Flashcards in immunology Deck (81):
MS, hay fever, SLE, goodpastures
T1DM, SLE, graves, hashimotos
pernicious anemia, hashimotos
type I HSR
IgE -> mast cell and basophil degranulation -> vasodilation of postcapillary venules -> delayed response from arachidonic acid metabolites (leukotrienes)
type II HSR
IgM, IgG bind to Ag on enemy cell -> cytotoxic killing via opsonization, complement + Fc receptor-mediated, and Ab-mediated cellular dysfxn. coombs test. acute transfusion rxns, AIHA, GBS, graves, MG, rheumatic fever, etc.
type III HSR
Ag, Ab, and complement get stuck together -> neutrophils release lysosomal enzymes. serum sickness and arthus rxn are specific types. SLE, post-strep glomerulonephritis, etc.
type IV HSR
NOT Ab-relatedd. delayed. T cells bind Ag -> cytokines -> macrophage activation. transplant rejection, TB skin test, touching (contact dermatitis). MS.
febrile nonhemolytic transfusion rxn
type II HSR. host Abs against donor HLA and WBCs -> fever, h/a, chills, flushing
acute hemolytic transfusion rxn
type II HSR. ABO incompatibility -> intravascular hemolysis, host Ab rxn w/foreign Ags -> extravascular hemolysis -> fever, hypotension, tachypnea, tachycardia, flank pain, hemoglobinuria (intravascular), jaundice (extravascular).
why does complement deficiency increase risk of SLE?
b/c complement is necessary to remove Ag/Ab complexes
anticardiolipin, lupus anticoagulant
limited scleroderma (CREST)
anti-glutamic acid decarboxylase (GAD-65)
anti-Jo-1, anti-SRP, anti-Mi-2
anti-Scl-70, anti-DNA topoisomerase I
anti-SSA, anti-SSB (anti-Ro, anti-La)
anti-U1 RNP (ribonucleoprotein)
mixed connective tissue dz
IgA anti-endomysial, IgA anti-tissue transglutaminase
microscopic polyangiitis, eosinophilis granulomatosis w/polyangiitis (churg-strauss)
granulomatosis w/polyangiitis (wegener)
RA. RF = IgM against IgG Gc region. anti-CCP = more specific
immunodeficiency that -> giardia, bacterial, enteroviral infxns after 6 mos
bruton's agammaglobulinemia. no BTK -> no B cell maturation, so no plasma cells. absent/scanty lymph nodes
immunodeficiency that -> recurrent mucosal infxns, esp. viral
selective IgA def. usually asymptomatic.
immunodef. that -> bacterial, enterovirus, and giardia infxns acquired later
common variable immunodef. many causes (e.g. B cell or helper T cell defect) -> B cell maturation failure -> dec. plasma cells, immunoglobulins. inc. risk of autoimmune dz, bronchiectasis, lymphoma, sinopumonary infxns.
dec. Th1 response. AR. -> disseminated mycobacterial and fungal infxns. may present after BCG vaccine. dec. IFN-gamma
AD. job syndrome. STAT3 mutation -> Th17 def. -> impaired neutophil recruitment. course facies, cold (non-inflamed) staph abscesses, retained primary teeth, inc. IgE, dermatologic problems (eczema). low IFN-gamma
no B cells ->
fungal + viral infxns
no T cells ->
bacterial + protozoal infxns
no IgA ->
no C5-9 ->
no C1 inhibiter ->
hereditary angioedema (esp. periorbital) + mucosal surfaces
3 causes of SCID
cytokine receptor defects
adenosine deaminase deficiency
MHC II def. -> dec. CD4+ -> dec. T + B cells
ATM gene defect -> failure to repair dsDNA breaks -> cell cycle arrest -> cerebellar defects, spider angiomas, IgA def. + inc. AFP, low IgA, IgG, IgE. lymphopenia.
WAS mutation, XR -> T cells can't reorganize actin cytoskeleton -> TTP, eczema, recurrent humoral + cellular infxns, inc risk of autoimmunity. low/nl IgG, IgM. inc. IgE, IgA. fewer, smaller plts.
leukocyte adhesion deficiency type 1
AR. defect in LFA-1 integrin CD18 subunit -> impaired migration + chemotaxis of phagocytes -> delayed cord separation, recurrent bacterial + mucosal infxns w/o pus.
AR defective lysosomal trafficking regulator gene (LYST). microtubule dysfxn -> lysosome + phagosome can't fuse. -> recurrent pyogenic staph + strep infxns, partial albinism, long nerve neuropathy, infiltrative lymphohistiocytosis. giant granules in granulocytes + plts. pancytopenia (impaired cell division), mild coag defect (primary hemostasis problem)
defective conversion of H2)2 -> HOCL -> inc. candida. normal NBT test
calcineurin inhibitor, binds cyclophilin. blocks T cell activation by preventing IL-2 transcription!! Tx for PPx transplant rejection, psoriasis, RA. nephrotoxic
= FK506. calcineurin inhibitor, binds FKBP. blocks T-call activation by preventing IL-2 transcription! Tx: PPx transplant rejection. nephrotoxic! inc. DM, neurotox. no gingival hyperplasia or hirsuitism
= rapamycin. mTOR inhibitor; bind FKBP. blocks T cell activation/B cell differentiation by preventing response to IL-2! Tx: kidney tranplant recetion PPx. not nephrotoxic. cytopenias, insulin resistance, HL
Abs block IL--2R. Tx: kidney tranplant PPx. edema, HTN, tremor
antimetabolite precursor of 6-mercaptopurine. inhibits lymphocyte proliferation by blocking nucleotide synthesis. Tx: rejection PPx, autoimmune stuff. cytopenias. 6-MP is degraded by xanthine oxidase so allopurinol -> inc. toxicity.
inhibit NF-kappaB. suppress B and T cells by dec. cytokine transcription.
= IL-2. use in renal cell CA, metastatic melanoma
= G-CSF. use for bone marrow recovery
= GM-CSF. use for bone marrow recovery
use in chronic hep B + C, kaposi sarcoma, malignant melanoma.
= IL-11. use in thrombocytopenia
targets CD52. use in CLL
targets VEGF. use for colorectal CA, renal cell CA. neovascular macular degeneration.
targets EGFR. use in stage IV colorectal CA, head + neck CA
targets CD20. use in H-cell NH lymphoma, CLL, RA, ITP
targets soluble TNF-alpha. use in IBD, RA, AK, psoriasis
decoy TNF-alpha receptor, not monoclonal Ab
targets complement protein C5. use in paroxysmal nocturnal hemoglobinuria
targets alpha4-integrin (WBC adhesion). use in MS, crohns. -> inc. risk of PML in pts w/JC virus.
targets plt glycoproteins IIb/IIIa. use to prevent ischemic complications during vascular cath.
targets RANKL. use in osteoporosis to inhibit osteoclast maturation.
digoxin immune Fab
antidote for dig toxicity
targets IgE. use for allergic asthma: prevents IgE binding to Fc-epsilon-RI