LE 4 Flashcards
Applied Immunology (299 cards)
1
Q
Which organ can regenerate after donation removal?
A
Liver
2
Q
What are some lifestyle diseases that are increasingly prevalent?
A
DIABETES or HYPERTENSION
3
Q
Diabetes and Hypertension will have detrimental effects on kidney and lead to
A
hypertensive nephroscelrosis
4
Q
Types of grafts and differentiate
A
autograft - transplant from another part of the body
isograft - transplant between genetically identical individuals (twins)
allograft - transplant between the same species
xenograft - transplant between different species
5
Q
Why is the rate of rejection high in animal transplants to humans?
A
Needs constant immune suppression
6
Q
What is the normal position of the kidney?
A
T12-L3
7
Q
The kidney is attached to which blood vessels
A
aorta and inferior vena cava
8
Q
Where is the donated kidney placed during a kidney transplant?
A
Iliac fossa
9
Q
during transplantation of donated kidney what blood vessels are attached to donated kidney for optimum blood flow
A
renal artery and renal vein
10
Q
What is considered the gold standard of transplantation due to its low rejection rate?
A
HLA-Identical
11
Q
Types of MHC pairing and define
A
HLA - identical - 2 identical alleles
HAPLO - identical - 1 identical allele
HLA - different - NO identical allele/s
12
Q
What is the chance of rejection in HLA-Identical transplantations due to HLA recombination?
A
<1% population
13
Q
What type of HLA pairing has one allele the same?
A
Haplo-Identical
14
Q
In which type of HLA pairing are all alleles different?
A
HLA-Different or Non-Identical
15
Q
Why are immunosuppression drugs needed in most transplantation cases?
A
Most cases are done between unrelated donors (HLA- different)
16
Q
mHC rejection rate
A
slow and minor rejection
17
Q
most common/predominant Ag in mHC
A
H-Y Ag
(Other Ags can be found on Autosomal Chromosomes)
18
Q
mHC is commonly found in what gender
A
males
19
Q
mHC is found where
A
protein membrane
20
Q
What causes minor histocompatibility (mHC) rejection?
A
Single nucleotide polymorphism/ Slight polymorphism
21
Q
Which antigens cause a T-cell response in minor histocompatibility reactions?
A
H-Y Ag
22
Q
Typical reaction of mHC
A
Tcell response (CD4, CD8)
23
Q
Explain the concept of single nucleotide polymorphism
A
recipient does not have the same nucleotides as the donor, causing it to be taken to Tcell = cell lysis
OR,
graft of activated T cell attacks and causes cell lysis
24
Q
What percentage of kidney rejections is due to MICA?
A
11%
25
On which cells is MICA expressed?
Keratinocytes, Endothelial cells, Fibroblasts, Epithelial cells [Dendritic cells, Monocytes]
26
Are MICA expressed on B and T cells? yes or no
No
27
Typical reaction of MICA
Ab-Ag reaction
Bcell response
(CD4)
28
BGA is expressed on:
RBC membrane, secretions and membrane of epithelium, endothelium (BV)
29
Which type of rejection is caused by blood group antigens?
Hyperacute Rejection
30
How does the ABO system cause transplant rejection?
Antibody of host attacks antigen from donor, activates complement system = cell lysis
31
Enumerate steps of Hyperacute rejection
1. Antibody of host attacks antigen of donor transplant
2. activates complement, formation of MAC unit and cell lysis
3. vWBF from Weibel-Palade body in endothelium activates and causes Platelet Adhesion
4. Collagen from lamina propria below the endothelium activates the intrinsic pathway (Factor 3: thromboplastin activates extrinsic pathway)
4. Formation of clot due to factors
5. Oxygenation to transplant is compromised
6. Hyperacute Rejection occurs
32
What happens when strength of binding of AR is greater than IR
Apoptosis (lysis)
33
What does the presence of fluorescence indicate in SPC?
