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PRIN 14 Immunity Flashcards

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1
Q

TH1 vs TH2

A

TH1: help activate macrophages
(role in Cell mediated Imm)

TH2: help activate naive B cells
(role in Humoral Imm)

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2
Q

Describe TCR Structure

A

a chain & b chain

both attached to a V and C region

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3
Q

What is the purpose of Positive Selection?

A

Choosing T cells that recognize peptide Ags

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4
Q

What is the purpose of Negative Selection?

A

Eliminating T cells that recognize TOO strongly to self Ag

prevent autoimmunity

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5
Q

What is needed to stimulate T Cells to proliferate and differentiate?

A

(1) Ag recognition
(2) Costimulation
(3) Cytokines

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6
Q

How does a CTL destroy target cells?

A

CTL binds DIRECTLY to target cell
Delivers Perforin & Granzyme B into the cell

Granzyme B triggers Caspases …apoptosis

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7
Q

What are TH17 cells?

A

Secrete IL-17 & IL-22

Host defense against bacterial & fungal infections

Role in tissue inflammation during autoimmunity

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8
Q

What is the role of T Regulatory cells?

A

Block activation of harmful lymphocytes specific for self Ag

Protect self from autoimmunity

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9
Q

Example of T cell role in Communicable Disease

A

People who have had TB develop memory T cells specific for TB Ags.

Therefore, when tested with SC injection … strong response

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10
Q

Example of T cell role in Non-communicable Disease

A

Obesity / Diabetes / Cancer

Islet Specific T cells in Type 2 DM secrete altered levels of cytokines. Changes occur in adipose, liver, pancreatic islets, vasculature

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11
Q

During the course of ones life, when does B cell production occur?

A

Begins before birth and continues throughout lifetime

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12
Q

Describe structure of Ig…

A

Light & Heavy Chains (Fab) with a constant (Fc) region at base.

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13
Q

What mechanisms contribute to the generation of Ig diversity?

A

(1) Combination of multiple gene segments (VDJ)
(2) Pairing of H & L Chains
(3) Junctional Diversity (addition / deletion of DNA bases)
(4) Somatic Hypermutation

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14
Q

What is Somatic Hyoermutation?

Which cells undergo it?

A

High rate of point mutations within VDJ gene DNA

Stimulated by cytokine signals via TH cells

Additional mutation occurring AFTER mature B cells are activated

Affects B cells ONLY

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15
Q

What is Anergy?

A

State of being non-functional

Unresponsive to Ag

Ag is there … but lack of cytokines mean no reactivity by B cells

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16
Q

Where do B cells go after they mature and leave the bone marrow?

A

Secondary Lymphoid Organs:

  • Spleen
  • Lymph Nodes
  • Tonsils
  • GALT & MALT
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17
Q

What happens during a T-Independent Ag response?

A

Involves Carbs / lipid Ag ..

(1) B-cell BCRs cluster via repeating carb units on microbe
(2) B Cell PRR responds to PAMP on microbe

RESULT: B cells proliferate and differentiate into Ab secreting cells (but NO memory cells)

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18
Q

Provide an example of surface interactions that occur during T-dependent activation of B-cells

A

Protein interactions between TH cell and B-cell

T-Cell CD28 binds to B-Cell B7

T-Cell CD40L binds to B-Cell CD40

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19
Q

What is required for Isotype class switching?

A

Must have the interaction between:

(1) T-Cell CD40L binds to B-Cell CD40
(2) Cytokines

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20
Q

What directs Isotype switching?

A

Cytokines

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21
Q

What happens if an individual has a mutation in CD40L?

A

T-Cell CD40L binding to B-Cell CD40
WILL NOT OCCUR

Therefore, this ppt will be stuck at IgM

RESULT: X-Linked hyper IgM syndrome

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22
Q

Order of Ig Production

A

MDGEA

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23
Q

What do secreted Abs do?

A

(1) coat infected cell, promoting NK attack
(2) Complement Activation
(3) Opsonization
(4) Neutralization

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24
Q

Which Ig is the greatest in the blood?

