Chapter 4 Complement System Flashcards

1
Q

Research in 1890 showed that sheep antiserum to which microbe caused bacterial lysis?

A

Vibrio cholerae

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2
Q

What destroyed the bacteriolytic activity of the sheep antiserum?

A

Heating it to 55°C for 30 min

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3
Q

How was the bacteriolytic activity restored in the sheep antiserum? What did it contain?

A

Adding fresh serum that did NOT contain antibody to the bacteria. It contained complement proteins C1-C9, factors B, D, and P, plus regulatory proteins

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4
Q

How many complement proteins are there?

A

More than 30

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5
Q

Where is complement synthesized?

A

Liver and by macrophages, blood monocytes, and epithelial cells

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6
Q

Explain how interferons work

A
  1. Virus enters cell
  2. Interferon gene switches on
  3. Cell produces interferons and secretes them
  4. Interferons bind interferon receptors on a different host cell
  5. IFN binding stimulates new cell to turn on antiviral genes
  6. Antiviral proteins block viral reproduction in new cell
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7
Q

Which cells secrete IFN-gamma?

A

lymphocytes

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8
Q

Which IFN types are alpha, beta, and gamma?

A

Alpha and beta = Type I
Gamma = Type II

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9
Q

IFNs activate which cells?

A

Macrophages and NK cells

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10
Q

At which step do the classical and alternative complement activation pathways meet?

A

C3

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11
Q

How are the classical and alternative pathways activated?

A

Classical: antibodies
Alternative: spontaneous

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12
Q

List the complement protein order of the classical pathway

A

C1 -> C4 -> C2 -> C3 -> C5 -> C6 -> C7 -> C8 -> C9

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13
Q

What are the main functions of complement?

A
  1. Opsonize to enhance phagocytosis
  2. Anaphylactic is to induce inflammatory response
  3. Direct killing through membrane attack complex (MAC) causing lysis
  4. Immune clearance, removing complexes from circulation
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14
Q

List the 3 anaphylatoxins of the classical complement pathway in order of their inflammatory potency

A

C5a -> C3a&raquo_space;> C4a

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15
Q

Which Igs can activate complement?

A

IgM and IgG, except IgG4

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16
Q

Which Ig most potently activates complement? Why?

A

IgM because only one alone sufficient to activate, whereas need at least 2 IgG to activate

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17
Q

Which pathway comes first in fighting infection? Which was discovered first?

A

Alternative pathway comes first, but classical pathway was discovered first and requires adaptive immune system

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18
Q

Describe the first 3 steps of classical complement activation

A
  1. IgG opsonizes target and C1 binds two evenly spaced apart IgGs
  2. C1 cleaves C4 into C4a and C4b. C4a remains in the fluid phase as an anaphylatoxin while C4b binds the cell surface/C1
  3. C4b binds C2, which gets cleaved by C1s esterase into C2a and C2b. C2b remains in fluid phase. C2a binds C4b and creates the complex called C4b2a (C3 convertase). This formula is specific to the classical pathway!
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19
Q

Describe the 4th step of complement activation

A

C3 convertase (C4b2a) cleaves C3 in to C3a and C3b. C3a remains in fluid phase as anaphylatoxin and C3b binds the complex to form C4b2a3b (C5 convertase).

20
Q

Describe the 5th step of the classical complement pathway

A

Once C5 convertase is formed, it cleaves C5 into C5a (anaphylatoxin) and C5b. C5b binds the complex. C5b is the first subunit of the MAC complex

21
Q

Describe the terminal steps of the classical complement pathway

A

Once C4b2a3b5b is formed, C6-C9 are recruited to form the MAC complex

22
Q

List the overall order of the alternative complement activation pathway

A

C3- > B -> C3 -> C5 -> C6 -> C7 -> C8 -> C9

23
Q

Which C proteins are not present in the alternative pathways?

A

C1, C2, and C4

24
Q

Describe the steps of the alternative pathway, right before the terminal steps

A
  1. C3 gets cleaved into C3a and C3b
  2. Factor B gets cleaved by factor D into Ba and Bb. Ba remains in fluid phase while Bb remains bound to C3b. This forms the C3bBb (C3 convertase) complex). Factor P stabilizes this complex
  3. C3 convertase cleaves another C3 and C3b binds the other side of C3b, forming C3bBb3b (C5 convertase) complex
  4. C5 convertase cleaves C5 and C5b remains bound to the complex.
25
Q

Describe the terminal steps of the alternative complement pathway

A

Same as classical. Starts with C5b -> C6 -> C7 -> C8 -> C9 to form MAC

26
Q

Examples of particles the MAC can lyse?

A

-viruses
-bacteria
-erythrocytes
-nucleated cells

27
Q

Which virus type is susceptible to complement-mediated lysis?

A

Enveloped viruses because the MAC is a transmembrane complex

28
Q

Which C protein is the major opsonin of the complement system?

A

C3b

29
Q

Phagocytic cells express which receptors to bind C3b?

A

CR1

30
Q

Which complex places large amounts of C3b on surface of pathogenic particle?

A

C5 convertase

31
Q

Which virus family does CMV belong to?

A

Herpes

32
Q

RBC account for ___% of CR1 in blood, while WBCs account for ____%. RBCs carry immune complexes to the _____

A

90%
10%
Spleen and liver

33
Q

Which cells express CR1?

A

Erythrocytes, monocytes, macrophages, neutrophils, B cells, T cells, DCs, and mast cells

34
Q

Which cells express CR2?

A

Mature B and T cells, DCs

35
Q

Which cells express CR3?

A

Monocytes, macrophages, NK cells, granulocytes

36
Q

What is systemic lupus erythematosus (SLE)?

A

Autoimmune disease with large number of immune complexes in blood, resulting in complement-mediated tissue damage by inducing inflammation and damage

37
Q

Common traits of SLE patients?

A

Deficient in C1, C2, or C4, leading to less C3b on immune complexes, hence decreased clearance. Express fewer CR1 on RBCs

38
Q

Epidemiology of SLE?

A

-1:2500 ppl affected
-10x women than men affected
-usually young adults
-familial (twins have 30% concordance rate)
-93-95% 5 year survival rate

39
Q

SLE symptoms?

A

-arthritis
-vasculitis and rash
-kidney disease
-blood abnormalities
-cardiovascular diseases

40
Q

How many symptoms out of 11 criteria required to diagnose lupus?

A

4

41
Q

Give 4 examples of SLE diagnosis criteria

A
  1. Buttterfly rash
  2. Arthritis
  3. Photosensitivity
  4. Renal disorder
42
Q

List immune-complex diseases

A

-SLE
-Glomerulonephritis
-Vasculitis

43
Q

A child deficient in ____ was at first thought to have _____?

A

C3
Agammaglobulinemia (absence of gamma globulin)

44
Q

C3 deficiency typically leads to ____ and ____

A

Recurrent bacterial infections and immune-complex diseases

45
Q

Function of CR1?

A

Enhance phagocytosis and regulates complement activation pathways

46
Q

Function of CR2?

A

Part of B-cell co-receptor. Lowers threshold of B cell activation by Ag

47
Q

Function of CR3?

A

Enhances phagocytosis