Presence of Antibody
34
unknown in antibody identification
naturally occurring antibodies
35
HLA testing that uses in situ hybridization
HLA genotyping
36
Superior HLA testing. why?
genotyping cuz only relies on dna thru pcr amplification
37
PCR Amplification is done with 2 methods
1. Amplify a specific code or bind to target gene
2. Amplify all HLA gene variants at specific locus and add probe
38
unknown in genotyping
hla gene
39
enumerate steps in HLA AI
1. px serum mixed with ag beads will create binding to specific HLA antibodies resulting to agglutination
2. addition of chromogen dye
3. checking for fluorescence in SPC
40
What is the purpose of checking for fluorescence in SPC?
Detect HLA Ab/subtypes that cause rejection
41
How is HLA CROSSMATCHING performed?
Incubate donor RBC with recipient plasma
42
HLA testing that has the same principle and procedure as IH
HLA crossmatching
43
What does agglutination indicate in HLA CROSSMATCHING?
Not compatible
44
Which blood groups are considered the most immunogenic?
ABO, Rh, Kell
45
Transplant rejection
1. allorecognition
2. Host vs graft disease (HVGD)
2. Graft vs host disease (GVHD)
46
What is allorecognition
#NAME?
47
What is direct allorecognition?
MHC Class 1: CD8 T cell/ cytotoxic cell, faster recognition, causes lysis,
Usually in:
1. hyperacute rejection
2. acute rejection
48
What is indirect allorecognition?
APC presents via MHC Class II to CD4 T cell, slower
Usually in:
1. acute rejection
2. chronic rejection
49
What causes hyperacute rejection in transplantation?
ABO variations in Antibody/Antigen, thrombosis
50
direct allorecognition rely on activation of T cell. T or F
False. indirect allorecognition rely on activation of t cell
51
Host Vs. Graft Diseases
#NAME?
52
how does hyperacute rejection occur?
abo variants in ab and ag of donor/recipient destroys tunica intima causing graft death due to formation of clot (thrombosis) blocking blood flow to transplant
53
hyperacute rejection can happen in
minutes to hours
54
how does acute rejection occur?
#NAME?
55
acute rejection can happen in
days to weeks
56
acute rejection is characterized by:
parenchymal and vascular injury infiltrated by CD4, CD8 and macrophages
57
interstitial fluid of acute rejection contains:
CD4, CD8 and macrophages
58
chronic rejection can happen in
months to years
59
chronic rejection is associated with
delayed hypersensitivity
60
chronic rejection is characterized by
graft arteriosclerosis and fibrosis
61
how does chronic rejection occur?
cytokines and growth factors by t cells cause proliferation of tunica intima smooth muscle cell
62
primary culprit in activation of proliferation of tunica intima smooth muscle cell
IFNys by T cell
63
Host is destroyed by graft transplant
GVHD
64
GVHD is usually found in what types of individuals
immunocompromised px
65
process of acquiring GVHD
1. pretreatment to release donor stem cell
2. stem cell is extracted (separated from blood and removed)
3. remaining blood is returned to px they apheresis
4. all previous stem cells are eradicated or killed.
5. donor stem cells are transfused
66
What is the first step in the process of a hematopoietic stem cell transplant?
Pretreatment to release donor stem cell
67
What must be done to the recipient's stem cells before a hematopoietic stem cell transplant can take place?
Recipient's stem cells must be removed / killed / eradicated
68
Results we can infer from transplant
1. not accepted = stem cells of donor will attack cells of recipient causing GVHD
2. accepted = transfusion/matching is successful
69
What is GVHD?
Graft versus host disease, where transplanted stem cells attack the recipient
70
What signifies a successful hematopoietic stem cell transplant?
The recipient's acceptance of the graft
71
What is a benefit of hematopoietic stem cell transplant in the presence of leukemic cells?
Graft VS Leukemia (GvL) effect
72
Two outcomes of stem cell transplant
1. graft vs leukemia (GVL)
2. GVHD
73
What does HSC do to leukemic cells?
