Phase 2a Gold Standard > ICS - Immunology > Flashcards

ICS - Immunology Flashcards

(49 cards)

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1
Q

What do toll like receptors respond to?

A

PAMPs - Pathogen
DAMPs - Damage

Associated Molecular Patterns

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2
Q

Important TLRs (apparently)

A

2,4,5,7,9

2- G+ and TB (extracellular)
4 - lipopolysaccharides (G-) (extracellular)
5 - Flagellin (extracellular)
7 - Single strand RNA (intracellular)
9 - unmethylated CPG DNA (intracellular)

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3
Q

Which TLRs are intracellular

A

3,7,8,9

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4
Q

All TLRs (1-11) and what they recognise

A

*2 - gram positive + TB
3 - viral dsRNA
*4 - Lipopolysaccharides (G-)
*5 - Flagellin
6 - Lipoteichoic acid (G+)
*7 - single stranded RNA
8 - DSRNA (G+)
*9 - CPG (non methylated) DNA (bacteria)
11 - bacteria (urogenital pathogens)

1,2,6 - bacterial cell wall components
3 - dsRNA
4 - G- LPS
5 - flagellin
7 - ssRNA
9 - unmethylated CpG

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5
Q

Innate vs adaptive immunity

A

Innate
- Non specific
- Resistance not improved by reinfection
- Instinctive
- Rapid response
- Phagocytes and natural killer cell
- No memory

Adaptive
- Specific “acquired” immunity
- Resistance improved by repeat infection
- Slower response
- Requires lymphocytes (T&B)
- Memory

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6
Q

Clinical indications of an allergic reaction
(Skin, Airways, GI)

A

Skin - Swelling, itching, reddening
Airways - Excessive mucus production, bronchoconstriction
GI - Abdominal bloating, vomiting, diarrhoea

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7
Q

What stem cell do blood cells originate from

A

Haematopoietic pluripotent stem cell

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8
Q

What are the 3 ways the complement system destroys pathogens

A

Innate immunity

  1. Direct lysis - (membrane attack complex) - Group of complements make a hole in pathogen
  2. Opsonisation - (C3b) antigen coated with complement that makes it easier to phagocytose
  3. Increase inflammation - (C3a and C5a)
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9
Q

Neutrophil properties

A

65% of blood
Lifespan: 6 hours - 12 days
Contain primary lysosomes and secondary granules which secrete toxic substances to kill microbes
Key role in innate immunity and inflammation

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10
Q

Monocyte properties

A

Lifespan: months
Innate (phagocytosis) and adaptive (antigen presentation) roles
Differentiate into macrophages in tissue

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11
Q

Macrophage properties

A

Lifespan: Months/years
Kupffer cells in liver, microglia in brain
innate (phagocytosis) and adaptive (antigen presenting) role
First line non self recognition

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12
Q

Macrophage properties

A

Lifespan: Months/years
Kupffer cells in liver, microglia in brain
innate (phagocytosis) and adaptive (antigen presenting) role
First line non self recognition

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13
Q

Eosinophil properties

A

Lifespan: 8-12 days
Contain major basic protein (MBP) toxin, which activates neutrophils and induces histamine release
Granules stain using eosin (red/pink)
Often seen in parasitic infection

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14
Q

Basophil properties

A

Lifespan: 2 days
Express high affinity IgE receptors, which cause degranulation and release of histamine.
Similar to mast cells (mast cells fixed, basophils circulate in blood)
Granules stain using haemotoxylin (blue/violet)

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15
Q

T lymphocyte (t cell) properties

A

Hours-years
Originate in bone marrow but mature in thymus
Recognise antigens displayed by antigen presenting cells, which they bind to with t cell receptors.
Produce cyotkines
Found in blood, lymph nodes, spleen

T helper 1&2 (CD4)
Cytotoxic T cell (CD8)
T reg

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16
Q

Natural killer cells

A

Express CD56
Recognise and kill virus infected cells and tumour cells by apoptosis

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17
Q

Primary vs secondary lymphoid organs

A

Primary - Bone marrow (immune cell origin, b cell maturation site), thymus (t cell maturation site)
Secondary - Lymph nodes, spleen (Removal site of RBC and antibody coated bacteria)

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18
Q

Physical and chemical barriers in innate immunity

A

Physical - skin, mucus, cilia
Chemical - Lysozyme in tears, stomach acid

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19
Q

What are antigen presenting cells and 2 functions?

A

E.g. dendritic cells
Present foreign antigens to T helper cells.

Stimulates Th proliferation
or B cell production

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20
Q

Explain TLR 4

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A

TLR activated by LPS on gram negative bacteria (endotoxin)
Trigger immune response (activate complement, cytokine release (TNFa, IL1,6), phagocytosis)

21
Q

Explain Thymic tolerance

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A

Thymic tolerance/selection used to see if immature T cells are functional. Any failed selection results in apoptosis.

+ selection (self recognition) - CD8 (Tc) binds to MHC-I, CD4 (Th) binds to MHC-II with moderate strength; recognise self. Allowed to survive.

