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Clinical Immunology and Haematology > Clinical Immunology > Flashcards

Clinical Immunology Flashcards

1
Q

What are the 4 sources of infection?

A

Bacteria, parasites, fungus and viruses

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2
Q

What is the immune system?

A

bodies natural defence against pathogens

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3
Q

What can the immune system do?

A

Identify threats, mount an attack, generate immunity and eliminate the threat

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4
Q

What are the challenges to fighting bacteria?

A

These can be both intracellular or extracellular and you also get commensals which you do not want to destroy

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5
Q

What are the challenges to fighting parasites?

A

These are multicellular, extracellular organisms which are hard to deal with cause immune cells are so small

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6
Q

Are fungus intra or extracellular?

A

Extracellular

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7
Q

Are viruses intra or extracellular?

A

Intracellular

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8
Q

What happens if the immune system gets it wrong and starts attacking yourself?

A

Autoimmunity

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9
Q

What is the first line of defence?

A

Physiological and physicals barriers - Skin, mucous membranes, cilia, body temperature, pH and enzymes

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10
Q

If pathogens get through the first line of defence what reaction occurs?

A

The innate immune system

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11
Q

What cells are part of the innate immune system?

A

Neutrophil, basophil, eosinophil, mast cell, macrophage, dendritic cell and NK cells

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12
Q

What cell forms a bridge between innate and adaptive immunity?

A

Dendritic cells

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13
Q

What cells are part of your adaptive immune system and are these specific?

A

Helper T cells,
Cytotoxic T cells,
B cells,
Plasma cells,

And yes

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14
Q

How do immune cells migrate through the body

A

Lymphatic vessels

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15
Q

How does your skin have low pH?

A

Sebum which is secreted by the sebaceous glands in the skin consist of fatty and lactic acid which keeps the skin at a pH or 3 - 5

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16
Q

What enzymes do you have in sweat and what do these do?

A

Lysozyme cleaves bacteria cell wall and proteoglycans

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17
Q

What does normal microbiota produce?

A

Anti-microbial surfaces to compete for nutrients and attachment to epithelial kill bacteria on their skin so they have more to eat

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18
Q

Is the innate immune system antigen specific?

A

No

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19
Q

What do NK cells do?

A

They are cytotoxic so they can kill infected or cnacerous cell

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20
Q

What do macrophages and phagocytes do?

A

Engulf other cells via phagosytosis

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21
Q

Is the adaptive immune response antigen specific?

A

Yes

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22
Q

How are T cells triggered?

A

They require presentation from professional antigen presenting cells (usually dendritic cells) in order to recognise their cognate antigen and undergo activation and clonal expansion.

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23
Q

What do mast cells do?

A

They degranulate and damage large pathogens such as worms

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24
Q

What do B cells and plasma cells do?

A

release antibodies

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25
Q

What signal is triggered so that the immune system knows what is self and what is not?

A

Danger signals - toll like receptors

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26
Q

How do toll like receptors work?

A

These are parts of pathogens contained in either the endosome (intracellular threats) or the cytosol (extracellular threats). These recognise LPS, dsRNA or CpG DNA as we don’t normally have these ourselves.

27
Q

How do neutrophils kill?

A

They engulf invading cells and take them inside to be destroyed.

28
Q

What can neutrophils release?

A

NETS - they release their DNA through netrosis to trap the bacteria and they are contained and then destroyed.

29
Q

What do mast cells do?

A

Upon activation (cross linking of IgG) the cells degranulate releasing hustamine into the environment.

30
Q

What do mast cells target and cause?

A

Target parasites and are involved in allergies

31
Q

How does antigen presentation work - dendritic cell telling the T-cell steps?

A

In the peripheral tissue PAMPs trigger TLR’s which activates the dendritic cells. These dendritic cells uptake the antigen onto MHC. Along with this a chemokine CCR7 is upregulated allowing the cell to leave the tissue and head towards the lymphatic system. On its journey they upregulate CD80 and CD86 which allows dendritic cell to talk to the T-cell and activate it.

32
Q

What are some T-cell subsets?

A

CD4 T-cells

CD8 T Cells

33
Q

What are CD4 T cells restricted by?

A

MHC 2

34
Q

What do CD4 T cells do?

A

They are helper cells which can differentiate into different subsets based on pathogen type and act as conductors of the immune response.

35
Q

What do CD8 T cells do?

A

They are cytotoxic T cells which kill infected cells through release of cytotoxic mediators and control tumours.

36
Q

What are CD8 T cells restricted by?

A

MHC1

37
Q

Do all cells have MHC1?

A

Yes but they will not be killed unless displaying a pathogen

38
Q

Antibodies - How are B cells activated?

