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128 Cards in this Set
- Front
- Back
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The innate immune system uses sensory molecules to do what?
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recognize infection through surface or metabolic differences
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What are collectins?
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soluble proteins
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The lectin portion of collectins bind to what?
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sugars
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The collagen portion of collectins binds to what?
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immune systme components
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Macrophages/sentinel cells contain what?
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toll like recptors and each receptor binds to a different molecule
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Sentinel cells kill pathogens and send out what?
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cytokines to alert system
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What are cytokines?
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soluble, low molecular weight glycoprotein messengers
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Name the cellular constituents. There are 6 of them.
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-neutrophils
-eosinophils -basophils -mecrophages/monocytes -dentdritic cells -NK cells |
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NK cells produce what?
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interferon-gamma which activates macrophages
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Macrophages and Dendritic cells produce what?
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interleukins 15 and 12 which regulate the activity and production of NK cells
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When injured, non-immune cells secrete interferon alpha which activates what?
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NK and Dendritic cells
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Phagocytes are produced where?
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bone marrow stem cells
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What are the 2 types of phagocytes?
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monocytes and neutrophils
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Monocytes recruit what?
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neutrophils
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Monocytes move into tissues where they do what?
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mature into macrophages
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Neutrophils stay in the blood and move into tissues when?
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only when infection occurs and the move via chemotoxis
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Phagocytes secrete what?
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proteolytic enzymes and defensins
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Phagocytes may change metabolism to produce what?
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hypochlorus acid, water and nitric acid
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Cytokines are involved in what kind of response?
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acute phase response
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Cytokines communitcate where/
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locally and at long distances
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Cytokines produce what?
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stimulating factors and chemokines
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What other things are involved in acute phase response?
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Interleukin 1 and 6 and TNF
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Cytokines induce acute phase production of what?
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serum proteins
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T cells recognize what?
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"bad guys"aka peptide antigens from intracellular pathogens and pathogens inside of phagosomes
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T cells bind what?
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antigen and HLA molecules
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Intracellular peptides are presented on what?
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HLA class I
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Phagocytosed peptides are presented on what?
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HLA class II
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Cytotoxic T cells express ________ which recognizes HLA I
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CD8
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Cytotoxic T cells do what?
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kill infected cells
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Helper T cells express _____ which recognizes HLA II
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Cd4
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Helper T cells coordinate what?
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the immune response
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CD3 hleps to trigger what?
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intracellular signaling
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What are the 2 functions of HLA?
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1-major physiologic function is to bind and present processed, foreign antigenic peptides to T cells, thus initiating the immune response
2-artificially distinguish the membrane antigens on the transplanted donor organ from those of the recipient, provoking an attack by the recipient's sensitized T cells |
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Class 1 antigens are found where/
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on all neucleated cells
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Class 1 antigens:
1-structure 2-identification 3-function |
1-three gene loci: HLA-A; HLA-B; and HLA-C
2-they are defined serologically with anti-HLA antibodies 3-present foreign antigenic peptides to CD8 cells |
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Class II antigens are found where?
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immunologic effector cells
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Class II antigens:
1-structure 2-idenitification 3-function |
1-have three gene loci within the D region (HLA-DP, HLA-DQ, and HLA-DR)
2-defined by cellular reactions 3-present foreign antigenic peptides to CD4 cells |
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CD3, CD4, or CD8 form an immunological synapse where?
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on antigens and presentation is via cytoplasmic tails
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Intercellular kinase cascade is activated by sending signals through where?
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cytoplasm
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Kinase activity causes transcription factors to do what?
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migrate to nucleus
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Gene transcription causes IL-2 secretion, which leads to what?
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increased number of T cells
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Increased Ca activates what?
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immunophillins
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CD8 cells do not recognize what?
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self-peptides on HLA 1
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CD8 cells do not act unless what?
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a danger signal is received
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Cytotoxic T cells secrete what?
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perforin which attacks cell membranes
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Granzyme is inserted into target cells which does what?
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activates capases, which kill infected cells
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NK cells will kill cells not expressing what?