  • selection - If TCR (T cell receptor) on t cell recognises and binds to MHC-I or II (producing immune response to self) it has to be phagocytosed. TCR shouldnt interact with self

allocation - If immature T cell interacts with MHC-1: CD8 upregulated and becomes Tc cell
If reacts with MHC-2: CD4 upregulated, becomes Th cell

22
Q

CD8 T cell function

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A

Cytotoxic T cells interact with MHC-I

Direct killers - Secrete Perforin or express FAS to trigger apoptosis

23
Q

CD4 T cell function

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A

T Helper cells that interact with MHC-II

TH1 - IFNy - Activate NK cells and macrophages (innate immunity)

TH2 - IL4 - Activate B cells to differentiate into plasma cells (adaptive immunity)

24
Q

Where are B cells produced and where do they mature

Study These Flashcards
A

Both in bone marrow

25
Explain B cell activation
Th2 is activated by antigen presenting cell (dendritic cell) binding and MHC-II interactions. It then releases IL 4 (causing B cell proliferation "clonal expansion") and IL 5 (causing B cell differentiation into plasma cells which produce immunoglobulins)
26
Give a brief overview of IgG
Most abundant in blood Key in secondary immune response (marker of immunological memory)
27
Give a brief overview of IgA
Most abundant in total body. Found on mucosal linings, in colostrum and in breast milk. Forms dimer
28
Give a brief overview of IgM
First Ig released in adaptive response Forms pentamer
29
Give a brief overview of IgE
Found in type 1 hypersensitivity (anaphylaxis) Activates mast cell/basophil degranulation
30
Give 3 functions of MHC molecules
Ensure T cells recognise self (positive selection) Check T cells can confer immunity and dont cause autoimmunity (negative selection) Confer autoimmunity to HLA (human leukocyte antigen) related inherited autoimmune conditions
31
Give the genes that cause these autoimmune conditions Spondyloarthropathies T1DM Coeliac SLE
All found on chromosome 6 Spondyloarthropathies: HLA-B27 T1DM: HLA-DR2DQ3 Coeliac: HLA- DQ2 (or DQ8) SLE: HLA B8
32
Explain type 1 hypersensitivity with examples
IgE mediated (anaphylaxis) IgE binds to mast cell/basophil causing degranulation and histamine release. E.g. atopy (asthma, hay fever, rhinitis)
33
Explain type 2 hypersensitivity with examples
Antigen-antibody complex IgG/IgM binds to antigen, activating MAC (complement) at SITE OF BINDING E.g. Goodpastures, pernicious anaemia, rheumatic fever
34
Explain type 3 hypersensitivity with examples
Immune complex deposition at sites away from binding IgG/IgA bind to antigen and activate complement at site of deposition E.g. SLE, post strep glomerulonephritis, IgA glomerulonephritis
35
Explain type 4 hypersensitivity with examples
T cell mediated w/ delayed response Th1 activated by APC, causing cytotoxic killing occurs around body E.g. Type 1 diabetes mellitus, TB, MS, Guillain barre
36
Describe patient presentation of anaphylaxis
Severe hypotension Tachycardia Dyspnoea Pale Cold extremities Puffed up face and tongue Pruritus/itching Central cyanosis
37
Explain treatment algorithm for anaphylaxis
1: ABCDE Airway - can they breathe Breathing - Rapid, wheezy, low SpO2? (<92%) Circulation - pale, cold, clammy, low BP, capillary refill time? Disability - Confused/comatose, movement Exposure to antigen 2 - 500mcg IM adrenaline
38
Effects of histamine
Vasodilation, increased permeability (H1 receptor), bronchoconstriction facial flush, pruritus, swollen tongue/face
39
Describe immune tolerance
Non responsiveness to specific antigens to prevent self immune response Central - occurs in the thymus/bone marrow during T/B cell maturation Peripheral - Occurs after mature cells have been released into blood. Works to prevent autoimmunity, in secondary organs such as spleen.
40
Define autoimmunity
Pathological immune response against self either through faulty immune tolerance or molecular mimicry
41
Give examples of organ specific autoimmunity
T1DM - pancreas (b cells) MS - Oligodendrocytes of CNS Pernicious anaemia - parietal cells of stomach Hashimoto's - antibodies against TPO Graves - Antibodies against TSH receptors
42
Give examples of non organ specific autoimmunity
SLE - affects DNA (ANA) Autoimmune anaemia affects RBC Autoimmune thrombocytic purpura affects platelets
43
Define immunodeficiency
The reduced ability of the body to fight infection or disease
44
Give some causes of immunodeficiency
Primary (Inherited): T/B cell defect/deficiency, IgA deficiency, CVID, SCID Secondary (Acquired): HIV, malnutrition, cancer, diabetes mellitus, chemotherapy, leukaemia, myeloma
45
Patterns of immunodeficiency
- Decreased CD4/T helper cells in HIV, leading to increased susceptibility to disease - Deficient B cells (decreased plasma cells/antibodies) - Neutrophil/macrophage deficiency (less phagocytosis/acute inflammation) - Complement deficiency (innate immunity doesnt work as well) - hyposplenism (lack of RBC recycling and killing of encapsulated bacteria)
46
Define active immunity with natural and artificial example
Active immunity involves: Ig production, immunological memory and response largely secondary. Natural: Body encounters pathogen, producing antibodies and memory cells Artificial: Vaccine mimics encountering pathogen, stimulating Ig production
47
Define passive immunity, with natural and artificial example
Passive involves Ig's passed directly to host with no memory and a primary response Natural: maternal antibodies passed to feeding baby through breast milk/colostrum Artificial: Antivenom, or Ig injection/transfusion
48
What are the aims of a perfect vaccine
- Achieve long term protection from small number of immunisations - Stimulate BOTH B and T cells - Induce memory B and T cells - Stimulate protective IgG and IgA production
49
Active vs passive immunity
Active - IgG production - Immunological memory - Secondary response Passive - IgG passed to host - No memory - Primary response
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