Final Flashcards
(135 cards)
1
Q
Is TH1 or TH2 the one involved in intracellular stuff? Which one is the one involved in extracellular stuff?
A
TH1 = intracellular (Produces IFN-gamma to activate macropahges and activates CD8+ and Cd4+ cells) TH2= Extracellular (Involved in antibody stuff and activates eosinophils, basophils, mast cells, and IgE
2
Q
No pro-inflammatory activator will be activated without ___. Likewise, anti-inflammatory cytokines are ___ independent
A
NF-kB (the cytokines IL-10 and TGF-B are independent of NF-kB since they are the anti-inflammatory ones)
3
Q
What are the three most important pro-inflammatory cytokines?
A
TNF, IL-1, and IL-6
4
Q
Fever, decreased appetite, increase in tiredness are results from __ effects of cytokines
A
Systemic
5
Q
The endotoxin ___ is the most potent inducer of TNF
A
LPS
6
Q
IFN-gamma-inducing factor is another name for which cytokine?
A
IL-18, since IL-18 and IL-12 work syngericly to stimulate IFN-gamma production
7
Q
What is the most important cytokine for cell mediated immunity?
A
IFN-gamma (activates macrophages so that they can kill intracellular microbes through phagocytosis, respiratory burst, etc.)
8
Q
IFN-gamma suppresses/blocks IL-__ which allows for allergic responses to be inhibited
A
IL-4
9
Q
What are three major anti-inflammatory cytokines?
A
IL-10, TGF-betta, and IL-1 receptor antagonist (IL-1ra)
10
Q
Name the type of cell that develops when a dendritic APC stimulates a Th0 cell.
1) IL-1 and IL-6
2) TGF-betta
3) IL-4 (or absence of any cytokines)
4) Il-12
A
1) TH17
2) T-regulatory cell
3) Th2
4) Th1
11
Q
What cytokine does T-regulatory cells produce the most of?
A
IL-10
12
Q
Activation of different transcription factors lead to the differentiation of the same T-cell into different cells. Name the type of cell developed when these TFs are activated in the cell?
1) FOXP3
2) GATA-3
3) T-bet
4) ROR-gamma-T
A
1) T-regulatory cell
2) Th2
3) Th1
4) Th17
13
Q
What blocks IL-2-induced proliferation of T-cells?
A
TGF-betta
14
Q
TH1 cells produce IFN-gamma which helps to increase the activation of macrophages and also stimulate production of ___ antibodies
A
IgG (since IgG can also help increase macrophage phagocytosis since remember it can bind to complement)
15
Q
Which two cytokines work in synergy to activate macrophages and kill intracellular bacteria?
A
IFN-gamma and IL-12
16
Q
Dendritic cell is loaded with Ag and moves into the T-cell zone located in the ___ of the lymph nodes
A
Parafollicular cortex
17
Q
For T-cells, the co-receptors are ___ and the co-stimulator is ___
A
CD4+/CD8+, B7 (CD80 and CD86)
18
Q
Who are the APCs in the tissue?
A
Macrophages
19
Q
CD40 expressed on APCs can plug into CD40L on T-cells. When this occurs, what three things are increased on the APC?
Also, remember that CD40L on the T-cell is required for activating B-cells
A
Increased B7, MHC II, and cytokine secretion
20
Q
What two mechanisms can CD8+ cells use to kill microbes?
A
Release of granules (granzymes and perforins) or Fas-L-Fas (CD95) interactions aka Fas-L on CD8+ cell binds to CD95 on target cell
21
Q
What cells can act as regulator cells, the first line of defense, and a bridge between innate and adaptive immunity?
A
Nontraditional T cells deltagamma
22
Q
___ T-cells are cells that do not need an APC to become active
A
Nontraditional gammadelta
23
Q
What do NKT (natural killer T) cells recognize? DO NOT CONFUSE THEM WITH NK CELLS
Also, what does the NKT cell recognize to become active?
A
Lipids and glycolipids
CD1d (which presents the lipid or glycolipid just as an APC would present a protein)
24
Q
All of the myeloid cells (Macrophages Mast cells Basophils and neutrophils) are rich in ___.
