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81 Cards in this Set

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Recognition and Response of immune system
required for the success of the immune response
utilize CD/cluster diferrentiation
Cluster of Differentiation
originally describe proteins found on the surface of lymphocetes
now used as labeling system to ID family of proteins on many cells
Types of antigen
Immunogenic
Antigenic
Antigenic determinant (epitote)
Antigenic determinant
portion of the antigen that is configured to recognize and bind to an antibody
Immunogenic
antigen's crteria in influencing degree of immunogenic: foreigness, size, complexity and qty.
Self-Antigen
missing immunogenic criteria of foreigness
we are tolerant of our own antigen
Administration of antigen
body receive antigen via vaccination at a specific/preferrential route (IM, SC, intraperitoneal, oral)
Tolerance
state of nonresponsivenss to immune system; passively allow self-antigen to persist; state of homeostasis
2 types of tolerance
Central and Peripheral tolerance
Central Tolerance
during differentiation, lymphoctes w/ receptors for self-antigen is eliminated/suppressed/deleted
Peripheral Tolerance
maintained in the secondary lymphoid organs through action of Treg
Haptens
small molecule structure of an antigent that doesn't elicit response unless it binds to a carrier protein called
Antibodies
aka immunoglobulins, challenges immunogens, produce by plasma cells
5 Classes of Antibody
IgG, IgA, IgM, IgE, IgD
IgG
most abundant (80-85%), it trasferred via placenta, 4 classes--IgG1-4
account for most protective activity against infection
IgA
2 types: IgA1 found in blood, IgA2 found in body secretions (tears, sweat, saliva, mucus and breastmilk)
IgM
largest immunoglobulins, 1st antibody during the primary response to an antigen, sythesized during fetal life
IgD
low in concentration, little info about it, found in the surface of developing B lymphocytes, functions as the type B cell antigen receptor
IgE
least concentration, mediator of common allergic responses, provides protection f/ large parasites
how does IgE provides protection from large parasites?
initiates inflammatory rxn to attract esosinophils
2 Typse of Immune System Response
Primary Response
2ndary Response
Primary Response of Immune System
slow, has a lag/delayed period where memory cells are differentiating; after 5-7 days IgM for specific antigen is detected; followed by IgG response in equal/slightly less
Secondary Response
more rapid, no differentiation of b cells, large amount of antibody is produced; IgM is produced in equal amounts as primary response by IgG is produced in great#
Antibody Function
Direct: naturalization, agglutination and precipitation
INDIRECT: opsonization
Secretory(mucosal) Immune System
lymphoid tissues that protect the external surfaces of the body where antibody is present in body secretions mainly containing IgA1 and small amt of IgG and IgM
Killing Mechanism of Secretory(mucosal) Immune system
cytotoxic T lymphoytes destroys cancer cells or infected virus by utilizing degrative enzymes (perforins and granzymes) or direct-receptor interaction
Other Cells involve in Immune system
Natural Killer cells--same mechanism as cytotoxic T cell
T reg--regulates the peripheral tolerance by affecting the recognition of antigen and the proliferative steps of antigen recognition
Fetal and Neonatal Immunity
antibody is defficient; capable of producing Igm response but incable of producing IgG challenge
Immunity provided by maternal antibody by:
trophoblastic cells transport maternal IgG across the placenta by birth/newborn IgG levels is near adult levels
Aging and Immune Function
Decease T cells activity; thymus size is 15% max size; decrease in circulating antibodies/memory cells and decrease production of specific antibodies; increase antigen-antibody complexes and autoantibodies
Hypersensitivity
Altered immunologic response to an antigen that results in disease or damage to the host;
characterized by immune mechanism
3 Types of Hypersensitivity rxn
allergy, autoimmunity, alloimmunity
Allergy
Deleterious effects of hypersensitivity to environmental (exogenous) antigens;
environmental antigen that causes atypical immunologic response to a genetically predisposed individual; allergen is contained in a particle too large to be phagocytosed or protected w/ anonallergenic coat; original insult is apparent
Alloimmunity
Immune reaction to tissues of another individual
Autoimmunity
Disturbance in the immunologic tolerance of self-antigens;
Breakdown of tolerance
Hypersesitivity is characterized by
immune mechanism
4 Types of Hypersensitivity Reaction
Type I, II, III, IV
Reactions: immediate/delayed
Type 1 Hypersensitivity
IgE mediated against environmenta antigens/allergens; IgE binds to the Fc receptors on the surface of mast cells w/c are cytotoic antibody;
degranulation of mast cells causes histamine release; has genetic predisposition
Manifestation of Type 1 Hypersensitivity
itching, uticaria, conjunctivitis, rhinitis, hypotention, bronchospasm, dysrhythmia, GI crams and malabsorption
Mast Cell degranulation
releases histamines that binds to either H1 receptor (proinflammatory) or H2 receptor (anti-inflammatory)
Type 1 Hypersensitivity can be evaluated through:
food challenges, skin test, lab test (RAS, ElISA)
Desensitation
IgG blocking antibodies produced by introducing incremental doses of antigen; allows person to build tolerance to environmental allergen
Type II Hypersensitivity
Tissue specific in w/c specific tissue/cell's antigen is target of immune response
Mechanism of Type II Hypersensitivity Response
cell is destroyed by antibodies and complement; cell destruction through phagocytosis; soluble antigen enter circulation and gets deposited on tissues; antigen-dependent cell mediated cytotoxicyt; cause target malfunction
TYPE III Hypersensitivity
immune complex mediated w/c are antigen-antibody complexes that enters circulation and deposited into vessel walls or extravascular tissue
NOT organ specific
Immune Complex Clearance
Large—macrophages
Small—renal clearance
Intermediate—deposit in tissues
Immune Complex Diseases
Serum Sickness (systemc)
Arthus Rxn (localized/vascular response) caused by repeated exposure to antigen that reacts w/ preformed AB and forms complexes that gets deposited on local vessel walls
Type IV Hypersensitive
cell-mediated; doesn't involve antibody;
involves cytotoxic T lymphocytes or lymphokine producing Th1 cells
Direct killing by Tc or recruitment of phagocytic cells by Th1 cells
Direct killing of Tc cells
by toxins/Tc cells releases soluble factors, lysosomal enzymes, toxic ROS f/ macrophage activity
Example of Type IV Hypersensitivity
Graft skin rejection, skin test TB, contact allergic rxn; autoimmune disease
Example of Type IV Hypersensitivity
rxn from tuberculin TB skin test; causes infiltration of lymphocytes and macrophages causing induratin (bubble) and erythema (redness)
Allergy
caused by environmental antigens that causes atypical immunologic responses in genetically predisposed individuals
Pollens, molds and fungi, foods, animals, etc.
