Unit 2 Flashcards

(650 cards)

1
Q

What is another name for antibody?

A

Immunoglobulin

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2
Q

What is an immunoglobulin?

A

Globular proteins (glycoproteins) that play a role in immunity

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3
Q

What is the composition of immunoglobulins?

A

86-98% polypeptides
2-14% carbohydrates

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4
Q

What percentage of plasma proteins are immunoglobulins?

A

20%

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5
Q

Describe serum protein electrophoresis procedure

A

①serum is placed on a agarose gel
②electric current applied to separate the proteins

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6
Q

What pH does electrophoresis separates most serum proteins by size and change?

A

8.6

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7
Q

What do the results of electrophoresis appear as?

A

Five bands

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8
Q

What are the slowest moving protein?

A

Immunoglobulins

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9
Q

What band contains the most antibody activity?

A

Gamma band

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10
Q

What are the 5 classes of immunoglobulins?

A

IgG
IgM
IgD
IgE
IgA

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11
Q

Describe the two dimensional form of IgG

A

-Two large peptide chains (heavy chains) (unique)
- two small peptide chains (light chains) (kappa or lambda)

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12
Q

What is the approximate molecular weight of the heavy chains?

A

50,000

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13
Q

What is the approximate molecular weight of light chains?

A

22,000

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14
Q

How do the kappa and lambda light chains differ?

A
  • Differ by just a few amino acid substitutions along their length
  • No functional difference
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15
Q

What are heavy and light chains held together by?

A

-Disulfide bonds (S-S)
-hydrogen bonds
-hydrophobic forces
-electrostatic attractions

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16
Q

What is the structural unit of all the immunglobulin classes?

A

Tetrapeptide structure

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17
Q

What has sequencing of the amino acids in the heavy and light chains revealed?

A

That each chain has a single variable region and one or more constant regions

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18
Q

Where is the variable region of immunoglobulin located?

A

In the first 110 amino acids of the molecule at the amino terminal

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19
Q

Describe the variable region of an immunoglobulin

A

-unique to each antibody
-allows the molecule to bind specifically to a particular antigen

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20
Q

Where is the constant region of the immunoglobulin located?

A

From amino acid 111 to the carboxyl terminal

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21
Q

Describe the constant region of an immunoglobulin

A
  • are they same in each immunoglobulin class/subclass
    -responsible for the biological functions that play a role in immune defense against an antigen
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22
Q

What are the 3 constant regions of an immunoglobulin?

A

CH1
CH2
CH3

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23
Q

What are CH2 and CH3 responsible tor?

A

For binding to complement and Fc receptors on phagocytic cells

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24
Q

What are the protolytic enzymes?

