PUlm defense mechanisms Flashcards by A B

Effects of chronic alcohol consumpotm

1) incr gram negative organisms
2) blunted cough and gag reflex = aspiration
3) decr mucocilliary clearance
4) impaired alveolar macrophage function

How well did you know this?

Not at all

Perfectly

how does alcohol affect oropharynx

1) bacterial colonization (gram neg)

2) poor dentition

How well did you know this?

Not at all

Perfectly

how does alcohol affect glottis and airway

1) incr aspiration

2) decr mucocilliary function

How well did you know this?

Not at all

Perfectly

how does alcohol affect innate immunity

vs. adaptive immunity

1) decr macrophage and neutrophil function

1) decr T cells and cytokines
2) decr B cells and airspace IgG

How well did you know this?

Not at all

Perfectly

when should asthmatics exercise

NOT IN afternoon because peak ozone concentration

How well did you know this?

Not at all

Perfectly

what should you tell patients about ozone during ozone alert

1) transient
2) stay inside b/c irritant
3) exercise early in morning

How well did you know this?

Not at all

Perfectly

Air contains what kinds of things?

1) pollutants
2) oxidants
3) dust pollens
4) toxins
5) bacteria and LPS
6) viruses

How well did you know this?

Not at all

Perfectly

what is airway clearance mechanism

1) air turbulence created by nasal passages trachea and large airway
2) large particle deposit on mucous surface of airway
3) mucus project to surface by beating cilia on epith cell
4) cleared by coughin, sneezing, swallowing

How well did you know this?

Not at all

Perfectly

how do we clear large particles deposit on mucous surface of airways

1) mucous project to surface via beating of cilia

2) cleared by cough, sneeze, swallow

How well did you know this?

Not at all

Perfectly

what are ciliary function

1) coordinate movement of particles from airways

How well did you know this?

Not at all

Perfectly

what are examples of things that make it hard to clear form lungs

1) air pollution/ozone
2) viral infection (sloughing of epithelial cell)

3) cigarette smoke (poison cilia

How well did you know this?

Not at all

Perfectly

Genetic disorders assoc with abnormal ciliar function

1) primary ciliary dyskinesia (immotile ciliary syndrome) AKA…

inheritance
due to ?
symptoms

1) AR
2) defect in dynein arms
3) sinusitis, bronchiectaissi, situs inversus, infertility (KARTAGENER’S when assoc with situs inversus)

How well did you know this?

Not at all

Perfectly

components of airway epithelial fluid (4)

1) antimicrobial peptides and proteins (defensins, cathelicidin, lysoszyme)
2) antioxidants
3) antiproteases
4) IgA

How well did you know this?

Not at all

Perfectly

Sarcoidosis
effects on
1) endocrine/renal
2) MSK

3) skin
4) spleen

1) diabetes insipidous rarely due to pituitary/hypothalamic involvement
2) musculoskeletal (sausage digits, bony erosions)
3) erythema nodosum/lupus pernio around eye fold
4) granulomatous inflamm

How well did you know this?

Not at all

Perfectly

what is function of innate
= early host defense against (3)

relies on ….

1) early host defense against virus, fungi, bacteria
2) PAMPs are recog by secreted, cell surface or intracellular PRR (
3) recruitment of phagocytes,
4) kill microbes + inflamm

How well did you know this?

Not at all

Perfectly

components of adaptive immunity

what does memory allow for?

1) B and T cells for antigen specificity

2) memory allows for more rapid and greater secondary response

How well did you know this?

Not at all

Perfectly

how do we clear small particles from lower airways

1) ingested by resident alveolar macrophages and/or dendritic
2) bind to lung collectins and surfactant protein A and D (secreted PRR)
3) PRR bind PAMP
4) opsonization and phagocytosis by macs and dendritic cell

How well did you know this?

Not at all

Perfectly

macrophages are a critical part of innate immunity located where?

in alveolar part of lung

How well did you know this?

Not at all

Perfectly

what is role of macrophage in host defense

1) suppress adaptive immune response
2) clear particles, bugs, debris, apoptotic cells
3) initiate inflamm response
4) transport particles and bugs to lymph nodes
5) clear alevoelar surfactant

How well did you know this?

Not at all

Perfectly

what is major component of normal bronchoalveolar lavage

how does that change with smoking

what is normal CD4:Cd8

1) macrophages
2) incr macrophages b/c eat tar granules can look black
3) 2:1

How well did you know this?

