Topic 13 Immunodeficiencies Definition: Pathogen ____ and ____ of the immune system Can be... - Primary (____) immunodeficiencies - Secondary (____) immunodeficiencies ``` Bank: subversion evasion acquired inherited ```

Immunodeficiencies Definition: Pathogen evasion and subversion of the immune system Can be... - Primary (inherited) immunodeficiencies - Secondary (acquired) immunodeficiencies

Topic 13 Mechanisms Used by Pathogens to Evade the Immune System: - Genetic ___ - Mutation and ___ - Antigenic drift: ____ - Antigenic shift: ____ - Gene ____ - Hiding: viral ____ - ____antigen ``` Bank: rearrangement recombination epidemics variation pandemics latency super ```

Mechanisms Used by Pathogens to Evade the Immune System: - Genetic variation - Mutation and recombination - Antigenic drift: epidemics - Antigenic shift: pandemics - Gene rearrangement - Hiding: viral latency - Superantigen

Topic 13 Pathogen Evasion: Genetic _____ - Strategy used by _____ to evade a host's immune response to maximize their probability of being transmitted to a fresh ___ or to continue growing. - S. pnuemoniae has at least 90 different ____ ``` Bank: serotypes pathogens host variation ```

Pathogen Evasion: Genetic Variation - Strategy used by pathogens to evade a host's immune response to maximize their probability of being transmitted to a fresh host or to continue growing. - S. pnuemoniae has at least 90 different serotypes

Topic 13 Pathogen Evasion: Gene Mutation - Influenza antigenic ___: high mutation rate of hemagglutinin (H) and neuraminidase (N) genes changes the surface antigens every year (____) - __ H variants and __ N variants (H1N1). - Original antigenic sin ``` Bank: epidemics drift 9 13 ```

Pathogen Evasion: Gene Mutation - Influenza antigenic drift: high mutation rate of hemagglutinin (H) and neuraminidase (N) genes changes the surface antigens every year – epidemics - 13 H variants and 9 N variants (H1N1). - Original antigenic sin

Topic 13 Pathogen Evasion: Genome Recombination - Influenza antigenic ____: influenza RNA genomes recombination between different -____ (e.g. human vs avian), happens every 10-50 years, and causes ____ diseases. Spanish flu killed millions of people Bank: pandemic species shift

Pathogen Evasion: Genome Recombination - Influenza antigenic shift: influenza RNA genomes recombination between different species (e.g. human vs avian), happens every 10-50 years, and causes pandemic diseases. Spanish flu killed millions of people

Topic 13 Pathogen Evasion: Gene Rearrangement - African _____ (a protozoan) has a life cycle between human and insects - Only one variant can express at a time by gene conversion _____ - ____ immune responses and dominant/minority changes and leaves immune complex depositions in the nerve system and causes ____ sickness ``` Bank: sleeping rearrangement repeated trypanosome ```

Pathogen Evasion: Gene Rearrangement - African Trypanosome (a protozoan) has a life cycle between human and insects - Only one variant can express at a time by gene conversion rearrangement - Repeated immune responses and dominant/minority changes and leaves immune complex depositions in the nerve system and causes sleeping sickness

Topic 13 Pathogen Evasion: Identity Hiding - ____ simplex virus (cause of cold sores) infects ____ cells and then spread to sensory neurons - Immune system clears those in ____, but not in the neurons due to viral latency and low of MHC-1 on neurons - ____ (sunlight, infection) reactivate the virus and they travel down and reinfect the epithelium - Herpesvirus varicella-zoster (____) and Epstein-Barr virus employ a similar strategy ``` Bank: epithelium shingles herpes epithelial stresses ```

Pathogen Evasion: Identity Hiding - Herpes simplex virus (cause of cold sores) infects epithelial cells and then spread to sensory neurons - Immune system clears those in epithelium, but not in the neurons due to viral latency and low of MHC-1 on neurons - Stresses (sunlight, infection) reactivate the virus and they travel down and reinfect the epithelium - Herpesvirus varicella-zoster (shingles) and Epstein-Barr virus employ a similar strategy

Topic 13 Pathogen Subversion Weakens the Immune System - _____ aureus makes staphylococcus superantigen-like protein (SSLP) - Blocks ____ - Inhibits ___ activation Bank: phagocytosis C5 staphylococcus

Pathogen Subversion Weakens the Immune System - Staphylococcus aureus makes staphylococcus superantigen-like protein (SSLP) - Blocks phagocytosis - Inhibits C5 activation

Topic 13 Superantigens - _____ superantigen: Soluble protein from bacterium, exotoxins - _____ superantigen: membrane proteins produced by some viruses - Up to 20% of circulating naïve ____ T cells can be activated and make IL-1, IL-2, TNF-α causing systemic shock - Useful _____ immune responses are suppressed ``` Bank: adaptive Endogenous Exogenous CD4 ```