Kills them
74
How does GVHD differ from allorejection?
GVHD attacks the recipient, allorejection attacks the graft
75
What are the two kinds of GVHD?
Acute and Chronic
76
When does Acute GVHD occur?
First 100 Days
77
When does Chronic GVHD occur?
Beyond 100 Days
78
Which organs are affected by Acute GVHD?
Skin, Liver, Gastrointestinal Tract
79
What are the symptoms of Chronic GVHD?
Fibrosis of Skin, Eyes, Mouth, Mucosal surfaces
80
MHC Class type of t cell present in Acute Allorejection
Acute Allorejection (Acute GVHD) - Direct (CD8)/ Indirect (CD4) Allorejection
81
Matching DQ
10-Oct
82
Matching DQ and DP
12-Dec
83
Immunosuppressive Agent: Antimetabolic Agents examples
1. Azathioprine
2. Mycophenolate
84
What is the only 'cure' for very severe fibrosis?
No cure, Another transplantation is needed
85
What is the purpose of matching HLA between donor and recipient in organ transplantation?
Avoidance of transplant reactions
86
Immunosuppressive Agent: Harvested from animals
Polyclonal Antibodies
87
What is considered perfect compatibility in HLA matching for transplantation?
08-Aug
88
Matching of HLA - A,B,C or DR to px cord blood
08-Aug
89
Immunosuppressive Agent: Target t-cells, depleting T-lymphocyte from circulation
Polyclonal Antibodies
90
Why do transplant patients need chronic immunosuppression even with proper HLA matching?
To avoid graft rejection
91
immunosuppressive agents
1. steroids
2. antimetabolic agents
3. calcineurin inhibitor
4. monoclonal ab
5. polyclonal ab
92
too much transfusion/ intake of polyclonal antibodies can cause [disease]?
serum sickness
93
What are the consequences of chronic immunosuppression in transplant patients?
Cancer & Infection
94
Immunosuppressive Agent: Binds IL-2R (CD25) to block production of IL2 [used for B cell differentiation]
Monoclonal Antibodies
95
Immunosuppressive agents that causes DM
Steroids
96
Immunosuppressive Agent: Polyclonal Antibodies
Thymoglobulin (rabbit serum)
ATGAM (horse)
97
What do steroids do as immunosuppressive agents in transplantation?
Block signaling pathways of cytokine & mediators, Anti-inflammatory, immunosuppressive
98
Immunosuppressive Agent: Monoclonal Antibodies
1. Basiliximab
2. Daclizumab
99
Immunosuppressive Agent: Impiairs IL, cytokines and IFNys
Calcineurin Inhibitor
100
Immunosuppressive Agent: Inhibit DNA replication/synthesis
Antimetabolic Agent
101
Immunosuppressive Agent: Blocks cell signaling
Calcineurin Inhibitor
102
HLA Antigens found in monocyte. T or F
True (present as WBCs)
103
Immunosuppressive Agent: Calcineurin inhibitor example
1. Cyclosporine- A
2. Tacrolimus
104
What provide the basis for donor selection in tissue transplantation?
Histocompatibility Antigens
105
HLA Antigen is found on RBCs. T or F
FALSE
106
Where are histocompatibility antigens absent?
RBCs, Trophoblastic cells, Sperm cells
107
Which tissues display the highest amount of antigen?
WBCs, Spleen, Lungs, Kidney, Heart
108
What are the most commonly transplanted organs?
Lungs, Kidney, Heart
109
What are Human Leukocyte Antigens (HLA)?
Part of the Histocompatibility Antigens located in the MHC gene on Chromosome 6
110
What chromosome is the Major Histocompatibility Complex (MHC) gene located on?
Chromosome 6
111
What cells detect Class I HLA molecules?