Not at all

Perfectly

what happens when you inhale harmless particle

Study These Flashcards

1) inhale harmless particle
2) bind to epithelial cell and mucus
3) mucociliary escalator to mouth to sneeze, cough
4) some particles bind to dendritic cell (projection between epithelial cell to sample airway)
5) if particle does not have a PAMP, then dendritic cell will go to draining lymph node —> not activated to induce adaptive immune response

tonic suppression of inflammation
tonic suppression of adaptive immunity
(what we normally inhale during day)

what happens when you inhale virus

Study These Flashcards

1) inhale virus
2) virus has PAMP
3) PAMP bind to epithelail cell —> activ —> chemokine/cytokine to recruit
neutorphils and induce microbial killing
4) PAMP bind to DC upregul CD8 and MHC
5) DC traffick to lymph node to present to T cells and induce adaptive immune response

activation of dendritic cell
PMN recruitment and adaptive immune response

what is mechanism of innate immune protect in lung

Study These Flashcards

1) cytokine/chemokine recruit
2) PMN recruit
3) microbial killing
4) dendritic cell maturation
5) monocyte recruit

TL4 mutations associated with ___ in humans

Study These Flashcards

endotoxin hyporesponsiveness (incr infection)

less likely to develop ARDS/ALI

TLR2 bind to gram positive TLR4 binds gram negative TLR7 and TLR8 bind HIV TLR9 binds DNA

where are TLR mostly expressed

innate immune system granulocytes/macrophages (mostly) dendritic cells too

what does TLR stimulation do?

1) induce proinflamm response (activ epithelial, DCs, cytokines, type 1 IFN) 2) bridge between innate and adaptive imunity

what is the function of MHC molecules?

antigen presenting cell via MHC class 2 or MHC class 1 1) encounter bug 2) phagocytosed 3) via antigen processing pathway, chopped up into peptides 4) bind to either MHC class 2 and interact with CD4 binds to MHC 1 to interact with CD8 5) dendritic cell activated --> must upregul co-stim molec must be costim must have both signals for optimal immune response

what are the major APC in the lung?

dendritic cells 1) pathogen has PAMP 2) bind to PRR 3) activation of dendritic cell 4) travel to lymph node 5) T cell area in lymph node 6) small freq of T cells specific for peptide on MHC 7) interaction btwn antigen specific receptor on TCR to allow T cell activ prolif and traffick to skin

Compare and contrast Resident macrophages. vs monocytes vs. resident dendritic cells major function

1) resident macrophage suppress adaptive imm, unwanted inflamm, phagocytose particulates 2) diff into inflamm macs, DCs patrol vascular endothelium 3) resident dendritic cell phag inhaled particulates, migrate to lymph nodes, maintain tolerance

which major cell types phagocytose inhaled particulates

resident macrophages and resident dendritic cells

which major cell type suppress adaptive immunity/unwanted inflamm

resident macrophages

which major cell type patrols vascular endothelium

monocytes

which major cell type maintains tolerance

resident dendritic cell

which major cell type activ by PAMPs

1) resident macrophage 2) monocytes 3) resident dendritic cells

what is the trimolecular complex?

T cell receptor + antigen peptide + MHC

Migratory DCs engulf antigen and traffic to __

mediastinal lymph nodes

in response to harmless antigen,

1) no adaptive immune response, no inflamm 2) DCs sample harmless antigen —> migrate to lymph node —> no co-stim molec and induce IL-10 and ICOS-L 3) convert that T cell to become regulator and decr inflamm response

In response to virus/bacteria, In response to allergen, cause DC to beocme activ via PAMP, maturation, and prolif of dendritic cell

cause DC to eat protein, become activ via PAMP stim —> DC migrate and amplify to T cell area of lymph node and present 2 signals to develop CD4 immune response

CD8+ T cell kinetics after acute LCMV infection of B6 mice vs. CD4+ T cell kinetics

1) expansion of CD8+ T cells specific for LCMV, the maintenance of response (amplification, contraction, maintenance) 2) amplification, contraction but then overall CD4+ count decr

how do you initiate the granulomatous response

1) inhale stim (MTB) 2) alveolitis, then granuloma formation to wall off 3) trigger CD4+ T cells by APCs 4) activ T cells and release Th1 cytokines (IL-2, IFNy) 5) accumulate immunocompetent cells

what is essential initial step in generating granuloma

alveolitis

T cells in lung are incr by 2 potential mechanisms after activation...

1) influx of Ag specific T cells from blood | 2) local T cell prolif

Adaptive immune response in lung process

1) antigen ingested by DC and alveolar macrophage 2) primary immune response NOT IN LUNG TRAFFIC TO MEDIASTINAL LYMPH NODE TO ENGAGE CD4 (representing specific antigen TCR 3) clonal prolfieration of T cell 4) traffic back to lung to decr immune response

what does BAL look like in sarcoidosis (CD4+ /CD8+) CD4:CD8 ratio

incr in number of CD4+ and CD8+ depending on severity 3-15:1 ratio rather than 2:1

what major cell type increases in BAL of sarcoidosis

lymphocytes

if you have greater CD8>CD4

hypersensitivity pneumonitis

If IL-12 around to stim naive CD4+ t cell then become

Th1 CD4+ T cell for cell-mediated immunity and intracellular pathogens (TB and legionella)

If IL-4 around to stim naive CD4+ t cell then become

Th2 CD4+ T cell for IL-4, IL-5, IL-13 humoral immunity, helminth infection, atopy

If IL-23, IL-6 around to stim naive CD4+ t cell then become

Th17 CD4+ T cells | clear bacterial pathogen/autoimmunity

in chronic beryllium disease | main type of T cell produced?

Th1 cytokine secretion

PUlm defense mechanisms Flashcards

(52 cards)