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Inflammation block > Overview of the immune system in health& disease > Flashcards

Overview of the immune system in health& disease Flashcards

1
Q

What are the primary organs of the immune system?

A
  • Thymus

- Bone marrow

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2
Q

What are the secondary organs of the immune system?

A
  • Spleen
  • Lymph nodes
  • Mucosal associated lymphoid tissue
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3
Q

Outline the mechanisms of defense used in natural immunity

A
  • skin, mucous membranes
  • Enzymes, complement,acute phase proteins
  • Macrophages and neutrophils
  • Natural killer( NK) cells
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4
Q

Outline the mechanisms of defense used in adaptive immunity

A
  • Lymphocytes
  • T cells: cytokines, killing
  • B cells: antibodies
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5
Q

What can trigger inflammation?

A
  • Infections: (bacterial, viral, parasitic) & microbial toxins
  • Trauma
  • Physical & chemical agents
  • Tissue necrosis
  • Foreign bodies ( splinters, dirt, sutures)
  • Immune reactions ( aka hypersensitivity reactions)
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6
Q

What is the function of inflammation?

A
  • To neutralize/destroy the harmful agent
  • To alert the body to the threat of tissue injury
  • To limit the extent of tissue injury
  • To prepare the injuries for repair
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7
Q

Outline the symptoms of inflammation and the physiological responses associated with them

A
  1. ) Heat ( Calor): due to increased blood flow and elevated cellular metabolism
  2. ) Redness (Rubor): due to vasodilation & increased blood flow
  3. ) Swelling (Tumor): due to vasodilation; extravasation of fluid (permeability); cellular influx ( chemotaxis) & elevated cellular metabolism
  4. ) Pain (Dolor): release of soluble mediators; permeability; Chemotaxis & elevated cellular metabolism
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8
Q

Outline the phases of inflammation

A
  1. ) INITIATION: Induction of the acute inflammatory response
  2. ) AMPLIFICATION: Dependent on the extent of injury
  3. ) DESTRUCTION: Phagocytosis, enzymatic, non-enzymatic mechanisms
  4. ) TERMINATION: Resolution of inflammation, anti-inflammatory mediators
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9
Q

What are the molecular sensors of the innate immune response?

A
  • Pattern recognition receptors ( PRRs)
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10
Q

What are the molecular sensors of the innate immune response able to detect?

A
  • Conserved pathogen structures ( Pathogen Associated Molecular Patterns, PAMPs)
  • Endogenous insults
  • Exogenous danger signals ( Danger Associated Molecular Patterns, DAMPs)
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11
Q

What mediates the recognition in innate immunity?

A

Diverse recognition elements, 4 key families of pattern recognition receptors

  • Toll like receptors (TLRs, transmembrane receptors)
  • Rigl-like receptors (RLRs, cytoplasmic RNA helicase)
  • NOD-like receptors (NLRs, cytoplasmic sensors)
  • C-type lectin receptors (CLRs, transmembrane receptors)
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12
Q

What is the function of Interleukin 8 ( IL-8) ?

A

-Good chemotaxic agent for neutrophils, recruiting them to the site of inflammation

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13
Q

What is the function of Interleukin 12 (IL-12)?

A

-Drives the development of certain types of T cell e.g Th1

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14
Q

Which interleukins up-regulate vascular adhesion molecules?

A

TNF-alpha
IL-1
IL-6

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15
Q

Which interleukins increase vascular permeability?

A

TNF-alpha

IL-1

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16
Q

Which interleukins allow for vasodilation?

A

TNF-alpha
IL-1
IL-6

17
Q

Which interleukins induce maturation of dendritic cells

A

TNF-alpha
IL-1
IL-6

18
Q

What are the 5 inflammatory cascades

A
  1. ) Complement
  2. ) Coagulation
  3. ) Bradykinin
  4. ) Arachidonic acid
  5. ) Free radicals
19
Q

What does the resolution phase of inflammation involve?