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HLA class 1 using perforin, granzyme and FAS ligand
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What is the first antibody produced during immune response?
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IgM
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What cell receptor on IgM fixes complement?
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B cell receptor
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IgA protects what and blocks what?
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-protects mucosal tissues, saliva, tears, etc
-blocks toxins from binding |
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What Ig fixes complement leading to cell lysis
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IgG
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IgE is associated with what?
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mast cells and basophils and they also release histamine
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What are the 2 types of B cells?
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memory and plasma
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Plasma B cells produce what?
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large amounts of IgG, IgA, or IgE
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Memory B cells are controlled by what?
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T helper cells to produce plasma cells capable of secreting immunoglobulins
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The 2nd antibody response is fast or slow/
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fast
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T independent B cells produce what?
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antibodies without help from T cells
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T independent B cells are located where and stimulated by what?
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located in spleen and stimulated by non protein antigens
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In a bacterial infection, collectins bind to bacteria which does what?
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activates complement and macrophages
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IL-2, TNF, and chemokines from macrophages attrack what cells that do what?
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-neutrophils that kill bacteria, however the neurtophils do not survive
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What immune system creates bacterial antibodies/
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adaptive immune system
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IgE is mediated via what cells in Type 1 hypersensitivity?
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mast cells and basophils
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In a type 1 reaction, antigen causes Th2 cells to produce what?
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IL-5 and IL-4 and B cells produce IgE in response
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Mast cells release what?
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histamines, prostaglandins, leukotrienes
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Type 3 reactions can be one of what 2 types?
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local or circulating
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Tell me about a local type 3 rxn
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-first exposure to antigen induces antibody formation in specific organ, Second exposure causes formation of immune complexes which, attract neutrophils causing inflammation
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Tell me about circulating type 3 rxn.
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-same general mechanism as above, but complexes deposits in joints, skin, kidneys, etc
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RA is a chronic inflammatory disorder caused by what?
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circulating immune complexes
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What is RF?
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an IgM antibody against IgG, which combines with IgG to frm circulating immune complex
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In RA, complement is activated which activates what?
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monocytes to produce TNF-alpha/IL-1 and neutrophils to release lysosomal enzymes
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RA results in what?
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-cargilage resorption
-proteolysis -T cell production -B cell stimulation -prostaglandin synthesis and inflammation |
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What joints are not effected in RA?
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DIP
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What are some tx for early RA?
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-DMARDS
-methotrexate -sulfasalizine -Azathroprine -Minocycline |
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You can use glucocoricoids only with what other drug?
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DMARDS as bridging therapy
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What are some new drugs used to tx RA?
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-Remicaid (Infliximab)
-Enbrel (etanercept) -Kineret (anakinra |
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In SLE, there is a clearance deficit for what?
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cell apoptosis
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In SLE, B cells recognize what as an antigen?
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double stranded DNA
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What immune complexes are formed in SLE?
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-DNA
-IgG -anti-DNA antibody |
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Auto-antibodoes for what are also generated in SLE?
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ribonucleoproteins
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What is the most specific test for SLE?
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ELISA anti-DNA antibody test
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What are 2 other specific markers for SLE?
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-Anti-ds DNA
-anti-Sm |
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What are some drugs that can cause SLE?
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-hydralazine
-procainamide -Minocycline |
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NSAIDS are used for what in SLE?
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joint pain and tenosinovitis
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Steroids are used for what in SLE?
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flare up
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In severe SLE, what drugs are used?
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immunosuppresive drugs like Cyclophosphamide or Azathroprine
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What is Primary Biliary cirrhosis?
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an immune mediated disorder of unknown cause
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In Primary Biliary Cirrhosis, there is a progressive destruction of what?
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intrahepatic bile ducts
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What are the usualy initial complaints of Primary Biliary Cirrhosis?
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fatigue and pruritis
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Alk phos and liver transaminases are what in Primary Biliary cirrhosis?
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elevated
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What are 4 other lab findings in Primary Billiary Cirrhosis?
