B&l: Test 2: 16. Dickinson : Transplantation Immunology

Front 1

Why does corneal transplantation not require immunosuppression?

**

Back 1

graft antigens do not access the lymphatics to reach the lymph nodes, where they would sensitize the recipients lymphocytes

Front 2

Transplant rejection and graft-versus-host reaction occur because...

Back 2

Result from genetic differences between donor and recipient

Front 3

what are alloantigens

Back 3

antigens that vary between members of the same species; immune responses provoked by alloantigens are termed alloreactions

Front 4

in graft rejection, what cell plays a major role?

*

Back 4

T-cell

Front 5

2 forms of allo rxns?

Back 5

transplant rejection (solid organ transplant) and GVHD (bone marrow transplantation)

Front 6

what is the dif btw transplant rejection and GVHD

Back 6

Transplant: recipients T cells attack the transplant (kidney)

GVHD: bone marrow transplanted the T cells in the transplant attack the recipient tissue

Front 7

define: Autologous grafts or autografts

Back 7

Grafts transplanted from one location to another in the same individual (skin grafting)

Front 8

define: Syngeneic grafts or isografts

Back 8

Grafts transplanted between monozygotic twins (genetically identical)

Front 9

define: Allogeneic grafts or allografts

Back 9

Grafts transplanted between two genetically different members of the same species (kidney transplant)

Front 10

define: Xenogeneic graft or xenograft

Back 10

Grafts transplanted from one species to another (pig to human)

Front 11

what antigen on an RBC most often makes it get rejected?

Back 11

Rhesus D

Front 12

2 mechanisms of red cell lysis after rejection?

Back 12

complement

Macrophage

Front 13

who are the universal donors and recipients (givers and TAKERS!!)

Back 13

givers: O -

selfish greedy takers: AB D+

Front 14

What are the 3 forms of graft rejection?

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Back 14

Hyperacute: Minutes to hours. Preformed anti-donor antibodies and complement destroy the graft (preformed antibodies can arise due to previous transplantation or pregnancy). Most devastating form of rejection

Acute: Days to weeks. Activation of T cells and macrophages

Chronic: Months to years. Initiates with antibody-complement reactions in the graft vasculature which reduces the blood supply to the graft (ischemia). Correlates with antibodies specific for the HLA class I molecules of the graft. The bound antibodies recruit monocytes and neutrophils. Accumulating damage results in inflammation and recruitment of additional immune cells (T cells and macrophages)

Front 15

what causes a hyperacute graft rejection

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Back 15

. Preformed anti-donor antibodies and complement destroy the graft (preformed antibodies can arise due to previous transplantation or pregnancy)

Front 16

what is the most devastating form of rejection?

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Back 16

Hyperacute

minutes to hours

Front 17

What causes an acute graft rejection?

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Back 17

Activation of T cells and macrophages

Front 18

what causes chronic graft rejections?

*

Back 18

Initiates with antibody-complement reactions in the graft vasculature which reduces the blood supply to the graft (ischemia). Correlates with antibodies specific for the HLA class I molecules of the graft. The bound antibodies recruit monocytes and neutrophils. Accumulating damage results in inflammation and recruitment of additional immune cells (T cells and macrophages)

Front 19

Transplanted organs are often “stressed” and therefore inflamed which induces expression of HLA class II on the endothelium. Thus, antibodies directed against HLA class II can also cause what kind of rejection?

*

Back 19

Hyperacute

Front 20

what is the cross-match test

Back 20

Detects antibodies in the recipient’s serum that trigger complement-mediated lysis of the donor’s lymphocytes

Front 21

quick review: which cells have both HLA class I and II

which have just class I

Back 21

B cells (positive for HLA class I and II)

T cells (positive for HLA class I)

Front 22

recipient’s CD4+ and CD8+ T cells react against HLA class II and HLA class I alloantigens of the donor tissue, respectively, in what type of rejection?

Back 22

Acute rejection

Front 23

describe the direct pathway of allorecognition...also, what type of rejection is this in?

**

Back 23

Kidney gets transplanted along with its antigens

antigens (dentritic cells) from the graft travel to the spleen where they activate host T Cells

these now hunt down the source of these foreign bodies (aka your grafted kidney)

rejects the graft.

Seen in ACUTE REJECTION

Front 24

what type of rejection is Characterized by reactions in the vasculature of the graft that causes ischemia and loss of graft function and eventually the graft dies?

*

Back 24

Chronic rejection

Front 25

describe the indirect pathway of allorecognition and what type of rejection it is in

**

Back 25

recipient dendritic cell endocytocises the Class I molecule of a donor

CD4 cells then recognize the donor Class I molecules as foreign and starts telling B cells to make antibodies

this is seen in CHRONIC rejection

Front 26

Allogeneic transplantation is made possible by the use of three types of immunosuppressive drugs..what are they?

Back 26

Corticosteroids: anti-inflammatory function by inhibiting NFB; inhibits inflammatory cytokine secretion

Cytotoxic drugs: kill proliferating T cells (ex. azathioprine, cyclophosphamide, methotrexate)

Selective inhibitors: inhibit T cell activation and therefore T cell cytokine production (ex. cyclosporin A, tacrolimus and rapamycin)

Front 27

the tissue for which transplantation is most sensitive to HLA disparity is...

Back 27

Bone marrow

Front 28

hematopoietic stem cell is...

objective

Back 28

CD34

Front 29

which form of GVHD does the following describe (objective)

Maculopapular rash, scaling
Diarrhea, hepatosplenomegaly, jaundice
Cardiac irregularity, CNS irritability, pulmonary infiltrates

Back 29

Acute GVHD

Front 30

which form of GVHD does the following describe (objective)

Chronic skin desquamation
Hepatosplenomegaly, lymphadenopathy
Chronic diarrhea and failure to thrive
Severe immunodeficiency

Back 30

Chronic GVHD