Immunodeficiency, Autoimmune diseases, and hypersensitivities

Question 1

primary immunodeficiency

Answer 1

• congenital immunodeficiency
• inborn error that affects 1 or more immune factors and leads to deficient immunity
• rare

Question 2

secondary immunodeficiency

Answer 2

• acquired immunodeficiency
• more common
• patient starts out with a normal immune system and then experiences a decline in immune system rigor

Question 3

causes of secondary immunodeficiencies

Answer 3

• age
• certain infectious agents
• medical interventions
• systemic disorders

Question 4

aging

Answer 4

• associated with increased susceptibility to infections
• associated with worse prognosis following infection and a longer recovery time
• aging is associated with reduced response to vaccination

Question 5

inflammaging

Answer 5

balance between anti-inflammatory and pro-inflammatory becomes unbalanced, favoriting pro-inflammatory

Question 6

immune senescence

Answer 6

• occurs during aging
• immune stimulation at the basal level leads to failure to respond to acute stimuli
• decline of output from the bone marrow of some cells
• function of cells declines
• causes decline of memory cells

Question 7

immunodeficiencies caused by infectious agents

Answer 7

• many pathogens have virulence factors that directly inhibit host immune defenses
• some break down antibodies, interfere with cellular signaling, or directly infect immune system cells

Question 8

how does HIV destroy the immune system?

Answer 8

• infects and kills CD4 T helper cells
• causes a decrease in the cell mediated and humoral branches of adaptive immunity

Question 9

what are the consequences from HIV of destruction of immune function

Answer 9

• AIDS
• increased susceptibility to opportunistic function

Question 10

secondary immune deficiencies: nutrition

Answer 10

• metabolism and nutrition are closely linked
• starvation and malnutrition can suppress immune function and increase susceptibility to infections
• obesity is associated with aberrant immune activity
• increasing risk for associated inflammatory diseases
• balanced nutritional and metabolic homeostasis are crucial for appropriate immune function

Question 11

what can lack of self tolerance lead to

Answer 11

autoimmune disorders

Question 12

rheumatoid arthritis

Answer 12

cartilage destruction, bone erosions, inflammation, impaired joint function, and pain

Question 13

dermatomyositis

Answer 13

• endothelial cell swelling and necrosis, vessel wall membrane attack complex deposition, and myocyte-specific MHC-1 up-regulation
• cell mediated and innate immune system dysfunction

Question 14

interstitial bladder cystitis/ mastocytosis

Answer 14

elevated levels of mast cell mediators in the urine such as interleukin and histamine cause vasodilation, bladder mucosa damage, inflammatory cell inflitrate

Question 15

systemic lupus erythematosus

Answer 15

global loss of self-tolerance, overactive T and B cells, joint, skin, kidneys, blood cells, brain, heart and lungs

Question 16

steps of systemic lupus erythematosus

Answer 16

1. production of autoantibody
2. immune complex formation between circulating DNA and antibodies to DNA
3. presentation of autoantigen to T cells
4. inflammatory cytokine production

Question 17

Type 1 diabetes implicated infectious agent

Answer 17

coxsackievirus B

Question 18

guillian-barre syndrome implicated infectious agent

Answer 18

campylobacter jejuni

Question 19

rheumatic heart disease implicated infectious agent

Answer 19

streptococcus pyogenes

Question 20

multiple sclerosis implicated infectious agent

Answer 20

over 20 have been identified
- mainly herpesvirus 6 and epstein-barr virus

Question 21

are there cures or preventions for autoimmune disorders

Answer 21

NO

Question 22

hypersensitivity

Answer 22

an inappropriate immune response

Question 23

Type 1 hypersensitivity

Answer 23

• Allergies
• driven by IgE
• NOT associated with autoimmunity
• ex. atopic asthma and atopic dermatitis

Question 24

development of Type 1 hypersenstivities

Answer 24

1. sensitization stage: allergens trigger IgE production, IgE binds to the surface of mast cells
2. post-sensitization exposure: a person is exposed to the allergen after sensitization, the allergen binds to IgE on mast cell, which triggers degranulation

Question 25

Type II hypersenstivities

Answer 25

• cytotoxic
• driven by IgG or IgM interacting with antigens on cell surfaces or extracellular antigens
• associated with autoimmunity

Question 26

erythroblastosis fetalis (Type II hypersensitivity)

Answer 26

• the mother has Rh- blood and the fetus has Rh+ blood, during labor, the fetal Rh+ blood with enter the mothers system, and she will develop anti-Rh antibodies
• This is only a problem if the mother becomes pregnant with another Rh+ baby, the mother anti-Rh antibodies will attack the fetus, leads to hemolytic disease of the newborn (HDN)

Question 27

Type III Hypersensitivities

Answer 27

• Immune complex
• driven by IgG or IgM interacting with soluble antigens
• associated with autoimmunity

Question 28

Type IV Hypersensitivities

Answer 28

• Delayed hypersenstivity
• driven by T cells interacting with soluble or cell- or matrix- bound antigens
• associated with autoimmunity