A

Pepsin and papain

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25
Describe papain
- Cleaves the IgG molecule below the set of the disulfide bonds that holds the two heavy chains together, resulting in formation of 3 fragments: 2 Fab fragments and1 Fc fragment
26
Describe Fab fragments
-each have one light chain and one half of a heavy chain - Located at amino-terminal end of the molecule - both are identical - have antigen-binding capability
27
Describe the Fc fragment
- Consists of the carboxyl-terminal halves of two heavy chains held together by disulfide bonds - spontaneously crystallizes at 4°C -does not bind antigen - contain constant regions CH2 and CH3*
28
Describe pepsin
- Cleaves IgG at the carboxyl- terminal side of the interchain disulfide bonds -2 fragments: F(ab’)2 fragment and Fc’
29
Describe the F(ab’)2 fragment
- Molecular weight of 100,000 daltons - contains all the antigen- binding ability in pepsin
30
Describe Fc’ (fragment of pepsin)
- In carboxyl- terminal portion of the molecule which is disintegrated into several smaller pieces -has no biological activity
31
What is the hinge region?
-The segment of heavy chain located between the CH1 and CH2 -rich in hydrophobic residues -high proline content that allows for flexibility
32
Why is flexibility important in the hinge region of immunoglobulin?
- Lets the two antigen binding sites operate independently and engage in angular motion relative to each other and to the Fc stem -initiation of complement cascade -binding to cells with specific receptors for the Fc portion of molecule
33
Which immunoglobulin classes have hinge region?
IgG IgD IgA
34
Why do IgM and IgE have flexibility even though they do not have a hinge region?
CH2 are paired in such a way as to confer flexibility to the Fab arms
35
What do immunoglobulins contain?
4 polypeptide chains Carbohydrate portion
36
Where is the carbohydrate portion of immunoglobulins located?
Between the CH2 domains of the two heavy chains
37
What are the functions of the carbohydrate portion of immunoglobulins?
①increasing solubility of immunoglobulin ②provide protection against degradation of molecule ③enhancing functional activity of Fc domains ( most important)
38
What are the 3 antigenic determinants?
Isotype Allotype Idiotype
39
Describe isotypes
- Unique amino acid sequences that are common to all immunoglobulins of given class/subclass -identical in all individuals of given species and differ from one species to another
40
What are isotypes comprised of?
Constant regions of the heavy chains that are unique to each immunoglobulin class and give each type its name
41
How can antibodies to human isotypes be prepared?
By immunizing animals with human serum
42
What are allotypes?
- Minor variations of amino acid sequences that are present in some individuals of the same species but not others
43
Where classes do allotypes occur in?
- four Ig classes -one IgA subclass - lambda light chain
44
Where are allotypes located an an immunoglobulin?
- Found in the constant region
45
What are idiotypes?
-The variable portion of each immunoglobulin chain are unique to a specific antibody molecule - essential to the formation of the antigen binding site
46
Where are idiotypes of the immunoglobulin located?
At the amino-terminal ends of both heavy chains and light chains
47
What is the predominant immunoglobulin in humans?
IgG
48
What is the percentage of total serum immunoglobulins that are IgG?
70-75%
49
What is the normal concentration of IgG?
800-1600 mg/dl
50
What immunoglobulin class has the longest half-life?
IgG
51
How long is the half-life of IgG?
23 days
52
Describe structure of IgG
- Monomer - consists of one tetrapeptide unit
53
What is the molecular weight of IgG?
150,000
54
What is the sedimentation coefficient of IgG
7S
55
What is sedimentation coefficient?
- Number of Svedberg units - measure of the rate by which the molecule sediments is a high-speed ultracentrifuge, and the S- value reflects the molecular weight of the molecule
56
What are the 4 major subclasses of IgG?
IgG1 IgG2 IgG3 IgG4
57
What is the composition of the IgG subclasses?
IgG1→ 66% IgG2→ 23% IgG3→7% IgG4→ 4%
58
What are IgG1 and IgG3 produced in response to?
protein antigens
59
What are IgG2 and IgG4 associated with?
Polysaccharide antigens
60
What immunoglobulins can cross the placenta?
All subclasses in IgG except IgG2
61
What are the major functions of IgG?
①The CH2 region is able to bind to complement ② important mediator of opsonization ③ participates in antibody- dependent cellular cytotoxicity ④ ability to bind to bacterial toxins and viruses and neutralize their activity ⑤ can cross placenta ⑥ agglutination reactions and precipitation takes place in vitro.
62
What does activation of complement result in?
In an enhanced inflammatory response and destruction of foreign cells such as bacteria
63
What is the most efficient subclass of IgG to bind complement? Why?
IgG3 →it was the largest hinge region and the largest number of interchain disulfide bonds
64
What is the 2nd most efficient subclass of IgG to bind complement?
IgG1
65
What is opsonization?
- The coating of a foreign antigen that leads to enhanced phagocytosis
66
Why are IgG1 and IgG3 are particularly good opsonins?
They bind most strongly to Fc receptors
67
Describe IgG participating in antibody- dependent cellular cytotoxicity (ADCC)?
-IgG binds to Fc receptors on the surface of marophrages, monocytes, neutrophils, and NK cells - binding triggers the release of enzymes by the cells, which destroy the antigen extracellularly
68
Why are IgG efficient at - its ability to bind to bacterial toxins and viruses and neutralize their activity?
Has a high diffusion coefficient that allows it to enter extravasular spaces more readily than the other immunoglobulin types
69
Why is IgG able to cross the placenta?
Because the placenta possesses receptors for the Fc region of IgG molecules, which take up the antibodies by receptor- mediated endocytosis and transport them to the fetal blood.
70
Why is passive transfer of maternal IgG to the fetus important?
Providing immunity to the newborn during its first few months of life, when its immune system is immature
71
Is IgG better at agglutination or precipitation? why?
Precipitation because it involves small soluble particles, which are brought together more easily by the relatively small IgG molecule.
72
What else is IgM called? Where does it get this name?
Macroglobulin because it is the largest of all the immunoglobulin classes
73
What is the sedimentation rate of IgM?
19S
74
What is the molecular weight of IgM?
900,000
75
What is the basic structure of IgM?
Pentameter of five monomers held together by J chain (joining)
76
Describe the J chain
- Glycoprotein that holds together monomers - cysteine residues form disulfide bonds that link the carboxyl- terminal ends of adjacent monomers in IgM and IgA
77
What does each monomer of IgM contain?
- Mu heavy chains and either kappa or lambda light chains -mu heavy chains possess one more constant domain (CH4) adding to its large size
78
What is the half life of IgM?
6 days
79
What percentage of immunoglobulins are IgM?
5-10%
80
What is the serum concentration range for IgM?
120-150 mg/dl
81
Why does IgM perform things more efficiently than IgG?
Because of IgMs multiple binding sites
82
What immunoglobulin is most efficient at triggering the classical pathway?
IgM because a single molecule can initiate the reaction when complement binds to two adjacent cha regions
83
Where are IgM mainly found?
In the intravascularpool and not in other body fluids or tissues because of its large size
84
What immunoglobulin is the first to appear after antigenic stimulation?
IgM
85
What is the first immunoglobulin that appears in maturing infants?
IgM
86
How many binding sites does IgM have?
10
87
What percentage of immunoglobulins are IgA?
10-15%
88
What is the normal serum concentration of IgA?
70-350 mg/dl
89
What is the molecular weight of IgA?
160,000
90
What is the sedimentation coefficient of IgA?
7S
91
Upon electrophoresis, IgA migrates where?
Between the beta and gamma bands
92
What immunoglobulins have complement fixation?
IgG IgM
93
Describe the basic structure of IgA
- Alpha heavy chains - contains one variable regions - contains three constant regions - dimer, two monomers held together by J chain
94
What are the two subclasses of IgA?
IgA1 and IgA2
95
How do IgA1 and IgA2 differ?
By 22 amino acids, 13 of which are located in hinge region (deleted in IgA2)
96
IgA2s lack of a hinge region causes what?
Make IgA2 more resistant to some bacterial proteinases that are able to cleave IgA1
97
Where are IgA2 found?
_ Secretions at mucosal surfaces -along respiratory,urogenital, and intestinal mucosa -appears in breast milks saliva, tears, sweat, and colostrum
98
Where are IgA1 found?
In serum
99
What is the major role of serum IgA?
-Anti-inflammatory agent - downregulate IgG mediated phagocytosis, chemotaxis, bactericidal activity, and cytokine release
100
What is the J chain essential for in IgA?
Essential for polymerization and secretion of IgA
101
Where are Secretory IgA synthesized?
Plasma cells found mainly in mucosal-associated lymphoid tissue and is released in dimeric form
102
Describe secretary component
- serves as specific receptors for IgA - precursor is present on surface of epithelial cells
103
What does secretary component derive from?
From epithelial cells found in plasma cells
104
Where do plasma cells secrete IgA?
Subepithelial tissue
105
What happens once IgA bind to SC precursors?
-Transcytosis -Both of them are taken inside the cell and released at the opposite surface
106
What is the main function of secretory IgA?
- To patrol mucosal surfaces and act as a first line of defense by preventing antigens from penetrating farther into the body
107
What is the important role of IgA?
Neutralizing toxins produced by microorganisms and helps prevent bacterial and viral adherence to mucosal surfaces
108
What immunoglobulin complex is trapped by mucus and coughed/sneezed out to protect the respiratory system?
IgA complex
109
Where is IgA found in humans?
- breast milk
110
How does breastfeeding help to maintain the health of newborns?
Passively transferring antibodies
111
What cells possess specific receptors for IgA?
Macrophages Monocytes Neutrophil
112
What does binding to IgA specific receptor trigger?
A respiratory burst and degranulation, indicating that IgA is capable of acting as an opsonin
113
What percentage of total immunoglobulin are IgD?
0.001%
114
What is the half life of IgD?
1-3 days
115
What is the molecular weight of IgD?
180,000
116
What antibody migrates as fast as a gamma protein?
IgD
117
What is the molecular weight of the IgD delta chain?
62,000
118
Describe the hinge region of IgD
-unusually long -58 amino acids
119
Why is IgD more susceptible to proteolysis than any other antibody?
Because of its long hinge region.this may be the reason for its short half life
120
Where are most IgD found?
Surface of unstimulated B cell
121
What is the second antibody that appears during an immune response?
IgD
122
What are the roles of IgD?
- B cell maturation and differentiation - not exactly understood
123