Superantigens - Exogenous superantigen: Soluble protein from bacterium, exotoxins - Endogenous superantigen: membrane proteins produced by some viruses - Up to 20% of circulating naïve CD4 T cells can be activated and make IL-1, IL-2, TNF-α causing systemic shock - Useful adaptive immune responses are suppressed

Topic 13 Inherited Immunodeficiencies - Caused by immune gene _ - 3 types: - ____ - ____ - ____ ``` Bank: mutations recessive dominant X-linked ```

Inherited Immunodeficiencies - Caused by immune gene mutations - 3 types: - Dominant - Recessive - X-linked

Topic 13 Defects of phagocytes - Leukocyte adhesion deficiency (___) - Chronic granulomatous disease (___) - Glucose-6-phosphate dehydrogenase (___) deficiency - Myeloperoxidase deficiency (___) - Chediak - Higashi syndrome (___) ``` Bank: CGD CHS G6PD MPOD LAD ```

Defects of phagocytes - Leukocyte adhesion deficiency (LAD) - Chronic granulomatous disease (CGD) - Glucose-6-phosphate dehydrogenase (G6PD) deficiency - Myeloperoxidase deficiency (MPOD) - Chediak - Higashi syndrome (CHS)

Topic 13 Therapies for Primary Immunodeficiency - Replacement of a ___ protein - Replacement of a missing or ___ gene - Replacement of a missing cell ____ or lineage Bank: defective type missing

Therapies for Primary Immunodeficiency - Replacement of a missing protein - Replacement of a missing or defective gene - Replacement of a missing cell type or lineage

Topic 13 Acquired Immune Deficiency Syndrome (AIDS) - Comes from human immunodeficiency virus (___) - It is a slow progressing ___ retrovirus, also called ___ - It infects ___ T cells, macrophages, and dendritic cells ``` Bank: HIV RNA lentivirus CD4+ CD8+ ```

Acquired Immune Deficiency Syndrome (AIDS) - Comes from human immunodeficiency virus (HIV) - It is a slow progressing RNA retrovirus, also called lentivirus - It infects CD4+ T cells, macrophages, and dendritic cells

Topic 13 Human Immunodeficiency Virus (HIV) - HIV-1 uses membrane protein ___ and ____ to bind to ___ on target cells (macrophage, DC, TH cells) - The entrance of HIV-1 into cells requires the CD4/gp120/gp41 complex bind to a co-receptor Chemokine receptor: ___ or ___ - HIV-1 has two major variants: - __ strain - __ strain ``` Bank: gp120 gp41 CD4 CD8 CCR5 CXCR4 R5 X4 ```

Human Immunodeficiency Virus (HIV) - HIV-1 uses membrane protein gp120 and gp41 to bind to CD4 on target cells (macrophage, DC, TH cells) - The entrance of HIV-1 into cells requires the CD4/gp120/gp41 complex bind to a co-receptor Chemokine receptor: CCR5 or CXCR4 - HIV-1 has two major variants: - R5 strain - X4 strain

Topic 13 HIV Infection Differs In Population with Different Genetic Background - People with ___ defects are resistant to HIV - ___ and ___ polymorphism influences the progress of AIDS Bank: CCR5 HLA KIR

HIV Infection Differs In Population with Different Genetic Background - People with CCR5 defects are resistant to HIV - HLA and KIR polymorphism influences the progress of AIDS

Imm: Exam IV Flashcards by Emily Ballew

Topic 13

Immunodeficiencies

Definition: Pathogen ____ and ____ of the immune system

Can be…

Primary (____) immunodeficiencies
Secondary (____) immunodeficiencies

Bank: 
subversion
evasion
acquired
inherited

Immunodeficiencies

Definition: Pathogen evasion and subversion of the immune system

Can be…

Primary (inherited) immunodeficiencies
Secondary (acquired) immunodeficiencies

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Topic 13

Mechanisms Used by Pathogens to Evade the Immune System:

Genetic ___
Mutation and ___
- Antigenic drift: ____
- Antigenic shift: ____
Gene ____
Hiding: viral ____
____antigen

Bank:
rearrangement
recombination
epidemics
variation
pandemics
latency
super

Mechanisms Used by Pathogens to Evade the Immune System:

Genetic variation
Mutation and recombination
- Antigenic drift: epidemics
- Antigenic shift: pandemics
Gene rearrangement
Hiding: viral latency
Superantigen

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Topic 13

Pathogen Evasion:
Genetic _____

Strategy used by _____ to evade a host’s immune response to maximize their probability of being transmitted to a fresh ___ or to continue growing.
S. pnuemoniae has at least 90 different ____