Which are the only 2 cells that cant produce COX-2
Which is the only cell that cant produce COX-1?
A
5-LO
Platelets and neutrophils
Neutrophils
25
Leukotrienes are ___, not hormones
autocoids
26
CysLT is the receptor for which compounds?
| BLT is the receptor for which compounds?
LTC4 and LTD4
| LTB4
27
Which of the following proteins is a chemoattractant for neutrophils?
Which of the following lipids is a chemoattractant for neutrophils?
IL-8
| LTB4 (Remember, neutrophils can make their own LTB4 to recruit even more neutrophils aka auto-amplify)
28
What shape/type of cells do you find lining the respiratory airways?
Ciliated columnar epithelium
29
Airway inflammation = ___
| Joint inflammation = ___
Leukotrienes
| Prostaglandins
30
Crosslinking of IgE receptors to trigger degranulation and relsease of histamine from mast cells, also results in the synthesis of what three eicosanoid?
LTC4, LTD4, and PGD2 (Are all bronchoconstricting agents, and LTC4 and LTD4 secrete mucus)
31
Histamine has two receptors. Which ones are found in the nasal and bronchials? Which ones are found in the heart/blood vessels? Which ones in the Bronchial and intestinal smooth muscle? Which ones are found in the stomach? Which ones in the sensory nerves? Skin capillary blood vessels?
Also, what role do these receptors play in each area mentioned above?
H1, H1 and H2, H1, H2, H1, H1 and H2
Nasal/bronchial = mucus secretion
Heart/Blood vessels = heart rate increases, blood vessel's peripheral resistance declines and vessels dilate
Bronchial/intesine = constriction
Stomach = gastric acid secretion
Sensory nerves = pain
Skin = Dilation, permeability, and pain sensitization
32
During anaphylaxis, there is an ___ heart rate, the is __ of blood vessels (which causes the dilvery of oxygen through the blood to be very inefficient), the is bronch__, and stimulation of __ release into the respiratory tract.
Increased, Relaxation, constriction, mucous
33
When a B-cell has a high affinity for a ___, it results in apoptosis, which is also called ___ selection. This type of selection that involves the thymus and bone barrow is classified into ___ tolerance
Another thing that can occur when a B-cell recognizes its self antigen is what?
self-antigen, negative, central
Class switching (also called receptor editing)
34
When a B-cell binds to antigen, what three things happen?
1) Proliferation
2) Increased expression of MHC II, B7, and Receptors for cytokines
3) Secretion of low IgM
35
What pathway does cytokine use to get a signal into the nucleus?
JAK-STAT
36
What interaction is critical for memory B-cells to be produced?
CD40-CD40L interaction (So if T-helper cells don't activate the B cells, there are no memory cells aka Thymus independent = no memory cells made)
37
There are two types of Thymus Independent Antigens. TH-__ antigens are polyclonal activators of B cells, where as TH-__ antigens are not polyclonal and have repeating epitopes for cross-linking of BCRs
TH-1
| TH-2
38
In Gout formation, macrophages and monocytes engulf ___ crystals and release ___ to cause inflammation. Then, ___ induces expression of inhesion molecules on the endothelium and expression of ___ in macrophages, monocytes, connective tissue, and endothelial cells. Now that Cox-2 is being expressed, and a little amount of Cox-1, prostaglandin mediators will start to be produced as well which can lead to vasodilation from ___ production, increased permeability to vessels from ___ production, fever from PGE2 in the __ and pain from PGE2 in the ___
Uric acid, IL-1betta and IL-8, IL-1betta (even though TNF also does this, IL-1betta is the major one in Gout formation**), COX-2, PGI2, PGE2, CNS, PNS
39
The process of fluid leaking out is called ___
Extravasation
40
In gout, which two cytokines are mainly produced?
| In bacterial infections, which two cytokines are mainly produced?
IL-1betta and IL-8
| IL-1 and TNF
41
___ is when a bacterial infection enters the blood stream and thrives. Aka this is SYSTEMIC INFLAMMATION
Sepsis
42
Since anaphylactic shock occurs when the vessels are dilated (which leads to blood pressure drop since fluid is leaking out) and bronchioles are constricted, one way to combat this is administer epinephrine. What two things does this drug most likely do?
