Immunological Aspect of the Renal System

Question 1

ischemic acute kidney injury leads to what?

Answer 1

metabolic acidosis and ATP depletion

Question 2

what is sterile inflammation induced by?

Answer 2

intrinsic DAMPS that are released by necrotic parenchymal kidney cells and due to ECM degradation

Question 3

what is another name for DAMPs?

Answer 3

alarmins

Question 4

what DAMP represents the nucleolus protein?

Answer 4

HMGB1

Question 5

what DAMP represents the exosomes?

Answer 5

HSPs

Question 6

what DAMP represents the cytoplasm?

Answer 6

S100

Question 7

what damp represents the degradation of the ECM?

Answer 7

hyaluronans

Question 8

what can bind DAMPs and activate the classical complement pathway?

Answer 8

C-reactive protein (CRP)

Question 9

what is the reason for the kidney’s unique susceptibility to complement-induced damage?

Answer 9

high filtration rate favors tissue deposition of immune complexes

Question 10

what do neutrophils release when activated?

Answer 10

proteases and ROS

Question 11

what are the immune responses of the early stages of AKI mediated by?

Answer 11

Th17 and Th1 cells

Question 12

what are the late stages of AKI mediated by?

Answer 12

Th1 cells

Question 13

what do DCs release?

Answer 13

IL-1, IL-6, and TGF-beta

Question 14

what does IL-17 induce?

Answer 14

inflammation

Question 15

what does IL-22 induce?

Answer 15

Homeostasis

Question 16

what does IL-17 induce the expression of and what does this lead to?

Answer 16

induces the expression of CCL20; leads to the recruitment of neutrophils, monocytes, and Th1/Th17 cells

Question 17

what do Th1 cells secrete?

Answer 17

IFN-gamma

Question 18

what does IFN-gamma induce?

Answer 18

classically activated M1 macrophages

Question 19

how are Th1 cells induced by DCs?

Answer 19

by IL-12

Question 20

besides inducing classical macrophage activation, what else does IFN-gamma induce?

Answer 20

isotype switching of B-cells

Question 21

what induces the activation of M2 macrophages?

Answer 21

IL-13 and IL-4 (from Th2 cells)

Question 22

what happens when TGF-beta is produced?

Answer 22

pericytes become myofibroblasts

Question 23

all acute kidney injuries happen and are mediated by what type of reactions?

Answer 23

type II and type III

Question 24

what is the mechanism of action for type II reactions of acute kidney injuries?

Answer 24

upon tissue damage, positively charged Ags can be planted into the negatively charged GBM

Question 25

what are the targets for transplant rejection?

Answer 25

HLA Ags

Question 26

what does clotting cascade generate?

Answer 26

fibrin and fibrinopeptides

Question 27

what is the role of fibrin?

Answer 27

it aggregates to yield a 3D network of the clot

Question 28

what is the role of fibrinopeptides?

Answer 28

they increase the local vascular permeability and leukocyte accumulation in the tissue

Question 29

what does the kinin cascade produce?

Answer 29

bradykinin (increases vascular permeability)

Question 30

what is a general description of microcytotoxicity test for class I HLA compatibility?

Answer 30

anti-HLA abs are added to both the donor and recipient lymphocytes; complement is added and then dye; there is an HLA match if the dye is found in both

Question 31

how do you test for HLA class II compatibility?

Answer 31

using mixed lymphocyte response

Question 32

what is mixed lymphocyte response?

Answer 32

uses radioactivity and labeled thymidine; the more radioactivity incorporated the great the class II HLA disparity