Why is IgD an ideal early responder?
High level of surface expression and its intrinsic flexibility
124
What is IgE best known for?
Very low concentration in serum and the fact that it has the ability to activate mast cells and basophils
125
What percentage of total immunoglobulins are IgE?
0.0005%
126
What is the normal concentration of IgE in adults ?
0.005 mg/dl
127
What is the molecular weight of IgE?
190,000
128
What is the sedimentation coefficient for IgE?
8S
129
What percentage of IgE consists of carbohydrates?
12%
130
Describe the structure of IgE?
-epsilon heavy chain is composed of one variable and four constant domains - A single disulfide bond joins each epsilon chain to a light chain, and two disulfide bonds link the heavy chains to one another
131
What is the most heat-liable antibodies? Why?
IgE heating to 56°C for between 30 minutes and 3 hours results in conformational change and loss of ability to bind to target cells
132
Does IgE participate in complement fixation, agglutination, or opsonization?
None of these
133
What cells does IgE bind to after synthesis? Describe?
- Basophils - eosinophils - Langerhern cells - tissue mast cells → through nigh affinity receptors for the Fc portion of epsilon chain,which are exclusively on the surface of these cells
134
Where can plasma cells that produce IgE be located?
Primarily in lungs and in the skin
135
Where can mast cells be located?
Mainly in the skin, -lining of the respiratory and alimentary tracts
136
What happens when two adjacent IgE molecules on a mast cell bind specific antigen?
A cascade of cellular events is initiated that results in degranulation of the mast cells with the release of vasoactive amines such as histamine and heparin
137
What does the release of IgE mediators induce?
- Type I immediate hypersensitivity - “allergic reaction"
138
What are typical reactions with allergic reactions?
- Anaphylactic shock - Asthma - diarrhea -hay fever -hives -vomiting
139
Describe IgE role
Serve a protective role by tinggering an acute inflammatory reaction that recruits neutrophils and eosinophils to the area to help destroy invading antigens that have penetrated IgA defenses
140
What occurs when the first time an individual is exposed to an antigen?
Primary antibody response
141
What are characteristics of primary antibody response?
-IgM shows up first - Lag phase between the encounter with the antigen and the production of detectable antibody - low affinity - amount of antibody produced are relatively low and decline during the span of a few weeks
142
Describe the lag phase of primary antibody response
- lasts 4 and 7 days - T and B cells are being activated to respond to the antigen by the T- dependent mechanism of antibody production
143
What does the lag phase of the primary antibody response result in?
Results in the generation of antibody- secreting plasma cells
144
What do the activated B cells from the primary response develop into?
- Plasma cells - expand into clonesof memory cells (long lived)
145
What happen to memory cells when they are transformed from an activated B cells?
Memory cells have undergone genetic changes that allow them to: ① resist apoptosis ② express high affinity antigen receptors ③ switch their production from IgM to another isotope, predominantly IgG
146
Describe secondary antibody response?
It memory cells are exposed to the same antigen weeks, months, or even years later, they can rapidly differentiate into plasma cells and larger amounts of antibody are produced
147
What are characteristics of the secondary antibody production?
- Shorter lag time → 1-2 - high affinity - results in production of low levels of IgM that rapidly decline - results in higher levels of other immunoglobulin isotypes, mainly IgG - levels decline slowly and persistfor longer periods
148
Describe clonal selection hypothesis
-Body has numerous clones of lymphocytes, each possessing surface receptors with a unique specificity -when body is exposed to antigen, the antigen selectively binds to receptors on cells to proliferate and mount antibody responses
149
What are individual lymphocytes genetically programmed to produced?
- Immunoglobulin receptor with a single antigen specificity - occurs before contact of antigen, during B cell maturation
150
What are mature lymphocytes in lymphoid tissue prepared for?
To respond to a diverse array of potentially harmful antigens long before the body actually encounters them
151
Describe an human immunoglobulins physical features
-found in 3 unlinked clusters -heavy chains are located on chromosome 14 -kappa light chain is found on chromosome 2 -lambda light chain is found on chromosome 22 -within each of clusters, a selection process occurs
152
When can a gene be transcribed and translated into functional antibody molecule?
Not until it undergoes rearrangement l, assisted by special recombinase enzymes
153
What does gene rearrangement involve?
Cutting and splicing process that removes much of the intervening DNA, resulting in a functional gene that codesfor a specific antibody
154
Where does rearrangement of the gene begin?
The heavy chains
155
What are the genes that code for vanable region of the heavy chain divided into?
Divided into 3 groups: ① V genes (variable) → 45 genes ② D genes (diversity) → 23 genes ③ J genes (joining) → 6
156
Where are all V, D and J genes present?
The germline DNA of a bone marrow stem cell
157
What are the set of genes that codes for the constant region?
- in order: C”mu”, C”delta”, C”gamma"3, C"gamana"1, C”alpha”1, C”gamma"2, C”gamma"4, C”epsilon” and C"alpha"2 -includes one gene for each heavy chain isotype
158
What occurs as the B cells mature and the heavy chain is constructed?
-a random choice is made from each of the sections so as to include one V gene, one D gene, one J gene, and one constant region
159
Joining of V gene, D gene, J gene and the constant region of a heavy chain is a two step process. What are the steps?
① in pro-B cells, one D gene and one J gene are randomly chosenand are joined by means of a recombines enzyme after the intervening DNA is deleted ②in pre-B cell stage, a V gene is joined to the DJ complex, resulting in a rearranged VDJ gene
160
Describe what the VDJ gene combination codes for.
-Codes for the entire variable region of a heavy chain.
161
What is allelic exclusion?
The genes on the second chromosome are not rearranged because the rearrangement of DNA on one chromosome 14 was successful the first time
162
What happens if the first rearrangement of heavy chains is unsuccessful?
-Rearrangement of the second set of genes on the other chromosome 14 occurs. -this mechanism maintains clonal specificity by ensuring each B cell only expresses a single antigen receptor
163
What happens after rearrangement of the genes of the heavy chains?
-the variable and constant regions are joined - occurs at the RNA level, thus conserving the DNA of the constant regions
164
During transcription and synthesis of messenger RNA of heavy chains, what occurs?
A constant region is spliced to the VDJ complex
165
Why is C“mu" the first to synthesized in heavy chains?
Closest to the J region
166
What are the markers of pre-B cells?
Mu heavy chains
167
What is transcribed after C"mu" region of the heavy chain?
-C"delta" region, which is closest to C”mu" region - often transcribed along with C"mu"
168
What does the presence of both C"mu" and C"delta" regions of heavy chains allow?
Allows for mRNA for IgD and IgM to be transcribed at the same time.
169
When do light chain rearrangement occur?
After mu chains appear
170
What is a pivotal stepin light chain rearrangement?
Mu- chain synthesis (in heavy chain)
171
What is the main difference between heavy chain and light chain rearrangement?
Light chains lack a D region
172
What chromosome do the recombination of V and J segments in light chains occur?
Chromosome 2
173
What chromosome does coding for kappa chains (light) occur?
Chromosome 2
174
What does chromosome 22 code for
Lambda chain
175
What does the kappa locus contain?
Approximately: -35 V(k) segments -5 J(k) segments -one functional C(k) region
176
Describe VJ joining of light chains?
-Accomplished by cutting out one intervening DNA -results in the V(k) and J(k) segments becoming permanently joined to one another on the rearranged chromosome
177
Describe transcriptions route of a light chain
- begins at one end of the V(k) segment and proceeds through the J(k) and C(k) segments
178
What happens when the J segments have not rearranged in a light chain?
Removed by RNA splicing, which occurs during translation
179
What happens when a successful rearrangement of the kappa genes occurs?
Keeps the other chromosomesfrom rearranging and shuts down any recombination of the lambda chain locus on chromosome 22
180
When does lambda chain synthesis occur in a light chain?
Only it a nonfunctioning gene product arises from kappa rearrangement
181
What does the lambda locus contain?
Approximately: -30 V(lambda) segments -4 J(lambda) segments -4 C(lambda) segments
182
It functional heavy and light chains are not produced in a B cell, what happens?
Cell dies by apoptosis
183
Light chain are joined with mu chains to form what?
-A complete IgM antibody -first appears in immature B cells
184
What happens once IgM and IgD present on the surface membrane?
The B cell is fully mature and capable of responding to antigen
185
What an essential for initiating the VDJ recombination during B cell maturation?
Recombinaseenzymes, RAG-1 and RAG-2
186
What is the role for RAG-1 and RAG-2?
-recognize specific recombination signal sequences in the DNA that flank all immunoglobulin gene segments
187
What is junctional diversity?
- V, D, and J segments doesn't always occurat a fixed position, so each sequence can vary by small number of nucleotides -major contributor to diversity in the variable-region genes
188
Where do immunoglobulins get their variation diversity from?
① Functional diversity ② different heavy chains can combine to different light chains ③ somatic hypermutation
189
What is somatic hypermutation?
-can occur after the B cell has had contact with antigen -during Tcell-dependent antibody response, Cytokines are produced that stimulate the B cellsto divide so that the response to the antigen is enhanced
190
What is affinity maturation?
-mutationin some of these B cells result in immunoglobulin receptors that can bind the antigen more strongly, and these B cells become the dominant clones as the immune response evolves
191
What is class switching?
As the immune response progresses, B cells may become capable of producing antibody of another class
192
What is switch recombination?
-a portion of the constant region DNA is deleted and the remaining C(h) genes are placed adjacent to the variable region genes - allows the same VDJ region to be coupled with a different C region to produce antibody of a different class but having identical specificity for antigen
193
What determines where switching takes place and which C(H) gene will be transcribed?
Contact with T cells and cytokines
194
What does a normal response to an antigen result in?
Production of polyclonal antibodies because ever purified antigen has multiple epitopes that stimulate a variety of B cells