Cause vasoconstriction and bronchodilation (to combat the anaphylactic shock)
43
Encapsulated bacteria are defended against best by which cells?
Thymus-independent B cells
44
An injured cell that results in a passive, catabolic cell death and then external toxic factors are released is called ___
Necrosis
45
What are three danger signals (DAMPs) we talked about during necrosis? Also what do all of these have in common?
HMGB1, Uric acid, HSPs
| They all activated NF-kB
46
What is the receptor for HMGB1 (High mobility group box 1)
RAGE
47
When macrophage cells become filled with lipids, they are called ___ cells, and this can lead to chronic inflammation in atherosclerosis
Foam
48
___ is a clean cell death where no tissue inflammation will occur, whereas ___ is a dirty cell death that can cause inflammation or harm other neighboring cells.
Apoptosis, Necrosis
49
___ is the process by which the immune system does not respond to self antigens. This is the opposite of nercrosis
Immunological tolerance
50
__ are the major executioners in the apoptotic program.
The __ pathway involves death receptors
The __ pathway is mitochondrial dependent
Caspases
Extrinsic
Intrinsic
51
The intrinsic apoptotic pathway is dependent on __ and involves which three triggers? Which main regulator? And which main executioners?
The extrinsic pathway is dependent on ___ and involves which main executioner?
Mitochondrial
Trigger = Bcl-2 family proteins (BAK and BAX), Calcium, Free radicals
Regulators = Cytochrome C
Executioners = Caspase 9 and 3
Fas-FasL binding
Executioners = Caspase 8 and 3
52
In autoimmune lymphoproliferative syndrome (ALPS), there is a defective gene in the __-mediated apoptosis pathway, which means cells don't die and this causes them to pool in the lympnodes etc.
Fas
53
What cytokines activate M1? Which cytokines activated M2?
| Macrophages
IFN-gamma activates M1
| IL-4, IL-13 activate M2
54
In the thymus, where T-cells mature, thymocytes (aka cells found in the thymus) present self antigens to the maturing T-cells in order to determine their fate. If a T-cell can not recognize the self-antigen displayed by a MHC I or II class then it __. If there is a weak interaction between the maturing T-cell and a MHC II class peptide is recognized it forms a mature ___ cell. If a weak interaction with MHC I class is recognized, it forms a mature __ cell. Both weak interactions are referred to as ___ selection. If a strong interaction between MHC I or II is encountered, __ selection occurs.
Dies (apoptosis), CD4+, CD8+, positive, negative
55
For the activation of B-cells, protein antigens illicit what kind of response? What about polysaccharides, lipids, and other non-protein antigens?
Thymus-dependent
| Thymus-independent
56
What are the first antibodies produced?
IgM
57
___ are toxin components of bacterial cell walls, whereas ___ are toxins which are secreted by the bacteria
Endo (main one is LPS), Exo
58
Name three exotoxins
Diptheria, Cholera, and Tetanus
59
What subunits make up C3 convertase for the Classical, MBL, and Alternative complement pathways?
What about C5 convertase for all the pathways?
Classical and MBL both have C3 convertase: C4bC2a
C5 convertase: C4bC2aC3b
Alternative has C3 convertase: C3bBb
C5 convertase: C3bBbC3b
60
IgG and IgA bind to what two receptors respectively on macrophages and neutrophils?
IgE binds to what receptor on mass cells, basophils, and eosinophils?
FC-gamma-RI and FC-alpha-RI
| FC-epsilon-RI
61
There are multiple types of ways to avoid immunity. Name them based on their definition, and also name which bacteria can do this.
