(13) MHC and transplantation Flashcards

(40 cards)

1
Q

Where has blood group substance been revealed by immunofluorescent staining?

A

In the cell membranes of all vascular endothelial cells, and certain epithelial cells

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2
Q

Normal individuals have naturally occuring isoagglutinins of which type?

A

Normal individuals have naturally occurring anti-A or anti-B isoagglutinins

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3
Q

How is blood group related to transplant?

A

Poor outcome of transplants performed between blood group incompatible individuals

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4
Q

Who discovered the MHC?

A

Peter Alfred Gorer

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5
Q

Describe the discovery of the MHC?

A
  • tumour transplantation between mouse strains
  • sarcoma tissue from strong’s albino A strain grew in F2 cross and backcross generations between the A strain and the resistant C57 black strain
  • all susceptible animals possessed an antigen derived form their albino acceptors “antigen II”
  • anti-antigen II antibody produced in C57 black mic by transfer of sarcoma tissue from the A strain
  • maximal titres of anti-antigen II antibody corresponded with time of complete tumour regression
  • “…genes govern the transplantability of the tumour and determine isoantigenic differences’
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6
Q

What was the experiment done by Peter Medawar concerning MHC?

A
  • skin allograft rejection in burns victims
  • rabbit skin graft model

gave different donor strains to incompatible recipient, measured time taken for graft to become necrotic

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7
Q

What were the results from Medawar’s experiment?

A
  1. recipient strain = X, donor strain = Y, graft loss = 10-14 days (1st set response)
  2. recipient strain = X’, donor strain = Y, graft loss = 5-7 days (2nd set response)
  3. recipient strain = X’, donor strain = Z, graft loss = 10-14 days (1st set response)

MHC responsible for these observations

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8
Q

The MHC is a set of genes found in who?

A

All vertebrate species

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9
Q

What is the role of the MHC?

A
  • immune function
  • diseases susceptibility
  • reproductive success
  • role in histocompatibility, major influence on graft survival
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10
Q

Where are the proteins encoded by the MHC expressed and what do they present?

A

They are expressed at the cell surface and function to present ‘self’ and ‘non-self’ antigens for inspection by T cell antigen receptors

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11
Q

How many MHC molecules are on the average mammalian cell?

A

50,000-100,000

It is the most prolific cell surface protein/antigen

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12
Q

Are MHC proteins polymorphic?

A

Highly polymorphic

Most polymorphic system in the human genome

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13
Q

Where is the human MHC genes found?

A

6p21.3

the short arm of chromosome 6

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14
Q

How big is the human MHC?

A

3.6Mbp

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15
Q

The MHC is divided into 3 regions. Which proteins/antigens do each of these 3 different regions encode?

A

class I region = HLA-A, B, C (‘classical’) antigens

class II region = HLA-DR, DQ, DP antigens

class III region = HSP70, TNF, C4A, C4B, C2, BF, CYP21

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16
Q

HLA-DR is encoded by what region of the MHC?

A

Class II region

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17
Q

What are the antigens encoded by MHC called?

A

HLA

Human leucocyte antigens

18
Q

Where are class I antigens found?

A

On all nucleated cells

19
Q

Class I HLA antigens mainly serve to present which antigens?

A

Endogenous antigens (result of changes in the cell eg. virus)

20
Q

Where are class II antigens found?

A

Primarily expressed on B lymphocytes but expression can be induced on T lymphocytes and other cells

21
Q

Class II HLA antigens mainly serve to present which antigens?

A

Exogenous antigens

22
Q

What type of proteins are HLA antigens?

A

Membrane-bound glycoproteins

23
Q

What are class I HLA-A, B, C molecules composed of?

A

MHC encoded 45kd heavy chain non-covalently associated with non-polymorphic B2 microglobulin

24
Q

What are class II HLA-DR, DP, DQ molecules composed of?

A

MHC encoded 31-34kd associated A chain non-covalently associated with 26-29kd B chain

25
Which part of the HLA molecule presents the antigen to the T cells?
The peptide-binding groove
26
How are MHC inherited?
Mendelian inheritance - 1 in 4 chance of mismatch with sibling, 1 in 2 chance of partial match, 1 in 4 chance of match En-bloc from each parental chromosome. Each individual inherits two antigens at a given locus Codominant expression. All of the inherited antigens are displayed on the cell surface (HLA phenotype)
27
Describe HLA polymorphism
- MHC is highly polymorphic - large number of allelic variants at each locus - allelic variation maintained at population level due to survival advantage - significant in terms of capacity of individual to mount an immune response in response to an antigenic challenge
28
In HLA nomenclature, what are the 3 levels of specificity?
- broad eg. HLA-A19 - split eg. HLA-A29(A19) - allele eg. HLA-A*29:01 serology (broad) serology (split) molecular (low) molecular (high)
29
In HLA nomenclature, what does an * mean?
* = molecular | no * = serology
30
What are the 3 categories of response when the immune system experiences foreign HLA in transplant tissue?
- direct recognition - indirect recognition - semi-direct recognition
31
What happens in direct recognition in response to transplant tissue (foreign HLA)?
- graft + damaged endothelium due to surgical stress - T cell binding direct to graft - donor DCs presenting to recipient T cells - T cell proliferation
32
What happens in indirect recognition in response to transplant tissue (foreign HLA)?
- graft peptides - movement of recipient APC - processing of donor peptides (lymph node) - T cells migrate to the graft (immune response)
33
What happens in semi-direct recognition in response to transplant tissue (foreign HLA)?
- movement of recipient APC - donor APC - recipient and donor APC interaction - migration of 'new' APC to lymph node to present to T cells
34
Which type of recognition (direct, indirect, semi-direct) occurs straight away in transplantation?
Direct Unique to transplantation
35
What is sensitisation and give examples of events
Any event which elicits an HLA directed immune response - pregnancy - blood transfusion - transplantation
36
How can you determine HLA profile?
- serum screening | - cross matching (directly test recipient serum against donor cells)
37
cRF% is a measure of what?
Sensitisation
38
If you have a 0% cRF, what does this mean?
Any donor can be used
39
What does 50% cRF mean?
50% sensitised lost 50% chance of finding donor but better than 100% cRF (100% not actually possible, but have to find donor exactly matching)
40
What happens in hyperacute rejection?
- activate clotting cascade - activate complement - lost integrity of vascular endothelium - organ engorges with blood and becomes necrotic - DIC