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Immunology Block 2 > Hypersensitivity > Flashcards

Hypersensitivity Flashcards

1
Q

Type I hypersensitivity is ____-mediated. What is the time frame?

A

IgE mediated; usually arises within minutes.

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2
Q

What are the mediators of Type I hypersensitivity?

A

Vasoactive mediators, lipid mediators, cytokines

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3
Q

Examples of Type I hypersensitivities?

A

Allergic diseases (e.g. anaphylaxis)

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4
Q

Which hypersensitivity reactions are mediated by antibodies?

A

I, II, and III

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5
Q

Type II hypersensitivity is ___-mediated

A

IgG and IgM

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6
Q

Goodpasture Syndrome:

A

An example of Type II hypersensitivity; Abs against basement membrane in kidney and lung activate Fc receptors, fix complement, resulting in inflammation.

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7
Q

Idiopathic thrombocytopenic purpura

A

Autoantibodies against platelets (–> opsonization). Type II.

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8
Q

Autoimmune hemolytic anemia:

A

Autoantibodies against RBC membrane proteins - type II hypersensitivity.

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9
Q

Myasthenia Gravis is an example of what type of hypersensitivity?

A

Type II

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10
Q

Graves disease is an example of what type of hypersensitivity?

A

Type II

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11
Q

Acute rheumatic fever is an example of what type of hypersensitivity?

A

Type II (against myocardial Ags)

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12
Q

Pemphigus vulgaris is an example of what type of hypersensitivity?

A

Type II (against desmosomes)

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13
Q

Pernicious anemia is an example of what type of hypersensitivity?

A

Type II (against intrinsic factor)

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14
Q

What is the classic example of Type III hypersensitivity?

A

Serum sickness

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15
Q

What is the time frame of Type III hypersensitivity?

A

Generally the first encounter will take 1-2 weeks (antibodies need to develop), followed by rapid (3-10 hours) with subsequent exposures

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16
Q

What type of hypersensitivity is Lupus?

A

Type III

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17
Q

Poststreptococcal glomerulonephritis is an example of ?

A

Type III hypersensitivity

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18
Q

Polyarteritis nodosa is an example of what?

A

Type III hypersensitivity

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19
Q

Type IV hypersensitivity reactions are ___-mediated

A

T-cell

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20
Q

Poison ivy is an example of ?

A

Type IV hypersensitivity reaction

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21
Q

A food allergy is an adverse health effect arising from a specific _______ that occurs ______ on exposure to a given food

A

immune response; reproducibly

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22
Q

What mediates the immediate Type I hypersensitivity reaction vs. the late-phase reaction?

A

Immediate is mediated by vasoactive amines and lipid mediators. Delayed is mediated by cytokines

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23
Q

What cytokine is important for IgE class switching?

A

IL-4

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24
Q

_____ is the receptor that IgE binds to on mast cells and basophils

A

High affinity Fc epsilon receptor

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25
Q

Describe the structure of Fc epsilon receptors:

A

Composed of 1 alpha chain (IgE binding) and 1 beta and 2 gamma chains (signal transduction)

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26
Q

What cytokine stimulates mast cell development/growth?

A

IL-3

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27
Q

What cytokine stimulates basophil development/growth?

A

IL-3

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28
Q

Mature mast cells are found in _____. Mature basophils are found ____.

A

Mast cells - Mucosa (and connective tissues). Basophils - Blood.

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29
Q

What is the cytokine that promotes eosinophil growth?