1) Alter their surface proteins
2) Have a capsule, destroy C3 convertase, or block MACs
3) Interfere with complement activation or inject anti-phagocytic effectors
4) Deactivate peroxide radicals
5) Inhibition of phagolysosome formation
6) Escape phagolysosome and move into cytoplasm of cell
1) Antigenic variation: Gohnarreah, E. Coli, Salmonella
2) Inhibition of complement: Many different bacteria
3) Resistance to phagocytosis: Pneumcoccus
4) Scavenging ROI: Catalase-positive staphylococci, myobacterium leprae
5) Myobacterium tuberculosis
6) Listeria monocytogenes
62
Complement receptor 1 (CR1) binds to ___
| CR2 binds to __
C3b and C4b
| iC3b or C3d
63
ONOO- also called ___ causes apoptosis and necrosis
Peroxynitrite
64
```
__ = different classes of antibodies (FC region)
__ = specific affinity for an antigen (FAB region)
```
Isotype
| Idiotype
65
An antibody can have two identical light chains, __ or __, but NEVER one of each!!!!
What chromosome is MHC found on?
kappa (on chromosome 2) or lambda (on chromosome 22)
6
66
The two heavy chains of an antibody are encoded on chromosome ___ and has which 5 isotypes?
14, MEGA D (big di*k) - mu, epsilon, gamma, alpha, delta
67
When a T cell is maturing it goes from double __ to double __ to single __
negative -> positive -> positive
68
The first heavy chain Isotype is __, which provides the IgM immunoglobulin class
Mu
69
__ are the coding regions, where as ___ are noncoding regions that get spliced out
Exons, introns
70
Expression of an Ig heavy chain involves two gene recombination events. __-__ joining and then __ is joined to the new __ complex.
Which genes follow the same sequence, but don't have a D region.
D-J, V, DJ complex (to make VDJ)
Ig light chains and TCR alpha chain
71
Combinational diversity, due to somatic recombination of V, D, and J is mediated by the enzyme ___
VDJ recombinase (aka it's the one that brings V/D/or J segments together
72
VDJ recombinase has what two proteins that recognize DNA sequences that flank all VDJ segments?
RAG-1 and RAG-2
73
___ diversity is the removal or addition of nucleotides introduced at the junctions of the recombining VDJ segments
Junctional
74
___ catalyzes the random addition of nucleotides that are not part of the germ line genes to the junctions between V and D/ D and J segments
TdT
75
The VDJ junction sequences encodes the amino acid ___, which is the most variable of them all
CDR3 (complementarity determining regions)
76
___ is when a B cell increases its affinity to bind to an antigen when a mutation occurs. Usually this mutation involves the base ___, which is replaced with a different base
Somatic hypermutation, cytosine
77
What size peptides do MHC 1 vs 2 bind?
```
1 = 8-10
2 = 13-25
```
78
In class 1 MHC molecules, which subunit is invariant (same in everyone) and also binds to CD8+ T-cells?
What about class 2 MHC?
Alpha-3
| Beta-2
79
Name the type of graft:
1) Graft where tissue is moved from one place to another in the same individual
2) Transplants between genetically identical individuals
3) Grafts between genetically different members of the same species
4) Grafts between members of different species
1) Autograft (autologous) - skin grafts
2) Isografts (syngeneic)
3) Allogenic grafts - kidney, liver, etc.
4) Xenogeneic grafts - pig heart to human hart
80
Which HLA complexes are the most important in predicting the likelihood of a tissue transplantation rejection?
HLA-A, HLA-B, HLA-DR
81
The set of MHC alleles present on each chromosome is called an ___.
Remember, it is the ___ that is important, not the individual MHC complex
MHC haplotype
Haplotype (because think about, you could have the same identical MHC complex as your brother, however if some of the HLA-As, Bs, or DRs are mixed on a different haplotype than what your brothers haplotype is, it will still have problems in graft rejections).
82
TH__ cells help CD8+ cells proliferate and CD8+ cells also produce some ___ which can help increase the activation of macrophages
1, IFN-gamma
83
The cytokine __ leads to inhibition of viral gene replication and up-regulation of MHC 1 molecules
Also was does this cytokine activate?
What antibodies FC region does an NK cell bind to?
IFN-alpha
NK cells
IgG via FC receptor (FC-gamma-RIII)
84
Where do virus-specific memory cells reside?
Spleen, bone marrow, and lymph nodes
85
When the PRR __ binds beta-Glucans, you know that a fungi is the microbe involved.
