Lecture 33: Immunodeficiency etc Flashcards
What are the ways immunodeficiencies can be categorised?
- Congenital or primary
- Acquired or secondary
Write some notes on congenital/primary immunodeficiency:
Congenital or primary:
- Genetic defect
- Selective IgA deficiency is common (1in500)
- Other congenital deficiencies are rare
- In-utero disease
Write some notes on acquired or secondary immunodeficiency:
- Infection i.e HIV
- Drugs i.e steroids or cytotoxic
- Systemic disease (Renal failure, malnutrition, malignancy, burns)
How are immunodeficiencies typically revealed?
Typically revealed by recurrent infections
What are the other factors that regulate immunity?
- T cell subsets
- Checkpoint regulators
- Environmental changes
- Neuroimmune relationships
- Psychological, social and cultural factors
What are some checkpoint regulators:
B7-1 -> CD28 (+ve)
B7-1 -> CTLA-4 (-ive)
PD-1 -> PD-L1 (-ive)
Describe how checkpoint inhibitors relate to cancer: and the potential for intervention:
Some tumour cells have on their surface molecules that bind to inhibitory receptors on cytotoxic T lymphocytes
Blocking these immune-inhibitory interactions is the role of immune checkpoint inhibitor drugs
What are CAR-T cells // chimeric antigen receptor T Cells:
- T cells are collected from patient blood
- Chimeric antigen receptors genes are inserted
- Expand Car-T cells in culture
- Infuse Car-T cells back into patient
What has a hygienic environment resulted in?
- Different infections
- # Different antigens
- Different profile of immune responses
- More allergies and hypersensitivities
- More inflammatory diseases and autoimmune disease
Whats the neuroimmune network:
ANS+Endocrine system influence the immune system
Immune cytokines influence the ANS and endocrine systems
Whats the role of pro-inflammatory cytokines in the nervous system:
- Increase body temperature
- Increase slow wave sleep
- Promote illness behaviours
Describe the role of IL-1 in the nervous system;
- IL-1 act on vagus nerve branches
- IL-1 secreted by astrocytes and glial cells
- IL-1 has neurotransmitter activity
Describe how the ANS communicates with lymph nodes:
Norepinephrine from sympathetic fibres comms with T cells
What impacts the sympathetic innervation of lymph nodes?
Sociability
- SNS terminals in T-cell rich areas
- Density related to social temperament
Psychosocial factors <-> immune regulation
Describe the neuroimmune connections: (i.e the flow diagram of factors)
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