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41 Cards in this Set
- Front
- Back
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What cells secrete IL-6 and what is its function?
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- Secreted by Th cells and macrophages
- Stimulates production of acute-phase reactants and Ig |
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What cells secrete IL-8 and what is its function?
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- Secreted by macrophages
- Major chemotactic factor for neutrophils |
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What cells secrete IL-10 and what is its function?
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- Secreted by Treg cells
- Inhibits actions of activated T cells - Activates Th2, inactivates Th1 |
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What cells secrete IL-12 and what is its function?
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- Secreted by B cells and macrophages
- Activates NK and Th1 cells |
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What cells secrete gamma-interferon and what is its function?
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- Secreted by Th1 cells
- Stimulates macrophages - Activates Th1, inhibits Th2 |
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What cells secrete TNF and what is its function?
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- Secreted by macrophages
- Mediates septic shock, triggers release of IL-1 - Causes leukocyte recruitment, vascular leak = cachectin |
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What does CD40 do, and where is it located?
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CD40 on macrophages and B cells binds to CD40-ligand on T cells for activation (co-stimulatory signal)
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What does CD14 do, and where is it located?
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CD14 on macrophages recognizes LPS --> cytokine release
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What disease has antihistone antibodies?
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Drug-induced lupus
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What disease has anti-IgG antibodies?
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Rheumatoid arthritis (anti-IgG antibodies = rheumatoid factor)
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What disease has antimitochondrial antibodies?
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Primary biliary cirrhosis
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What disease has anti-Jo-1 antibodies?
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Polymyositis, dermatomyositis
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What disease has anti-SS-A (anti-Ro) and anti-SS-B (anti-La) antibodies?
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Sjogren's syndrome
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What disease has anti-U1 RNP antibodies?
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Mixed connective tissue disease
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What disease has anti-smooth muscle antibodies?
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Autoimmune hepatitis
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What disease has anti-glutamate decarboxylase antibodies?
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Type I DM
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What causes Bruton's agammaglobulinemia?
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X-linked recessive defect in BTK, a tyrosine kinase gene --> blocks B-cell differentiation/maturation
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What causes hyper-IgM syndrome?
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Defective CD40 ligand on Th cells --> inability to class switch
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What causes common variable immunodeficiency, and how do patients present?
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- Defect in B cell maturation with many causes
- Can be acquired in 20s-30s - Pts have increased risk of autoimmune disease, lymphoma, and sinopulmonary infections - Pts have normal # of B cells, but decreased plasma cells and Ig levels |
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Normal number of B cells, decreased plasma cells, decreased plasma Ig... what is it?
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Common variable immunodeficiency
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Pt with severe lung infections, retained primary teeth, and increased IgE levels... what is it?
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Hyper-IgE syndrome (Job's syndrome)
- Th cells fail to produce IFN-gamma --> inability of neutrophils to respond to chemotactic stimuli - Pts also have coarse facies, cold (noninflamed) staph abscesses, and bone problems |
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What causes chronic mucocutaneous candidiasis?
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T-cell dysfunction
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What can cause SCID?
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- Defective IL-2 receptor (most common; X-linked)
- Adenosine deaminase deficiency - Failure to synthesize MHC II antigens |
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How do you treat SCID?
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Bone marrow transplant (no allograft rejection will occur!)
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Pt with cerebellar defects, telangiectasias, and IgA deficiency... what is it?
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Ataxia-telangiectasia
- Due to defect in DNA repair enzymes (mutated ATM gene --> failure of p53 activation) |
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Pt with recurrent infections, thrombocytopenia, and eczema... what is it?
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Wiskott-Aldrich syndrome
- X-linked recessive - Progressive deletion of B and T cells - Labs show increased IgE and IgA but decreased IgM |
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Pt with recurrent bacterial infections, lack of pus formation, delayed separation of umbilicus, and neutrophilia... what is it?
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Leukocyte adhesion deficiency (type 1)
- Defect in LFA-1 integrin (binds ICAM-1) on phagocytes |
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Pt with recurrent pyogenic infections, partial albinism, peripheral neuropathy, and neutropenia... what is it?
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Chediak-Higashi syndrome
- Autosomal recessive defect in microtubular function (leads to impaired phagocytosis) |
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Negative nitroblue tetrazolium dye reduction test... what is it?
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Chronic granulomatous disease (lack of NADPH oxidase)
- Increased susceptibility to catalase-positive organisms (S. aureus, E. coli, Aspergillus) |
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What is muromonab-CD3 (OKT3), and what are its major toxicities?
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Monoclonal Ab that binds CD3 on T cells
- Used for post-transplant immunosuppression - Toxicity: cytokine release syndrome, hypersensitivity |
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What is mycophenolate mofetil?
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Antimetabolite (inhibits de novo guanine synthesis)
- Used for post-transplant immunosuppression in combo with cyclosporine and corticosteroids |
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What is daclizumab?
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Monoclonal Ab against IL-2 receptor on activated T cells
- Basiliximab is also an anti-IL-2 Ab |
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What's the major toxicity of cyclosporine?
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Nephrotoxicity
- Worsened by anti-inflammatory drugs (diclofenac, sulindac, etc.) - Prevent with mannitol diuresis |
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What are the major toxicities of tacrolimus?
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Nephrotoxicity, peripheral neuropathy, HTN, pleural effusion, hyperglycemia (can cause IDDM)
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What immunosuppressant is associated with a risk of developing post-transplant IDDM?
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Tacrolimus (binds FK-BP, inhibits IL-2 secretion)
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What immunosuppressant is associated with a risk of hyperlipidemia?
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Sirolimus (binds mTOR, inhibits T cell prolif. in response to IL-2)
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What is aldesleukin?
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Recombinant IL-2
- Used for renal cell ca, metastatic melanoma |
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What is sargramostim?
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Recombinant GM-CSF
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What diseases can be treated with interferon-alpha?
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HBV, HCV, Kaposi's sarcoma, leukemias, malignant melanoma
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What disease can be treated with interferon-beta?
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MS
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What disease can be treated with interferon-gamma?
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Chronic granulomatous disease
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