Dectin 1
86
___ tolerance is induced in the immature self-reactive lymphocytes
___ tolerance is induced in the mature self-reactive lymphocytes
Central (generative aka primary = thymus and bone marrow)
| Peripheral (secondary)
87
If you have autoimmune disease, what cells are most likely the cause?
T regulatory cells
88
Several tissue antigens called __ are not expressed in the thymus because of a mutation in the transcription factor ___, so immature T cells specific for these antigens are not eliminated. However, these antigens are expressed normally in the appropriate peripheral tissues since this transcription factor only controls the thymic expression of the antigen. So now, when these T-cells go into the peripheral tissues, they encounter the antigens and react agaisnt them since they werent killed when maturing. This is referred to as a breakdown in ___ tolerance
TRAs, AIRE (AutoImmune REgulator)
| Central
89
Strong recognition for T-cell and self-antigen result in what two possibilities for negative selection?
1) T-cell kills itself
| 2) T-cell becomes regulatory cell (Produces anti-apoptotic molecules to protect them from apoptosis)
90
T-regulatory cells are all CD__+ cells. And in order to not die when negatively selected against (due to their strong binding of self-antigen) ___ produces a higher concentration of anti-apoptotic molecules than there are pro-apoptotic molecules. In addition, Treg-cells express high levels of __, which is a CD28 analog that binds to B7 to cause T-cell anergy. They also express high levels of ___, the alpha chain of the IL-2 receptor
4, FoxP3, CTLA-4, CD25+
91
T-regulator cells play in role in blocking the activation of an immune response (potentially harmful lymphocytes) for their self antigen. They can do this in multiple ways, name the three most important
1) Expressing IL-10 and TGF-betta to inhibit activation of lymphocytes, dendritic cells, and macrophages. 2) Express CTLA-4 to block B7 costimulation and activation of T-cells. 3) Since regulatory T cells need IL-2 they use it and therefore it takes away from the amount that is able to be used by T-cells that are trying to grow and proliferate.
92
__ T-regulatory cells are generated by self-antigen recognition in the thymus
__ T-regulatory cells are generated by self-antigen recognition in the lymph-nodes
Natural
| Inducible
93
TGF-betta is a chemoattractant for ___, decreases activation of M1 macrophages and moves them towards the M2 phenotype, regulates differentiation of FoxP3+ T-regulatory cells, and promotes class switching from IgM to Ig__
fibroblast, IgA
94
Autoimmunity is always ___ (acute of chronic)?
Chronic
95
T cells that are physically separated from their specific antigen cannot become activated and this is called ___
Immunologic ignorance
96
The genes that are most associated with autoimmunity are the __ genes (aka in order to develop this condition, you must have genetics that pre-dispose you)
MHC
97
In order to have autoimmune disease, an environmental factor must influence it. There are multiple ways that environmental factors can do this. One way is called ___ and this is where microbes that have infected the body can produce peptide antigens that are similar to self antigens. Therefore lymphoctyes and even antibodies are tricked into not only attacking the microbe, but also attacking our normal body cells that mimic the microbe's antigens.
Another way is when infections injure tissue, which causes the tissue to release antigens that are normally ___ (since these antigens are normally not seen and instead ignored, when they are released it can initiate an autoimmune reaction against the tissue). One last mentioned way is by polyclonal aka ___ activation, which is produced by a cytokine field.
Molecular mimicry, sequestered (aka suppressed), bystander
98
In the disease ___, antibodies against streptococci are produced, but since streptococci have molecular mimicry that make antigens very similar to a myocardial antigen called ___, the antibodies also bind to the heart antigens and cause a heart disease.
In the disease ___, T cells are activated when a Epstein-Barr virus, Influenza, or papillomavirus attack. However, these microbes have molecular mimicry which produce antigens similar to the normal ___ which causes an autoimmune disease where nerves are damaged
Rheumatic fever, cardiac myosin
| Multiple sclerosis, myelin basic protein
99
Gram negative bacteria have an outer membrane with LPS. The LPS is made up of three regions, and the innermost region that connects the the outer membrane bilayer has an endotoxin called ___
Lipid A (when bacteria are lysed, this is released into circulation and it's toxic)
100
Gram ___ is vulnerable to lysozyme and penicillin attacks, but gram __ is not
Positive, negative
(since positive can't block the diffusion of low molecular weight compounds that can pass through, but negative have LPS which blocks the passage of these small molecules)
101
All medically important bacteria are ___ (chemo/photo and auto/hetero)?