Bank:
serotypes
pathogens
host
variation

Pathogen Evasion:
Genetic Variation

Strategy used by pathogens to evade a host’s immune response to maximize their probability of being transmitted to a fresh host or to continue growing.
S. pnuemoniae has at least 90 different serotypes

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Topic 13

Pathogen Evasion: Gene Mutation

Influenza antigenic ___: high mutation rate of hemagglutinin (H) and neuraminidase (N) genes changes the surface antigens every year (____)
__ H variants and __ N variants (H1N1).
Original antigenic sin

Bank:
epidemics
drift
9
13

Pathogen Evasion: Gene Mutation

Influenza antigenic drift: high mutation rate of hemagglutinin (H) and neuraminidase (N) genes changes the surface antigens every year – epidemics
13 H variants and 9 N variants (H1N1).
Original antigenic sin

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Topic 13

Pathogen Evasion: Genome Recombination

Influenza antigenic ____: influenza RNA genomes recombination between different -____ (e.g. human vs avian), happens every 10-50 years, and causes ____ diseases. Spanish flu killed millions of people

Bank:
pandemic
species
shift

Pathogen Evasion: Genome Recombination

Influenza antigenic shift: influenza RNA genomes recombination between different species (e.g. human vs avian), happens every 10-50 years, and causes pandemic diseases. Spanish flu killed millions of people

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Topic 13

Pathogen Evasion:
Gene Rearrangement

African _____ (a protozoan) has a life cycle between human and insects
Only one variant can express at a time by gene conversion _____
____ immune responses and dominant/minority changes and leaves immune complex depositions in
the nerve system and causes ____ sickness

Bank:
sleeping
rearrangement
repeated
trypanosome

Pathogen Evasion:
Gene Rearrangement

African Trypanosome (a protozoan) has a life cycle between human and insects
Only one variant can express at a time by gene conversion rearrangement
Repeated immune responses and dominant/minority changes and leaves immune complex depositions in
the nerve system and causes sleeping sickness

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Topic 13

Pathogen Evasion: Identity Hiding

____ simplex virus (cause of cold sores) infects ____ cells and then spread to sensory neurons
Immune system clears those in ____, but not in the neurons due to viral latency and low of MHC-1 on neurons
____ (sunlight, infection) reactivate the virus and they travel down and reinfect the epithelium
Herpesvirus varicella-zoster (____) and Epstein-Barr virus employ a similar strategy

Bank:
epithelium
shingles
herpes
epithelial
stresses

Pathogen Evasion: Identity Hiding

Herpes simplex virus (cause of cold sores) infects epithelial cells and then spread to sensory neurons
Immune system clears those in epithelium, but not in the neurons due to viral latency and low of MHC-1 on neurons
Stresses (sunlight, infection) reactivate the virus and they travel down and reinfect the epithelium
Herpesvirus varicella-zoster (shingles) and Epstein-Barr virus employ a similar strategy

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Topic 13

Pathogen Subversion Weakens the Immune System

_____ aureus makes
staphylococcus superantigen-like protein (SSLP)
Blocks ____
Inhibits ___ activation

Bank:
phagocytosis
C5
staphylococcus

Pathogen Subversion Weakens the Immune System

Staphylococcus aureus makes
staphylococcus superantigen-like protein (SSLP)
Blocks phagocytosis
Inhibits C5 activation

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Topic 13

Superantigens

_____ superantigen: Soluble protein from bacterium, exotoxins
_____ superantigen: membrane proteins produced by some viruses
Up to 20% of circulating naïve ____ T cells can be activated and make IL-1, IL-2, TNF-α causing systemic shock
Useful _____ immune responses are suppressed

Bank:
adaptive
Endogenous
Exogenous
CD4

Superantigens

Exogenous superantigen: Soluble protein from bacterium, exotoxins
Endogenous superantigen: membrane proteins produced by some viruses
Up to 20% of circulating naïve CD4 T cells can be activated and make IL-1, IL-2, TNF-α causing systemic shock
Useful adaptive immune responses are suppressed

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Topic 13

Inherited Immunodeficiencies

Caused by immune gene _
3 types:
- ____
- ____
- ____

Bank:
mutations
recessive
dominant
X-linked

Inherited Immunodeficiencies

Caused by immune gene mutations
3 types:
- Dominant
- Recessive
- X-linked

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Topic 13

Severe Combined Immunodeficiency (SCID)

X-linked SCID:
- X-Linked Agamaglobulinemia (XLA), Mutant Bruton’s Tyrosine Kinase (Btk), no __ cells

- X-linked hyper IgM syndrome, defect of \_\_\_\_ ligand gene in T cells, no isotype switching, B cells only produce IgM
- IL-2R-γ chain mutation, T cell fails development

Bank:
B
T
CD40
CD80

Severe Combined Immunodeficiency (SCID)

