Prep2 For Exam Flashcards
(85 cards)
What are the types of allograft rejection?
- Hyperacute (antibody-mediated); 2. Acute vascular (antibody-mediated); 3. Cellular; 4. Chronic (antibody-mediated)
What causes the development of anti-HLA antibodies?
Pregnancy, blood transfusion, previous transplant
How does hyper acute graft rejection occur?
Antibody recognition of antigen on the endothelial surface occurs, followed by complement fixation and activation of the coagulation cascade
How does acute cellular rejection of a transplantation occur?
Caused by effector T cells responding to HLA differences and minor histocompatibility antigens between donor and recipient
How do steroids affect transplants?
Immunosuppressive; change patterns of gene expression
What does cyclosporine do?
Calcineurin inhibitor (therefore inhibiting T-cell activation)
What does Rapamycin do?
MTOR inhibitor, therefore having a sparing effect on Treg cells
How is GVHD beneficial?
It can help engraftment and prevent the relapse of malignant disease
How can GVHD occur even when HLA match is identical?
Recognition of minor histocompatibility antigens (peptide polymorphisms)
How is organ rejection prevented?
Identical twins, immunosuppressive drugs, induce tolerance
What are the stages of the development of autoimmune disease?
- Healthy w/ genetic susceptibility/environment; 2. Healthy w/ autoimmune response but no tissue injury; 3. Disease w/ autoimmune-driven inflammation and tissue injury
Regarding immunology, what do identical twins share? Not share?
They share MHC/HLA, but they are NOT identical in their T and B cell repertoires
What is APECED?
Inadequate expression of self-peptides in thymus resulting in failure of negative selection to remove self-reactive T cells; symptoms include hypothyroidism, alopecia, vitiligo, malabsorption, hepatitis, etc; mainly organ-specific disease
What is IPEX?
Defect in FOXP3 gene, resulting in deficiency of Tregs; symptoms are somewhat similar to APECED, mainly organ-specific diseases
What are the differences between MHC Class I associated disease and MHC Class II associated disease?
MHC Class I: no autoantibodies, CD8 T cell pathogenesis; Class II: autoantibodies reflecting CD4 T cell help - injury may be from auto antibody or CD4 T cell
How does MHC affect Type I diabetes?
HLA-DQ8 aspartic acid is replaced by alanine, which can’t form salt bridge, permitting the positive thymocytes selection of a potentially pathogen T cell pop and failure to induce T regs
Define: ANA
SLE patients will have autoantibodies that react w/ nuclear antigens at a dilution of 1:160; there is a diversity of ANA patterns
Which populations have increased autoantibodies?
Women, older people (increases w/ age), African Americans
Define: Immune Tolerance
Discrimination between non-self and self and between harmless and dangerous
Define: Affinity
Binding strength of one receptor to one ligand
Define: avidity
Aggregate binding strength of multiple ligands
What kind of avidity do you want in T cell activation?
Low-to-intermediate
What is AIRE?
Autoimmune regulator gene that is highly expressed in thymocytes epithelium; encodes a transcriptional activator and induces expression of “ectopic” self proteins
What happens if you have Signal 1 without Signal 2?
Anergy occurs - a state of long-term hypo responsiveness to all further antigenic stimulation