1
Q

what are the sites of microbe entry?

A
→Conjunctiva 
→Arthropod 
→Capillary 
→Scratch
→ injury 
→Skin 
→Anus 
→Urinogenital tract 
→Alimentary tract 
→Respiratory Tract
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2
Q

describe the inflammatory response

A

→ generic defence mechanism
→to localize and eliminate injurious agents
→remove damaged tissue components
→enhanced permeability and extravasation

→ Neutrophil recruitment
→ Enhanced cell adhesion
→Enhance clotting
→Triggered by the release of pro-inflammatory cytokines and chemokines at the site of infection

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3
Q

what do cytokines do?

A

→Act to modify the behaviour of cells in the immune response
→Most of these are called interleukins (eg. IL-1

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4
Q

what do chemokines do?

A

→Act as chemotactic factors
→ i.e. they create concentration gradients which attract (or occasionally repel) specific cell types to a site of production/infection

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5
Q

what is IL-1?

A

→Main producer = Macrophages + keratinocytes
→Acts upon = lymphocytes + liver
→Effect = Enhances response
→ Induces acute-phase protein secretion

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6
Q

what is IL-6?

A

→ Main producer = Macrophages + dendritic cells
→ Acts upon = lymphocytes + liver
→ Effect = Enhances response
→ Induces acute-phase protein secretion

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7
Q

what is CXCL8 (IL-8)?

A

→Main producer: Macrophages + dendritic cells
→Acts upon: Phagocytes
→Effect: Chemoattractant for neutrophils

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8
Q

what is IL-12?

A

→Main producer: Macrophages + dendritic cells
→ Acts upon: Naive T cells
→Effect: Diverts immune response to type 1, →proinflammatory, cytokine secretion

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9
Q

what is TNF - alpha?

A

→Main producer: Macrophages + dendritic cells
→Acts upon: Vascular endothelium
→Effect: Induces changes in vascular endothelium (expression of cell-adhesion molecules (E- + P- selectin), changes in cell-cell junctions w/increased fluid loss

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10
Q

how do macrophages “see” microbes?

A

→Passive sampling
→ Scavenger receptors
→Engulfing apoptotic cells

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11
Q

what are examples of Pathogen-associated Molecular Patterns (PAMPs)?

A

→Gram-negative bacteria; lipopolysaccharides (LPSs) found in outer membrane

→Gram-positive bacteria; teichoic acid, lipoteichoic acid, peptidoglycan found in outer membrane

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12
Q

what are other PAMPs?

A

→Bacterial flagellin
→Abnormal protein glycosylation
→Abnormal nucleic acids - viruses

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13
Q

what are Pattern recognition receptors (PRRs)?

A

→Host factors that specifically recognise a particular type of PAMP
→They are germ-line encoded

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14
Q

what are the three classes of PRRs?

A

Extracellular
→ they recognise PAMPs outside of a cell and trigger a co-ordinated response to the pathogen

Intracellular (cytoplasmic)
→ they recognise PAMPs inside a cell and act to co-ordinate a response to the pathogen

Secreted
→ they act to tag circulating pathogens for elimination

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15
Q

Lectin receptors

A

→Ligand: terminal mannose and fucose

→Outcome: phagocytosis

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16
Q

Scavenger receptors

A

→Ligand: bacterial cell walls modified low-density lipoproteins
→Outcome: phagocytosis

17
Q

Toll-like receptors (TLRs) (surface and endosomal)

A

→Ligand: LPS (together with CD14) lipoproteins unmethylated CpG flagellin ds RNA; ss RNA (in endosomes)

→Outcome: inflammation: cytokine release (TNF, IL-1, IL-12) enhanced killing: reactive oxygen species, NO)

18
Q

NOD-like receptors (NLRs) (cytoplasm)

A

→Ligand: peptidoglycan from Gram positive and negative bacteria some viral DNA and RNA (indirect?)

→Outcome: inflammation: cytokine release (IL-1, IL-8)

19
Q

RIG-like receptors (RIG-1 and MDA5) (cytoplasmic)

A

→Ligand: dsRNA and 5’-triphospho RNA

→Outcome: type I interferon production

20
Q

how do macrophages “see” microbes?

A

→Passive sampling
→ Scavenger receptors
→Engulfing apoptotic cells

21
Q

what is the complement and what does it do?

A

→system of secreted proteins made in the liver that recognise PAMPs on the surface of microbes and “decorate” or “tag” them.

→The microbes are then cleared by phagocytosis, “opsonised” or they have holes punched in them

22
Q

what are the three ways of activating complement?

A

→Recognition of LPS and other PAMPs by the C1q component of “classical” pathway (

→Non-host glycosylation is recognised by MBP and other lectins to activate the “lectin” pathway

→ Membranes that are recognised as “non-self” activate the “alternative” pathway

→Complement activation involves a proteolytic cascade

23
Q

Natural Killer (NK) cells (Large granular lymphocytes)

A

→4% white blood cells
→Lymphocyte-like but larger with granular cytoplasm
→Kill certain tumour & virally infected cells
→ Target cell destruction is caused by cytotoxic molecules called granzymes & perforins

24
Q

how are NK cells activated?

A

→NK cells possess the ability to recognise and lyse virally infected cells and certain tumour cells.
→Selectivity is conferred by LOSS of “self” MHC molecules on target cell surfaces, AND up-regulation of activating ligands

25
how does cell death happen?
→Perforin + cytotoxic granules | →Engagement of death receptors
26
CMV has four gene products which
→reduce the expression of Class 1 MHC molecules and two class I MHC homologues (UL18 & M144), that give a negative signal to NK cells
27
NK cells bind
→cells bind HLA-E which carries in its groove a peptide from the leader sequence of classical class I MHC molecules
28
inherited defects associated with Innate Immunity
→Complement – core defects (e.g. C3) linked to development of autoimmune diseases such as lupus →Complement – non-core defects linked to suspectibility to specific types of pathogens such as Neisseria Macrophage deficiencies →Chronic granulomatous disease (CGD); No oxidative burst for bacterial killing Macrophage deficiencies →IRF8 mutations linked to susceptibility to TB Aicardi–Goutières syndrome associated with constitutive production of inflammatory cytokines Lack of interferon-responsiveness → sensitivity to viral infection (e.g. measles)