X-linked SCID:
- X-Linked Agamaglobulinemia (XLA), Mutant Bruton’s Tyrosine Kinase (Btk), no B cells

- X-linked hyper IgM syndrome, defect of CD40 ligand gene in T cells, no isotype switching, B cells only produce IgM
- IL-2R-γ chain mutation, T cell fails development

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Topic 13

Severe Combined Immunodeficiency (SCID)

Autosomal SCID:
- RAG1/2 mutation (____)

- \_\_\_\_ mutation
- ZAP-70
- FOXN1 mutation, \_\_\_\_ (nude mice)

Bank:
CD3
athymic
Omenn syndrome

Severe Combined Immunodeficiency (SCID)

Autosomal SCID:
- RAG1/2 mutation (Omenn syndrome)

- CD3 mutation
- ZAP-70
- FOXN1 mutation, athymic (nude mice)

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Topic 13

Gene mutations
affect __ and __
cell development and activation

Gene Mutations
Affect T and B
Cell Development

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Topic 13

Defects of phagocytes

Leukocyte adhesion deficiency (___)
Chronic granulomatous disease (___)
Glucose-6-phosphate dehydrogenase (___) deficiency
Myeloperoxidase deficiency (___)
Chediak - Higashi syndrome (___)

Bank: 
CGD
CHS
G6PD
MPOD
LAD

Defects of phagocytes

Leukocyte adhesion deficiency (LAD)
Chronic granulomatous disease (CGD)
Glucose-6-phosphate dehydrogenase (G6PD) deficiency
Myeloperoxidase deficiency (MPOD)
Chediak - Higashi syndrome (CHS)

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Topic 13

Complement System Gene Mutations

Classical pathway: deficiency leads to _____ disease

MBL pathway: Deficiency of MBL leads to ____ infections, mainly in childhood

Alternative pathway: deficiency leads to infection with ____ bacteria and Neisseria app. but no immune complex disease

Bank:
bacterial
immune-complex
pyogenic

Complement System Gene Mutations

Classical pathway: deficiency leads to immune-complex disease

MBL pathway: Deficiency of MBL leads to bacterial infections, mainly in childhood

Alternative pathway: deficiency leads to infection with pyogenic bacteria and Neisseria app. but no immune complex disease

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Topic 13

Therapies for Primary Immunodeficiency

Replacement of a ___ protein
Replacement of a missing or ___ gene
Replacement of a missing cell ____ or lineage

Bank:
defective
type
missing

Therapies for Primary Immunodeficiency

Replacement of a missing protein
Replacement of a missing or defective gene
Replacement of a missing cell type or lineage

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Topic 13

Acquired Immune Deficiency Syndrome (AIDS)

Comes from human immunodeficiency virus (___)
It is a slow progressing ___ retrovirus, also called ___
It infects ___ T cells, macrophages, and dendritic cells

Bank:
HIV
RNA
lentivirus
CD4+
CD8+

Acquired Immune Deficiency Syndrome (AIDS)

Comes from human immunodeficiency virus (HIV)
It is a slow progressing RNA retrovirus, also called lentivirus
It infects CD4+ T cells, macrophages, and dendritic cells

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Topic 13

Human Immunodeficiency Virus (HIV)

HIV-1 uses membrane protein ___ and ____ to bind to ___ on target cells (macrophage, DC, TH cells)
The entrance of HIV-1 into cells requires the CD4/gp120/gp41 complex bind to a co-receptor
Chemokine receptor: ___ or ___
HIV-1 has two major variants:
- __ strain
- __ strain

Bank:
gp120
gp41
CD4
CD8
CCR5
CXCR4
R5
X4

Human Immunodeficiency Virus (HIV)

HIV-1 uses membrane protein gp120 and gp41 to bind to CD4 on target cells (macrophage, DC, TH cells)
The entrance of HIV-1 into cells requires the CD4/gp120/gp41 complex bind to a co-receptor
Chemokine receptor: CCR5 or CXCR4
HIV-1 has two major variants:
- R5 strain
- X4 strain

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Topic 13

HIV Unleashes ______
Infections

HIV Unleashes Opportunistic

Infections

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Topic 13

Why Can’t the Immune System Completely Eliminate HIV?

1) HIV is ____: RNA to DNA: high ____
2) HIV infects ___ T cells: block immune response
3) Unknown

Bank: 
mutation
retrovirus
CD4+
CD8+

Why Can’t the Immune System Completely Eliminate HIV?