CD8+ T Cells
112
MHC Classes of Genes and Composition
Class 1 - HLA [A,B,C]
Class 2 - HLA [DR,DQ,DP]
Class 3 - Complement proteins
113
What cells detect Class II HLA molecules?
CD4+ T Cells
114
What is an Autograft?
A transplant where tissue from one part of the body is transplanted to another part of the same body
115
Other name of autograft
autologous graft
116
Why is there less chance for graft rejection in an autograft?
Because the tissue comes from the person's own body
117
2 types of Holograft
1. semi-syngeneic
2. Allogeneic
118
Other name of isograft
syngeneic/ isogeneic graft
119
What is a syngeneic allograft?
Between genetically identical individuals
120
Other name of allograft
#NAME?
121
What is a xenograft?
Occurred from one species to another
122
In what fossa do the kidney and renal vein attach to the present blood vessels?
iliac fossa
123
most common kidney donation
Left kidney donation and transplant
124
Why is Left kidney donation and transplant most common
Because of its long renal artery and renal vein making it easier for attachment or anastomosis of BV to transplanted kidney on illac fossa (external iliac)
125
To whom is the left lobe of the liver usually given to?
pediatric patients
126
What happens to the liver cells that grow back whole after months?
the cells rapidly multiply
127
What is the common diagnosis that uses (in) liver transplant?
Fibrosis
128
Fibrosis is the common diagnosis that uses what?
liver transplant
129
HLA Antigens are prone to severe rejections. True or False
TRUE
130
What is the HLA ANTIGEN part of?
Major Histocompatibility Complex
131
Where is of the Major Histocompatibility Complex located?
Short arm of Chromosome 6
132
What HLA Antigen is most polymorphic with how many loci
HLA-B - 61 loci
133
Most polymorphic HLA Class II Antigen
HLA-DR
134
HLA Antigens and its Transplant loci
A - 28
B - 61
C - 10
R - 24
Q - 9
P - 6
135
What is a short arm of chromosome 6 called?
Locus
136
Define HLA Class 1 (EHMNRH)
- Expressed on all nucleated Cells
- HLA [A, B, C (E, F, G)]
- Most immunogenic
- Numerous
- compatibility of organ transplantation
- Highly polymorphic HLA [A, B, C]
137
Define HLA Class (EHH)
- Expressed in APCs (Macrophage, B cells, Langerhans, Interdigitating cells, Dendritic cells)
- HLA [DP, DQ, DR]
- Highly polymorphic HLA-DR
138
Histocompatibility Systems is inherited thru
mendelian pattern (Punnet square)
139
Principle of Histocompatibility systems
codominant expression (cis-AB, or A, B)
140
What causes the release of vWBF in the Endothelial cells?
Platelet Adhesion
141
Results when Strength of binding or IR is greater than AR
nothing happens
142
Collagen found in what is below the endothelium?
lamina propria
143
Where are Killer Immunoglobulin-Like Receptors found?
NK cells
144
2 major receptor KIR complex
inhibiting ad activating receptors
145
Result when strength of binding of inhibitor is equal to the strength of binding of activating
nothing happens
146
HLA testing
1. Phenotyping
2. Genotyping
3. Antibody Identification
4. Crossmatching
147
classical procedure for specific type of alleles
phenotyping
148
what is the unknown in phenotyping
antigen
149
principle to HLA phenotyping
CDC - complement dependent cytotoxicity
150
What type of antibodies are incubated with lymphocytes from buffy coat to be HLA typed in separate wells of a microtiter plate (terasaki plate)
monoclonal antibodies
151
Antibodies attack the specific antigen on what in phenotyping?
B Cells or T Cells
152
AB labeled with paramagnetic substance targeted to T-cell (CD3)/ B cell (CD20)
HLA Phenotyping
153
Enumerate the steps of HLA phenotyping
1. buffy coat preparation
2. buffy coat incubated wt pure HLA antibodies
3. antibodies attack specific antigen on b cells and t cells
4. in presence of bound antibody complement is activated = cells are killed
5. addition of fluorescent dye to be able to view on microscope
154
when is complement activated in phenotyping?
when there is presence of bound antigen (only happens when lymphocyte expresses HLa antigen targeted by antisera
155
What attack the specific antigen on B Cells or T Cells?
