9. Mechanisms of tolerance Flashcards

(40 cards)

1
Q

What is immune system tolerant to?

A

Immune system is tolerant to self (self-tolerance)

Immune system is tolerant to harmless antigens such food or environmental ag

Immune system is tolerant to commensal microbiota

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2
Q

What is immunological tolerance?

A

Immunological tolerance refers to the mechanisms by which lack of immunological reactivity is induced and maintained

Like immunity, tolerance is antigen specific (unlike immunosuppression)

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3
Q

How do T cells recognise antigens?

A

Through TCR

Express TCR/CD3 (plus CD4 or CD8)

Recognise self MHC
Recognise peptide ag

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4
Q

What is significant about the T cell repertoire regarding tolerance?

A

The primary repertoire of T cells (and B cells & BCRs) is enormous as a result of combinatorial diversity

This repertoire contains self-reactive TCRs (*) and yet a normal immune system does not exhibit self-reactivity (i.e. autoimmunity).

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5
Q

Where does T cell development initially take place?

A

Lymphoid progenitors migrate from the bone marrow to the thymus where they develop into mature T cells

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6
Q

Role of thymus in T cell differentiation

A

The thymus is absolutely required for the differentiation of immature precursor into mature T cells.
Children without thymus (Di-George syndrome) or mice lacking a thymus (nude mice) do not have mature T cells.

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7
Q

How does the thymus change with age?

A

The human thymus is fully developed before birth and increases in size during puberty

Thymus is most active in the young and it atrophies markedly with age

It progressively shrinks (fat replaces areas where thymocytes existed)

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8
Q

What happens to the thymus by age 30

A

Degeneration is complete by the age of 30, but residual thymic activity persists until advanced age

The reduced production of T-cells does not completely impair immunity. Once established the repertoire of the T-cells is long-lived

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9
Q

What is immunosenescence

A

immunosenescence : progressive deterioration of immune responses mainly associated with age

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10
Q

What happens to TCR genes in the thymus?

A

they undergo DNA rearrangement in thymus

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11
Q

Why is a mechanism for repertoire selection and self-tolerance needed?

A

Generation of the TcR repertoire involves many random mechanisms to allow diversity

The specificity of TcR in the immature repertoire is also random & will include cells with receptors that are:

  1. Harmful - negatively selected
  2. Useless - neglect
  3. Useful - positively selected
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12
Q

Which cells will form the peripheral T cell pool?

A

Only cells that bear antigen receptor with appropriate affinity for the peptide presented in self MHC complexes complete their maturation and form the peripheral T cell pool

Naïve T cells 
which are:
self MHC restricted 
and 
self tolerant
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13
Q

Where do most T cells die?

A

T cells mature in the thymus but most die there.
98% of cells die in the thymus without inducing any inflammation or any change in the size of the thymus.

Thymic macrophages phagocytose apoptotic thymocytes.
5x10^7 go in per day but only 2x10^6 leave

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14
Q

Where does T cell development occur?

A

T cell development occurs in defined thymic microenvironment

Thymic stroma (epithelial cells + connective tissue) provides the microenviroment for T cell development and selection

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15
Q

What are thymocytes associated with?

A

Thymocytes are intimately associated with epithelial cells as they develop in the thymus

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16
Q

What does the T cell screening system involve?

A

Discrete forms of selection

Positive selection and negative selection

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17
Q

Positive selection

A

Retention of thymocytes expressing TcR that are RESTRICTED in their recognition of antigen by
self MHC
i.e. selection of the USEFUL

18
Q

Negative selection

A

Removal of thymocytes expressing TcR that either recognise self antigens presented by self MHC
i.e. selection of the HARMFUL

19
Q

Steps of positive selection

A

T cells from bone marrow negative for CD4,CD8,TCR: double negative go into thymus

in thymus: somatic rearrangement of genes encoding for b and a chains of TCR and expression of both CD4 and CD8 (small non-dividing cortical thymocytes, short life-span).

Thymocytes express TCR
Thymocytes able to recognise self MHC expressed on the surface of cortical epithelial cells SURVIVE

Induction to survival, differentiation, maturation (long-lived cells).

Those who cannot, DIE (apoptosis by dendritic cells)

20
Q

Central tolerance steps

A

Positive selection: MHC restriction, get rid of those that bind too weakly

Negative selection: tolerance induction - get rid of those that bind too strongly

21
Q

What T cells does the thymus accept?

A

The thymus accepts T cells that fall into a narrow window of affinity for MHC molecules

22
Q

Where do positive and negative selection occur?

A

Positive and negative selection occur in distinct thymic microenvironments after interaction with different types of thymic stromal cells

Positive - using cortical epithelial cell in cortex
Negative - using dendritic cells in cortico-medullary junction

23
Q

How can the thymus express all self antigens – including self antigens only made by specialised tissues?

How do we become self tolerant to these antigens?

A

Transcription factor expressed at high levels by thymic medullary epithelial cells

Mutations of AIRE lead to autoimmune polyendocrinopathy with candidiasis and ectodermal dysplasia (APECED), also called autoimmune polyendocrine syndrome (APS-1)
Mouse knockout: failure to express many self antigens in the thymus and expression of autoantibodies

24
Q

How is self-tolerance established to antigens that

cannot be expressed in the thymus?