A

They have to physically be linked and recognise the antigen being displayed on the T-cells. These then differentiate and make plasma cells to secrete antibodies

39
Q

What is the functions of antibodies?

A

Neutralise microbes and toxins
Opsonisation and phagocytosis of microbes
Antibody-dependent cellular cytotoxicity
Lysis of microbes
Phagocytosis of microbes opsonised with complement fragment
Inflammation
Complement activation

40
Q

What are the different antibody classes?

A

IgM (first antibody made), IgA (protects mucosal surfaces), IgG (helps NK cells kill), IgE (causes allergies and defends against parasites).

41
Q

What are cytokines?

A

Regulatory proteins released by many cells of the immune system to help modulate immune responses.

42
Q

What can cytokines regulate?

A

Haematopoiesis
Cellular and humeral immune response
Inflammatory responses
Wound healing

43
Q

What are some examples of cytokines?

A

Chemokines, IL-2 etc.

44
Q

What do cytokines react with?

A

Unique receptors

45
Q

Are cytokines secreted or membrane bound?

A

Mainly secreted but TNFalpha and IL-15 are membrane bound

46
Q

What do cytokines work in tandem with other signals to do?

A

Provide regulation for immune cells

47
Q

Can cytokines function at low concentrations?

A

Yes

48
Q

Do they have a long half life?

This means nothing if you are not doing them in order

A

No a short one

49
Q

What does overstimulating cytokines lead to?

A

Cytokine storm which is fatal

50
Q

How do cytokines influence haematopoiesis?

A

They inform cell lineage and push stem cells to differentiatiate down a specific pathway

51
Q

What do cytokines control?

A

The proliferation and polarisation of immune cells e.g. can direct the T cell response into one of the T-cell subsets and can polarise macrophages to the inflammatory phenotype during an immune response or anti-inflammatory during resolution or wound healing.

52
Q

What are chemokines?

A

Subset of cytokines which work through G-coupled receptors to help the cells migrate during immune response.

53
Q

What are the two functional categories chemokines can be split up into?

A

Homesotatic - important during development and if there is issues with this it can be fatal

Inflammatory - helps cells get to where they are needed such as CCR7 and the dendritic cells

54
Q

How many structural groups of chemokines and what are they defined by?

A

4 and defined by where the cystine is

55
Q

How do chemokines function?

A

Through the chemokine receptors which are split into subgroups depending on function e.g. 4 atypical receptors, 10 CC receptor,s 6CXC receptors, 1CX3c receptors, 1CX3C receptors and 1XC receptor.

56
Q

How do chemokines move and what happens is the receptors is atypical?

A

Once the chemokine is internalised it will begin to move towards the chemokine. In the case of atypical receptors this is blocked from entering the cell and degraded.

57
Q

Why do we need atypical receptos?

A

To absorb excess chemokines and turn of the immune response. Also, stop any of the motherschemokines from crossing the placenta into the baby as this could cause increased differentation and issues for the baby.

58
Q

Where are chemokines expressed?

A

On immune cells

59
Q

What does CCR2 do?

A

helps monocytes exit the bone marrow

60
Q

If you are missing CCR5 what does this mean for you?

A

One mutation means you are restant to HIV, 2 means you are immune to HIV and it doesn’t have much affect on the immune system unless you get Westnel virus which will then be fatal for you.

61
Q

Can chemokines act as post codes?

A

Yes, for example, they can get dendritic cells to go to lymph nodes. When there is an infection lymph nodes upregulate their ‘post code’ so immune cells can get the infection to them.

62
Q

How do chemokines extravate?

A

Neutrophils following chemokines bind onto adhesion molecules in the blood and then come to a stop with tight binding. The neutrophil will then follow the chemokines through the blood vessels and tissues via diapedesis before migrating to the site of infection.

63
Q

What works in tandem?

A

Cells, cytokines and chemokines

64
Q

The steps of the immune response (1- 6)

A

1) Pathogen enters the body and immune cells in the tissue notice the PAMPs and uptake the pathogen to destroy it.

2) Immune cells also upregulate CCR7 and MHC which allows migration to the lymph nodes.

3) The dendritic cells upregulates MHC and CD80/CD6 which links to the TCR and CD2B receptor on the naive T-cell. This causes this cell to be activated. (You need the CD80/86 or the T cell will not react.

4) They also produce cytokines which will polarise the T-cell response and the cytokine produced and the T-cell response depends on what PAMP was triggered back at the site of infection.

5) The now active T-cell activate B cells and depending on the type of T-cell activated depends on the antibodies produced.

6) These antibodies then go to the site of infection and kills the pathogen.

Clinical Immunology and Haematology (25 decks)

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