195
What are monoclonal antibodies?
- Derived from single antibody-producing cell that has reproduced many times to form a clone -all the cells in the clone are identical and the antibody produced is exactly the same -directed against a specific epitope on an antigen
196
What is a hybridoma?
-Fusion of activated B cell and myeloma cell -myeloma cell chosen lacks essential enzymes and cannot produce own antibodies
197
How does production of hybridomas begin?
By immunizing a mouse with the desired antigen
198
What is the traditional process of mouse monoclonal antibody production?
① immunize a mouse with a specific antigen ②harvest spleen cells from mouse spleen ③ combine spleen cells with myeloma cells in the presence of PEG ④select fused cells and screen for presence ot desired antibody ⑤ grow positive cells in larger quantities
199
Were initial monoclonal antibodies in vivo or in vitro?
In vitro
200
Describe what was used before the development of monoclonal antibodies?
Antibody reagent could only be produced my immunizing animals such as horses or goats with the desired antigen and isolating polyclonal antibodies from the animal serum
201
What are the primary advantages of the monoclonal antibody reagents?
- They provide decreased lot-to-lot variation - increased specificity toward a single epitope, rather than multiple epitopes of an antigen
202
What has been used as therapeutic agents to treat a variety of diseases?
Monoclonal antibodies
203
What is a major limitation of using mouse monoclonal antibody as therapeutic agents
- They are highly immunogenic for humans, inducing the development of human-anti-mouse antibodies (HAMAs) that can cause severe hypersensitivity reactions
204
Describe carbohydrates in any immunoglobulin?
- Localized between the CH2 domains at the two H chains - increases the solubility of immunoglobulin - provides protection against degradation -enhances functional activity of the Fc domains
205
Where are isotypes located?
Constant region of heavy chains
206
Where are allotypes located?
In the constant regions of the IgG subclasses, one IgA subclass, and the light chain
207
Where are idiotypes located?
Amino terminal regions of heavy and light chains
208
Where do antigens bind on immunoglobulins?
Hypervariable regions that contain CDRs
209
What does complement fixation accomplish?
① enhances inflammatory response ②uses a positive feedback cycle to promote phagocytosis ③ enlists more defensive elements
210
Explain process of complement fixation
①antibodies bound to cells change shape and expose complement binding sites ②this triggers complement fixation and cell lysis
211
Describe neutralization of antibody action
Antibodies bind to and block specific sites on viruses or exotoxins, thus preventing these antigens from binding to receptors on tissue cells
212
Describe agglutination of antibody action
- makes antigen- antibody complexes that are cross-linked, causing clumping
213
What is precipitation of antibody action?
- Soluble molecules are cross-linked into large insoluble complexes
214
What enhances phagocytosis at the antigen- antibody complex?
-neutralization -agglutination - precipitation - complement
215
What enhances inflammation of antigen-antibody complex?
Complement
216
What is the sedimentation coefficient of IgD?
7S
217
What are cytokines?
-Chemical messengers that regulate immunity -small proteins that bind to and activate receptors located on target cells.
218
Describe regulations of cytokines?
-important in determining whether cytokine action will be effective or inappropriate - massive overproduction and dysregulation of cytokines can lead to hypercytokinemia - results in hypotension, fever,edema, multi- organ failure, or death
219
What is pleiotropy?
Single cytokine with many different actions
220
What is redundancy?
-Occurs when different cytokines activate some of the same pathway and genes - can be explained by the fact many cytokines share receptor subunits
221
How is cytokine activity classified?
According to the distance traveled between the producing cell and its target cells
222
What is autocrine?
Cytokines that bind to receptors on the same cell from which they were secreted
223
What is paracrine?
Cytokines that act on cells within tissue region surrounding their cellular source
224
What is endocrine?
Some cytokines diffuse into the bloodstream, allowing them to influence cells far from the cells that produce them.
225
What is synergistic?
Interactions that complement and enhance each other
226
What is antagonism?
If one cytokine counteracts the action of another
227
What is a cytokine cascade?
Many cytokines induce the production of additional cytokines by target cells
228
What is the antagonist of IL-4?
TNF-alpha
229
What synergies with IFN- gamma?
TNF-alpha
230
What is hypercytokinemia?
- Also referred to as cytokine storm - massive overproduction and dysregulation of cytokines can result in hyperstimulation of the immune response
231
What are major proinflammatory cytokines?
-TNF-alpha -IL-1 -IL-6 -IFN-gamma
232
What are major anti-inflammatory cytokines?
-TGF-beta -IL-10 -IL-13 -IL-35
233
What are the primary cytokines provoked by infection with extracellular microbes?
IL-1 IL-6 TNF-alpha
234
What happens once IL-1, IL-6, and TNF- alpha are produced?
mediate a handful of paracrine effects: ① increased capillary permeability ② increased platelet aggregation ② alterations of adhesion molecule expression on capillary endothelial cells
235
Describe increased capillary permeability that IL-1, IL-6, and TNF-alpha induces
-Allows soluble anti-microbial proteins to enter the tissues from blood plasma -anti-microbial proteins → complement,and C-reactive protein
236
Describe increased platelet aggregation caused by IL-1, IL-6, and TNF-alpha
Helps to seal off local blood vessels presenting dissemination of the infection into the blood
237
Describe alteration of adhesion molecule expression on capillary endothelial cells caused by IL-1, IL-6, and TNF-alpha
Enhances entry of leukocytes from the blood into inflamed tissue
238
What effects occur when a severe infection stimulates production of larger quantities of inflammatory cytokines?
Causes systemic endocrine effects: ① an increase in body temperatures, which may make the body less hospitable to invading microbes ②an increase in the production of immune cells by the bone marrow and acute phase reactants by the liver ③ subject to feeling ill
239
What is the most important role of IL-1, IL-6, and TNF- alpha?
Recruiting effector cells, such as neutrophils and monocytes, into inflamed tissues.
240
How many cytokines are in the IL-1 family?
11
241
What are the best characterized cytokines of the IL-1 family?
IL-1alpha IL-1beta IL-1RA
242
Where are IL-1beta and IL-1RA expressed?
Dendritic cells Macrophages Monocytes
243
Where is IL-1alpha expressed?
-In innate phagocytic cells -epithelial cells of skin, lungs, and GI tract
244
What can induce production of IL-1?
-Microbial components - such as lipoteichoic acid, bacterial or viral nucleic acids, and other cytokines
245
Describe IL-1alpha
- retained within the cell cytoplasm - only released after cell death - presence of IL-1alpha helps to attract inflammatory cells to areas where cells and tissues are being damaged or killed
246
What is IL-1beta released from?
Macrophages Monocytes
247
Describe IL-1beta
- mediates most paracrine (local) and hormonal (systemic) activity - before secretion, IL-1beta must be cleaved intracellularly to an active form
248
What is the most important paracrine effect of IL-1beta?
Recruiting immune cells into inflamed tissues
249
What happens when IL-1beta and IL-1 receptors bind on blood vessels of endothelial cells?
-Alter adhesion molecule expression and stimulates the production of chemokines -changes cause immune cells (granulocytes and monocytes)to stop moving through the blood and begin diapedsis
250
Why is IL-1beta referred to as endogenous pyrogens?
Its ability to induce fever
251
What purposes does a fever have?
① inhibit growth of many bacteria and fungi ② 'increase the microbicidial activities of macrophages and neutrophils ③ contribute to feeling of discomfort and fatigue, compelling individuals to rest
252
What are the overall roles of IL-1beta?
① activation of phagocytes ② induce fever ③ production of acute-phase reactant
253
Where does IL-1RA get its name?
It antagonizes or works against IL-1 cytokines
254
How does IL-1RA accomplish its antagonism of the IL-1 family?
By binding to only one of the two transmembrane proteins that compose the IL-1 receptor
255
What occurs when IL-1RA is lighted by IL-1alpha and IL-1beta?
Two receptor subunits are brought together, initiating an intracellular signaling cascade that alerts the target cell to presence of IL-1
256
What are TNF products of?
Macrophages Lymphocytes
257
How many different proteins does the TNF family have?
19
258
Describe CD40 ligand
Essential for signaling between T and B cells
259
What is the most important TNF in inflammation?
TNF-alpha
260
What is a major inducer of TNF-alpha production?
Microbial substances such as LPS
261
What is LPS?
A component of the cell walls of gram-negative bacteria
262
TNF-a is a ligand for what two receptors?
-TNFR1 →expressed on many tissues , and cells throughout body -TNFR2→ expression limited to cells of Hematopoïetic origin and endothelial cells
263
Describe TNFbeta
-soluble - produced by lymphocytes→ special class called lymphoid tissue inducer cells - causes cell death (cytotoxicity) -plays role in development of lymphoid tissues in the GI tract
264
What are IL-6 related to?
-type I IFNs - several hematopoietic growth factors
265
What do two identical IL-6 polypeptide chains come together and form?
Homodimer (active form of cytokines)
266
What are the most common sources of IL-6? Other sources?
Macrophages Monocytes Others: Endothelial cells Fibroblasts lymphocytes Skeletal muscle cells
267
The activity of IL-6 is highly _______.
Pleiotropic
268
What are the innate roles of IL-6?
-stimulates the production of acute-phase proteins by liver hepatocytes - This increases the production and release of granulocytes by the bone marrow
269
What are the adaptive roles of IL-6?
-increases activation of B and T cells -modulates immunoglobulin synthesis by causing B cells to proliferate and differentiate into plasma cells
270
What are the IL-6 receptor subunits?
IL-6R gp130
271
With IL-6 bound, what happens when IL-6R subunit assembles with gp130?
- prompts conformational change in the gp130 - allows its cytoplasmic domains to initiate intracellular signaling cascades, driving the expression of IL-6 mediated genes that code for products such as C-reactive protein, complement proteins, and fibrinogen
272
What are chemoxines?
Subgroup of cytokines that influence the motility and migration of their target cells
273
How are chemokines classified?
Into four families based on the sequence of amino acids found in their N- terminal,specifically the positioning of cysteine residues
274
What are the four families of chemokines?
① CXC ② CC ③ C ④ CX3C
275
Describe CXC chemokines
-contain single amino acid (X)between the first and second cysteines
276
Describe CC chemokines