Chemoheterotrophs (because they use chemical and organic compounds, such as glucose, for organic energy)
102
B-cells that bind strongly to self-antigens in the bone marrow __ or ___.
B-cells that weakly bind to self-antigens in the bone marrow __
```
Die or undergo receptor editing.
Become anergic (this is not what happens to T-cells)
```
103
B-cells have an inhibitory receptor called CD__, and when a ligand binds to it, __ is phosphorylated, which causes ___ tyrosine-phosphatase to be recruited, and then attenuating B cell receptor signaling occurs (attenuating = turning down). Therefore, mutations in any of these can cause a never-stopping signal and therefore autoimmunity.
22, Lyn (Src for B cells), SHP-1
104
Name the antibody associated with the function (For type IgG, name the specific subtype)
1) Mast Cell activation (Also defense against parasites)
2) Opsonization
3) Mucosal Immunity
4) Anaohylactic shock
5) Neonatal Passive immunity (through breast milk)
6) Complement activation
7) Feedback inhibition of B cells
8) Naive B cell antigen receptor
9) Neonatal immunity (through placenta)
10) ADCC (antibody-dependent cellular cytotoxicity)
1) IgE (It seems that this can lead to degranulation of all granulocytes)
2) IgG1
3) IgA
4) IgE
5) IgA
6) IgG 3 or IgM
7) IgG 4
8) IgM
9) IgG (no number given)
10) IgG 3
105
When using florescent dyes, __ stains green and ___ stains red
FITC (fluorescein isothiocyanate), PE (phycoerythrin)
106
The Heidelberger-Kendall Curve uses a __colonal antiserum for immunoagglutination
In __ assays, you have a constant solution with antibodies in various wells. And you add your antigen starting from very dilute -> more dilute until you see if agglutination occurs. However, if patient has a very high concentration of serum C-ractive protein and you take a non-diluted sample, you will get a ___ result.
This problem does not exist in __ assays. In this assay, you are taking pre-made conjugated particles and simply adding your antigen to see if it breaks apart the conjugated molecule since it will be competing for antibody binding sites. In this assay, you always __ absorbance so you can never get a false negative result.
In both of them, if you have a decrease in PH, this will lead to a __ result since the proteins themselves will precipitate due to isoelectric point
Also, both of these techniques are __tative
Poly
Direct, False negative (you must use VERY diluted samples to prevent this), indirect, decrease
False positive
Quantitative
107
___ uses a semisolid agar gel to cause migration of Ab and Ag and therefore precipitate. It is a __tative technique. However, this technique is slow because you must incubate it overnight to allow diffusion. A better technique is __ which accelerates diffusion with an electrical field and creates a "rocket". This technique is __tative. Immunoelectrophoresis (IEP) can also be used to identify monoclonal immunoglobulins and this is a __tative technique.
Ouchterlony Immunodiffusion, qualitative (detect antibody and antigen in sample), electroimmunoassay (EIA which is also a type of immunoelectrophoresis), quantitative (measure level of antigens in sample), Qualitative
108
Immunoelectrophoresis (IEP) is mainly used to identify monoclonal immunoglobulins also called ___, associated with plasma cell neoplasia
M-component
109
The ___ Coombs test is used to detect antibodies or complement proteins that are bound to the surface of red blood cells
The __ Coombs test is used in prenatal testing of pregnant women and in testing blood prior to a blood transfusion.
Direct
Indirect
110
ELISA is a __tative test. In this test, you coat the wells with a __clonal antobody. There are three different assays that can be used. Direct, indirect, and capture assay. Which one is best for quantitative measuring?
