Transplantation Immunology

Question 1

One of the MOST POLYMORPHIC
gene system known

Answer 1

Human
Leukocyte
Antigen

Question 2

in human leukocyte antigen, Associated protein is coded in the
______ in the
major histocompatibility complex

Answer 2

short arm of chromosome 6

Question 3

Can occur in special case in which
immunocompetent tissue is
transplanted into an
immunocompromised host (Bone
Marrow, Thymus, Fresh Whole Blood)

Answer 3

Graft vs
Host
Disease (GvHD)

Question 4

T cells from the transplant recognize
the host MHC molecules as non
-self
and attack the host

Answer 4

gvhd

Question 5

Preformed antibodies and complement
that reacts with donor

Answer 5

Hyperacute
“White graft”

Question 6

Reactivation of sensitized T cells
Pre-sensitized T cells; due to low level of
antibody present in the body in
pretransplant period

Answer 6

Accelerated

Question 7

Primary activation of T cells
Development of allogenic reaction to
donor Ag

Answer 7

Acute

Question 8

Causes are unclear , antibodies, immune
complex, slow cellular reaction, recurrence
of disease; side effects of
immunosuppressive drugs

Answer 8

Chronic

Question 9

HLA Typing in
Laboratory

Answer 9

• DNA sequencing (Polymerase Chain
  Reaction)
• Serological assay
• Mixed lymphocyte culture / Mixed
  lymphocyte reaction (MLC/MLR)
• Crossmatching

Question 10

– Amplification and specific probes to
detect different alleles
– Highly specific / sensitive
– Method of choice

Answer 10

DNA SEQUENCING (POLYMERASE CHAIN
REACTION)

Question 11

– Cells from the donor and recipient are
reacted with a battery of antibodies,
each one of which is specific for a
different class I and II protein
– Complement is then added, and any
cell bearing an MHC protein
homologous to the known antibody
will lyse
– Satisfactory in most cases

Answer 11

SEROLOGICAL ASSAY

Question 12

“Stimulator” lymphocytes from a potential donor are first killed
by radiation and then mixed with live “responder” lymphocyte
from the recipient

Answer 12

• MLC/MLR

Result: the greater the amount of DNA synthesis in the
responder cells, the more foreign are the Class I and II MHC
proteins of the donor cell

Question 13

– The fetus is an allograft that is not rejected
– Trophoblast layer of the placenta does not allow maternal T cells
to enter the fetus

Answer 13

CROSSMATCHING

Question 14

KINDS OF IMMUNOSUPRESSIVE AGENTS

Answer 14

*Corticosteroids
*Antimetabolic Agents
*Calcineurin Inhibitors
*Monoclonal antibodies
*Polyclonal antibodies

Question 15

To suppress antigraft immune response in solid-organ and stem cell
transplantation

Increase susceptibility to infection, malignancies , and other
associated toxic side effects

Answer 15

IMMUNOSUPPRESSIVE AGENTS

Question 16

can cause uninhibited cell division if their
expression is altered or if they are mutated
into oncogenes

Answer 16

• PROTO-ONCOGENES

Question 17

• TUMOUR SUPPRESSOR GENES

Answer 17

• PROTO-ONCOGENES

Question 18

are characterized by slow growth restricted
anatomic location and do not cause deatH

Answer 18

BENIGN NEOPLASM

Question 19

MALIGNANT NEOPLASM OF

Answer 19

– is often referred as cancer or tumor.

They are
characterized by:
a. Anaplasia in which cells lose their differentiating features

b. Invasion of the body

c. Metastatic spread which can result in death

Question 20

Often named by adding the suffix –oma (lipoma) to the cell
type but there are exceptions such as lymphomas,
melanomas, hepatoma

Answer 20

BENIGN TUMOR

Question 21

Benign tumors arising from glands are called _____ and
those from epithelial surfaces are termed ________

Answer 21

Benign tumors arising from glands are called adenomas and
those from epithelial surfaces are termed polyps or
papillomas

Question 22

CHARACTERISTICS OF BENIGN TUMOR

Answer 22

Usually are encapsulated
Grow slowly
Usually are nonspreading
Have minimal mitotic activity
Resemble the parent tissue

Question 23

MALGNANT TUMOR those arising
from glandular epithelium are
called

Answer 23

adenocarcinoma

Question 24

Referred to as carcinoma or
cance

Answer 24

MALIGNANT
TUMOR

Question 25

CHARACTERISTIC OF MALIGNANT TUMOR

Answer 25

Increase in the number of cells that accumulate Involves invasion of tissue Dissemination by lymphatic spread or by seeding within a body cavity Metastasis Characteristic nuclear cellular features Receptors for intergrin molecules

Question 26

is when the malignant cells travel through the body, causing new foci of malignancy until body function is so disrupted that death occurs

Answer 26

METASTASIS

Question 27

Most widely used cancer staging system

Answer 27

TNM System The T refers to the size and extent of the main tumor. The main tumor is usually called the primary tumor. * The N refers to the the number of nearby lymph nodes that have cancer. * The M refers to whether the cancer has metastasized. This means that the cancer has spread from the primary tumor to other parts of the body.

