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77 Cards in this Set
- Front
- Back
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HLA A3
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hemochromatosis
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HLA B27
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PAIR
psoriasis, ankylosing spondylitis, inflammatory bowel disease, reiter's syndrome |
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HLA B8
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Grave's dse
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HLA DR2
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MS, hay fever, SLE, Goodpastures
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HLA DR4
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RA, DM type 1
also see DR3 with DM type 1 |
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HLA DR5
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Pernicious anemia- B12 def
Hashimoto's thyroiditis |
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HLA DR7
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steroid-responsive nephrotic syndrome
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IL-12
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forms Th1 cell
cell mediated response makes IL-2, ifn gamma, and activate macrophages and cd8+ t cells |
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IL-4
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forms Th2 cells- humoral response
make il 4, il 5, and help b cells make ab (ige>igg) |
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APCs
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Macrophage, Dendritic cell, B cell
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Macrophage-lymphocyte interaction
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activated lymphocytes release ifn gamma
activated macrophages release IL-1, tnf alpha stimulate one another |
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Th1 cell
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regulate cell med response
secretes il 2, ifn gamma activates macrophages and cd8+ t cells inhibited by il 10 |
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Th2 cell
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regulates humoral response
secretes il 4, il 5, il 10 helps b cells make antibody inhibited by ifn gamma |
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Regulatory T cells
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help maintain specific immune tolerance by suppressing cd4 and cd8 t cell effector functions
express CD3, CD4, CD25 produce anti inflamm cytokines like IL-10 and tgf beta |
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Antibody structure
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variable part recognizes antigens
Fc portion of igm and igg fixes complement |
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Mature B lymphocytes express what Ig isotypes
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IgM and IgD on their surfaces
may differentiate by isotype switching into plasma cells that secrete IgA, IgE, IgG |
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Ig with lowest concentration in serum
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IgE
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Thymus independent ag
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ag lack peptide component ex lps from cell envelope of gram neg bacteria, cant be presented by MHC to t cells, stimulate release of IgM ab only, no immunologic memory
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Thymus dependent ag
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ag containing protein component ex conjugated H flu vax, class switching and memory occur as result of direct contact of B cells with Th2 cells and release of il 4,5,6
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MAC
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membrane attack complex of complement, defends against gram neg bacteria, cytolysis
C5b-9 |
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C1-4
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viral neutralization
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C3b and IgG
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opsonization
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C3a and C5a
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anaphylaxis
C5a also does neutrophil chemotaxis |
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Inhibitors of complement activation on self cells, ex RBCs
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Decay accelerating factor (DAF) and C1 esterase inhibitor
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Classic complement activation pathway
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IgG or IgM mediated
alternative pathway- activated by microbe surface molecules |
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C1 esterase inhibitor def
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hereditary angioedema
ACE inhibitors contraindicated |
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C3 def
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severe recurrent pyogenic sinus and resp tract infxns, inc susceptibility to type III hs rxns
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C5-8 def
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recurrent Neisseria bacteremia
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DAF- GPI anchored enzyme- def
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complement mediated lysis of RBCs and PNH- paroxysmal nocturnal hemoglobinuria
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Cytokine functions
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Hot T Bone stEAk
IL-1- fever Hot IL-2- stimulates T cells IL-3- stimulates Bone marrow IL-4- stimulates igE prod IL-5- stimulates igA prod |
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Neutrophils recruited by what cytokine
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IL-8
Clean up on aisle 8 recruited by IL-8 to clear infxns |
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IL 3
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supports growth and differentiation of bm stem cells
functions like GM CSF |
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IL 5
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promotes diff of B cells, enhances class switching to IgA, stim growth and diff of eosinophils
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IL 10
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anti inflammatory
inhib th1 and activated t cel activates th2 sec by regulatory T cells |
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TGF beta
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anti inflammatory
sec by regulatory T cells |
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Interferons
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interfere with viruses
alpha and beta inhibit viral protein synthesis by producing ribonuclease that degrades viral mRNA gamma inc MHC I and II expression and ag presentation in all cells activates NK cells |
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IL 12
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induces diff of T cells into Th1 cells
activates NK cells, also secreted by B cells |
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Cell surface protein receptor for EBV
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CD 21 on B cells
you can drink Beer at the Barr when you're 21 B cells, Epstein Barr virus, CD 21 |
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Cell surface proteins on macrophages
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CD 14, 40
MHC II, B7 Fc and C3b receptors- enhance phagocytosis |
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Unique marker for NK cells
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CD56