Antibodies
156
What does bound antibody occur only when the lymphocyte expresses the HLA antigen targeted by the antisera?
if the lymphocyte expresses the HLA antigen targeted by the antisera
157
What is activated in the presence of bound antibody?
complement is activated
158
what happens when complement is activeted?
cells die
159
What is added to be able to view agglutination in microscope ?
fluorescent dye
160
what dyes are added for HLA phenotyping
acridine orange = viable cells (green)= presence of binding
ethidium bromide = nonviable cells (red) no presence of binding
161
How many genes does one family member share from the mother to the child?
half
162
How much of the mother's genes does the child contain?
half
163
How many genes do sibling-to-sibling share?
half
164
Differentiate the two types of allograft
1. semi-syngeneic/ semi-allogeneic - one family member donates to other family members
2. allogeneic - from one person to another (graft to same species different individuals)
165
What is used to identify with the lowest risk of complications?
tissue typing techniques
166
How do we reduce the risk of complications?
increase compatibility
167
What are donors ranked based on in case they become available?
compatibility
168
Preformed Abs [detected during HLA cross-matching] may be formed during
1. Pregnancy
2. Previous Blood Transfusion
3. Previous transplantation
169
agglutination/ reaction during testing indicates ____?
incompatibility
170
Ways to increase tissue compatibility
1. HLA Typing
- Phenotyping
- Genotyping
- Abs Identification
2. Cross-matching
171
When can a lot of medications be given to a patient with renal issues?
Before they have End-Stage Renal Disease
172
Indications for Solid Organ Transplantation
1. Damage is irreversible, alternative treatments are not applicable
2. Disease must not reoccur in graft
3. Chances of rejection must be minimized
173
What happens if a patient with renal issues is not compliant with treatment?
They progress to End-Stage Renal Disease
174
What is the only treatment for End-Stage Renal Disease?
Transplantation
175
Why might some patients in the Philippines choose not to undergo transplantation for End-Stage Renal Disease?
Cost and scarcity of the kidney
176
What is the concern when transplanting organs in patients with Goodpasture Syndrome?
Disease recurrence
177
Which organ is most commonly damaged in Goodpasture's Syndrome?
Kidney
178
Why may a transplanted kidney be diseased again in a patient with Goodpasture's Syndrome?
Presence of disease in circulating lymphocytes and not the organ itself
179
What happens when you have endothelial injury?
Prothrombotic state
180
HYPERACUTE REJECTION:
- time
- cause for rejection
- example
- schematic of rejection
A. immediately (minutes to hours)
B. antibodies against donor graft endothelial cells
C. Hypersensitivity II, Natural IgM antibodies against ABO antigens (MHC Class 1)
D. Complement Activation > Endothelial Injury > Thrombosis > Ischemic Necrosis
181
CHRONIC REJECTION:
HYPERACUTE REJECTION:
- time
- cause for rejection
A. months to years after transplantation
B. graft failure
182
ACUTE REJECTION:
HYPERACUTE REJECTION:
- time
- cause for rejection
- due to
- prevented by
A. Days to weeks
B. Early graft failure (most common), discontinued/tapered immunosuppression
C. HLA Incompatibility
D. immunosuppressive drugs/medications
183
cancer in the brain/spinal chord
glioma
184
What occurs when a thrombus forms in small blood vessels?
Thrombosis
185
What happens to tissue when it becomes hypoxic and eventually necrotic?
Ischemic necrosis
186
cancer/ tumor filled with hair, tissue, teeth
tetranoma
187
How can hyperacute rejection be prevented?
ABO & HLA cross-matching
188
Why is ABO compatibility crucial in transplantation?