A

IL-5

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30
Q

Allergen-triggered cross-linking of __-____ complexes results in mast cell ____ and _____

A

IgE-FceRI; mast cell activation and degranulation

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31
Q

Immunologic tolerance:

A

unresponsiveness to self-antigens

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32
Q

Tolerogens:

A

Antigens that induce tolerance

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33
Q

Immunogens:

A

antigens that induce an immune response

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34
Q

Autoimmunity:

A

Failure of self-tolerance and resulting immune reaction to self-antigens

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35
Q

Central tolerance occurs in the:

A

thymus and bone marrow

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36
Q

Peripheral tolerance occurs in the:

A

peripheral tissues

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37
Q

Explain central tolerance:

A

In primary lymphoid organs, if a B or T cells is found to recognize a self-antigen strongly, it can either undergo apoptosis, undergo receptor editing (B cells only), or develop into regulatory T lymphocytes (CD4+ T cells only).

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38
Q

Explain peripheral tolerance:

A

Mature B or T cells that encounter and bind a self-antigen in the periphery can be controlled via anergy, apoptosis, or suppression via regulatory T cells.

39
Q

B cells can be controlled in central tolerance via:

A

Receptor editing, deletion, or anergy

40
Q

T cells can be controlled in central tolerance via:

A

Deletion, regulatory T lymphocytes

41
Q

T cells can be controlled in peripheral tolerance via:

A

anergy, suppression, or deletion (apoptosis)

42
Q

B cells can be controlled in peripheral tolerance via:

A

anergy, suppression, deletion

43
Q

During development in the thymus, positive selection occurs in the ____ and negative selection occurs in the _____

A

Positive selection - cortex. Negative selection - medulla.

44
Q

Positive T cell selection occurs in the ____ with the help of _____

A

Occurs in the cortex, with the help of cortical epithelium (cTEC)

45
Q

Negative T cell selection occurs in the ____ with the help of ____

A

Occurs in the medulla, with the help of medullary epithelium (mTEC)

46
Q

AIRE is a ____ that resides in _____ and controls expression of ____, playing a critical role in ______

A

AIRE is a TRANSCRIPTION FACTOR that resides in mTECs and controls expression of PERIPHERAL TISSUE SELF-ANTIGENS, playing a critical role in NEGATIVE SELECTION AND SELF TOLERANCE

47
Q

APECED stands for:

A

Autoimmune PolyEndocrinopathy Candidiasis Ectodermal Dystrophy

48
Q

What is the classic triad of APECED?

A

Mucocutaneous candidiasis, adrenal insufficiency, and hypothyroidism

49
Q

Regulatory T cells can be identified by what cell surface markers?

A

CD3+CD4+CD25high and FoxP3+

50
Q

What cytokines are produced by regulatory T cells?

A

TGF-B and IL-10

51
Q

CTLA-4:

A

a co-receptor that exists on regulatory T cells

52
Q

What processes result in anergy?

A

If a signaling block occurs during APC/T cell binding or there is an engagement of APC receptors with CTLA-4

53
Q

Ipilimumab:

A

Blocks CTLA-4, resulting in T cell activation. This is used to boost immune response to certain cancers, but can cause autoimmune disease

54
Q

Abatacept:

A

A recombinant CTLA-4 fused to an Fc portion of an IgG molecule. Given to people with arthritis, because the CTLA-4 mimickers engage the CD80/86, which prevents engagement of CD28 (and thus prevents activation)

55
Q

Name 3 ways that regulatory T cells suppress the immune response:

A

Produce inhibitory cytokines, express CTLA-4, and expression IL-32 receptors, capturing IL-2.

56
Q

IPEX stands for:

A

Immune Dysregulation, Polyendocrinopathy, Enteropathy, X-linked syndrome

57
Q

IPEX is caused by what mutation?

A

Mutation in Fox-P3 gene (X-linked recessive)

58
Q

How is apoptosis initiated in Peripheral T lymphocyte deletion?

A
  1. If antigen is presented with out co-signal, inducers of apoptosis are released from mitochondria. 2. Fas and FasL act as co-stimulators and induce death.
59
Q

ALPS stands for:

A

Autoimmune Lympho-Proliferation Syndrome

60
Q

ALPS is a disorder of ___

A

apoptosis

61
Q

ALPS can arise due to a mutation in what?