Question 28

Primary Tumor (T)

Answer 28

Primary Tumor (T) * TX: Main tumor cannot be measured. * T0: Main tumor cannot be found. * T1, T2, T3, T4: Refers to the size and/or extent of the main tumor. The higher the number after the T, the larger the tumor or the more it has grown into nearby tissues. T's may be further divided to provide more detail, such as T3a and T3b

Question 29

Regional Lymph Nodes (N)

Answer 29

* NX: Cancer in nearby lymph nodes cannot be measured. * N0: There is no cancer in nearby lymph nodes. * N1, N2, N3: Refers to the number and location of lymph nodes that contain cancer. The higher the number after the N, the more lymph nodes that contain cancer.

Question 30

Distant Metastasis (M)

Answer 30

* MX: Metastasis cannot be measured. * M0: Cancer has not spread to other parts of the body. * M1: Cancer has spread to other parts of the body.

Question 31

n the course of malignant transformation of a cell, new antigens or tumor associated antigens develop at the cell surface and the host recognize malignant cells as “non self”

Answer 31

Tumor Associated Antigens (TAA) The quantity of TAA increases proportionally with tumor growth and decreases with effective threrapeutic response

Question 32

TUMOR SASSOCIATED ANTIGEN- ABSAHIN ANG HABA POTA

Question 33

Oncofetal Antigens

Answer 33

AFP AND CEA

Question 34

synthesized by fetal liver cells. Most but not all hepatomas secrete large amounts of AFP. Its presence in serum is not diagnostic of hepatoma but is merely suggestive

Answer 34

AFP OR ALPHA FETO PROTEIN

Question 35

– glycoprotein found in glycocalyx of cells derived from endoderm and present in gastro intestinal carcinomas especially cancer of colon

Answer 35

CARCINOEMBRYONIC ANTIGEN (CEA)

Question 36

These viral “finger prints” form a major part of the evidence that links viruses with human malignancy.

Answer 36

Virus – Induced TAA

Question 37

have found in the cells of patients with Burkitt’s Lymphoma and Nasopharyngeal carcinom

Answer 37

EPSTEIN –BARR VIRUS (EBV)

Question 38

Virus – Induced TAA AND WHERE THEY CNA BE FOUND

Answer 38

* HEPATITIS B found in Primary Liver Cancer * HUMAN PAPILLOMA VIRUSES 16 AND 18 in Cervical Cacinoma * HUMAN T-CELL LEUKEMIA VIRUS found in Adult T-Cell leukemia

Question 39

Antigens that can induce a protective immune response in the host if they occur in the membrane of the malignant cell

Answer 39

Tumor Specific Transplantation Antigens (TSTA)

Question 40

Immunosurveillance READ

Question 41

EFFECTOR MECHANISM AGAINST CANCER

Answer 41

* Monocyte / macrophage release lytic enzymes and phagocytose necrotic material * Antibody against tumour antigens * Induction of tumour-specific CTL and TIL * Initiation of NK / CTL cytotoxic responses * Release of cytokines / chemokines (TNFα, IFNs etc) and antiangiogenic factors

Question 42

Immunoediting- The Great Escape!

Answer 42

*Strong evidence that IR controls and eradicates nascent cancer cells *“Immunoediting” eventually produces low antigenicity tumour cells *Pressure from immune system coupled with genomic instability selects for escape

Question 43

Three Es of Immunoediting

Answer 43

Elimination Equilibrium Escape

Question 44

– can detect expressed antigens using labeled antibodies,

Answer 44

Immunohistochemistry

Question 45

Many cancers are associated with particular karyotypes. However, as more precise knowledge of the exact gene defects present in various cancers is gained, testing for the aberrant genes is becoming more prevalent.

Answer 45

* Cytogenetic Studies

Question 46

Polymerase chain reaction (PCR) and its variants increase the inherent level of DNA or RNA, allowing the detection of small populations of cancer cells (including circulating cells in metastasis) and the detection of mutations, deletions, and gene rearrangements/translocations

Answer 46

Nucleic Amplification Technique

Question 47

Nucleic acid probes capable of binding to sequences of interest are tagged with fluorophors and applied to cells. Cells containing the sequence of interest can be visualized with fluorescent microscopes. Similar techniques using nonfluorescent labels such as enzymes and silver stains are also becoming available

Answer 47

Flourescent In Situ Hybridization

Question 48

The goal of active immunotherapy is to have the patient develop an immune response that will help eliminate the tumor

Answer 48

ACTIVE IMMUNOTHERAPY

Question 49

* Passive transfer of allogeneic cellular immunity from one person to another to fight cancer has many barriers: * Possible recipient rejection of foreign cells * Graft-versus-host disease (GVHD) * Fragility of live cells, although research models are being studied

Answer 49

* PASSIVE IMMUNOTHERAPY