Allergen is contained within a particle too large to be phagocytosed or is protected by a nonallergenic coat
Original insult is apparent
Autoimmunity
 Breakdown of tolerance
Body recognizes self-antigens as foreign
Sequestered antigen
self-antigens not normally seen by the immune system
Autoimmunity Theories
Infectious disease, neoantigen, forbidden clone, ineffective peripheral tolerance, original insult and genetic factor
Infectious Disease
works on molecular mimicry; where antigen of m.o. is similar to self-antigen
Neoantigen
involves haptens that attaches to host protein and elicit immune response
Forbidden Clone
during differentiation, lymphocytes produce have receptors that react to self-antigen; these lymphocytes are forbidden to mature but those that survice can later on proliferate
Ineffective peripheral tolerance
defective regulatory T cells; leads to expansion of clones of autoreactive cells
Original insults
like allergy; cause is known; like known m.o. that causes immune response
Genetic Factor
easier to ID; deffective HLA alleles and variety of non MHC genes
Autoimmunity Examples
SLE-sytemic lupus erythematous and graft rejection
Systemic lupus erythematosus (SLE)
Chronic multisystem inflammatory disease
Autoantibodies against: Nucleic acids, erythrocytes, coagulation proteins, phospholipids, lymphocytes, platelets, etc.
Deposition of circulating immune complexes containing antibody against host DNA
More common in females
Graft Rejection/transplant rejection is classified
according to time; amount of time elapse between transplantation and rejection
3 Classification of Graft Rejection
Hyperacute:Immediate and rare; Preexisting antibody to the antigens of the graft
Acute:
Cell-mediated immune response against unmatched HLA antigens
Chronic:
Months or years
Inflammatory damage to endothelial cells of vessels due to a weak cell-mediated reaction against minor HLA antigens
Transfusion Reactions
Antibodies against blood group antigens
ABO system
Two major carbohydrate antigens
A and B (co-dominant)
Individuals have naturally occurring antibodies to the A and B antigens they lack
Anti-A and anti-B antibody production is induced by similar antigens on naturally occurring bacteria in the intestinal tract
Antibodies are usually of the IgM class
O blood type (universal donor)
AB blood type (universal recipient)
Immune Deficiencies
Failure of immune mechanisms of self-defense
2 Types of Immune Deficiency
Primary (congenital) immunodeficiency
Genetic anomaly
Secondary (acquired) immunodeficiency
Caused by another illness
More common
Clinical Presentation of Immune Deficiency
Development of unusual or recurrent, severe infections
T cell deficiencies
Viral, fungal, yeast, and atypical microorganisms
B cell and phagocyte deficiencies
Microorganisms requiring opsonization
Complement deficiencies
Secondary Deficiencies:
Also referred to as acquired deficiencies
Far more common than primary deficiencies
Secondary Deficiencies are caused by
Normal physiology conditions
Psychological stress
Dietary insufficiencies
Malignancies
Physical trauma
Medical treatments
Infections
Acquired immunodeficiency syndrome (AIDS)
Anaphylaxis
immediate, rapid immune response; life threatening and needs immediate attention;
caused by systemic rxn from ingestion/injestion/inhalation of substance by a sensitive individual
Onset: min to no more than 1 hr
Signs and Symptoms of Anaphylaxis
Uneasy, lightheaded, itching (uticaria), swelling(angioedema) of eyelids, lips, tongue, hands, feet, genitalia, uvulva, larynx, bronchioles, hypotention
Tissue response of anaphylaxis
sudden, multifocal rxn, mast cells bound to IgE, histamines release causing vasodilation, increased permeability, leakage
Treatment of Anaphylaxis
ABC: airway, breathing, circulation and definitive action is giving antihistamines such as benadryl IV or epinepherine
Prevention of Anaphylaxis
Teaching about known offenders, epi pen and medical bracelets
Evaluation of Immunity
Basic Lab test: CBC w/ differentials, quatitative determination of immunoglobulins, assay for total complement and skin test
Immunocompormised are at risk for
GVHD; Graft vs Host Disease where the T cells in the graft are mature and capable of cell-mediated destruction of tissues w/in the recipient
GVHD
T cells in the graft are mature and capable of cell-mediated destruction of tissues w/in the recipient
Treatment for Immune deficiencies
gamma-globulin therapy, transplantation and transfusion; treatment with soluble immune mediators; gene therapy
Immunocompormised are at risk for
GVHD; Graft vs Host Disease where the T cells in the graft are mature and capable of cell-mediated destruction of tissues w/in the recipient
GVHD
T cells in the graft are mature and capable of cell-mediated destruction of tissues w/in the recipient
Treatment for Immune deficiencies
gamma-globulin therapy, transplantation and transfusion; treatment with soluble immune mediators; gene therapy