review Flashcards

1
Q

intraepithelial lymphocytes

A

resident lymphocytes in MALT

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2
Q

what do enterocytes respond to

A

PMAPs through intracellular TLR4

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3
Q

class switching to igA

A

can be TI and TD depedning on BAFF and april

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4
Q

what are the ways antigens can cross mucosal epithelial barriers

A

FcR
golet cells
m cells
direct APC contact

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5
Q

th1 response

A

two phases
inductive and effector phase

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6
Q

what response are alarmins a part of

A

th2

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7
Q

celiac disease first step

A

sensitiation: exposure to gluten peptides

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8
Q

igA antibodies in celiac

A

anti tTg
anti gliadin
anti endomysial

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9
Q

genetic component of celiac

A

HLA DQ2 and 8

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10
Q

Enviromental component of celiac

A

il15, 21 AND IFN a

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11
Q

alveolar macrophages

A

balance tolerance and inflamation in lung

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12
Q

what is the last step of a normal graft response

A

resolution

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13
Q

first and second set rejection timeline

A

12-14 days
5-6 days

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14
Q

what cells play a role in graft rejection

A

cd4 and 8
cd4 more important

anti cd4 and 8 keeps the survival of graft for much longer

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15
Q

what are the stages of graft rejection

A

sensitization
hyperactute
acute
effector
chornic

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16
Q

recognize peptides from donor MHC on self apc

A

INDIRECT RECOGNITION

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17
Q

recognize donor MHC

A

direct recognition

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18
Q

effector stage

A

heavy infiltation of recipient cells
neutrophils
DC
macrophages
ADCC
complement
CD4,8+
inc in lytic enzymes and MHC
inc in membrane damage and cytotoxicity
lysis
NK cell

-directly damage by lysis or apoptosis

rarely Ab against donor HLA and endothelial ag

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19
Q

when does hyperactute rejection occur

A

before tissue revascularizes

within 24 hrs

20
Q

acute and hyperacute mediated by what

A

acute- cd4 t cells
hyperacture- ab

21
Q

mechanism of acute rejection

A

massive infiltration of lymphocyte and macrophages and effector stage

22
Q

mechanism of chronic rejectino

A

ab or cell mediated

23
Q

when is total lymphoid irradiation used

A

bone marrow transplant and graft vs host disease

24
Q

azathioprine

A

mitotic inhibitor diminishes b and t cell proliferation

25
general immunosupresive therapy
azathioprine and cylophosphamide and corticosteroids
26
specific immunosupressive therapy
bellatracept- CTLA4 fusion- induces t cell anergy OKT3- CD3 mAb that depletes t cells
27
where does central tolerance occur
in primary lymphoid organs
28
where is AIRE expressed
mostly in lymphoid organs
29
what does positive selection
thymic epithelial cells
30
disease for absence of AIRE
autoimmune polyendocrine syndrome 1 APS1
31
where are self reactive B cells deleted or inactivated
in the bone marrow
32
what are the methods of peripheral tolerance
anergy/ unresponsiveness due to lack of costimulation apoptosis through fas/fasL
33
what forms self reactive b cells
SHM in the germinal centres
34
molecular basis of t cell anergy
only get signal one from antigen - anergy and no iL2 expression
35
activation of fas receptor known as
ACID activation induced cell death anergic b cells also express fas
36
people w mutated fas
ALPS autoimmune lymphoproliferative syndrome
37
mice w mutated fas and fasL
lpr and gld inc in autoimmune diseaeds and lymphocytes
38
what initiates oral tolerance
encounter of food ags with GALR -enters circulation and taken by APC and shown to T cells without B7 costimulation leadnig to T cell anergy - gut microbiome plays a role
39
etiology of autoimmunity
genetics -family clustering -HLA and non HLA associated environmental -microbial antigens and trauma mix of environmental and genetic drug and hormonal triggers
40
polyclonal activation
encountering PAMPs like LPS on gram -ve bact interacts w activating receptors activates many clones intracellular detection of pathogenic patterns of DNA
41
what are the types of enviromental suscpetibility
sequestered antigen molecular mimickery polyclonal activation inapproperiate expression of class II MHC
42
what transfers autoimmunity
CD4+ TH1 polarization inc autoimmunity specific HLA alleles must have trimolecular complex interaction and lack of T reg (linked supression)
43
autoimmunity treatment
immunosupressive -immmunosupressants -anti inflamatory -anti CD4 targetted therapies block only ag activated T cells
44
targetted therapies for autoimmune diseases
anti cytokine ab or blockers -block TNFa -embrel, rumicade, humira -RA, crohns, ankylosing spondylitis ritixumab -mAb against CD20 inducing apoptosis and ADCC -RA
45
challenge of only blocking activated T cells
must only block activated ones -mAb against ILRa subunit -potential neg effect on Treg block specific associated TCR chains
46