review

Question 1

intraepithelial lymphocytes

Answer 1

resident lymphocytes in MALT

Question 2

what do enterocytes respond to

Answer 2

PMAPs through intracellular TLR4

Question 3

class switching to igA

Answer 3

can be TI and TD depedning on BAFF and april

Question 4

what are the ways antigens can cross mucosal epithelial barriers

Answer 4

FcR
golet cells
m cells
direct APC contact

Question 5

th1 response

Answer 5

two phases
inductive and effector phase

Question 6

what response are alarmins a part of

Answer 6

th2

Question 7

celiac disease first step

Answer 7

sensitiation: exposure to gluten peptides

Question 8

igA antibodies in celiac

Answer 8

anti tTg
anti gliadin
anti endomysial

Question 9

genetic component of celiac

Answer 9

HLA DQ2 and 8

Question 10

Enviromental component of celiac

Answer 10

il15, 21 AND IFN a

Question 11

alveolar macrophages

Answer 11

balance tolerance and inflamation in lung

Question 12

what is the last step of a normal graft response

Answer 12

resolution

Question 13

first and second set rejection timeline

Answer 13

12-14 days
5-6 days

Question 14

what cells play a role in graft rejection

Answer 14

cd4 and 8
cd4 more important

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

Question 15

what are the stages of graft rejection

Answer 15

sensitization
hyperactute
acute
effector
chornic

Question 16

recognize peptides from donor MHC on self apc

Answer 16

INDIRECT RECOGNITION

Question 17

recognize donor MHC

Answer 17

direct recognition

Question 18

effector stage

Answer 18

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

Question 19

when does hyperactute rejection occur

Answer 19

before tissue revascularizes

within 24 hrs

Question 20

acute and hyperacute mediated by what

Answer 20

acute- cd4 t cells
hyperacture- ab

Question 21

mechanism of acute rejection

Answer 21

massive infiltration of lymphocyte and macrophages and effector stage

Question 22

mechanism of chronic rejectino

Answer 22

ab or cell mediated

Question 23

when is total lymphoid irradiation used

Answer 23

bone marrow transplant and graft vs host disease

Question 24

azathioprine

Answer 24

mitotic inhibitor diminishes b and t cell proliferation

Question 25

general immunosupresive therapy

Answer 25

azathioprine and cylophosphamide and corticosteroids

Question 26

specific immunosupressive therapy

Answer 26

bellatracept- CTLA4 fusion- induces t cell anergy
OKT3- CD3 mAb that depletes t cells

Question 27

where does central tolerance occur

Answer 27

in primary lymphoid organs

Question 28

where is AIRE expressed

Answer 28

mostly in lymphoid organs

Question 29

what does positive selection

Answer 29

thymic epithelial cells

Question 30

disease for absence of AIRE

Answer 30

autoimmune polyendocrine syndrome 1 APS1

Question 31

where are self reactive B cells deleted or inactivated

Answer 31

in the bone marrow

Question 32

what are the methods of peripheral tolerance

Answer 32

anergy/ unresponsiveness due to lack of costimulation

apoptosis through fas/fasL

Question 33

what forms self reactive b cells

Answer 33

SHM in the germinal centres

Question 34

molecular basis of t cell anergy

Answer 34

only get signal one from antigen - anergy and no iL2 expression

Question 35

activation of fas receptor known as

Answer 35

ACID
activation induced cell death

anergic b cells also express fas

Question 36

people w mutated fas

Answer 36

ALPS
autoimmune lymphoproliferative syndrome

Question 37

mice w mutated fas and fasL

Answer 37

lpr and gld

inc in autoimmune diseaeds and lymphocytes

Question 38

what initiates oral tolerance

Answer 38

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

Question 39

etiology of autoimmunity

Answer 39

genetics
-family clustering
-HLA and non HLA associated

environmental
-microbial antigens and trauma

mix of environmental and genetic

drug and hormonal triggers

Question 40

polyclonal activation

Answer 40

encountering PAMPs like LPS on gram -ve bact interacts w activating receptors

activates many clones

intracellular detection of pathogenic patterns of DNA

Question 41

what are the types of enviromental suscpetibility

Answer 41

sequestered antigen
molecular mimickery
polyclonal activation
inapproperiate expression of class II MHC

Question 42

what transfers autoimmunity

Answer 42

CD4+

TH1 polarization inc autoimmunity
specific HLA alleles
must have trimolecular complex interaction

and lack of T reg (linked supression)

Question 43

autoimmunity treatment

Answer 43

immunosupressive
-immmunosupressants
-anti inflamatory
-anti CD4

targetted therapies
block only ag activated T cells

Question 44

targetted therapies for autoimmune diseases

Answer 44

anti cytokine ab or blockers
-block TNFa
-embrel, rumicade, humira
-RA, crohns, ankylosing spondylitis

ritixumab
-mAb against CD20 inducing apoptosis and ADCC
-RA

Question 45

challenge of only blocking activated T cells

Answer 45

must only block activated ones
-mAb against ILRa subunit
-potential neg effect on Treg

block specific associated TCR chains