1) HIV is retrovirus: RNA to DNA: high mutation
2) HIV infects CD4+ T cells: block immune response
3) Unknown

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Topic 13

HIV Infection Differs In Population with Different Genetic Background

People with ___ defects are resistant to HIV
___ and ___ polymorphism influences the progress of AIDS

Bank:
CCR5
HLA
KIR

HIV Infection Differs In Population with Different Genetic Background

People with CCR5 defects are resistant to HIV
HLA and KIR polymorphism influences the progress of AIDS

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Topic 13

AIDS Treatments

1) Vaccine: ___
2) Inhibitors: partially ____
3) Only two completely cured cases (The ___ patient (Timothy Brown) and The ____ patient ( Adam Castillejo)

Bank:
successful
failed
Berlin
London

AIDS Treatments

1) Vaccine: failed
2) Inhibitors: partially successful
3) Only two completely cured cases (The Berlin patient (Timothy Brown) and The London patient ( Adam Castillejo)

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Topic 14

Hypersensitivity

_____: Immune responses (similar to inflammation reactions) to ______.

______ - the result of secondary immune responses to innocuous environmental antigens.

______ - antigens that elicit allergic reaction.

______ - state of hypersensitivity against harmless environmental antigens.

Bank:
Allergy
Allergic reactions
Allergens
Hypersensitivity
Innocuous antigens

Hypersensitivity

Hypersensitivity: Immune responses (similar to inflammation reactions) to innocuous antigens.

Allergic reactions - the result of secondary immune responses to innocuous environmental antigens.

Allergens - antigens that elicit allergic reaction.

Allergy - state of hypersensitivity against harmless environmental antigens.

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Topic 14

Common sources of Allergens (4)?

Respiratory
Circulatory
Digestive tract
Integument

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Topic 14 Types of hypersensitivity Type I: ___: Depends on mast cells; most common Type II: ___ Type III: Small _____ system, cannot aggregate to large structure (soluble) Type IV: Controlled by ___ ``` Bank: immunocomplex IgE T cells IgG ```

Types of hypersensitivity Type I: IgE: Depends on mast cells; most common Type II: IgG Type III: Small immunocomplex system, cannot aggregate to large structure (soluble) Type IV: Controlled by T cells

Topic 14 Type I Hypersensitivity - ___ mediated sensitivity - _____, basophils, a. nonactivated eosinophils - Immune responses designed for multicellular _____ - ____ binding has the highest binding affinity, “irreversible” - Mast cells also express _____ ( Inhibitory signal; IgG shots for allergy ) ``` Bank: parasite infections Mast cells IgE/FcεRI IgE FcγRIIB ```

Type I Hypersensitivity - IgE mediated sensitivity - Mast cells, basophils, a. nonactivated eosinophils - Immune responses designed for multicellular parasite infections - IgE/FcεRI binding has the highest binding affinity, “irreversible” - Mast cells also express FcγRIIB ( Inhibitory signal; IgG shots for allergy )

Topic 14 Sensitization of Mast Cells By Inhaled Allergens - Pollen activates antigen-specific ____ cells - Tfh2 cells activates __ cells to recreate ___ - IgE binds to _____ and arms mast cells ``` Bank: IgE Tfh2 B T Fc( epsilon ) ```

Sensitization of Mast Cells By Inhaled Allergens - Pollen activates antigen-specific Tfh2 cells - Tfh2 cells activates B cells to recreate IgE - IgE binds to Fc( epsilon ) and arms mast cells

Topic 14 IgE Production - Basophils Drives ___ Differentiation by making ____ - TH2 helps naïve __ cell to develop to ___, producing plasma cells by isotype switching - IgE binds to ___ receptors on mast cells ``` Bank: IL-4 TH2 FcεR1 B T IgE IgG ```

IgE Production - Basophils Drives TH2 Differentiation by making IL-4 - TH2 helps naïve B cell to develop to IgE, producing plasma cells by isotype switching - IgE binds to FcεR1 receptors on mast cells

Topic 14 Sensitized Mast Cells Ready for Parasite Re-infection or Allergen - ____ = normal response - _____ = when the receptors get confused and think something is a parasite response Bank: Allergic Anti-parasite

Sensitized Mast Cells Ready for Parasite Re-infection or Allergen - Anti-parasite = normal response - Allergic = when the receptors get confused and think something is a parasite response

Topic 14 Sensitized Mast Cell Degranulates When Parasites or Allergens Appear Again - The allergen binding will cross link and send the signal to the ______

Sensitized Mast Cell Degranulates When Parasites or Allergens Appear Again - The allergen binding will cross link and send the signal to the cytoplasm

Topic 14 Mast Cell Degranulation Resting mast cell: contains granules containing ____ Activated mast cell: multivalent antigen cross-links bound ___ antibody, chasing release of granule contents Bank: IgE IgG histidine

Mast Cell Degranulation Resting mast cell: contains granules containing histidine Activated mast cell: multivalent antigen cross-links bound IgE antibody, chasing release of granule contents