A

T cells bearing TcR reactive with proteins expressed in the thymus are deleted.
Some self proteins are not expressed in the thymus e.g. antigens first expressed at puberty
Self tolerance needs to be induced and maintained outside the thymus

-> PERIPHERAL TOLERANCE

25
Peripheral tolerance
Tolerance to foreign antigens is induced and maintained in mature lymphocytes Not all potential ‘self’ molecules are present in the thymus during TCR development eg lactose, insulin, antigens first expressed at puberty etc etc ... Don’t want to make an immune response against harmless things / food Don’t want excessive lymphocyte activation and tissue damage during normal protective responses against infections Auto-immunity/allergy - breakdown of peripheral tolerance: the immune system responds to self or environmental ag
26
mechanisms of peripheral tolerance
IGNORANCE: lymphocytes fail to recognise or respond CLONAL ANERGY: binding of ag makes lymphocyte unresponsive CLONAL EXAUSTION: continued stimulation by persistent antigen may ‘wear out’ responsive cells SUPPRESSION: interaction with other cells (or cytokines) may inhibit responsiveness
27
Clonal ignorance
self reactive lymphocytes fail to recognise or respond to some self antigens in the periphery cells neither die nor become anergic
28
What is immune privilege?
Self -reactive T cells sometimes ignore ag antigens anatomically sequestered from the immune system: T cells cannot reach cells bearing the ag Tissue grafts placed in these sites are not rejected immunologically privileged sites (eye, testis, uterus/placenta) if sequestred ag is released autoimmunity can result (many vasectomised males have anti-sperm Abs)
29
Eye as an immune-privileged site
Eye anterior chamber is an immune-privileged site. Normally, self-antigens in this site are not exposed to the immune system Physical trauma in one eye can initiate autoimmune response to both eyes. This can cause blindness in the both damaged and undamaged eyes: Sympathetic ophthalmia
30
2. Induction of anergy
presentation without costimulation CTLA-4 signaling CD28 and CTLA-4 have opposing functions Knockout of CTLA-4 in mice and heterozygous mutation in humans results in immune dysregulation (lymphoproliferation, multi-organ inflammation)
31
Therapeutic application of CTLA-4
Blocking CTLA-4 promotes tumor rejection CTLA-4 limits immune responses to tumors Administration of antibody that blocks CTLA-4 in tumor-bearing mouse leads to tumor regression Anti-CTLA-4 antibody is approved for tumor immunotherapy (enhancing immune responses against tumors) Even more impressive results with anti-PD-1 in cancer patients
32
Activation-induced cell death (AICD)
Repeated stimulation of T lymphocytes by persistent antigens results in death by apoptosis of the activated cell Elimination of T cells specific for abundant peripheral antigens: Clonal exhaustion (expression of inhibitory receptors on exhausted T cells, e.g. CTLA-4, PD-1)
33
suppression
Treg cells are critical components in the maintenance of peripheral tolerance through “suppressive” mechanisms Tregs suppress the activation of effector responses and are critical for regulating homeostasis and tolerance to self antigens
34
Treg deficiency
Deficiency of T regulatory cells is associated with aggressive autoimmunity IPEX [Immunodysregulation, Polyendocrinopathy and Enteropathy, X-linked syndrome]: fatal autoimmune disorder characterised by systemic autoimmunity in the first year of life
35
Treg clinical application
Critical role of Treg in promoting tolerance may be exploited to: strengthen or re-establish self-tolerance in autoimmune disease induce tolerance to non-self-antigens in organ transplantation, GVHD and allergy Induce tumour immunity in cancer patients
36
What determines whether an antigen is tolerogenic or immunogenic
the same antigen can be tolerogenic or immunogenic, depending on how/when/where it is encountered How the antigen is presented to lymphocytes: concentration timing persistence tissue distribution nature of the cell presenting the antigen How the responses of specific lymphocytes to that antigen are regulated
37
Antigen properties
Molecular weight Smaller, soluble, not-aggregated molecules favors tolerance large, aggregated, complex molecules favors immunogenicity Dosage very small or large favors tolerance intermediate favors immunogenicity Routes of administration Oral, intratracheal, orbital exposure can activate T cells to secrete TGFbeta (Tregs).
38
Oral tolerance
Interaction of food proteins with gut-associated lymphoid tissue (GALT) in the intestinal transit is the essential prerequisite for oral tolerance. Different cells of the immune system participate in oral tolerance induction, with regulatory T cells being the most important.
39
Clinical applications of oral tolerance
clinical trials : ``` Disease Antigen Multiple Sclerosis (MS) Myelin Basic Protein (MPB) ``` Rheumatoid Arthritis (RA) Type II collagen Type I Diabetes Insulin
40
Hyposensitisation ImmunotherapyOral immunotheraphy (OIT)
using small amount of allergens (food, pollen) to induce antigen specific tolerance continuous administration of the allergen, rather than its elimination, to promote the development and maintenance of tolerance Oral/sublingual desensitisation immunotherapy for peanut allergy holds promise for the control of allergy Note: Sensitization to food antigen can occur through cutaneous exposure!