A

Fas, FasL, caspase 8, or caspase 10

62
Q

Describe the clinical presentation of a patient with ALPS

A

Lymphoproliferation, exhibited by splenomegaly, lymphadenopathy, and/or hepatomegaly

63
Q

AIRE gene defects are associated with:

A

Autoimmune polyendocrine syndrome (APS-1)

64
Q

FOXP3 gene defects are associated with:

A

X-linked polyendocrinopathy and enteropathy (IPEX)

65
Q

FAS gene defects are associated with:

A

Autoimmune lymphoprolierative syndrome (ALPS)

66
Q

SLE is associated with defective ___ lymphocyte tolerance

A

B and T

67
Q

Direct Coomb’s autoimmune hemolytic anemia is an example of what type of hypersensitivity?

A

Type II

68
Q

Immunological self tolerance is unresponsiveness to specific antigens ____ by exposure of lymphocytes to that antigen

A

induced

69
Q

What environmental factors can make a person more susceptible to autoimmunity?

A

Infection, UV radiation, Drugs and chemicals

70
Q

Autograft:

A

A graft between different sites on the same individual. “autologous transplantation”

71
Q

Isograft:

A

Between the same inbred strain of animals or between monozygotic twins

72
Q

Allograft:

A

One between non-identical animals/humans of the same species

73
Q

Xenograft:

A

between different species

74
Q

Allogenic hematopoietic stem cell grafts contain ______ that can target cancer

A

donor-derived immune cells

75
Q

_____ is not the goal of SCT

A

Complete donor/recipient tolerance

76
Q

T cell depletion of donor stem cell graft increases _____

A

relapse

77
Q

If a cancer patient treated with stem cells relapses, what is the best way to treat them?

A

These patients can be successfully treated with more T cells from the donor.

78
Q

Syngenic transplants are associated with a higher rate of ______

A

relapse

79
Q

Removing T cells from a stem cell graft ______ change of relapse by 3x (increases or decreases)

A

INCREASES

80
Q

Using a genetically identical (syngenic) donor _____ relapse risk by 3x (increases or decreases)

A

INCREASES

81
Q

The odds of any sibling being an HLA match is:

A

1/4

82
Q

Haplo-identical:

A

Half HLA matches (parents and children of patient - usually these need to be T cell depleted and risk of relapse is high)

83
Q

SCT can/can’t be performed across ABO incompatibilities (explain)

A

CAN be performed, because hematopoiesis will be provided by the donor’s stem cells.

84
Q

GFVD:

A

Graft Vs. Host Disease; where donor-derived, T cell mediated reactivity occurs against recipient tissues.

85
Q

How is GVDH treated?

A

immunosuppressive drugs

86
Q

acute GCHD attacks what tissues?

A

skin, colon, liver

87
Q

chronic GVHD affects:

A

skin, eyes, GI tract, liver, lung

88
Q

miHA:

A

minor histocompatibility antigens

89
Q

miHA are ____-specific

A

tissue

90
Q

Hyperacute graft rejection:

A

Occurs within hours (antibodies must be preformed), such as anti-A or anti-B blood group antibodies or anti-HLA antibodies. Results in complement fixation, vascular damage, and thrombosis

91
Q

Direct allorecognition:

A

Recipient T cells recognise peptide/HLA complexes presented by donor (graft) APC. T cell reactivity depends on donor APCs, which decrease over time.

92
Q

Indirect allorecognition:

A

Recipient APC processes donor proteins and present on recipient HLA.

93
Q

Acute Rejection:

A

7-21 days after transplant. Recipient derived cell-mediated cytotoxicity. Humoral graft rejection (antibodies are not preformed)

94
Q

Chronic Rejection:

A

> 21 days after transplant. Interstitial fibrosis. Mononuclear cell infiltration. Leads to organ ischemia.

Immunology Block 2 (9 decks)

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