-the cysteines are found together, with no intervening amino acid
277
Describe C chemokines
Has only a single cysteine
278
Describe CX3C chemokines
Have 3 amino acids between the cysteines
279
What is the most important effect of chemokines?
Recruitment of leukocytes from the blood into infected or damaged tissues
280
How do chemokines accomplish recruitment of leukocytes?
By modulating the adhesion between leukocytes to roll along capillary walls and to subsequently exit the blood vessel and enter into the tissues
281
What are interferons?
Soluble substances produced by virally infected cells that interfere with the ability or viruses to replicate by making host cells less hospitable to viral takeover
282
What are the 3 groups of IFNs?
Type I Type II Type III
283
What are the most important cytokines in response to viral infections?
IFN-alpha IFN-beta (Both type I)
284
What is IFN- alpha produced by?
Dendritic cells Macrophages
285
What is IFN-beta produced by?
Wide variety of infected cells
286
What are the functions of type I IFN?
① interfere with viral replication ② activate NK cells ③ enhances expression of class I MHC proteins on target cells
287
What happens when type I IFN receptors are ligated by IFN-alpha and IFN-beta?
Cause NK cells to become activated, traffic to virally infected area and rapidly expandin number
288
What is the most important innate defense mechanism against viral infection?
Combination of IFN-alpha and IFN-beta and NK cell killing
289
What are the cytokines associated with adaptive immunity secreted by mostly?
T cells, especially T helper cells (CD4+)
290
What are the 4 subpopulations of T helper cells
Th1 Th2 Th17 Treg cells
291
What is differentiation ( related to Th cells)?
Th cells undertake a process during which they are transformed into one of the four subclasses
292
What is Th cell differention influenced by?
Cytokines found in the lymph node during T-cell activation and early differentiation
293
What causes differentiation to the Th1 lineage?
Dendritic cell production of cytokine IL-12
294
What drives antibody mediated immunity
IL-4
295
What arises in the presence of IL-23?
Th17 cells
296
What are produced in response to TGF-beta?
Treg cells
297
What is the hallmark of Th1 cells?
-high level expression of the proliferative cytokine IL-2 and IFN- gamma, a type II IFN
298
What are the roles of Th1 cells?
① Expand to combat infection with viruses and intracellular bacteria ②promote cell-mediated immunity with cytotoxic T cells, and activate macrophages ③ 'cause antigen-activated B cells to produce IgG1 and IgG3 antibodies capable of opsonization and fixing complement
299
What is another name for IL-2?
T-cell growth factor
300
What are the roles of IL-2?
①drives proliferation and differentiation of both T and B cells ② enhances the lytic activity of NK cells ③ causes naive Th to differentiate into Th1 cells
301
In cooperation with IFN-gamma, what does IL-2 do to naive T helper cells?
Differentiate into Th1 cells
302
What are IL-2 receptors (IL-2R) composed of?
3 protein subunits: ① alpha ② beta ③ gamma
303
What is the primary cytokine of the Th1 response?
IFN-gamma
304
What are the roles of IFN-gamma?
① influences expression of more than 200 target-cell genes ② stimulates antigen presentation by class I and class II MHC ③ potent activator of macrophages ④ involved in regulation and activation of CD4+ Th1 cells, CD8+ cytotoxic T cells and NK cells
305
What are the most influential Th2 cytokines?
IL-4 IL-10
306
What are IL-4 receptors expressed on?
- Lymphocytes - nonhematopoietic cells
307
What is the IL-4 activity on naive T cells?
-turns on genes that generate Th2 cells and turns off genes that promote Th1 cells
308
What are Th2 cells responsible for regulating?
- Allergies -autoimmune disease -parasites
309
What does IL-4 induce production of
-MHC I -IL-4 -IL-5 -IL-13 -CD80 -CD86 -IgG2a -IgE
310
What does IL-5 do along with IgE?
Drives differentiation and activation of eosinophils in both allergic immune response and responses to parasitic infection
311
What does IL-13 and IL-4 have in common?
-induce worm expulsion -favor IgE class switching
312
How do IL-4 and IL-13 differ?
IL-13 plays anti-inflammatory role by inhibiting activation and cytokine secretion by monocytes
313
What is IL-10 produced by?
- Macrophages - monocytes - CD8+ cells T cells - CD4+ Th2 cells
314
In one word, how would you describe the effects of IL-10?
Inhibitory
315
What are the roles of IL-10?
① has anti-inflammatory and suppressive ' effects on Th1 calls ② inhibits antigen presentation by macrophages and dendritic cells ③ down regulates immune response by counteracting IFN-gamma
316
What is the antagonist of IFN- gamma?
IL-10
317
How can Treg cells be identified?
Expression of CD4, CD25, and FoxP3
318
When do Treg cells form?
Either during thymic development or differentiate from naive T cells in the periphery
319
What are Treg cells called when the form outside of the thymus?
Induced Tregs
320
Why are Treg cells essential?
For establishing peripheral tolerance to a wide variety of self-antigens ant harmless antigens
321
What are the roles of Treg cells?
① establish peripheral tolerance to self-antigens and harmless antigens ② produce suppressive cytolanes: TGF-beta and IL-10 ③down regulate immune response to prevent chronic inflammation (main) ④may preventtumor cells from attack by inhibiting cancer-fight cells
322
What are the hypotheses for how Treg cells suppress immunity?
① The production of suppressive cytokines, such as IL-10 and TGF-beta ② disruption of T-cell metabolism ③ direct cytotoxic killing of T cells and APCs ④ modulation of signaling between APC and T cells
323
What does Th17 subset secrete?
IL-17 family of cytokines
324
What are the cytokines that differentiate T cells to maintain them as Th17?
TGF-beta IL-6
325
What cytokine play a role in finalizing the commitment to Th17?
IL-23
326
What is IL-23 produced by?
Dendritic cells Macrophages
327
What is the most studied IL-17 cytokine?
IL-17A
328
What are the roles of Th17?
① host defense against bacterial and fungal infections at mucosal surfaces. ② secretion of IL-17 ③promote recruitment of neutrophils ④ promote release of antimicrobial peptides ⑤ when dysregulated, may promote pathogenesis of several inflammatory diseases
329
What does IL-17 induce the expression of? And where?
TNF-alpha IL-1beta IL-6 In epithelial cells, endothelial cells, keratinocytes, fibroblasts, and macrophages
330
What cytokines induce epithelial cells, endothelial cells, and fibroblasts to produce CXC ligand 8 (CXCL-8)?
-IL-17A and IL-17F
331
Why is CXCL-8 crucial?
For the recruitment of neutrophils to the site of inflammation
332
What are the APC cytokines?
IL-12 and IL-23
333
What are the primary mediators of hematopoiesis called? Why?
CSFs→ ' -IL-3 - erythropoietin (EPO) -granulocyte colony stimulating factor (G-CSF) -macrophage colony stimulator factor (M-CSF) And granulocyte-macrophage colony-stimulating factor (GM-CSF)
334
Why does IL-3 act on bone marrow stem cells?
To begin differentiation cycle
335
What happens if M-CSF is activated?
The cells become macrophages
336
What is the role of M-CSF?
Increases phagocytosis, chemotaxis, and additional cytokine production in monocytes and macrophages
337
What happens if G-CSF is activated?
Cells become neutrophils
338
What are the roles of G-CSF?
① Enhances function of mature neutrophils ② Affects the survival, proliferation, and differentiation of all cell types in neutrophil lineage ③ decreases IFN-gamma production ④ increases production IL-4 in T cells ⑤ mobilizes multipotent stem cells from the bone marrow
339
What does GM-CSF do?
Acts to drive differentiation toward other WBC types
340
What does EPO do?
- Regulate RBC production in the bone marrow
341
What is EPO primarily produced by?
The kidneys
342
What is recombinant EPO?
- Administered to improve RBC counts for individual with anemia and those with cancer
343
What happens when EPO induce RBC proliferation?
Improves oxygenation of the tissues and eventually switches off EPO production
344
What is the normal serum EPO values?
5-28 U/L
345
What is anti-cytokine therapy?
Aims to break vicious cycle of chronic inflammation by targeting the interactions between specific cytokines and their cognate receptors
346
Describe the first anti-cytokine therapeutics
Mostly murine monoclonal antibodies
347
Describe newer anti-cytokine agents
- Greatly improved using recombinant DNA techniques to generate humanized monoclonal DNA antibodies that are much less immunogenic
348
Describe infliximab
- Chimeric antibody containing human constant regions and murine variable regions that bind specifically to human TNF-alpha -treatment for Crohn's disease, RA, ulcerative colitis -blocks TNF-alpha activity rapidly, dramatically reducing inflammation
349
Describe the blockade of IL-17 function
-IL-17 blocking antibody to prevent IL-17 mediated pathogenesis -another treatment
350
Describe the hybrid protein based anti-cytokine therapy
- Development of a class of hybrid proteins containing cytokine receptorbinding sites attached to immunoglobulin constant regions -Etanercept approved for use in humans
351
Describe Etanercept
- Consists of extracellular domains of type 2 TNF receptor fused to heavy chain of constant region of IgG1 -fusion protein can bind TNF-alpha and block its activity -cost effective -reduces signs/symptom, disease activity, and disabilities -treatment for RA, any losing spondylitis, psoriasis, pediatric arthritis, and pediatric psoriasis
352
What is the half life of Etanercept?
4.8- days
353
Describe ixekizumab
-block to prevent IL-17 mediated pathogenesis -treatment for plaque psoriasis, psoriasis and any losing spondylitis
354
What are 3 cytokine assayformats?
① Multiplexed enzyme-linked immunosorbent assays(ELISAs) ② microbead assays ③ ELISpot assays
355
Described Multiplexed ELISAs
- Can detect many pro- and anti- inflammatory cytokines in one reaction - allow for simultaneous detection of several cytokines from serum or plasma in a single test run. - has " spots "
356
Describe microbead assays
- Allow for the simultaneous detection of multiple cytokines in a single tube -each bead type has own fluorescent wavelength. When combined with fluorescent secondary antibody bound to a specific cytokine, allows for detection stop to 100 different analyses in one tube
357
What biomarkers are simultaneously measured by multiplexed bead array?
-CRP -Th1 -Th2 - proinflammatory cytokines -IFN-gamma -IL-2 -IL-4 -IL-5 -IL-10 -CSFs
358
Describe ELISpot
-similar to ELISA performed on in vitro - activated peripheral WBC - Allow the detection and enumeration of individual cytokine-secreting cells - performed using cell culture microplates coated with cytokine-specific capture antibodies
359
What is a clinical application that ELISpot is well-likedfor?
The detection of circulation Th1 cells that secrete IFN-gamma in responseto an antigen
360
What is the ELISpot process?
① PBMCs are added to the wells of antibody- coated microplate and treat with synthetic protein antigen ② incubation period → Th1 cells secrete cytokines as they rest as the rest at the bottom of the microplate well. ③ PBMCs and any soluble substances (cytokines) are washed from wells ④ detection antibody specific to the target cytokine, is added to wells
