Lecture 19 Flashcards
(27 cards)
How does the fetus prevent activation of maternal T cells?
-trophoblast layer does not express MHC II and only low levels of MHC I preventing activation of maternal T cells
Which special MHC class I protein does the trophoblast express as protection from maternal NK cells?
HLA-G
Which enzyme does the fetus express to break down tryptophan to prevent T cell proliferation?
indoleamine 2,3-dioxygenase
Which cytokines does the fetus express to suppress and inhibit effector T cells and induce development of induced regulatory T cells (iTregs)?
-TGF-B and IL-10
Which cells allow implantation of developing embryo in uterine wall?
-iTregs (paternal-fetal antigens)
Expression of which cells are down-regulated in maternal decidua lining the uterus
T-cell attracting chemokines to prevent accumulation of maternal effector T cells
PD-L1 and PD-L2 are expressed on chorionic villi. Interaction with PD-L1 and PD-L2 at which immune checkpoint on maternal T cells prevent activation?
PD-1 immune checkpoint
Women with repeated miscarriages are suspected of having increased levels of which cells?
-NK cells, autoantibodies, and inflammatory cytokines
What are treatments to alter and down-regulate immune response (immunomodulators)?
-steroid immunosuppressants and IVIG
Mediators of which cells are believed to act on uterine smooth muscle cells to stimulate uterine contractions
-mast cells
Which proinflammatory T cells are recruited into rupture zones of fetal membranes during labor?
Th17
Hematopoietic stem cells are originally generated where? and then where do they migrate to?
- embryonic yolk sac
- migrate to fetal liver
Where do fetal B and T lymphocytes develop?
B cells- liver
-T cells-thymus from precursors that migrate from fetal liver
Where are fetal CD4 and CD* cells found?
fetal spleen
Late in gestation HSCs migrate to where?
bone marrow
Upon exposure, newborns show Th cell polarization of which subset and reduced Th subset?
- upregulate Th2 and Th17
- downregulate Th1
physiologic hypoglobulinemia
-3 month window of low IgG level in infant from reduction in maternal IgG and rise in endogenous production
What anti-microbial components does maternal milk contain?
- lactoferrin (bind iron)
- lysozyme (degrade bacterial cell walls)
- lipids (detergent activity)
- carbohydrates (growth of Bidifo, probiotics)
- leukocytes (neutrophils and macrophages)
What happens with autoantibodies to Ro and La ribonucleoproteins?
- congential heart block
- treat with steroids, plasmapheresis, or IVIG
What type of HS is involved with RhD blood groups?
-Type II HS
hemolytic disease of newborn (HDN)
- destruction of fetal RBC and impaired platelet function
- breakdown hemoglobin can impair liver function and cause jaundice
Which 3 dead vaccines are recommended during pregnancy?
- Flu vaccine
- Tdap
- Hep A and B vaccines
What causes whooping cough?
bordetella pertussis
What factors effect timing of childhood vaccinations?
- limited ability of neonates to mount immune response
- presence of maternal IgG antibodies in blood