Donor tissue may die if incompatible
189
Methods of increasing graft survival
1. HLA matching
2. Immunosuppressive therapy
3. Plasmapheresis
190
cancer that forms in the lining of the blood vessels
Kaposi sarcoma
191
What organs does not need HLA matching
1. liver
2. heart
3. lungs
192
immunosuppression leads to
increased susceptibility to opportunistic pathogens
193
Malignancies due to latent viral infections due to immunosuppression
EBV-induced burkitts lymphoma
HPV-induced squamous cell carcinoma
HHV-8 induced kaposi sarcoma
194
2 problems unique to HSC transplantation
1. GVHD
2. immunodeficiency
195
ACUTE GVDH
a. time
b. mediated by
c. involved organs
d. presentation (s/s)
a. days to weeks of transplantation (within 100 days)
b. mediated by CD8+ T cells /. Cytotoxic T-cells
c. skin, liver, gastrointestinal tract (intestines)
d. rashes, jaundice and bloody diarrhea
196
CHRONIC GVDH
a. time
b. mediated by
c. involved organs
d. presentation (s/s)
a. after 100 days
b. autoimmunity grafted from CD4+ T cells stimulating B cell differentiation
c. skin (cutaneous injury), mouth, eyes, liver and esophageal structures
d. thymic involution, lymphocyte and lymph node depletion
197
fatal complications of immunodeficiency caused by HSC transplantation
cytomegalovirus-induced pneumonitis
198
frequent complicaton of HSC transplantation
Immunodeficiency
199
What do benign tumors generally retain?
Normal function
200
What changes signal potential for aggressive behavior in malignant tumors?
Pleomorphism, abnormal nuclei, mitotic figures, loss of polarity
201
What does the loss of function and obtaining new ones in tumors refer to?
Paraneoplastic Syndrome
202
What does 'loss of polarity' refer to in the context of tumors?
Epithelial cells losing distinction between apical and basal surfaces
203
What is the second most reliable discriminator of malignancy?
Local invasion/ systemic spread
204
Can benign tumors metastasize?
No
205
cohesive masses that remain localized to the site of origin
benign tumore
206
What makes complete resection of malignant tumors difficult?
Systemic spread
207
What is an unequivocal marker of malignancy?
Metastasis
1. reduces possibility of cure
2. stage 4 classification
3. no good prognosis
208
#NAME?
malignant tumors
209
What stage are patients classified as when they have metastasis?
Stage 4
210
spread of tumor to sites that are physically discontinuous with the original tumor
metastasis
211
Which tumor spread (pathway) is more common in carcinomas?
Lymphatic spread
212
Which tumor spread (pathway) is more common in sarcomas?
Hematogenous spread
213
Do benign tumors remain localized to their site of origin?
Yes
214
How do malignant tumors typically grow compared to benign tumors?
Erratic growth
215
eight fundamental changes in cell physiology
1. self-sufficiency in growth signals
2. insensitive to growth-inhibitory signals
3. altered cellular metabolism
4. evasion to apoptosis
5. limitless replicative potential
6. sustained angionesis
7. ability to evade and metastasize
8. ability to evade host immune response
216
ability of immune system to scan the body for emerging malignant cells and destroy them
immune surveillance
217
presence of immune surveillance is demostrated by? (4)
1. presence of tumor-specific t cells and antibodies
2. immune infiltrates in cancers correlate with outcome
3. increased incidence of cancer in immunocompromised people
4. response of advanced cancers to therapeutic agents that stimulate latent host t-cell response
218
How can cancers evade the immune system?
Antigen-negative variants, loss of MHC molecules, inhibiting T cell activation, immunosuppressive factors, regulatory T cells
219
What are some mechanisms of immune invasion by cancers? (SELIS)
1. selective outgrowth of Antigen-negative variants,
2. loss of MHC molecules,
3. engagement of pathways inhibiting T cell activation,
4. secretion of immunosuppressive factors,
5. induction of regulatory T cells (reduce CD4/8 T cell function)
220
How do chemicals act as carcinogenic agents?
highly reactive agent that is capable od DNA damage leading to mutations
221
What are the two types of chemical carcinogenesis?