A
  • Clearance of injurious stimuli
  • Clearance of mediators and acute inflammatory cells
  • Replacement of injured cells
  • Normal function
20
Q

Outline the characteristics of chronic inflammation

A
  • Self perpetuating, may develop in the course of recurrent or progressive acute inflammation, or low grade irritants that fail to elicit a classical acute inflammatory response
  • Chronic inflammatory cells: lymphocytes, macrophages
  • Neo-vascularization
  • No/less exudation
  • Prominent fibrosis
21
Q

Outline the characteristics of acute inflammation

A
  • flush,flare& wheel
  • acute inflammatory cells: Neutrophils
  • vascular damage
  • More exudation
  • Little/no fibrosis
22
Q

What is granulomatous inflammation?

A
  • A distinctive pattern of the chronic inflammatory reaction
  • A protective response to chronic infection or foreign material, preventing dissemination & restricting inflammation
23
Q

Which diseases may present with granulomatous inflammation?

A
  • TB
  • Fungal infections
  • Leprosy
  • Schistosomiasis
  • Foreign material
  • Autoimmune diseases
  • Rheumatoid arthiritis
  • Crohn’s disease
  • Sarcoidosis
24
Q

What are the differences in the systemic manifestations found in acute & chronic inflammation

A

Acute: fever, often high
Chronic: Low grade fever, weight loss, anemia

25
Q

What is the importance of IgA

A

-Important in the gut immune system and breast milk

26
Q

Outline the pneumonic ‘DAMEG’

A 
-helps to remember the immunoglobulin classes
IgD
IgA
IgM
IgE
IgG
27
Q

How can we classify the immunologic diseases for hypersensitivity?

A

Type I: Immediate hypersensitivity

  • Immune mechanism= IgE antibody
  • Mechanism of tissue injury= Mast cells & their mediators
  • EG: allergic rhinitis, asthma, systemic anaphylaxis

Type II:

  • Immune mechanism= IgM, IgG Abs to cell surface extracellular matrix Ag
  • Mechanism of tissue injury: Opsonisation& phagocytosis of cell; complement & FcR- mediated recruitment & activation leukocytes
  • EG: drug allergies, transfusion reaction, autoimmune haemolytic anaemia, Graves diseas, myasthenia gravis

Type III:

  • Immune mechanism: immune complexes of circulating Ags & IgM or IgG Abs
  • Mechanism of tissue injury: Complement & FcR-mediated recruitment & activation of leukocytes
  • EG: serum sickness, SLE

Type IV:

  • Immune mechanism:
    1. ) CD4+ (Delayed- type hypersensitivity)
    2. ) CD8+ CTLs ( T cell mediated cytolysis)
  • Mechanism of tissue injury:
    1. ) Macrophage activation: cytokine mediated inflammation
    2. ) Direct target cell lysis, cytokine-inflammation
28
Q

What are the stages of anaphylaxis?

A
  1. ) Generalised itching; urticaria
  2. ) Swelling away from the sting;incontinence
  3. )Difficulty in breathing
  4. ) Fall in BP; loss of consciousness
29
Q

Outline allergen crosslinkage of cell- bound IgE

A
  • occurs on the surface of a mast cell
  • Type I hypersensitivity; this signals degranulation
  • The allergen cross links with IgE Fc receptors found on the surface of the mast cell
30
Q

How can we diagnose type I hypersensitivity?

A
  1. ) Skin test:
    - Done under clinical conditions
    - Wheal( swelling) and flare (redness around the outside)
    - Measure the size of the wheal& flare reaction- this tells you how allergic the patient is to that particular allergen
  2. ) Immunoassay:
    - You need enzyme or radio labelled anti-IgE + IgE antibody in test sample + allergen coated paper disc
    - This is the radioallergosorbent test (RAST)
    - a blood test using radioimmunoassay test to detect specific IgE antibodies, to determine the substances a subject is allergic to.
31
Q

Outline the difference between a RAST test and a skin allergy test

A

-A skin allergy test determines allergy by the reaction of a person’s skin to different substances

Inflammation block (27 decks)

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