361
What is the role of ELISpot detection antibody?
To produce a signal indicating where target cytokine is bound to capture antibody
362
What do the "spots" represent in ELISpot?
Tiny, elliptical silhouettes of captured IFN- gamma speckling plate bottom
363
What is a drawback of having protein based technologies?
Short half life of certi an cytokines
364
What is PCR product?
Made using fluorescent- labeled primer and can be hybridized to either solid or liquid phase arrays
365
Describe the solid-phase array of PCR
-have up to 40,000 spots containing specific single-stranded DNA (ssDNA) oligonucleotides representing individual genes - fluorescence of a spot indicates that gene was expressed in the celland that cell was producing the cytokine
366
Describe liquid arrays of PCR
- use same beads as microbead arrays but have oligonucleotides on surfaces instead of antibodies. Snow up to 100 different complementary DNAs to be identified - combination of bead fluorescence and fluorescence of labeled cDNA produces an emission spectrum that identifies the cytokine gene that was expressed in cell
367
What are the 4 approaches to anti-cytokine therapy?
①disrupting interaction between cytokines and their cognate receptors ②using monoclonal antibodies that function as cytokines agonists ③ hybrid proteins containing cytokine receptor binding sites attacked to Ig constant regions to block cytokine activity ④blocking IL-17 function
368
What are Th2 cells involved in?
Antibody-mediated responses
369
What are Th1 induced by?
Dendritic cell production of IL-12
370
What are Th2 induced by?
IL-4
371
What are Th17 induced by?
IL-23
372
What are Treg cells induced by?
TGF-beta
373
What are the 3 isoforms of TGF-beta?
TGF-beta1 TGF-beta2 TGF-beta3
374
What are the roles of TGF- beta?
①induces antiproliferative activity in many cell types ② regulates cell growth, differentiation, apoptosis, migration, and the inflammatory response ③helps down-regulate the inflammatory response when no longer needed ④ inhibits activation of macrophages and the growth of different somatic cell types ⑤functions as an anti-inflammatory factor for mature T calls ⑥ block production of IL-12 and inhibits induction of IFN-gamma ⑦inhibits proliferation of activated B cells
375
What are the roles of chemokines?
① enhance motility and promote migration of many types of WBC toward source of the chemokines (chemotaxis) ②modulate adhesion of WBCs to endothelial cells lining The blood vessels, facilitating extravasation into the tissues
376
Describe TNF-alpha
-LPS is a major trigger of TNF- alpha production - secreted by activated monocytes and macrophages - cause vasodilation and increased vasopermeability -activates T cells by inducing expression of MHC class II molecules, vascular adhesion molecules and chemokines
377
Describe IL-1RA
- Produced by dendritic cells, macrophages, and monocytes - Has an anti-inflammatory effect
378
What are the roles of cytokines in innate immune response?
① induce inflammation ② recruit effector cellsinto inflamed tissues ③produce synthesis effects including fever, malaise, increased hematopoietic, increased production of acute phase reactants
379
What are the Cytokines in innate immune response?
- IL-1 - chemokines -TNF- alpha -TGF-beta -IL-6 -IFN-alpha -IFN-beta
380
Describe cytokine actions
-Have multiple -widespread distribution of receptors on many cells types - ability to alter expression of numerous genes - may share properties and receptors - may have overlapping effects - can determine whether host will be able to mount an effective defense
381
What are the roles of complement?l
① cause lysis of forgein cells ② acts as opsonins ③ increase vascular permeability ④recruit monocytes and neutrophils to the area of antigen concentration ⑤trigger secretion of immunoregulatory molecules that amplify the immune response
382
What is complement?
A series of more than 50 soluble and cell-bound proteins that interact to enhance host defense mechanisms against foreign cells
383
Where is the plasma complement synthesized?
Liver (NOT C1 complement or factor D)
384
What produces C1 complement?
Intestinal epithelial cells
385
Where is Factor D made?
Adipose tissue
386
Besides the liver, what is a good additional source of early complement components (C1,C2,C3, and C4)?
WBC
387
What are the three pathways of complement system activation?
① classical ② alternative ③ lectin
388
What is the end product of complement system activation?
Lysis of invading cells
389
Describe classical pathway
-Involves 9 proteins that are trigger primarily by antigen-antibody complexes - major role in natural defense system
390
What classes of immunoglobulins activate the classic pathway?
IgM, IgG1, IgG2, and IgG3
391
What is required for the classical pathway to activate complement?
Two IgG molecules must attach to antigen within 30 to 40 nm of each other OR certain cells substances can bind directly such as: CRP, several viruses, mycoplasmas, some protozoa and certain gram-negative bacteria's
392
Describe recognition unit of the classical pathway?
- Formation of C1
393
Describe activation unit of classical pathway
-once C1is bound, C4, C2, and C3 are activated
394
Describe membrane attacks complex (MAC)?
- Comprises of C5 through C9 - completes lysis of foreign particles
395
What is the first complement component of the classical pathways
C1
396
Describe C1 of the classical pathway
- Molecular complex of 740 kDa - consist of 3 subunits: C1q, C1r, and C1s - subunits require calcium to maintain structure
397
What does C1r and C1s generate during the classical pathways
Enzyme activity to begin cascade
398
What is the molecular weight of C1q 7
410 kDa
399
How many globular heads of C1q must be bound to Fc receptors for initiation of the classical pathway?
2-6
400
What are C1r and C1s?
Serine protease proenzymes, or zygomens
401
What happens once the classical pathway is activated?
C1r cleaves a thioester bond on C1s, which in turn, activates it.
402
Describe activated C1r
-extremely specific because its only known substrate is C1s
403
Describe activated C1s
- Has limited specificity,with its only substrates being C4 and C2
404
What does it mean when C1s is activated?
Recognition stage ends
405
What marks the beginning of the activation unit of the classical pathway?
-begins when C1s cleaves C4
406
What marks the end of the activation unit in the classical pathway?
- The production of the enzyme C3 convertase
407
What is the second most abundant complement protein?
C4
408
What is the serum concentration of C4?
600 ug/ml
409
What occurs when C1s cleaves C4?
-Releases a 77_amino acid fragment called C4a -it opens a thioester- containing active site on remaining part, C4b
410
What happens if C4b takes longer than a few seconds to bind to protein or carbohydrate:
-will react with water molecules to form iC4b, which is rapidly degraded
411
What does C4b bind to in the classical pathway?
-Antigen in clusters that are within a 40-nm radius of C1 - represents first amplification step apin the cascade
412
For every C1 molecule attached, approximately how many C4 molecules are split and attached
30
413
What occurs when C2 is combined with C4b is presence in magnesium ions?
-C2 is cleaved by C1s to form the fragments, C2a and C2b
414
What is the molecular weight of C2a?
70 kDa
415
What is the molecular weight of C2b?
34 kDa
416
What is the combination of C4b and C2a called?
C3 convertase
417
How is C4bC2a complex stability.?
Not very stable
418
What is the half life for the C4bC2a complex?
15 seconds-3 minutes
419
What occurs if C3 does not bind quickly?
Cleaved into two fragments, C3a and C3b
420
What is the central constituent of the complement system?
C3
421
What is serum concentration of C3?
1-1.5 mg/ml
422
What is the most significant step of complement system?
Cleavage of C3 to C3b
423
What is the molecular weight of C3?
190 kDa
424
Describe structure of C3
-Consists of two polypeptide chains, alpha and beta -alpha chain highly reactive thioster group
425
What has to occur for C3b to have the ability to bind to hydroxyl groups on car bohydrates and proteins?
C3a is removed by cleavage of single bond in alpha chain, exposing the thioster
426
What is the half life of C3b?
60 micro seconds is not bound to antigen
427
What occurs after cleavage of C3 in the classical pathway?
About 200 molecules are split for every molecule of C4bC2a
428
C3b also serves as a powerful _________
Opsonin
429
What has specific receptors for C3b? Explain
Macrophages, primed to phagocytize antigen that has bound to C3b
430
Where does C3b bind in classical pathway? What does this create?
-Within 40 nm of the C4bC2a - C4bC2aC36 is created. Also called C5 convertase
431
Describe the structure of C5
- Contains two polypeptide chains, alpha and beta. Which are linked by disulfide bonds to form a molecule
432
What is the molecular weight of C5?
190 kDa
433
What are the two fragments is C5 split into?
C5a and C5b
434
Describe C5a
- 74 amino acid fragment - released into circulation
435
Describe C5b
-attaches to cell membrane - forms beginning of MAC -extremely liable -rapidly inactivated unless binding to C6 occurs
436
Describe C5b-9
- The MAC -these proteins do not have enzymatic activity -all present in much smaller amounts than preceding components
437
Describe C8
- made up of three dissimilar chains, alpha, beta, and gamma, joined by disulfide bonds
438
Describe C9
- Single polypeptide chain - carboxyl terminal end is hydrophobic -amino terminal end is hydrophilic - presence greatly accelerate lysis
439
What is the hydrophobic parts role of C9?
- Serves to anchor the MAC within the target membrane
440
What occurs when sC5b-9 is formed in the classical pathway?
- MAC produces a pole of 70 to 100A that allows ions pass in and out of the membrane
441
How does destruction of target cells occur?
Occurs through an influx of water and a corresponding loss of electrolytes
442
What is the molecular weight of C1q?
410 kDa
443
What is the serum concentration of C1q?
150 ug/ml
444
What diseases are associated with abnormal C1q, C1r and C1s?
SLE, recurrent infections
445
What is the function of C1q?
Binds to Fc region of IgM and IgG, synaptic pruning
446
What is the molecular weight of C1r?
85 kDa
447
What is the serum concentration of C1r?
50 ug/ml
448
What is the function of C1r?
Activates C1s
449
What is the molecular weight of C1s?
85 kDa
450
What is the serum concentration of C1s?
50 ug/ml
451
What is the function of C1s?
Cleaves C4 and C2
452
What is the molecular weight of C4?
205 kDa
453
What is the serum concentration of C4?
300-600 ug/ml
454
What is the function of C4?
Part of C3 convertase (C4b)
455
What is the molecular weight of C2?
102 kDa
456
What is the serum concentration of C2?
25 ug/ml
457
What is the function of C2?
-binds to C4b → forming C3 convertase
458
What diseases are associated with abnormal serum concentration of C4?
- RA - SLE -infection - usually asymptomatic
459
What diseases are associated with abnormal serum concentration of C2?
-SLE -recurrent infection - arthersclerosis -may be asymptomatic
460
What is the molecular weight of MBL?
200-600 kDa
461
What is the serum concentration of MBL?
