S2 Innate Immune System Flashcards

(35 cards)

1
Q

What are the 3 factors determining the outcome of the host-pathogen relationship? Which part of the infection model does each effect?

A
  • infectivity (pathogen)
  • host’s immune response (patient)
  • virulence (mechanism of infection)
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2
Q

What does infectivity mean?

A

Ability of microbe to establish itself within/on the host

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3
Q

What does virulence mean?

A

Capacity of the microbe to do damage

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4
Q

Which 3 groups are at increased risk of infection?

A
  1. Elderly
  2. Children
  3. Pregnant women
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5
Q

What is the immune system?

A

Cells and organs that contribute to immune defences against infectious and non-infectious conditions (self vs non-self)

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6
Q

What is an example of a non-infectious condition the immune system targets?

A

Cancer

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7
Q

What is an infectious disease?

A

When the pathogen succeeds in evading and/or overwhelming the host’s immune defences

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8
Q

What are the 4 roles of the immune system?

A
  1. Pathogen recognition (cell surface and soluble receptors)
  2. Containing/eliminating the infection (killing and clearance mechanisms)
  3. Regulating itself (minimum damage to host)
  4. Remembering pathogens (preventing reoccurrence of the disease)
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9
Q

What are the two types of immunity?

A
  • innate immunity

* adaptive immunity

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10
Q

What is innate immunity?

A
  • first immunity
  • immediate protection
  • fast (seconds)
  • lack of specificity
  • lack of memory
  • non change in intensity
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11
Q

What is adaptive immunity?

A
  • second immunity, if any pathogen gets through innate
  • long lasting protection
  • slow (days)
  • specificity
  • immunologic memory
  • changes in intensity
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12
Q

What are the first lines of defence?

A

Factors that prevent entry and limit growth of pathogens

  • physical barriers
  • physiological barriers
  • chemical barriers
  • biological barriers
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13
Q

What are the physical barriers?

A
  • skin
  • mucous membranes (mouth, respiratory tract, GI tract, urinary tract)
  • bronchial cilia
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14
Q

What are the physiological barriers? Give an example of an infectious disease that causes each

A
  • diarrhoea (food poisoning)
  • vomiting (hepatitis)
  • coughing (pneumonia)
  • sneezing (sinusitis)
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15
Q

What are the chemical barriers?

A
  • low pH e.g. on skin, in stomach and vagina

* antimicrobial molecules - IgA, lysozyme, mucus, gastric acid and pepsin, beta-defensins

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16
Q

What are the biological barriers?

A
  • normal flora (non-pathogenic microbes) that become pathogenic if get into wrong location
17
Q

What are the benefits of the human microbiome?

A
  • they compete with pathogens for attachment sites and resources
  • produce antimicrobial chemicals
  • synthesis vitamins
  • lead to immune maturation
18
Q

Give examples of some normal flora that inhabit the skin.

A
  • staphylococcus aureus
  • staphylococcus epidermidis
  • streptococcus pyogenes
  • candida albicans
  • clostridium perfingens
19
Q

Give examples of some normal flora that inhabit the nasopharynx.

A
  • streptococcus pneumoniae
  • neisseria meningitidis
  • haemophilius species
20
Q

When do clinical problems arise from normal flora?

A

Displacement of normal flora by e.g. breaching of the skin integrity, fecal-oral route or fecal-perineal-urethral route, poor dental hygiene/dental work, depleted by antibiotic therapy or overgrown and becomes pathogenic

21
Q

Who are high-risk patients to serious infections?

A
  • asplenic patients
  • patients with damaged or prosthetic heart valves
  • patients with previous infective endocarditis
22
Q

What are the second lines of defence?

A

Factors that will contain and clear the infection

  • phagocytes
  • chemicals
  • inflammation
23
Q

What are the 3 main phagocytes?

A
  • macrophages (in all organs) - produce cytokines/chemokines and phagocytose microbes
  • monocytes (in blood) - differentiate into macrophages at infected tissue
  • neutrophils (blood) - increase during infection, recruited by chemokines to infection site
24
Q

What are the other key cells of the innate immunity (minus phagocytes)?

A
  • basophils/mast cells
  • eosinophils
  • natural killer cells
  • dendritic cells - present microbial antigens to T cells (acquired immunity)
25
How do phagocytes recognise microbes?
Phagocytes have pathogen recognition receptors (PRRs) e.g. TLR4 that recognise and bind to pathogen-associated molecular patterns (PAMPs) on the microbe Microbes also have proteins called opsonins on their surface that bind to opsonin receptors on phagocyte Two attachments increases recognition - more enhanced
26
What are examples of opsonins? Why are they important?
* complement proteins * antibodies e.g. IgG * acute phase proteins e.g. CRP Essential in clearing encapsulated bacteria
27
What do phagocytes do?
Ingest and destroy (phagocytosis)
28
In which two pathways do phagocytes kill microbes?
* oxygen dependent pathway (respiratory burst) - toxic oxygen products * oxygen-independent pathways - enzymes
29
What is the antimicrobial action of C3a and C5a complement serum proteins?
Recruitment of phagocytes
30
What is the antimicrobial action of C3b-C4b complement serum proteins?
Opsonisation of pathogens
31
What is the antimicrobial action of C5- C9 complement serum proteins?
Killing of pathogens Membrane attack complex
32
What are the 2 activating pathways of complement serum proteins?
* alternative pathway | * MBL pathway
33
What are clinical problems that arise if phagocytosis is reduced?
* decrease spleen function * decrease neutrophil number * decrease neutrophil function
34
What are the antimicrobial actions of macrophage-derived cytokines like TNFalpha/IL-6/IL-1
* systemic actions - liver (CRP and MBL - complement activation), bone marrow (neutrophil mobilisation), hypothalamus (increased temp) * local inflammatory actions - blood vessels (vasodilation, vascular permeability, expression fo adhesion molecule to attract neutrophils)
35
What is the summary of the innate immune response?
1. Innate barrier breached 2. Complement, mast cells and macrophage activation 3. Cytokine/chemokine production causes vascular changes and chemoattraction 4. Hypothalamus and liver cause fever and acute phase response 5. Redness, heat, swelling and pain due to local inflammation