Direct Acting, Indirect Acting
222
Do direct-acting agents require metabolic conversion?
No
223
example of direct acting agents
alkylating agents
224
Do indirect-acting agents require metabolic conversion?
Yes
225
What are the two processes in chemical carcinogenesis?
Initiation, Promotion
226
chemical carcinogenesis process that induce tumor to arise from initiated cells
promotion
227
microbe that causes chronic inflammation and gastric cell proliferation
helicobacter pylori
228
What is the process of initiation in chemical carcinogenesis?
Expose cells to cause permanent mutation
229
How does radiant energy contribute to carcinogenesis?
Mutagenic and carcinogenic
230
How can radiation cause mutations and cancers?
1. Chromosome breakage, translocations, and mutations,
2. UV rays - induce pyrimidine dimer formation
3. xeroderma pigmentosum
231
microbe which causes gastric adenocarcinoma (GALT) nd MALToma (mucosa-associated lymphoma)
helicobacter pylori
232
preformed antibodies against donor HLA may be formed during?
pregnancy, transfusion, and previous transplantation
233
What is one of the most common organs being transplanted in the Philippines?
kidney
234
What is optimized by HLA match?
Graft survival
235
What match optimizes graft survival?
HLA match
236
What is the reason why we transplant from a related person?
they share a similar genetic makeup compared to patients wherein we transplant from a totally unrelated person
237
What type of immunosuppression is required for px with heart transplant?
potent immunosuppression
238
Graft Antigens are processed and present by recipient APCs to recipient T cells
indirect pathway
239
process wherein Tcells and antibodies are produced against graft (foreign body) antigens and destroy graft
graft rejection
240
Donor graft APCs present antigens to recipient T cells
direct pathway
241
What type of donor does a human being only have one heart, one pancreas, and patients require corneas to see?
cadaver or a dead person
242
For what type of donor is it possible to have a live type of donor?
liver, kidney, stem cells
243
2 pathway of recognition of donor HLA
1. Direct Pathway
2. Indirect Pathway
244
main problem and consideration in all solid organ transplant
graft rejection
245
How many kidneys do we have?
two
246
What organ achieves the best result when there is match of HLA [A,B,C, and DR]
stem cells
247
What type of cells can we give one to another person?
stem cells
248
what organ is not affected by the degree of HLA matching?
liver
249
What organ requires potent immunosuppression because HLA matching is not always possible
heart
250
What organ does not need immunosuppression because it is avascularized
corneas
251
What organ needs optimized HLA match for graft survival and immunosuppression?
Kidney
252
What organ is transplanted along with kidney to diabetic patients?
Pancreas
253
2 Types of graft rejection
1. HVGD
2. GVHD
254
competent donor cells will produce an immune response against antigent of immunocompromised recipient.
GVHD
255
recipient produce immune response against donor graft or tissue
HVGD
256
Occurs during HSC transplantation
GVHD
257
What is Sarcoma's benign version called?
fibroma
258
suffix attached to malignant tumors
carcinoma
sarcoma
leukemia
lymphoma
259
swelling caused by inflammation
tumor
260
What is a benign neoplasm finger-like projections' called?"
papilloma
261
collective term for malignant tumors
cancer
262
What type of tumor is the suffix -oma given to?