0.0002-10 ug/ml
462
What is the function of MBL?
Binds to mannose
463
What diseases are associated with abnormal serum concentration MBL?
-pneumococcal diseases - sepsis -Neisseria infections -bacterial infection -some autoimmunity - mostly asymptomatic
464
What is the molecular weight of MASP-1?
93 kDa
465
What is the scrum concentration of MASP-1?
1.5-12 ug/ml
466
What is the function of MASP-1?
Unknown
467
What diseases are associated with abnormal serum concentration of MAPS-1?
3MC syndrome
468
What is the molecular weight of MASP-2?
76 kDa
469
What is the serum concentration of MASP-2?
Unknown
470
What is the function of MASP-2?
Cleaves C4 and C2
471
What diseases are associated with abnormal serum concentration of MASP-2?
-respiratory infections (pneumococcal diseases) -mostly asymptomatic
472
What is the molecular weight of factor B?
93 kDa
473
What is the serum concentration of factor B?
200 ug/ml
474
What is the function of factor B?
Binds to C3bto form C3 contentase
475
What diseases are associated with abnormal serum concentration of factor B?
- Neisseria -pneumococcal infections
476
What is the molecular weight of Factor D?
24 kDa
477
What is the serum concentration of factor D?
2 ug/ml
478
What is the function of factor D?
Cleaves factor B
479
What are diseases associated with abnormal serum concentration of factor D?
Bacterial infections
480
What is the molecular weight of properdin?
55 kDa
481
What is the serum concentration of properdin?
15 -25 ug/ml
482
What is the function of properdin?
Stabilizes C3Bb-C3 convertase
483
What disease are associated with abnormal serum concentrations of properdin?
- Neisseria infections - Severe recurrent infection
484
What is the serum concentration of C3?
1200 ug/ml
485
What is the function of C3?
Key intermediate in all pathways
486
What arc diseases associated with abnormal serum concentration of C3?
- Glomerulonephritis - severe recurrent infection; aHUS, C3G, AMD with gain of function
487
What is the semi concentration of C5?
80 ug/ml
488
What is the function of C5?
Initiates MAC
489
What diseases are associated with abnormal serum concentration of C5, C6, C7, and C8?
-Neisseria infection
490
What is the molecular weight of C6?
110 kDa
491
What is the serum concentration of C6?
45 kDa
492
What is the function of C6?
Binds to C5b in MAC
493
What is the molecular weight of C7?
100 kDa
494
What is the serum concentration of C7?
90 ug/ml
495
What is the function of C7?
Binds to C5bC6 in MAC
496
What is the molecular weight of C8?
150 kDa
497
What is the serum concentration of C8?
55 ug/ml
498
What is the function of C8?
Starts pore formation on membrane
499
What is the molecular weight of C9?
70 kDa
500
What is the serum concentration of C9?
60 ug/ml
501
What is the function of C9?
Polymerizes to cause cell lysis
502
What are the diseases associated with abnormal serum concentrate of C9?
No known diseases
503
What are the steps of the classical pathway?
Recognition unit ①The zygomens C1r and C1s are converted into active enzymes as binding of C1q occurs ② autoactivation of C1r results from a change that takes place as C1q is bound ③when activated, C1r cleaves a thioster bond on C1s, which activates it. Activation unit ④ C1s cleaves C4 to create C4b and C2 to make C2a ⑤ C3 convertase (C4b2a) is formed ⑥ C3b binds to C4b2a to form C5 convertase (C4b2a3b) MAC ⑦ C5 convertase splits C5 into C5a and C5b ⑧ C5b attaches to the cell membrane to initiate formation of the MAC (C5b6789)
504
How is the lectin pathway activated?
By direct recognition of surface moieties that are found on pathogens
505
How does the lectin pathway provides an additional link to the innate and adaptive immune response?
Because it involves nonspecific recognition of carbohydrates that are common continents of microbial cell walls
506
How does the lectin pathway play an important role in infancy?
Defense mechanism during the interval between the loss of maternal antibody and the acquisition of a full-fledged antibody response to pathogens
507
What are the 3 recognition molecules of the lectin pathway?
- Lectin - ficolins - collectins ( CL-L1)
508
Describe structures of lectin, ficolins, and collectins
- All similar to C1q structure
509
What is the key protein of the lectin pathway? Describe this protein
-Mannan binding lectin (MBL) -binds to mannose or other related sugars in a calcium-dependent manner to initiate this pathway -considered acute phase protein because produced in liver and normally present in serum
510
What are the steps of the lectin pathway?
① binds to mannose or relaletal sugar to initiate pathway ② complex associates with MASP-1, MASP-2, and MASP-3. Complex act like C1qrs ③ MASP-2 cleaves C4 and C2 ④ C3 convertase (C4b2a) is formed ⑤ C3b binds to C4b2a to form C5 convertase (C4b2a3b) MAC ⑥ C5 convertase splits C5 into C5a and C5b ⑦ C5b attaches to the cell membrane to initiate formation of the MAC (C5b6789)
511
What are the steps of the alternative pathway?
① C3 is hydrolyzedby water to produce C3b which binds Factor B, and together they attach to target tell surface ② B is cleaved by Factor D into the fragments Ba and Bb. Bb combines with C35 to form C3bBb, an enzyme with C3 convertase activity ③more C3is cleared, forming more C3bBb. This enzyme is stabilized by properdin and, it continues to cleave additional C3 ④it a molecule of C3 remains attached to the C3bBbP enzyme, the convertase now has the capability to cleave C5. The C5 convertase this consists of C3bBbP3b. ⑤ C5b attaches to the cell membrane to initiate formation of the MAC (C5b6789
512
What is the role of the alternative pathway?
Functions largely as an amplification loop for activation started for activation started from the classical or lectin pathways
513
What are some triggering substances for the alternative pathway?
- bacterial cell walls - some parasites - fungal cell wall -viruses/viral infected cells -tumor cell line - yeasts *these all serve as binding sites complex C3bBb
514
What proteins are involved in the alternative pathway?
- C3 - C5-C9 - factor B - factor D - P(properdin)
515
Describe alternative pathway
- Acts as a natural defense system
516
What protein is not stable in plasma in the alternative pathway?
C3
517
What is it called when C3 activates spontaneously?
-Tick-over - results in iC3
518
What has the ability to bind to factor B?
iC3 (C3b)
519
What happens when C3b binds to factor B in the alternative pathway?
- Factor D with magnesium can cleave B into Ba and Bb
520
Describe factor D
-plasma protein that circulates in active enzyme form - serine protease -only substrate is bound to factor B
521
What happens once B is cleaved into Ba and Bb in the alternative pathway?
① Ba goes off into plasma ② Bb binds to the surface of the triggering cellular antigen ③ if it does not bind quickly-it disintegrates
522
Describe C3bBb stability
-Extremely unstable unless properdin binds to the complex - properdin increases C3bBb complex half life from seconds to 30 minutes
523
What is the role of of the majority of control proteins?
Aim to halting accumulation of C3b
524
What does C1 inhibitor (C1-INH) inhibit?
-Activation of the first stages of the classical and lectin pathway
525
What are the role of C1-INH?
① Inactivate C1 by binding to the active sites of C1r and C1s ② inactivates MASP-2 binding to MBL-MASP-2
526
Where is C1-INH synthesized?
-Liver - monocytes contribute
527
Why is C1-INH considered a suicide inhibitor?
- Can only inhibit one serine protease
528
What are the four main regulators that inhibit C3 convertase further forming?
- C4- binding protein (C4BP) - complement receptor type 1 (CR1) - membrane cofactor protein (MCP) -decay-accelerating factor (DAF) -ALL WORK IN CONCERT WITH FACTOR I
529
What is MCP also known as?
CD46
530
What is DAF is also known as?
CD55
531
What is Factor I?
- Serine protease that inactivates C3b and C4b when bound to one of these regulators
532
Describe C4BP
- Abundant in plasma - capable combining with fluid-phase or cell-bound C4b - blocks C4b from binding to C2 -direct degradation by Factor I
533
What is CR1 also known as
CD35
534
Describe CR1
-Large polymorphic glycoprotein found on the cell surface of peripheral blood cells - binds C3b and C4b, greatest affinity for C3b - key receptor on platelets and RBC
535
What type of peripheral blood cells have CR1s on their surface?
- B cells - eosinophils - erythrocytes - follicular dendritic cells - macrophages - monocytes - neutrophils - T cells
536
What is immune adherence?
The ability of cells to bind complement-coated particles
537
What is the molecular weight of MCP?
50-70 kDa
538
Where are MCPs found?
- Found on the cell membrane of virtually all epithelial and endothelial cells except erythrocytes
539
What is the most efficient cofactor for factor I?
MCP
540
What serves as a cofactor for cleavage of C4b?
MCP, but not as efficient as C4BP
541
Describe DAF
- A membrane glycoprotein that has wide tissue distribution. - found on peripheral blood calls, endothelial calls, fibroblasts, and numerous types of epithelial cells
542
What are the roles of DAF?
① capable of dissociating the C3 convertase of classical and lectin pathways ② it can bind to both C3b and C4b in a manner similar to CR1 ③ can rapidly dissociate both from their binding sites, thus preventing the assembly of active C3 convertase
543
Describe DAFs mobility
- Covalently attached to a glycophospholipid anchor that is inserted into the outer layer of the membrane lipid bilayer - allows mobility within the membrane so that it can reach C3 convertase sites that are not immediately adjacent to it
544
What does the presence of DAF on host cells protect them from what?
Bystander lysis
545
What is bystander lysis?
-main mechanism used in discrimination of self from nonself because foreign cells do not possess this substance
546
What are the steps of the alternative pathway REGULATION?
① factor H competes with factor B for binding to spontaneously (hydrolytically) activated C3b ② factor H dissociates any C3bBb complexes that form on self-cell surfaces ③ factor H is a cofactor with factor I (FI), enabling cleavage of C3b.The resulting iC3b loses enzymatic activity but is still an opsonin ④ CR1 is a cofactor with FI, enabling cleavage of iC3b. The resulting C3dg is an opsonin and a cofactor in B cell stimulation
547
What is the principle soluble regulator of alternative pathway?
Factor H
548
What does Factor H do in the alternative pathway?
- Acts by binding to C3b to prevent binding of Factor B
549
What is S protein?
- Soluble control protein that acts a at deeper level of complement activation - also known as vitronectin -interacts with C5b-7 complex as it forms in fluid phasebut preventsit from binding to cell membranes - terminal pathway
550
Describe membrane inhibitor of reactive lysis (MIRL)
-also known as CD59 - acts to block for motion of MAC -widely distributed on the cell membranes of all circulating blood cells including RBC, on endothelial, epithelial, and on other types of cells
551
What is the serum concentration of C1-INH?
240 mg/ml
552
What is the main function of C1-INH?
Dissociates C1s and C1r from C1q
553
What diseases are associated with abnormal serum concentration of C1-INH?