also have CD16- binds Fc of IgG |
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Superantigens
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GBS and staph aurus
stim ifn gamma release from Th1 cells, subsequent release of il 1, 6, and tnf alpha from macrophages |
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Endotoxins/LPS
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from gram neg bacteria, directly stim macrophages by binding endotoxin receptor CD14, Th cells not involved
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When is a patient give passive immunity
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after exposure to Tetanus toxin, Botulinum toxin, Hbv, or Rabies virus, pts given preformed antibodies To Be Healed Rapidly
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Live attenuated vax induces
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cellular response
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Inactivated or killed vax induces
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humoral immunity
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Serum sickness
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immune complex dse- type III hs rxn- ab to foreign proteins produced- takes 5 days, immune complexes form, deposit in membranes, fix complement, leads to tissue damage
sx fever urticaria arthralgias proteinuria lymphadenopathy more common than arthus rxn |
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Arthus rxn
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local subacute ab med type ii hs rxn, intradermal injection of ag induces ab, form ag ab complexes in skin
sx edema necrosis activation of complement |
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Types of HS rxns
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ACID
Anaphylactic and Atopic I Cytotoxic (ab med) II Immune complex III Delayed (cell med) IV |
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4 T's of type iv hs
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T lymphocytes (t cell mediated), Transplant rejections, TB skin test, Touching (contact dermatitis)
delayed type! not transferable by serum! |
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Febrile non hemolytic transfusion rxn
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type II hs, host ab against donor HLA ag and leukocytes
sx fever ha chills flushing |
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Acute hemolytic transfusion rxn
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type ii hs, intravasc hemolysis (ABO blood group incompatibility) or extravasc hemolysis (host ab rxn against foreign ag on donor RBCs)
sx fever hypotension tachypnea tachycardia flank pain hemoglobinemia in intravasc jaundice in extravasc |
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Anti ds DNA
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SLE glomerulonephritis
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Anti histone
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drug induced lupus
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anticentromere
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limited scleroderma
CREST |
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Anti SCl 70 (anti DNA topoisomerase I)
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diffuse scleroderma
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Antimitochondrial
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primary biliary cirrhosis
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Anti basement membrane
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Goodpastures
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Anti gliadin, antiendomysial
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celiac
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Anti desmoglein
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Pemphigus vulgaris
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Antimicrosomal, anithyroglobulin
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Hashimoto's thyroiditis
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Anti Jo 1
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polymyositis, dermatomyositis
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Ati U1 RNP (ribonucleoprotein)
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Mixed connective tissue disease
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Anti smooth muscle
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Autoimmune hepatitis
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Anti glutamate decarboxylase
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DM type 1
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c ANCA
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Wegener's granulomatosis
C my Wedgie! |
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p ANCA
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other vasculitides
ex Churg Strass, microscopic polyangiitis |
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Thymic aplasia
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DiGeorge syndrome- 22q11 deletion, failure to develop 3rd and 4th pharngeal pouches
sx tetany- hypocalcemia, recurrent viral/fungal infxns- t cell def, congenital heart and great vessel defects |
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Brutons agammaglobuminemia
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X linked recessive, higher in Boys, defect in BTK a tyrosine kinase gene, blocks pro B conversion to pre B
recurrent bacterial infxns after 6 mo- when maternal igG dec, due to opsonization defect |
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Hyper IgM syndrome
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defective cd40L in Th2 cells, inability to class switch, severe pyogenic infxns in early life
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IL 12 receptor def
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dec Th1 response, disseminated mycobacterial infxns, dec ifn gamma
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Hyper IgE syndrome (Job's syndrome)
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Th1 cells fail to produce ifn gamma, neutrophils cant respond to chemotactic stimuli
FATED- course Facies, staph Abscesses, retained primary Teeth, inc igE, Derm problems ex eczema |
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SCID
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defective IL 2 receptor most common, x linked
ADA def, failure to synMHC II ag b and t cell def, recurrent infxns, tx with bone marrow transplant |
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Ataxia telangiectasia
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defects in ATM gene which codes for DNA repair enzymes
sx cerebellar defects, spider angiomas, IgA def |
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Wiskott Aldrich syndrome
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X linked recessive, progressive deletion of b and t cells
sx TIE- Thrombocytopenic pupura, Infections, Eczema inc ige,iga; dec igm |
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Leukocyte adhesion deficiency type 1
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defect in LFA 1 integrin (CD 18) protein on phagocytes, recurrent bacterial infxns, absent pus formation, delayed sep of umbilicus
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Chediak Higashi syndrome
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AR, defect in lysosomal regulator trafficking gene, microtubule dysfunction in phago-lyso funsion, recurrent pyogenic infxns with staph and strep, partial albinism, peripheral neuropathy
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GVHD
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type iv hs rxn, grafted immunocompetent t cells prolif in irradiated immunocomp dise host and reject cells with "foreign" proteins, elading to sever organ dysfunction
ras, jaundice, HSM, diarrhea |