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-positive ANA
-increased IgM -positve RF -positive anti-smooth muscle antibodies |
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What are some tx for Primary Biliary Cirrhosis/
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-transplant is only cure
-ursodeoxycholic acid -fat soluble vitamins -Cholestyramine for puritus |
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Autoimmune hepatitis is a chronic inflammatory disorder of what organ/
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liver
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What are attacked in autoimmune hepatitis?
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hepatocytes
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Autoimmune hepatitis is more common in what sex and what ages"/
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-females
-15-25 and 45-60 |
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In autoimmune hepatitis there is jaundice, fatigue and increased what/
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IgG
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Type 1 autoimmune hepatitis is characterized by what?
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ANA, AMS (anti-smooth muscle), and anti-actin
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They 2 autoimmune hepatitis is characterized by what?
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-anti-liver -kidney-microsomal antibodies (LKM-1)
-anti-liber- cytosol antibodies -there is NO ANA or SMA |
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What is the tx for autoimmune heptatis?
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-prednisone
-azathioprine -transplant |
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What are the 2 types of scleroderma?
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diffuse and limited
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Limited scleroderma show no what?
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skin thickening
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What is the initial presentation of limited scleroderma?
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Raynaud's
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CREST is a variant of limited scheroderma which stands for what?
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C-calcinosis
R-Raynauds E-esophageal dysmotility S-sclerodactyly T-telangectasia |
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What antibodies are seen in CREST?
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anticentromere antibodies
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Sjogrens primarily affects who?
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postmenopausal women
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Sjogrens may be 2nd to what?
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RA or SLE
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In Sjogrens, there are autoantibodies to what?
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salivary duct antigens
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What forms in the salivary glands in Sjogrens?
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lymphocytis infiltration and immune complex formation
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Sjogrens will show a positive on what test?
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Shirmer test
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What is Celiac Dz?
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immunological reaction to gulten which destroys the inner lining of the small intestine
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In Celiac Dz, there is inflammation caused by what which does what?
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Gliadin which destroys villi in small intestine
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What are some S/S of Celiacs Disease?
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-weight loss
-diarrhea -cramps -gas/bloating -general weakness -foul smelling stools -stunted growht -osteoporosis |
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What antibodies are present in Celiacs Dz/
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-endomysial
-anti-tissue transaminase -anti-gliadin |
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What is Wilson's Disease?
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rare autosomal recessive disorder of copper metabolism
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What is impaired in Wilson's Dz?
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incorporation into ceruloplasmin is impaired, so biliary excretion of copper is impaired resulting in high hepatic overload
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Wilson's mostly affects who?
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under 40
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In Wilson's disease, there is copper deposits where?
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liver, brain, kidneys, eyes, etc
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What are some thing sthat WIlson's dz can cause?
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-liver disease
-neurologic problems -psychiatric problems -hemolytic anemia -renal tubular syndrome -skeletal changes |
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What are some tx for Wilson's disease?
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-Zinc Acetate
-tetrathomolybidate -penicillamine |
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What is hemochromatosis?
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hereditary/inherited disorder of iron metabolism typically in people or N. european descent
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What happens in hemochromatosis?
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duodenal crypt cells become villial cells there is an increase in iron transport protein-ferroportin
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What cells store iron in the liver?
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hepatocytes
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In Hemochromatosis, iron overload induces what?
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oxidation damages to cells
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In hematochromatosis, protibrogenic cytokines do what?
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stimulate collagen fromation with increased fibrosis and cirrhosis
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What is tx for hematochormaotisis?
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-weekly phlebotomy
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In Crohns dz there is epithelial injury due to what?
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cytokines INF-8 and reactive oxygen species
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What are some S/S of Crohns dz/
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-chronic diarrhea
-weight loss -anorexia -colicky pain -blood in stool |
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Pts with Crohns dz may present with what?
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-abscess
-fistulas -perianal fissues -leukocytosis -bowel strictures -autoimmine arthritis -anemia |
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What kind of lesion are common in Crohns?
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skip lesions
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