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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

25
what kind of IgA subclass predominates in small intestine and vaginal tract?
IgA2 (this is the one missing the 13aa proline rich sequence in hinge region)
26
IgA proteases are common in
hemophilus influenzae neisseria gonorrhea nisseria meningitidis (note- strep sanguinis and pneumonia have metalloproteases)
27
sphingosine-1-phosphate
T cell egress from lymph node s
28
what does IV, intraperitoneally, subq, IM or intradermal injection induce?
induce serum IgG or IgM do not induce sIgA
29
what are the inductive sites for production of IgA committed B cells?
peyer's patch
30
describe path from gut lumen to LP
M cell --\> Peyers patch --\> mesenteric lymph node --\> lymph --\> thoracic duct --\> venous blood --\> heart --\> arterial circulation --\> capillaries and afferent lymphatics to lamina propira
31
do peyers patches have afferent lyphatics?
no, they get all their info from m cells
32
is the B cell class switch in peyers patch T cell dependent or independent?
T cell dependent
33
home molecules for GI tract
integrin a4b7 chemokine receptor CCR9
34
CCL25
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
MAdCAM-1
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
can IgA traffic to other mucosal sites?
yes but frequently the heterologous distal response is not as robust as site of induction
37
major switch factor for sIgA
TGF beta
38
what interleukins are imp for IgA production
Il5 and Il6
39
Is sIgA production to indigenous flora of the gut T cell dependent or T cell indiependent ?
T cel independent; special class of B cells mediate this (B1)
40
intraepithelial lymphocytes
* 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
what kind of T cells are in the lamina propria and mesenteric lymph nodes?
CD4+ (help B cells secrete IgA via IL5&6) Tregs (tolerance)
42
what is the significance of cytomegalovirus
76% transmission rate through breast milke
43
what kind of B cells in peyers patch
B2 (conventional B cells, T cell dependent)
44
where do sIgA B cells differentiate into plasma cells?
LP
45
Ceftriaxone
common antibiotic
46
confounding factor
* is a risk factor for the disease in the unexposed population * is not in the causal pathway * associated with the exposure
47
genotype for Rh+
Dd or DD
48
genotype for Rh-
dd
49
tx for HDNB
exchange transfusion bili light
50
51
netosis
neutrophils explode and release DNA → could trigger TLR 789

Block 6: Immunology and Inflammation (6 decks)

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