Topic 14 Mast Cells Release Inflammatory Mediators in Two Phases Phase I: Immediate phase - ____ remodel connective tissue matrix - _____ kill parasites - _____ promote inflammation Phase II: Late phase - _____ stimulate and amplify Th2 cell response and promote eosinophil production and activation - ______ attract monocytes, macrophages, and neutrophils - _____ cause smooth muscle contraction and attract leukocytes ``` Bank: Chemokines Cytokines Cytokines Enzymes Lipid mediators Toxic mediators ```

Mast Cells Release Inflammatory Mediators in Two Phases Phase I: Immediate phase - Enzymes remodel connective tissue matrix - Toxic mediators kill parasites - Cytokines promote inflammation Phase II: Late phase - Cytokines stimulate and amplify Th2 cell response and promote eosinophil production and activation - Chemokine attract monocytes, macrophages, and neutrophils - Lipid mediators cause smooth muscle contraction and attract leukocytes

Topic 14 _____ Permanently Inactivates _____ Synthesis

Aspirin Permanently Inactivates Prostaglandin Synthesis

Topic 14 Eosinophils - Immidiate response involves mast cells and ___ antibodies - ____ reactions = eosinophils (can produce toxic substances that make the reaction worse) - More involved in ____ allergic reactions ``` Bank: IgE IgG Mild Severe Chronic Isolated ```

Eosinophils - Immidiate response involves mast cells and IgE antibodies - Severe reactions = eosinophils (can produce toxic substances that make the reaction worse) - More involved in chronic allergic reactions

Topic 14 Eosinophils Release Inflammatory Mediators in Two Phases Phase I: Immediate phase - ____ kill parasites and remodels connective tissue matrix - _____ kill parasites and has an antiviral effect by degrading RNA Phase II: Late phase - _____ amplify eosinophil production and activates eosinophils - ______ promote an influx of leukocytes - ______ attract and activate neutrophils and platelets and increase the synthesis of lipid mediators ``` Bank: Chemokines Cytokines Enzymes Lipid mediators Toxins ```

Eosinophils Release Inflammatory Mediators in Two Phases Phase I: Immediate phase - Enzymes kill parasites and remodels connective tissue matrix - Toxins kill parasites and has an antiviral effect by degrading RNA Phase II: Late phase - Cytokines amplify eosinophil production and activates eosinophils - Chemokines promote an influx of leukocytes - Lipid mediators attract and activate neutrophils and platelets and increase the synthesis of lipid mediators

Topic 14 Common Allergens Share Similar Structure as the _____ Antigen - this is why our bodies think that certain allergens are parasites

Common Allergens Share Similar Structure as the Helminth Antigen - this is why our bodies think that certain allergens are parasites

Topic 14 Allergic Reactions Can Be Tested using the peak expiratory flow rate (PEFR) - there is a dip in the PEFR at about the __ minute mark, with it peaking between __ and __ (begins late phase) hours after exposure - another dip at ~ __ hours after exposure ``` Bank: 15 30 45 1 3 6 9 12 ```

Allergic Reactions Can Be Tested using the peak expiratory flow rate (PEFR) - there is a dip in the PEFR at about the 30 minute mark, with it peaking between 1 and 6 (begins late phase) hours after exposure - another dip at ~ 9 hours after exposure

Topic 14 Allergic Reactions Vary Depending on the route the allergens introduced - ____ system----Systemic Anaphylaxis - ____ system----Rhinitis or Asthma - ____----Hives, dermatitis - ____ tract----Food allergy ``` Bank: Circulation Gastrointestinal Respiratory Skin ```

Allergic Reactions Vary Depending on the route the allergens introduced - Circulation system----Systemic Anaphylaxis - Respiratory system----Rhinitis or Asthma - Skin----Hives, dermatitis - Gastrointestinal tract----Food allergy

Topic 14 Systemic Anaphylaxis - ____ borne allergens - ____ shock - ____ vascular permeability - Causes smooth muscle contraction - ____ in blood pressure ``` Bank: Anaphylactic Blood Increases Increases Decreases Decreases ```

Systemic Anaphylaxis - Blood borne allergens - Anaphylactic shock - Increases vascular permeability - Causes smooth muscle contraction - Decreases in blood pressure

Topic 14 ____ Is Needed For Sensitive Patients - ____ can reverse reactions caused by mast cells [Same answer]

Epinephrine Is Needed For Sensitive Patients - Epinephrine can reverse reactions caused by mast cells

Topic 14 Rhinitis & Asthma Are Caused by Inhaled Allergens - Allergic ____ (hay fever) - mild allergies to inhaled antigens causing sneezing and runny nose. - Allergic ____ - triggered by activation of submucosal ____ cells in the lower airways. ``` Bank: asthma rhinitis B T mast ```

Rhinitis & Asthma Are Caused by Inhaled Allergens - Allergic rhinitis (hay fever) - mild allergies to inhaled antigens causing sneezing and runny nose. - Allergic asthma - triggered by activation of submucosal mast cells in the lower airways.

