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47 Cards in this Set
- Front
- Back
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What is the broad overview of the chain of events of a hypersensitivity response?
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Allergen
IL-3 and IL-4 release IgE production IgE and allergen bind to mast cells mast cells release mediators early phase effect, late phase promotion |
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What compounds do mediators to mast cells release?
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Histamine
PGE LT PAF cytokines |
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Allergic individuals exhibit more of what molecule, cell, and aka?
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Atopy: higher circulating levels of IgE and eosinophils
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Atopy is linked to what genetic loci?
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-cytokine genes (IL3, IL4, IL4R, IL5, IL13, CM-CSF)
-HLA class II (MHC class II) alleles |
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IgE mediated allergic reactions, what are the 5 different syndromes and typical routes of entry?
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anaphylaxis: IV or oral
food: oral asthma: inhalation rhinitis: inhalation urticaria: skin |
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Common allergens for each of 5 syndromes
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systemic: drugs, serum, peanuts
food: tree nuts, peanuts, shellfish, milk, eggs asthma: danders, pollens, dust mite feces allergies: pollens (ragweed, birch, timothy grass) urticaria: fur, insects, allergy testing |
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Tracheal occulsion vs. bronchial occlusion happen in which allergic syndromes?
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tracheal: systemic
bronchial: asthma |
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Th2 cell responses are favored by what doses which activates what cells?
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low doses, activating IL4 producing CD4 T cells
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Features of inhaled allergens include, protiens?
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-low molecular weight, stable, soluble
-proteins (often proteases) that prime T-cell by binding MHC class II often at low doses |
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IgE activated mast cells affect which body systems how?
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GI: more peristalsis and fluid secretion: vomit, poop
Airway: more mucus, smaller diameter: phlegm, wheezing Vessels: more flow and permiablilty: increased lymph flow, protein, effector responses |
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Type I hypersensitvity phases happen when?
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early, 30 min
late, 8 hours |
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Mast cells release what 5 classes of products?
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enzymes, toxins, cytokines, chemokines, lipids
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In immediate response to binding Fc-epsilon-RI, mast cells release what granule associated contents?
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TNF-alpha
histamine platelet activating factor leukotrienes prostoglandins |
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In immediate phase response, mast cells initiate the production of ?
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cytokines (TNF-alpha, IL4, IL5, IL13)
chemokines leukotrienes |
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In immediate phase response, mast cells recruit and activate what cells?
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Th2
basophils eosinophils neutrophils |
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IL4 and IL13 are derived from which cells and induce what in type 1 hypersensitivity responses?
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IL4 first from NK1.1 T cells, then Th2 and mast cells
IL13 from Th2 and mast cells both induce class switching to IgE |
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A good indicator of inhalation allergy?
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lots of eosinophils in nasal swab
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IL 5 is produced where and causes what?
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IL5 is produced by mast cells, Th2 cells, basophils and eosinophils.
IL5 stimulates eosinophil production in bone marrow, and eosinophil activation |
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IL4 is released by what and plays what role in creation of plasma cell?
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released by NK1.1 cell
aids in conversion of Th0 to Th2 cells Th2 to B cell B cell to Plasma cell and IgE class switching |
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Mast cells release what in response to IgE-allergen binding?
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histamine, PAF, leukotrienes prostoglandins (PGE), TNFalpha, chemokines
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Eosinophils are signaled by mast cells with?
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IL3, IL5, CM-CSF
PAF |
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PAF (platelet activating factor) from mast cells attracts what and activates what?
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attracts leukocytes
activates neutorphils eosinophils platelets amplifies lipid mediator production |
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Mediators released by both eosinophils and mast cells include?
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lipid mediators: leukotrienes, PAF
cytokines: IL3, IL5, CM-CSF |
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Toxic proteins released from eosinophils include and result in?