A

IgG

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25
IgG Characteristics
Can cross placenta Predominant IgG in blood
26
IgA Characteristics
Resistant to stomach acid protects mucosal surfaces secreted in milk
27
IgM Characteristics
FIRST Ab produced Pentamer (so its big) NOT CROSS PLACENTA
28
IgE Characteristics
Defends against parasites | causes allergies
29
What is PID?
Primary Immune Deficiency * Genetically determined * Enhanced susceptibility to infectious disease, autoimmunity and malignancy
30
What are current treatment options for primary immunodeficiency?
(1) Passive admin of Abs (2) Prophylactic Abx (3) Stem Cell transplantation (4) Gene Therapy
31
What are Secondary Immune Defiencies?
ACQUIRED | (eg) HIV, Malnutrition, Medically induced immunosuppression
32
Gel & Coombs Classification of Hypersensitivities
(1) IgE mediated H. (2) Ab mediated H. (3) Immune Complex mediated H. (4) Cell Mediated H. (time delayed)
33
Gel & Coombs Classification of Hypersensitivities | TYPE 1
(1) IgE mediated H. ALLERGIES IgE for specific Ag is produced and then sits on Mast Cells ... gets activated Wheel >2mm indicates IgE production for specified Ag
34
What is the new way to treat Allergic Diseases?
DRUG: Omalizumab Anti-IgE Ab: approved in Canada for severe asthma (expensive) Recognizes IgE and takes it out of circulation
35
Gel & Coombs Classification of Hypersensitivities | TYPE 2
(2) Ab mediated H. Abs target self Ags and trigger destruction of self cells (autoimmune) (eg) Blood Type Rejection (eg) Hemolytic Disease of Newborn
36
Gel & Coombs Classification of Hypersensitivities | TYPE 3
(3) Immune Complex mediated H. Immune Complexes form and get deposited in small vessels and in joints ... cause inflammation (eg) SLE, Serum Sickness
37
Is SLE considered a Primary Immune Disease?
No, SLE is not conferred by a single gene. There is myriad of variable factors that contribute to the disease. (genetics AND environment) Note .. Lupus is actually Types 2 & 3
38
Diagnosing SLE
``` 4/7: Rash Discoid Rash Photosensitivity Oral Ulcers Arthritis Serositis Kidney dysfunction CNS involvement ... seizures Cytopenia Immunologic tests Antinucelar Abs ```
39
Gel & Coombs Classification of Hypersensitivities | TYPE 4
(4) Cell Mediated H. (time delayed) CD4 TH cells can activate macrophages or eosinophils CD8 CTLs cause tissue damage often takes several days to set in
40
Examples of Type 4
(4) Cell Mediated H. (time delayed) Contact Dermatitis Mantoux Test / TB test Type 1 DM MS
41
What are the 3 signals from the Innate APC required to induce Adaptive Immunity?
(1) Ag Presentation (2) Co-stimulation (3) Cytokines
42
What is the role of cytokines?
Steer / direct / shape the quality & quantity of the immune response. Cytokines are involved in the specific differentiation of T cells in proliferation
43
What states do Lymphocytes need to be in to exert effector functions?
Must be activated to offer protection from infection Naive Adaptive Cells do NOT protect
44
What are the three "tempos" of immune response?
(1) RAPID Immediate Innate (2) INTERMEDIATE 5-7 days Innate & Adaptive (most disease for vaccines) (3) SLOW >7 days Adaptive (most infections are cleared without us even knowing they were ever there...)
45
What are examples of pathogen virulence within the 3 tempos?
(1) RAPID Ebola v (2) INTERMEDIATE Pneumococcus Influenza (3) SLOW M. Tuberculosus H. Papillomavirus
46
What are the 4 steps in Lymphocyte action?
``` Selection Activation Expansion Contraction (>95% of Ag specific immune cells die ... only a few are retaiend as memory) ```
47
How are Memory Cells stimulated?
Only need Antigen to be presented **do not need (2) Costimulation and (3) cytokines
48
Vaccines prevent infections by ...
Vaccines prevent infections by ... ...inducing protective immune memory
49
What is Arepanrix (GSK)
``` Trade name Flu Shot (1) Antigen: influenza v. inactivated (2) Adjuvent: a-tocopherol (Vit E) Squalene ```
50
Why is a-tocopherol used?
Vit E | lipid based - keeps squalene in solution
51
Why is squalene used?
Main adjuvent | Causes inflammation via disruption of cell membrane
52
What else is a good adjuvent
Aluminum
53
Why use adjuvents? How do they make vaccines work?
Adjuvents work by upregulating (2) costimulation (3) cytokines
54
What does a Positive Hep C test indicate?
she been previously exposed to Hep C OR has a chronic HepC infection
55
In the Hep C pregnant woman, the rash on ther legs is caused by which type of Hypersensitivity Reaction?
Type 3: Immune Complex Mediated Hypersensitivity
56
Why did the doctor ask if Concepion had any joint pain?
To assess if the immune complexes were getting deposited in her joints. This occurs in about 1/3 of Hep C patients.
57
Hemolytic Disease of Newborn is caused by what type of Hypersensitivity Reaction?
Type 2 Ab mediated Hypersensitivity.
58
How does RF connect with this case?
In 1/3 of Hep C cases, IgM will be evoked to bind the Fc region of the IgG-Hep C complex. This will result in BIG ASS immune complex forming and getting deposited in small vessels.
59
In a male with O negative blood what Abs would be in his serum?
anti-A and Anti-B only (he's never encountered Rh(D) in order to produce Abs / memory against it
60
How do CTL's kill?
Once in direct contact with affected cell, CTL releases Perforin & Granyme B into it ... triggers Caspases ... apoptosis
61
What is the affect of a patient having no CD40 ligand on the surface of his T cells?
Isotype / Class Switching cannot occur
62
What is Arthralgia?
Joint Pain
63
Arthralgia is an example of which Gel & Coombs Hypersensitivity?
Type 3 Hypersensitivity: Immune Complex
64
When immune complexes deposit on blood vessel endothelium in the skin, a rash may develop. The damage to the blood vessels at the site of IC deposition is predominantly mediated by which of the following activated cells or systems?
Neutrophils
65
A woman with blood type A+ is pregnant for the first time with a fetus that has B+ blood. Why DOESNT the woman destroy the fetal red cells?
Maternal antibodies to blood ABO proteins are typically IgM.

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