Defense & Barriers 2: SA Immunodeficiency Flashcards
immunodeficiency definition
= a state in which the body’s ability to fight INFECTIOUS DISEASES or CANCER is COMPROMISED or ABSENT
PRIMARY immunodeficiency definition? how common is it?
SECONDARY immunodeficiency can be caused by what 8 things?
PRIMARY immunodeficiency… = CONGENITAL or INHERITED, but RARE!!
SECONDARY immunodeficiency…
1. Hyperadrenocorticism (Cushing’s)
2. Iatrogenic (GCCs, cyclosporine, etc.)
3. Malnutrition
4. Barrier damage
5. Severe cutaneous or systemic disease
6. Immunosuppressive viruses (FeLV, FIV)
7. Non-viral infections
8. Stress (psychological & physical)
what disease should we suspect in neonates, juveniles or young adults with recurrent infections?
PRIMARY immunodeficiency
in what situations should we suspect IMMUNODEFICIENCIES? (7)
- INCREASED FREQUENCY or SEVERITY of infection
- CHRONIC/PROLONGED course of infection
- INCOMPLETE CLEARING between infection episodes
- Incomplete/no response to treatment
- Infections with usually NON-PATHOGENIC/OPPORTUNISTIC ORGANISMS
- SEVERE, ATYPICAL manifestations
- Adverse reactions to MODIFIED LIVE VACCINES
5 common clinical signs of immunodeficiency?
what ABOUT all of them indicates immunodeficiency?
5 clinical signs?
1. Respiratory disease
2. Otitis externa
3. Pyoderma
4. Vomiting/diarrhea
5. Ill thrift
IN ALL CASES, THEY DO NOT RESOLVE WITH APPROPRIATE TREATMENT IF PATIENT IS IMMUNODEFICIENT
what CLINICAL SIGNS/DISEASES should we expect if there are immunodeficiencies in THESE parts of the immune system…
neutrophils?
NK cells?
cytotoxic T cells?
complement?
NEUTROPHILS = extracellular recurrent bacterial infections
NK cells = tumors
CYTOTOXIC T CELLS = more prone to viruses
COMPLEMENT = phagocytic defect
DIAGNOSTICS for immunodeficiency…
CBC values? (3)
neutrophil testing? (what 4 things does it test/how do they work? include 2 points for last marker)
CBC…
1. neutropenia
2. neutrophilia
3. lymphopenia
neutrophil testing? = determines FUNCTIONALITY of neutrophils
- ADHESION = via flow cytometry
- CHEMOTAXIS = moving of neutrophil TOWARDS infection
- PHAGOCYTOSIS
- BACTERICIDAL activity
–> Feed neutrophils opsonized bacteria and see if they can break them down via OXIDATIVE BURST
–> Can use a GREEN FLUORESCENCE ASSAY to TRACK OXIDATIVE BURST
= the HYDROGEN PEROXIDE produced will FLUORESCE GREEN
describe this chart, what it’s testing for/how it works
also describe the leftmost tube vs. the rightmost tube
this is a TOTAL HEMOLYTIC COMPLEMENT (CH50)
this complement assay aims to determine if SERUM COMPLEMENT COMPONENTS in the CLASSICAL PATHWAY are CAPABLE OF LYSING ANTIBODY-BOUND SHEEP RBCs
LEFTMOST = NO COMPLEMENT ACTIVATION, so RBCs PELLET AT BOTTOM & SERUM IS CLEAR
RIGHTMOST = COMPLEMENT ACTIVATION so RBCs LYSED & Hb released
what is this? (2)
describe what’s going on (2)
this is a RADIAL IMMUNODIFFUSION ASSAY (COMPLEMENT assay)
add patient’s SERUM and if CLEARING = COMPLEMENT ACTIVATION where ANTIGEN AND Ab BIND
BIGGER CLEARING = MORE complement activation
describe what this test is
define the LEFTMOST and RIGHTMOST peaks
how does it relate to immunodeficiency?
this is SERUM GEL ELECTROPHORESIS, which takes patient serum and SEPARATES OUT PROTEIN by SIZE AND CHARGE
LEFTMOST peak = ALBUMIN, MOST ABUNDANT PROTEIN
RIGHTMOST peak = IMMUNOGLOBULINS
in IMMUNODEFICIENCY, can determine if LACK OF IMMUNOGLOBULINS (lack of rightmost peak), OR if there’s MONOCLONAL POPULATION (neoplasia) if the IMMUNOGLOBULIN PEAK RESEMBLES ALBUMIN PEAK
what test does this describe?
after adding patient’s neutrophils, if the graph shifts…
LEFT?
RIGHT?
= BACTERICIDAL activity in NEUTROPHILS based on RELEASE OF HYDROGEN PEROXIDE in OXIDATIVE BURST
if the graph shifts…
LEFT = NEUTROPHILS HAVE BAD BACTERICIDAL ACTIVITY, more like control
RIGHT = NEUTROPHILS HAVE GOOD BACTERICIDAL ACTIVITY
lymphocyte blastogenesis…
helps determine WHAT?
how does it work? (2)
helps determine T CELL COMPETENCE
how does it work?
1. separate out WBC component of blood and CULTURE with something that makes T cells STRONGLY ACTIVE & DIVIDE
- If POOR PROLIFERATION = T cell DEFECT usually due to immunodeficiency
flow cytometry…
commonality?
how does it work? (2)
what disease is this usually diagnostic for?
** MOST COMMON DIAGNOSTIC TEST AVAILABLE FOR IMMUNODEFICIENCY
how does it work?
1. use LASERS to RUN ON SUSPENSION to determine if there’s a LACK OF T CELLS due to immunodeficiency
2. enumerates T and B cells
usually diagnostic for LYMPHOMA
SECONDARY/ACQUIRED immunodeficiencies are MORE COMMON than PRIMARY immunodeficiencies, TRUE OR FALSE?
TRUE
feline immunodeficiency virus…
acronym/common name?
classification? (2)
what SPECIFICALLY does it attack?
pathogenesis? (3, first one has 3 subsets)
net effect? (2, second one has 3 subsets)
relation to lymphoma?
FIV!
classification?
1. RETROVIRUS that is also a LENTIVIRUS
2. Related to HIV but has a slower/less predictable progression to AIDS than HIV
what SPECIFICALLY does it attack?
= preferentially infects CD4 T cells (T helper cells)
pathogenesis?
1. Virus infects CD4 T cells via entry through a CD4-specific receptor, causing…
–> Decreased production of CD4 T cells
–> Decreased lifespan of CD4 T cells
–> Increased apoptosis of CD4 T ells
- CD8 T cells (virus-specific cytotoxic) and Abs will rise and CONTROL but NOT ERADICATE infection
- Can also lead to lack of IL-2, which causes immune function compromise
net effect?
1. OVERALL, FIV results in LOSS OF ALL T CELL SUBSETS (lymphoid depletion)
2. May see a rise in OPPORTUNISTIC infections in cats with FIV, such as…
–> Mycobacterium avium
–> hemotropic mycoplasma (infects RBCs and causes anemia)
–> toxoplasma gondii
** Cats with FIV are 5-6x more likely to develop LYMPHOMA
what DISEASE is this?
TRAPPED NEUTROPHIL SYNDROME