benign
263
collection of cells and stroma composed of new growths
neoplasm
264
malignant form of fibroma, cancer in solid mesenchymal tissue
sarcoma
265
malignant tumors that resembles stratified squamous epithelium
squamous cell carcinoma
266
triggered by an acquired or inherited mutation affecting a single cell and its progeny
neoplasm
267
malignant tumor that resemble glandular epithelium
adenocarcinoma
268
explain the relationship between differentiation and prognosis, and anaplasia and prognosis
BETTER differentiation = BETTER prognosis
MORE anaplastic = WORSE prognosis
269
epithelial neoplasms forming cystic masses
cystadenoma
270
table benign or malignant:
https://docs.google.com/document/d/1hFa_m2Ynqfv3HtPVwzRyoHbPVytS6oT8HM0XCAgoCjM/edit
A. fibrosarcoma
b. lipoma
c. chondrosarcoma
d. osteoma
e. squamous cell papilloma
f. squamous cell carcinoma
g. Adenocarcinoma
h. papilloma
i. hepatocellular carcinoma
j. leukemia
k. lymphoma
271
lack of differentiation
anaplasia
272
extent to which neoplastic cells resemble normal cells morphologically and functionally
differentiation
273
What type of viruses produce antigens?
oncogenic viruses
274
What are the tumor cells expressing that are recognized as foreign ?
tumor antigens
275
What are the three antigens expressed by tumor cells?
1. neoantigens by mutated genes
2. Overexpressed or aberrantly expressed self-proteins
3. antigens by oncogenic viruses
276
What is the principal mechanism of ANTITUMOR EFFECTOR MECHANISM
Killing of tumor cells by CD8+ cytotoxic T cells specific to the tumor antigen
277
What is the mechanism capable of producing immune response against tumor antigens?
CD8+ cytotoxic T cell
278
other mechanisms of antitumor effectors are? (5)
1. CD8+ t cell
2. CD4+ t cell
3. NK cells
4. Activated macrophages
5. Antibodies
279
schematic (how does) antitumor effector mechanism (work)
1. tumor is found in cells
2. tumor is recognized by dendritic cell
3. travel to lymph node
4. dendritic cell (APCs) will present tumor to T cell
5. activation of T cell
6. Migration of T cell to tumor
7. Destruction of tumor
280
What defect in repair of pyrimidine dimers leads to increased risk for skin cancer?
xeroderma pigmentosum
281
Carcinogenic Agents (Microbes)
1. HPV 16/18
2. EBV
3. HCV/HBV
4. Helicobacter pylori
282
Microbe that causes chronic inflammation, injury, and hepatocyte proliferation
HBV, HCV
283
phenomenon which allows fetal implantation and placental development, even tho mother is capable of produce Abs against fetus
immune tolerance
284
produce oncoproteins that inhibit tumor euppresor genes
HPV type 16/18
285
in HPV type 16/18:
E6 targets tumor suppressor gene __?
E7 tragets?
a. p53
b. retinoblastoma (Rb) suppressor gene
286
causes 70-85% hepatocellular carcinomas
hepatitis B and C virus
287
maternofetal cell that expresses MHC class 1 antigen
Invasive Extravillous cytotrophoblast
288
fetal-maternal interface is immunologically inert. T or F
False. NOT immunologically inert (mother can produce Abs against fetal Ags)
289
immunologically inert at all gestational stages
villous trophoblast
290
Cause squamous cell carcinoma of the cervix, anogenital region and the head and neck
HPV 16/18
291
cause burkitt's lymphoma, and other B cell tumors and nasopharyngeal carcinoma
epstein-barr virus
292
maternofetal HLA antigen that protects placenta from immune rejection
HLA-G
293
HLA antigen present in invasive extravillous cytotrophoblast
HLA-G
294
Are MHC Class 1 and 2 (absent/present) in villous trophoblasts?
absent
295
what kind of graft is the fetus and placenta
semi-allogenic graft
296
What are the only fetus-derived cells in direct contact with maternal tissues and blood?
Trophoblastic Cells
297
Cells that do not have major histocompatibility
villous trophoblasts
298
maternofetal cells found in the placenta
Trophoblasts and Cytotrophoblasts
299
The __ is attached to the mother thru the ___ which contains ___, by which it is attached to the __ which is attached to the ___
1. fetus
2. umbilical cord
3. 2-3 veins
4. placenta
5. maternal uterus