Which ones are semi-quantitative?
quantitative, mono (specific for Ag of interest)
Capture assay
Both direct and indirect
111
Name the CDs associated with the leukocytes
1) All T Cell
2) All B Cell
3) Dendritic Cell
4) NK Cell
5) Stem Cell (HSC)
6) Macrophage/Monocyte
7) Granulocyte
8) Leukocyte
9) T helper cells
10) Killer T cells
11) T-regulatory cells
12) Naive T-cells
13) Memory T cells
1) 3
2) 19
3) 11c,123
4) 56
5) 34
6) 14,33
7) 66b
8) 45
9) 4
10) 8
11) 25
12) 45Ra
13) 44
112
You are asked to determine how many CD4 and CD8 cells are in a patients blood serum. What technique do you use?
Also what color do FITC labeled cells present. What about PE labeled cells?
FACS (Fluorescence-activated cell sorting) aka Flow cytometry
Green, Red
113
The GI has anaerobic conditions so cells can not go there. The only way we can protect the lumen is to provide ___ to protect endothelial cells from bacteria adhering to their surface.
antibodies
114
There are many different mechanisms employed in GALT (Gut-associated lymphoid tissue) to protect against bacteria. Microvilli, tight junctions so bacteria can't slip through, glycocalyx where the bacteria will get stuck to, antimicrobial peptides, and ___ cells which overlie peyers patches and lymphoid follicles to facilitate luminal sampling (these cells promote uptake and transport of luminal contents)
M-cells (microfold)
115
GALT is constantly exposed to a threat (ALL OF THE TIME) and therefore must have a response that can be activated locally along the tissue. This response occurs in __ and Naive T and B cells can be activated (it mimics what occurs in the peripheral organs). Unlike M-cells which deliver antigen to dendritic cells, dendritic cells can also take in antigens themselves by reaching between the epithelial cells, however this does NOT OCCUR in the peyers patch.
Which is the dominant way that microbes are sampled in the GI?
Peyer's patches
Peyer's patches through M cells
116
In the GALT, antigens are taken in by M-cells and passed to ___ dendritic cells. These cells then move into the lymphoid follicles presenting the antigen, and activated B and T cells. These cells and some dendritic APCs travel to the __ lymph nodes which activate more Naive-T cells and then the effector cells go into system circulation. When they respond to a bacteria, CD8, CD4, gammadelta T-cells all migrate to the site of infection. Also, B cells secrete __ and __ which line the mucous to prevent the bacteria from entering circulation
follicular, mesenteric, SIgA and SIgM (S= secretory)
117
If a T-cell is activated in the GI lamina propina, it is most likely a __ cell. However, __ cells can also accumulate in the intestine when unhealthy microflora in the gut produce it as a byproduct. This cell releases the cytokine __, which leads to inflammation and can cause an autoimmune disease.
Healthy microflora synthesize __, which is an important factor in helping B-cells produce Iga
T-regulatory (This is to reduce inflammation), Th17, IL-17
Retinoic acid
118
Gut microflora control the levels of Ig__ and a deficiency leads to alterations in the composition of the gut microflora.
A
119
Bacteroides fragilis produce ___ cells and segmented filamentous bacteria produce (SFB) __ cells
T-regulatory, Th17
120
The disruption of the microflora is a process called __. This leads to increased __cells and IL__, along with and decreased ___ cell levels.
In order to not have inflammation occur, what is suppressed by the microflora and which receptor does it bind to in order to suppress it.
Dysbiosis, Th17, IL-1, T-regulatory
Nf-kB, PPAR (Peroxisome Proliferator-Activated Receptor and it exports the activated Nf-kB from the nucleus)
121
Which hypersensitivity reactions are antibody mediated?
| Which ones are cell-mediated?
1,2,3
| 4
122
Name the type of immunity involved.
