
Q
A
51
Q

netosis

A

neutrophils explode and release DNA → could trigger TLR 789

Block 6: Immunology and Inflammation (6 decks)

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