Perturbations in the Super System Flashcards

1
Q

What are superantigens?

A

In contrast to conventional peptides that require uptake and processing prior to presentation by T-lymphocytes, superantigens interact with the “side” of the MHC Class II-TCR complex

-Effectively, they cross-link MHC Class II to T-cell receptors

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2
Q

Give two examples of superantigens

A

Toxic Shock Syndrome Toxin-1 (TSST-1) and Staphylococcal enterotoxin (SE)

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3
Q

What follows in response to superantigen binding?

A

Cytokine storm: polyclonal extensive activation of T cells leads to the over-production of TNFalpha (and IL-1/6)

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4
Q

Which are the 4 hallmark signs of toxic shock syndrome?

A

Fever, hypotension, rash, desquamation (1-2 weeks after illness, particularly involving the palms and soles of your feet)

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5
Q

Toxic Shock Syndrome is caused by toxin released from what bacteria?

A

Staph Aureus

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6
Q

The clinical manifestations of TSS are precipitated by what immune response?

A

Cytokine storm —> disease

Causes low blood pressure, fever, diarrhea, shedding of skin

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7
Q

CCR5 deficient individuals are resistant to what virus, but very susceptible to what other virus?

A

Resistant to HIV

Susceptible to West Nile Virus

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8
Q

What is CCR5?

A

CCR5 is a chemokine receptor for chemokines that attract and direct the migration of T cells to the site of infection

CCR5 is located ON the T cells

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9
Q

Why are CCR5 deficient individuals resistant to HIV?

A

CCR5 is a co-receptor (along with CD4) for binding and entry into human T-lymphocytes by HIV-1

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10
Q

Why are CCR5 deficient individuals susceptible to west nile virus?

A

They are susceptible because T-cells cannot taxi to the site of infection, as they cannot follow the CCR5 signal

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11
Q

What is the most cytokine produced by virally infected cells?

A

Interferons.

Interferons then activate macrophages, dendritic cells, they drive a Th1 response (CD8+, B cells) and NK cells

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12
Q

In contrast to most viruses, certain viruses have the capability of directly inducing IL-10 (such as HIV). What is the consequence of this?

A

IL-10 is very immunosuppressive.

This reduces the capacity of DCs and macrophages to wage war, drives a Th2 response, and reduces the immune response in general

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13
Q

How does the herpes virus suppress the immune response?

A

The herpes virus has acquired human IL-10 in their genome, so when they infect a cell and start to replicate, they produce immunosuppressive IL-10

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14
Q

List 4 ways viruses can alter chemokine function to benefit their survival

A

1) Chemokine secretion attracts susceptible cells for further infection
2) Chemokine secretion attracts infected cells to distant tissues
3) Chemokine receptor function or expression may be inhibited
4) Chemokines and/or receptors may be sequestered inside the cell

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15
Q

Autoimmune diseases are caused by self-reactive what?

A

T and B lymphocytes

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16
Q

How do genetics play a role in autoimmune diseases?

A

Some people are genetically predisposed to autoimmune dysfunction

Females are disproportionately affected by autoimmune diseases (3:1) (after puberty- sex hormones contribute)

Also, females have a more vigorous Th1 response to antigen and more successfully produce antibodies

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17
Q

Peripheral tolerance is enforced by which cells?

A

CD4+25+ FoxP3+ T regs

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18
Q

During what recombinant process can self-reactive B cells be generated? How are they usually controlled?

A

Somatic hypermutation.

They usually die from neglect or are downregulated by Tregs

19
Q

Goodpasture’s syndrome is an organ specific autoimmune disease against which organ?

A

Lung and kidneys

20
Q

Myasthenia gravis is an organ specific autoimmune disease against which organ?

A

neuromuscular

21
Q

MS is an organ specific autoimmune disease against which organ?

A

The brain

22
Q

Lupus is a systemic autoimmune disease against what?

A

Basement membranes

23
Q

Autoimmune cells of Insulin dependent diabetes mellitus type I are primarily of what type?

A

CD8+ , with some antibody response, against pancreatic beta cells

24
Q

What is Grave’s disease?

A

Ab against TSH receptor activates the receptor and leads to excessive thyroid hormone/hyperthyroidism

25
Q

What is Goodpasture’s syndrome?

A

Ab to type IV collagen –> pulmonary hemorrhage and glomerulonephritis

26
Q

What is Myasthenia gravis?

A

Ab to acetylcholine receptor. Blocks neurotransmission –> muscle weakness

27
Q

What is multiple sclerosis?

A

CD4+ cells react with the myelin sheath –> demyelination

28
Q

What is lupus?

A

Ab to DNA –> immune complex deposition at basement membranes

29
Q

What is Rheumatoid arthritis?

A

CD4+ response that stimulates an inflammatory response within the joints

30
Q

Define Type II hypersensitivites

A

Ab against cell-surface or extracellular matrix antigens

31
Q

Define Type III hypersensitivites

A

Ab-antigen immune complex deposition

32
Q

Define Type IV hypersensitivity

A

delayed type- T-cell mediated

33
Q

Name three type II hypersensitivity autoimmune diseases

A

Graves, Myasthenia Gravis and Goodpastures

34
Q

Name a type III hypersensitivity autoimmune disease

A

lupus

35
Q

Name three type IV hypersensitivity autoimmune diseases

A

Insulin Dependent Diabetes Mellitus type I, Rheumatoid arthritis and Multiple sclerosis

36
Q

How are C3 levels affected by lupus?

A

C3 levels are low. All of the immune-complexes formed attract C3 deposition and C3 cannot be replenished fast enough

37
Q

Pancreatic beta cells are almost selectively damaged by what viruses?

A

Mumps, rubella, and coxsackie B

38
Q

What is Rheumatoid factor?

A

IgM, IgG and IgA specific for IgG. This leads to immune complex formation and increases inflammation

39
Q

What portion of people with rheumatoid arthritis have rheumatoid factor?

A

85%

40
Q

Describe the basic sequence of events that leads to inflammation of joints in people with rheumatoid arthritis

A

Unknown trigger begins inflammation in synovial joints
Autoreactive T cells activate macrophages
MACROPHAGES SECRETE IL-6 AND TNFalpha that interacts with the fibroblasts

Fibroblasts release MMPs that destroy tissue, along with RANK-ligand (which activates osteoclasts to break down bone)

41
Q

What is the autoantigen in multiple sclerosis?

A

Basic myelin protein

42
Q

How do T-cells get across the blood brain barrieR?

A

They sneak in when the brain is inflamed

Inflammation makes the brain locally permeable to leukocytes and blood proteins

43
Q

What activates autoreactive T cells in the brain in MS?

A

Microglial cells present antigen to autoreactive T cells

This sets up an inflammatory reaction

44
Q

Name four risk factors for autoimmune diseases

A

1) Genetics (mostly HLA-DR)
2) Female
3) Environmental (smoking with RA)
4) Infections