Immunity Flashcards

0
Q

What is the definition of an infectious disease?

A

When a pathogen succeeds in evading/overwhelming the host’s immune system

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1
Q

What is the definition of the immune system?

A

Cells/organs that contribute to immune defences against infections & non-infectious conditions

  • pathogen recognition
  • contain/eliminate infection
  • resolution
  • memory
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2
Q

What are the key differences between the innate and adaptive immune systems?

A

INNATE ADAPTIVE
Fast (seconds) Slow (days)
Non-specific (groups of microbes) Specific (one pathogen)
No memory Memory
No change in intensity Increases in intensity

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3
Q

What factors of the innate immune system limit the entry and growth of pathogens?

A

PHYSICAL: skin, mucous membranes, bronchial cilia

PHYSIOLOGICAL: diarrhoea, vomiting, coughing, sneezing

CHEMICAL:

  • low pH (skin, stomach, vagina)
  • antimicrobials (gastric acid & pepsin, mucus, IgA in tears & saliva, lysozymes in sebum & urine & sweat, beta-defensins in epithelium)

BIOLOGICAL: external commensals compete with pathogens for attachment sites/resources, produce antimicrobials, synthesise vitamins

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4
Q

How do the components of adaptive immunity lead to an immune response?

A

Naive T-cell (not been exposed to antigen/pathogen) + Antigen-presenting cell + Pathogen = Immune response

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5
Q

What are the important features of antigen-presenting cells?

A

Antigen-presenting cells = B-cells, interdigitating dendritic cells (lymph nodes), Langerhan’s cells (skin), macrophages

Location:

  • skin (skin-associated lymphoid tissue)
  • mucous membranes (& associated lymphoid tissue)
  • lymphoid organs (lymph nodes + spleen)
  • blood circulation (plasmacytoid + myeloid dendritic cells)

Macrophages can phagocytose whole microbes, whilst other antigen-presenting cells use micropinocytosis (random uptake of soluble microbe)

Cell-surface receptors sense extracellular microbes (bacteria), intracellular receptors sense intracellular microbes (viruses)

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6
Q

How are naive T-cells alerted to the presence of a pathogen?

A

Major Histocompatibility Complex (MHC)/Human Leucocyte Antigen (HLA) (on cell membrane)

MHC Class 1:

  • found on all nucleated cells (any cell which can be infected by viruses)
  • present peptides from intracellular microbes (endogenous pathway) to CD8+ T-cells
  • CD8+ T-cells bind at the alpha-3 subunit

MHC Class II:

  • found on dendritic cells, macrophages, B-cells (+ some activated T-cells, in thymus, in intestine)
  • present peptides from extracellular microbes (exogenous pathway) to CD4 +
  • CD4+ T-cells bind at the beta-2 subunit

note: genes involved in MHCs are co-dominant (increased no. of different types of MHC that are present) and are polymorphic (more antigens/microbes are able to be presented)

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7
Q

What are some problems caused by MHC molecules?

A

Organ transplant rejection (mismatch between HLA variants present in the donor and the recipient) -> recipient immune system attacks donor tissue

Graft v.s. host -> donor immune system attacks recipient tissue

Association with autoimmune diseases e.g. ankylosing spondylitis, insulin-dependent diabetes

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8
Q

Contrast the general immune response to extracellular and intracellular microbes.

A

Extracellular microbes —> endogenous pathway —> MHC II —> binds CD4+ T-cells —> humoral immunity (non-cell mediated: antibody & complement)

Intracellular microbes —> endogenous & exogenous pathways

  • > endogenous —> MHC II —> binds CD4+ T-cells —> cell-mediated immunity (antibody, complement, macrophages)
  • > exogenous —> MHC I —> binds CD8+ T-cells —> cytotoxic T-cells
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9
Q

Contrast the actions of B-cells and macrophages.

A

B-cells:

  • antibody-dependent cell cytotoxicity (IgG, IgE)
  • opsonisation (IgG)
  • neutralisation (IgA)
  • complement activation
  • allergies (IgE)

Macrophage: phagocytose opsonised microbes

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10
Q

Where are macrophages located?

A

Liver
Gut
Lungs
Spleen

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11
Q

What is MALT?