Topic 14 Asthma - ____ Asthma: degranulation of ____ cells in the lower airways of respiratory tract; short of breath, wheezing; affects 130 million people - ____ Asthma: develops in the ____ of allergen; sensitive to other stimuli; airway occluded by plugs of mucus; eosinophils involved. ``` Bank: Allergic Chronic B T mast presence absence ```

Asthma - Allergic Asthma: degranulation of Mast cells in the lower airways of respiratory tract; short of breath, wheezing; affects 130 million people - Chronic Asthma: develops in the absence of allergen; sensitive to other stimuli; airway occluded by plugs of mucus; eosinophils involved.

Topic 14 Allergic Reactions in the Skin - ____ (hives) - activation of mast cells in the skin to release histamine. - ____ - activation of mast cells deeper in the subcutaneous tissue leading to more diffuse swelling. - ____ dermatitis (eczema) - more prolonged allergic reaction leading to chronic and itching skin rash. Bank: Angioedema Apotic Urticaria

Allergic Reactions in the Skin - Urticaria (hives) - activation of mast cells in the skin to release histamine. - Angioedema - activation of mast cells deeper in the subcutaneous tissue leading to more diffuse swelling. - Apotic dermatitis (eczema) - more prolonged allergic reaction leading to chronic and itching skin rash.

Topic 14 Food Allergies - ___ is made against an extremely small proportion of food proteins. - With food allergies, the allergen crosses the gut wall and activates ____ cells via IgE. - Fluid leaves the ____ and passes into the lumen of the gut. ``` Bank: IgE IgG B T mast blood fluid ```

Food Allergies - IgE is made against an extremely small proportion of food proteins. - With food allergies, the allergen crosses the gut wall and activates mast cells via IgE. - Fluid leaves the blood and passes into the lumen of the gut.

Topic 14 Hygiene Hypothesis of Allergy - Children exposed to farm environment prenatally or neonatally are ____ likely to suffer from allergic problems. - ____ exposure = less the immune system is used to fighting ``` Bank: More More Less Less ```

Hygiene Hypothesis of Allergy - Children exposed to farm environment prenatally or neonatally are less likely to suffer from allergic problems. - Less exposure = less the immune system is used to fighting

Topic 14 Treatments of Allergic Reactions (4) - ____ - ____ - ____ - ____?

Treatments of Allergic Reactions (4) - Prevention - Drugs - Immunotherapy - Parasite treatment?

Topic 14 Drug Treatment of Type I Hypersensitivity - ____: tightens the cell wall

Drug Treatment of Type I Hypersensitivity - Epinephrine: tightens the cell wall

Topic 14 Anti-Allergy Immunotherapy Anti-IgE: Therapeutic anti-IgE binds to ___ and prevents it from binding Fc(epsilon)RI and activating the ___ cell IgG4: An immune complex containing ____ bound to Fc(lambda) RIIB and ____ bound to Fc(lambda) RIIA --> the macrophage ceases its inflammatory response ``` Bank: IgE IgG B T mast IgG4 IgG1 ```

Anti-Allergy Immunotherapy Anti-IgE: Theraputic anti-IgE binds to IgE and prevents it from binding Fc(epsilon)RI and activating the mast cell IgG4: An immune complex containing IgG4 bound to Fc(lambda) RIIB and IgG1 bound to Fc(lambda) RIIA --> the macrophage ceases its inflammatory response

Topic 14 Can We Use Controlled and Deliberate Helminth Infection to Treat Severe Allergic Conditions?

Yes, looks like it!

Topic 14 Type II Hypersensitivity - Caused by ____ specific for altered components of host cells. - Creates new ____ that stimulate IgG - Leads to ____ and ADCC - Activates the ____ system ``` Bank: antibodies complement epitopes phagocytosis ```

Type II Hypersensitivity - Caused by antibodies specific for altered components of host cells. - Creates new epitopes that stimulate IgG - Leads to phagocytosis and ADCC - Activates the complement system

Topic 14 Penicillin Modifies ____

Penicillin modifies red blood cells (example of type II hypersensitivity)

Topic 14 Penicillin modified red blood cells induce ___ or ___ production

Penicillin modified red blood cells induce IgG or IgE production

Topic 14 ABO Blood Group RBC antigens - Blood type __ individuals have glycosyltransferase A, so A antigen - __ individuals have glycosyltransferase B, so B antigen - __ individuals have no glycosyltransferase, so O (H) antigen (no A or B antigen) Bank: A B O

ABO Blood Group RBC antigens - Blood type A individuals have glycosyltransferase A, so A antigen - B individuals have glycosyltransferase B, so B antigen - O individuals have no glycosyltransferase, so O (H) antigen (no A or B antigen)

