L19: Introduction to Immunological disorders Flashcards

(35 cards)

1
Q

List the different mechanisms of immunological tolerance

A
  1. central
  2. peripheral
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2
Q

explain what tolerance is

A

the education of the immune system to recognise self

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3
Q

Where does education / tolerance take place

A

lymphoid tissue - where lymphocytes are found

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4
Q

Where are the major sites of tolerance for central tolerance

A

thymus and bone marrow

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5
Q

what are the major sites of peripheral tolerance

A

spleen, lymph nodes, tonsils, adenoids

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6
Q

explain how central tolerance occurs

A
  1. immature lymphocytes specific for self antigens may encouter these in the lymphoid organs
  2. self-reactive immature cells are deleted, change their specificity (B cells), develop into regulatroy lymphocytes

too strong binding, no binding 203

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7
Q

explain how peripheral tolerance works

A
  1. Some self-reactive lymphocytes mature and enter peripheral tissues.
  2. There they may be inactivated or deleted by encounter with self antigens in these tissues, or are suppressed by the regulatory T cells
    (peripheral tolerance).

anergy, apoptosis, suppression

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8
Q

what are the three mechanisms of central tolerance?

A

non-selective (death by neglect)
positive selection
negative selection

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9
Q

What is central tolerance based on?

A

mature T cells recognising both MHC and peptide - refers to the strength of binding

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10
Q

explain death by neglect

A

TCR that fail to bind self MHC - 80%

aka non selection

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11
Q

explain the term negative selection

A

TCR that bind too strongly to MHC - 20%

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12
Q

explain the term psositive selection

A

1-2% lymphocytes whose TCR recognise self MHC not too strong/weak - displays non-self peptides in the periphery

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13
Q

how do T-cells encounter self-antigen in the thymus?

A
  1. thymic epithelial cells (TECs) express extra-thymic antigens
  2. ETA are usually expressed in other tissues/organs
  3. lymphocytes negatively selected when their affinity with self antigen-MHC complexed presented to TEC is very high - apotptotic death
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14
Q

TEC

A

thymic epithelial cells

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15
Q

how are Tregs developed?

A

some self reactive thymocytes are not deleted by differentiate into Tregs

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16
Q

why are Tregs important

A

important for peripheral tolerance - otherwise you can get autoimmunity

17
Q

Explain the process of central tolerance in B cells

A
  1. Immature B-cells recognise self antigens present at high concentration then B-cells edit sequence of BCR
  2. If editing fails B cells maybe deleted (mechanism not well understood)
  3. If self antigen recognition is weak the B cells become
    unresponsive and exit bone marrow in an ‘unresponsive’ state (anergic)
18
Q

What are the three mechanisms of peripheral tolerance

A
  1. clonal anergy
  2. suppression
  3. immunological tolerance
19
Q

clonal anergy

A

Self-reactive lymphocytes still exist, but are
inactivated and are resistant to antigen stimulation.

20
Q

Suppression

A

Tregs control the activation of self-reactive lymphocytes

21
Q

Immunological tolerance

A

Self-reactive lymphocytes are present, but do not mount a pathological response

a) Antigens are sequestered in immunologically “privileged” sites (eg the anterior chamber of the eye or the testis)
b) B cells lacking adequate T cell help
c) Lack co-stimulation by other molecules

22
Q

explain peripheral tolerance in B cells

A

B cells require help form T-cells to triger antibody secretion
- t cell tolerance therfore leads to B cell tolerance

23
Q

define autoimmunity

A

failure of an organism to recognise its own molecules as “self” - loss of tolerance

24
Q

List the requirements for AID

A
  1. Escape of autoreactive clones from thymus or bone marrow
  2. Autoreactive clones encounter self-antigens
  3. Peripheral tolerance failure
  4. Autoreactive tissue damage
25
explain the mechanism for AID
1. genetic susceptibility 2. infection or injury 3. influx self reactive lymphocytes 4. activation of self reactive lymphocytes
26
how does genetic susceptibility affect AID
disrupt self tolerance mechanisms
27
How does infection/injury affect AID
alter the way seld antigens are displayed
28
Explain how an influx of self reactive LC affect AID
infection or injury induces inflammation
29
What is molecular mimicry
component of pathogen has an epitope (small peptide piece) that resembles a self epitope. T and B cells think they look the same
30
How does molecular mimicry occur (genetically)
The antigens/proteins on pathogen and self are NOT the same, but they have stretches of sequence that ARE the same
31
give examples of AID
- ARF - MS - T1D - Rheumatoid Arthitis - Coeliac Disease
32
what is the relenvance of genetics in developing and AID
- suscetibility can increase - polgenic - many genes invoved in suceptibility - environmental factors involved too
33
Give some examples of genes involved in AID development
antigen presentation genes (MHC) antigen receptr genes (TCR) complement genes regulatory genes (Cytokines)
34
What are the treatment types for T1 AID
palliative - treat resulting deficits - replacement (lost secretions) - infection treamtnet (AB) - remove trigger (gluten)
35
What are the treatment types for T2 AID
- suppress immunity - corticosteroids, NSAIDS, DMARDs