1) Antibodies interact with the tissue antigens (Fc receptors, and complement)
2) T-cells produce cytokines which cause activation of macrophages
3) Involves participation of unique antibodies (Ig) and mast cells
4) Antibodies find soluble antigen in the plasma and become big complexes where they get stuck in vessels
1) Type 2
2) Type 4
3) Type 1
4) Type 3
123
Individuals with a strong propensity to develop allergic reactions are said to be __
atopic
124
In type 1 hypersensitivity, an allergen causes Th__ activation and B cells to produce Ig_ antibodies, that bind to the Fc__R1 receptor on mast cells. The first time this occurs, NO reaction takes place. However the second exposure to allergen causes an __ reaction. When the mast cells first release their granules, it results in vasodilation, congestion, and edema. The __ phase reaction, which occurs 2-24 hours after, results in what cells coming to the site of infection?
Th2, E, epsilon, immediate, Late, Eosinophils/neutrophils/T-cells
125
In type 2 hypersensitivity, talking about tissue damage, Ig__ antibodies bind to neutrophils an macrophages to active them and result in a pro-inflammatory response. The major players in this type of immunity is chemoattractants released by the macrophages and neutrophils, and also __ activation which releases the anaphylatoxins __and __ (these attract PMNs which are 60% neutrophils)
IgG (IgM can also participate if we were talking about endothelial cells), complement, C3a and C5a
126
Autoimmune hemolytic anemia, Idiopathic thrombocytopenic purpura, Goodpasture's syndrome, Grave's disease (hypothyroidism), Myasthenia gravis, Pemphigus vulgaris, Pernicious anemia, and Rheumatic fever are all types of type __ hypersensitivity
Type 2
127
In type 3 hypersensitivity, complexes of Ag-Abs are deposited in ___ basement membranes (anywhere that you have capillary networks like the skin, kidney, lungs, etc.) and just like type 2, IgG and IgM activate complement and Fc receptor leukocytes, which trigger inflammation in the vasculature
Vascular
128
Systemic lupus erythematosus, polyarteritis nodosa, post-streptococcal glomerulonephritis, serum sickness, and arthus reaction are results from type __ hypersensitivity
3
129
Type 4 hypersensitivity is cell-mediated, specifically, CD8+ cells, CD4+ cells including Th__ and Th__, and macrophages (as APC and produce cytokines and ROSs) .
The major cause of type 4 hypersensitivity is __ and exaggerated or presistent responses to environmental antigens.
1 and 17, autoimmunity
130
Type 4 hypersensitivity is also called __ type hypersensitivity due to the fact that it takes about 24-48 hours for a T-cell response to be detectable.
Delayed (DTH)
131
Multiple sclerosis, Rheumatoid arthritis, Type 1 diabetes mellitus, Crohns disease, contact sensitivity to poison ivy, tuberculosis, viral hepatitis, and superantigenmediated disease are all type __ diseases
4
132
Tuberculosis and poison ivy are two of the diseases we talked about most for type __ hypersensitivity
4
133
In order to inhibit T-cell mediated responses, you can prescribe anti-inflammatory steroids aka __, anti-TNF, anti-CD20 (inhibits B cells), anti-CD40L, T-regulatory cell injections, CTLA-4, inhibit Jak-Stat signaling, and a million more things...
corticosteroids
134
NAME THE HYPERSENSITIVITY
1) Multiple sclerosis
2) Polyarteritis nodosa
3) Autoimmune hemolytic anemia
4) Rheumatoid arthritis
5) Idiopathic thrombocytopenic purpura
6) Systemic lupus erythematosus
7) Goodpasture's syndrome
8) Grave's disease (hypothyroidism)
9) Type 1 diabetes mellitus
10) Myasthenia gravis
11) Post-streptococcal glomerulonephritis
12) Pemphigus vulgaris
13) Crohns disease
14) Serum sickness
15) contact sensitivity to poison ivy
16) tuberculosis
17) DONT NEED TO KNOW THIS ONE
18) Arthus reaction
19) viral hepatitis
20) Rheumatic fever
21) superantigenmediated disease
1) 4
2) 3
3) 2
4) 4
5) 2
6) 3
7) 2
8) 2
9) 4
10) 2
11) 3
12) 2
13) 4
14) 3
15) 4
16) 4
17)
18) 3
19) 4
20) 2
21) 4
135
What are the two most common forms of meningococcal infections and what are they associated with?
Neisseria meningitis and Streptococcus pneumoniae
Complement deficiency