Hereditary angioedema
554
What is the serum concentration of Factor I?
35 mg/ml
555
What is the main function of Factor I?
Cleaves C3b and C4b
556
What is the molecular weight of C1-INH?
105 kDa
557
What pathways does C1-INH participate in?
Classical Lectin
558
What pathways does factor I participate in?
Classical Lectin
559
What diseases are associated with abnormal serum concentration of factor I and factor H?
- recurrent pyogenic infections - aHUS or C3G - AMD with gain of function
560
What is the molecular weight of Factor I?
88 kDa
561
What is the molecular weight of factor H?
150 kDa
562
What is the serum concentration of factor H?
300-450 kDa
563
What are the main functions of factor H?
① cofactor with factor I to inactivate C3b ② prevents binding of B to C3b
564
What pathways does factor H participate in?
Alternative
565
What is the molecular weight of C4BP?
520 kDa
566
What is the serum concentration of C4BP?
250 mg/ml
567
What is the main function of C4BP?
Acts as a factor with factor I to inactivate C4b
568
What pathways does C4BP participate in?
Classical Lectin
569
What diseases are associated with abnormal serum concentration C4BP?
- Atypical morbus -Behcet's disease -Angioedema - protein S deficit
570
What is the molecular weight of S protein?
84 kDa
571
What is the serum concentration of S protein?
500 mg/ml
572
What is the main function of S protein?
-prevents attachment of C5b67 complex to cell membranes
573
What pathways does S proteins participate in?
Classical Lectin Alternative
574
What ligands are associated with DAF
C3b C4b
575
Where are DAF found?
- B cells - endothelial cells - epithelial cells - fibroblasts - monocytes - neutrophils - platelet - RBCs
576
What is the main functi{on of DAF?
-dissociates C2b or Bb from binding sites, thus preventing formation of C3 convertase
577
What diseases are associated with DAF?
PNH (paroxysmal nocturnal hemoglobinaria) protein-losing enteropathy
578
What ligands are associated with MIRL?
C8
579
What cells have MIRLs?
- endothelial cells - epithelial cells - monocytes - neutrophils - platelets - RBC
580
What is the main function of MIRL?
Prevent insertion of C9 into cell membrane
581
What ligands are associated with MCP?
C3b C4b
582
What cells are MCPs found?
- B cells - endothelial cells - macrophages - monocytes - neutrophils - platelets - T cells
583
What is the main function of MCP?
Cofactor for factor I cleavage of C3b and C4b
584
What is CR1 also known as?
CD35
585
What ligands ave associated with CR1?
C3b iC3b C4b
586
What is the main function of CR1?
Cofactor for factor I; mediates transport of immune complexes
587
What is CR2 also known as?
CD21
588
What ligands are associated with CR2?
C3dg C3d iC3b
589
What is the main function of CR2?
-B cell co-receptor for antigen with CD19
590
What cells are CR2 found?
- B cells - epithelial cells -follicular dendritic cells
591
What is CR3 also known as?
CD11b OR CD18
592
What ligands are associated with CR3?
iC3b C3d C3b
593
What cells are CR3 found?
- macrophages - monocytes - neutrophils - NK cells
594
What is the main function of C3?
Adhesion and increased activity of phagocytic cells
595
What is CR4 also known as?
CD11c CD18
596
What ligands are associated with CR4?
iC3b C3b
597
What cells are CR4 found on?
- Activated B and T cells - dendritic cells - macrophages - monocytes - neutrophil - NK cells
598
What is the main function of CR4?
Adhesion and increased activity of phagocytic cells
599
What diseases are associated with abnormal serum concentration of MIRL?
Paroxysmal nocturnal hemoglobinuria
600
What are 4 biological manifestations of complement?
- Amplifies inflammatory response - role in uptake and presentation of antigens in adaptive immune response - facilitates B cell activation - role in neural development
601
What is present when the inflammatory response is amplified by complement?
① anaphylatoxins (C5a, C3a) →increases vascular permeability ② chemotâxins (C5a) → attract phagocytic cells to enhance phagocytosis ③ opsonins (C3b, C4b, iC3b, C3dg)→ coat damaged or foreign cells to enhance phagocytosis
602
How can complement be harmful?
① it is activated systemically on a large scale, as in gram-negative septicemia ②it is activated by tissue necrosis and results in obstruction of the blood supply, as in myocardial infarction ③ lysis of RBCs occurs as in cold agglutinin disease or autoimmune hemolytic anemia
603
Describe Atypical Hemolytic Uremia Syndrome
-rare kidney disorder that result in acute renal failure in children -caused by mutations in genes coding for Factor H, MCP, Factor I, Factor B, C3 or thrombomodulin; or to autoantibodies against Factor H
604
Describe C3 glomerulopathy
Inflammation of the renal glomeruli that maybe due to autoantibodies that cause C’ dysregulation (C3 nephrotic factors; C3NeFs)
605
What do the techniques involve when trying to detect complement abnormalties?
-measurement of components as antigens in serum -measurement of functional activity of complement pathways
606
When detecting complement abnormalities, what are the immunologic assays of individual components?
-automated nephelometry or immunoturbidimetry - radial immunodiffusion (RID)
607
What are classical pathway assays?
① hemolytic titration (CH50) assay ② CH50 test for lysis of liposomes ③ ELISA to detect C9 epitopes exposed after binding In MAC
608
What are the alternative pathway assays?
①AH50 ② ELISA to detect C3bBbP or C3bP
609
What is the CH50 Test procedure?
① Serum to be tested is diluted serially and added to sensitized sheep RBC. ②tubes are incubated at 37°C ③ centrifuged to pellet the unlysed cells
610
What is CH50 defined as?
As the reciprocal of the dilution that causes lysis of 50% of the cells used in the assay
611
Describe the complement fixation test
- Destroy any complement present in patient serum by heating serum to 56°C for 30 minutes -dilutions of serum are combined with known antigen and a measurement amount of Guinea pig complement -if patient antibody is present it will bind with the reagent antigen and complement be bound
612
What are the steps of complement fixation test?
① add sheep RBCs that are coated with a hemolysin (will lyse if any complement is present) ② incubate and centrifuge tubes ③ read for hemolysis ④ it hemolysis is present→ No patient antibody→ test is negative. If hemolysis is absent→ patient antibody to complement→ test is positive
613
What are some limitations(?) of complement fixation test?
① results are expressed as highest dilution showing no hemolysis ② controls must be used ③ more sensitive than agglutination and precipitation, less sensitive than labeled immunoassay ④ errors
614
What errors could occur with the complement fixation test?
① amount of manual manipulations required makes it easy to make technical errors ② lack of standardization ③numerous controls discourage use in clinical laboratories
615
What pathways are affected by abnormal C1q, C1r, and? C1s
Classical → low
616
What pathways are affected by abnormal C4 and C2?
Classical → low Lectin → low
617
What pathways are affected by abnormal MBL and MASP2?
Lectin→ low
618
What pathways are affected by abnormal B, D and P?
Alternative →low
619
What pathways are affected by abnormal C3, and C5-C9?
All three→ low
620
What pathways are affected by abnormal C1-INH?
Classical → low Lectin → low
621
What pathways are affected by abnormal Factors H and I?
All three → low
622
What is recombinant C1-INH used to treat?
HAE
623
What are some complement therapeutics?
①target key points in the complement pathways to treat disease ② recombinant C1-INH is used to treat HAE ③ monoclonal antibodY to C5 (eculizumab) is used to block formation of C5a and the MAC
624
What is monoclonal antibody to C5 (eculizumab) used to treat?
-aHUS and PNH
625
What decreases with monoclonal antibody to C5 ?
- Soluble C5b-9 levels - CH50 - AH50
626
What are the symptoms of C3 glomerulopathy?
- Cause inflammation of the glomeruli of the kidneys - hematuria - proteinuria - hypertension - gradual decline of kidney function
627
What are symptoms of HUS?
- Hemolytic anemia - low platelet count - acute renal failure
628
What is the primary cause of HUS ?
- Exposure to a Shiga toxin from acute diarherral illness
629
What are levels of C3 and C4 routinely measured by?
- Automated nephlometry or immunoturbidimetry.
630
Describe nephlometry?
Measures the concentration of an individual complement protein according to the amount of light scattered by the antigen-antibody mixture
631
Describe immunoturbidimetry
Based on reduction in light transmission resulting from immune complex formation
632
What is the difference between the CH50 and AH50 assays?
- Magnesium chloride is added to buffer -ethylene glycol tetraacetic acid added to buffer - calcium left out
633
Describe the AH50 assay
- Buffer chelates calcium, blocking classical pathway activation -rabbit RBC are used as the indicator
634
Describe ELISA testing in alternative pathway
- Can detect C3bBb or C3bP complexes in very small quantities -micrometer wells typically coated with bacterial lipopolyssachardes to trigger activation of the alternative pathways
635
What are the assays that test for complement activation?
- ELISA or multiplex versions of immunoassays
636
What are the potential benefits of measuring complement fragments?
①more sensitive to any complement activation ② measuring anaphylatoxin levels directly can be informative about the degree of inflammation that is being driven by complement ③ by measuring individual fragments,it is possible to determine which pathways are activated and where any control is achieved in the cascade of complement activation
637
This cells affect the innate immune response by inducing production of which cytolones?
IL-2 IL-4
638
Describe macrophage- colony stimulating factor (M-CSF)
-if activated, the cells become macrophages -increase phagocytosis, chomotaxis and additional production in monocytes and macrophages
639
What is autocrine stimulation?
Affecting same cell that secreted it
640
Describe colony stimulating factor
Stimulates formation of colonies of calls in the bone marrow
641
What is an integrin?
Cell adhesion molecules on leukocytes
642
Describe erythropoietin (EPO)
CSF that regulates RBC production in bone marrow
643
Describe granulocyte colony stimulating factor (G-CSF)
-If activated, the cells become neutrophils, -enhances function of mature neutrophils and affects survival, proliferation, and differentiation of all cell types in the neutrophil lineage
644
Describe endocrine activity
Systemic affects
645
Describe adaptive T regulatory 1 cells
-CD4+ T cells that are induced from antigen activated naïve T cells in presence of IL-10
646
Describe granulocyte-macrophage colony stimulating factor(GM-CSF)
-cytokines produced by T cells and other cell lines that stimulates an increased supply of granuloytic cells and macrophages
647
What is the main difference between IgE and IgG?
IgE has one more constant region
648
What is the cytokine that promotes differentiation of T cell to The Th1 subclass?
IL-12
649
What reasons are CSF given to cancer patients?
The increase production of certain types of leukocytes
650
What is the best assay to measure a specific cytokine?
ELISA assay