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-major basic protein (toxic to parasites and mammalian cells, triggers histamine response from mast cells)
-eosinophil cationic protein (parasite and neurotoxin) -eosinophil-derived neurotoxin |
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Mediators released from mast cells and not eosinophils include?
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-histamine (toxic to parasites, increase vascular per miabilty, smooth muscle contraction)
-IL4 and IL13 (Th2 response) -TNFalpha (cytokine and endothelium) -tissue matrix remodeling carboxypepsidase, chymase, tryptase -MIP-1alpha |
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Normal bacteria in the gut mediate immunologic tolerance by?
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promoting activation of regulatory T cells and thus preventing responses against other antigens
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IPEX stands for
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immunodysregulation, polyendrocrinopathy, and enteropathy, X-linked
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Fox3p is what? is expressed in high levels where? and results in self-reactivity when?
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transcription factor
CD4+CD25+ cells in absence of TLR signaling |
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Regulatory T cells arise where? are activated by what? activation results in?
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-Treg arise in thymus
-activated by dendritic cells in absence of TLR signaling -suppressive functions with TGFbeta and IL10 |
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When Treg cells are activated in response to an allergen (with normal microbiotica) Th2 cells are?
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Th2 cells are inhibited by Treg cells with a normal GI
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Loss of mucosal tolerance leads Th2 cells?
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to respond to an allergen
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Breast-feeding may create antigen-specific tolerance from the transfer of
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allergens and TGFbeta
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asthma is primarily an inflammatory disease that can be treated by
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inhaled corticosteroids
leukotriene inhibitor beta-2 agonists |
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traditional allergen-specific immunotherapy consists of and results in?
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sub-cutaneous or sub-lingual doses of allergen
generates IgG4, reduces IgE, induces Treg |
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new therapeutic approaches for allergy therapy include and are used for?
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anti IgE monoclonal antibodies (steroid-resistant pt.,anaphylaxis)
anti cytokine or receptor of IL4 IL5 TNFalpha --maybe |
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Type II hypersensitivity responses are mediated by what and examples are?
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-IgG antibody mediated
-drug induced or newborn hemolytic anemia |
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The pathway from drug binding to hemolytic and thrombocytopenia?
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drug binds to RBC or platelet
IgG antibodies bind to cell classical complement pathway activated lysis or phagocytosis |
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Hemolytic anemia of newborn is caused by
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maternal exposure to Rh+ blood (usually 1st preg)
anti Rh antibodies (IgG) cross placenta (usually 2nd preg) |
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How does anti-Rh IgG protect 2nd child?
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IgG suppresses generation of memory B cells
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Type III hypersensitivity responses are caused by what and where?
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antigen and IgG interaction in solution causing tissue/organ damage
local or circulatory |
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Local Type III hypersensitivity examples are?
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Arthus reaction (to vaccine) or Farmers lung
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If type III hypersensitivity reactions are circulating, damage can occur in ?
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many organs, esp renal, for example glomerulonephritis
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basic steps of the Arthus reaction include
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antigen IgG binding at site of injection
activation of Fc-gamma-R on mast cells local inflammation leading to vessel occlusion |
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five hypersensitivity responses?
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Type I - Allergy (immediate)
Type II - Cytotoxic, antibody-dependent Type III - Immune complex disease Type IV - Delayed-type hypersensitivity(Antibody Independant) Type V - Autoimmune disease |
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type IV hypersensitivity response is also known as? a classic example is? happens at what time? Is dependent on what T cell?
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delayed hypersensitivity, TB skin test, 24-72 hours, Th1 cell dependent
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general scheme for type IV hypersensitivity response?
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agent into skin
taken in by Langerhans' cells L. cells present altered self peptides to Th1 cells Th1 cells secrete IFNgamma and chemokines, recruit macrophages inflamaiton insues with Cytolytic T cells (CTL) attack cells with altered self peptides |
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Poison ivy ilicits what kind of response? The toxin is known as?
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type IV hypersensitivity response, the poison being pentadecacatechol
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