A

Mucosal associated lymphoid tissue

  • GALT (gut associated lymphoid tissue) = Peyer’s patches, appendiceal lymph nodes, tonsils
  • thyroid
  • breast
  • lung
  • salivary glands
  • skin

Contains lymphocytes, macrophages, plasma cells (+ M cells in intestinal MALT which sample antigens)

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12
Q

Explain the location of the tonsils.

A

Pharyngeal (adenoid) tonsils

Palatine tonsils

Lingual tonsils

Drain into cervical lymph nodes which lie along the jugular vein

e.g. adenovirus often causes sore throats and cervical lymphadenopathy

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13
Q

Where are the Peyer’s patches? What conditions can cause inflammation of the Peyer’s patches?

A

Found in the ileum (differentiates the ileum from the duodenum - contains Brunner’s glands - and the jejunum - no Peyer’s patches or Brunner’s glands)

Ileocaecal lymphatic tissue important as the large intestine has a large no. of microbes

Typhoid fever causes inflammation of Peyer’s patches in the terminal ileum (can cause perforation)

Mesenteric adenitis (inflammation of mesenteric lymph nodes e.g. adenovirus/Coxsackie virus) —> right iliac fossa pain

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14
Q

What is the immunoglobulin responsible for passive immune protection of neonates via breastfeeding in the mucosal membranes (respiratory and GI)?

A

IgA

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15
Q

What is the most abundant immunoglobulin present in the blood?

A

IgG (also able to cross the placenta)

16
Q

What cell type controls antibody synthesis and isotope switching?

A

CD4+ T cells (stimulate B cells to produce antibodies)

17
Q

What cell type antigens does the spleen respond to?

A

Blood borne B-cells and T-cells

18
Q

What cell produces IgE?

A

Plasma cells (stimulated by mast cells)

19
Q

What are some of the important features of mast cells?

A
  • degranulation (granules contain chemicals)
  • located in all tissues
  • bind to IgE during sensitisation
  • modulate T cell response (TH2)
20
Q

What is the difference in immunoglobulin produced in the first and second exposure to infection?

A

first - IgM

Second - IgG

21
Q

What is the function of CRP, and what can it indicate?

A

Involved in opsonisation

Indicates non-specific inflammation (e.g. infection)

Can be used to monitor patient progress and response to therapy

Produced in liver by TNF

22
Q

What surface molecules does HIV interact with?

A

CD4+

CCR5 & CXCR4

23
Q

Important antigens to avoid graft vs host?

A

ABO red cell antigens (acute rejection)

HLA antigens

24
Q

What is the mechanism behind vaccine non-responders?

A

HLA polymorphisms

25
Q

Why is the body not constantly in a state of inflammation due to the presence of commensal bacteria/frequent exposure to pathogens?

A

Level of immune response regulated according to:

  • ecological factors e.g. presence of commensal bacteria (not recognised as pathogenic)
  • antigenic degeneracy & pathogenicity (whether something is recognised as a pathogen in that organ by the specific immune cells present)
26
Q

Outline the features, functions, and location of IgM.

A

Generally 1st Ig formed after antigenic stimulation
(therefore present in newborn —> indicates intra-uterine/congenital infection)

Expressed on surface of B-cells (found primarily in plasma)

  • agglutination (promotes phagocytosis)
  • classical complement pathway activation
27
Q

Outline the features and functions of IgG.

A

Greatest amount present

Only Ig which crosses the placenta (responsible for passive immunity in newborn)

  • classical complement pathway activation
  • opsonisation/neutralisation of microbes/viruses
  • initiating antibody-dependent cell-mediated cytotoxicity
  • Type II hypersensitivity (autoimmune disorders)
28
Q

Outline the features, functions, and location of IgA.

A

Found on mucosal surfaces (inc. saliva)
(increases resistance to enzymatic degradation)
(initial defence against pathogens)

Most Ig produced daily

  • alternative complement pathway activation
29
Q

Outline the features, functions, and location of IgE.

A

Present on surfaces of mast cells & eosinophils
(increased no. in allergic conditions/worm infestation)

Chiefly produced in linings of respiratory and intestinal tracts

Antigen binding cross-links IgE on surface of mast cells —> histamine and other inflammatory mediators released —> immediate (Type I) hypersensitivity reaction