Topic 14 Type III Hypersensitivity (Immune Complexes) - _____ aggregates of immune complexes fix complement effectively, therefore are quickly cleared by phagocytosis - ____ immune complexes in circulation are not cleared out due to less efficient complement fixation - They deposit at blood vessel wall and cause ____ reaction (Type III hypersensitivity) - Type III hypersensitivity may not require ____ ``` Bank: inflammatory larger sensitization small ```

Type III Hypersensitivity (Immune Complexes) - Larger aggregates of immune complexes fix complement effectively, therefore are quickly cleared by phagocytosis - Small immune complexes in circulation are not cleared out due to less efficient complement fixation - They deposit at blood vessel wall and cause inflammatory reaction (Type III hypersensitivity) - Type III hypersensitivity may not require sensitization

Topic 14 Size of the immune complex depends on the relative concentration of soluble ____ and ____

Size of the immune complex depends on the relative concentration of soluble antigen and antibody

Topic 14 ____ ____: Local deposition of immune complex

Arthurs Reaction: Local deposition of immune complex

Topic 14 Serum Sickness - High dose i.v. injection of soluble foreign ____ induces immune complex ____ at tissues - The deposition induces ____ responses Bank: antigens deposition inflammatory

Serum Sickness - High dose i.v. injection of soluble foreign antigens induces immune complex deposition at tissues - The deposition induces inflammatory responses

Topic 14 Farmer’s Lung - ___ antibodies combine with the inhaled allergen to form immune complexes in the walls of the alveoli in the lungs, inducing local inflammation - This causes fluid, protein and cells to accumulate in the alveolar wall which slows ____ and compromises the function of the lung. ``` Bank: IgA IgE IgG blood-blood interchange blood-gas interchange blood-muscle interchange ```

Farmer’s Lung - IgG antibodies combine with the inhaled allergen to form immune complexes in the walls of the alveoli in the lungs, inducing local inflammation - This causes fluid, protein and cells to accumulate in the alveolar wall which slows blood-gas interchange and compromises the function of the lung.

Topic 14 Type IV Hypersensitivity - Reactions mediated by antigen-specific (____) effector __ cells: TH-1, TH-2, TC - Takes 1-3 days to develop (_____) - Involves ____ - Examples tuberculin test (TB): TH-1 ____: TC, TH-1 Nickel allergy ``` Bank: B Delayed-type hypersensitivity (DTH) macrophages poison ivy sensitized T ```

Type IV Hypersensitivity - Reactions mediated by antigen-specific (sensitized) effector T cells: TH-1, TH-2, TC - Takes 1-3 days to develop (Delayed-type hypersensitivity (DTH)) - Involves macrophages - Examples tuberculin test (TB): TH-1 poison ivy: TC, TH-1 Nickel allergy

Topic 14 Contact Hypersensitivity - Takes place in the skin after contact with allergen (____) - Caused by highly reactive small molecules that easily penetrate skin and form complex with self protein, like a hapten/_____ Intracellular: _____ T cells Extracellular: _____ T cells - Sensitized (____) T cells activate keratinocytes to produce pro-inflammatory cytokines and cause local inflammation - Poison ivy, coins, jewelry, some other metallic objects containing ____ ``` Bank: allergic contact dermatitis CD4+ CD8+ conjugate copper memory nickel ```

Contact Hypersensitivity - Takes place in the skin after contact with allergen (Allergic contact dermatitis_ - Caused by highly reactive small molecules that easily penetrate skin and form complex with self protein, like a hapten/conjugate Intracellular: CD8+ T cells Extracellular: CD4+ T cells - Sensitized (memory) T cells activate keratinocytes to produce pro-inflammatory cytokines and cause local inflammation - Poison ivy, coins, jewelry, some other metallic objects containing nickel

Topic 14 Metal ____ modifies self protein and create novel epitope, which stimulates T cell allergic reactions

``` Metal Nickel (Ni) modifies self protein and create novel epitope, which stimulates T cell allergic reactions ```

Topic 14 Allergic Contact Dermatitis Urushoil oil (Pentacacatechol) from leaf or root of ____ penetrates skin - Bind to ____ protein, creates novel epitope for CD4+ TH-1 cells. - Bind to ____ protein creates novel epitope for CD8+ TC cells. ``` Bank: extracellular intracellular maple tree poison oak ```

Allergic Contact Dermatitis Urushoil oil (Pentacacatechol) from leaf or root of poison oak penetrates skin - Bind to extracellular protein, creates novel epitope for CD4+ TH-1 cells. - Bind to intracellular protein creates novel epitope for CD8+ TC cells.

Imm: Exam IV Flashcards

(62 cards)