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21 Cards in this Set
- Front
- Back
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which cells recognise foreign antigens
how |
Tcells recognise HLA/MHC molecules
CD8= recognise MHC class 1 CD4= recognise MHC class2 |
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which cells express HLA class 1 on cell surface
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all nucleated cells
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which cells express HLA class 2 on their surface?
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specialised APCs:
- Bcells, dendritic cells, macrophages |
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how many types and variants of each HLA molecule are there?
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3 types of each HLA class
2 variants of each class (2 HLA classes --> 6 total types --> 12 total variants) |
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how are transplant rejections minimised
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HLA matching
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which HLA classes and types are the most important in matching for transplant
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class 2 HLA-DR >> class 1 HLA-B >> class 1 HLA-A
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wchi are HLA-DR the most important
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expressed highly on CD4 T helper cells
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what 4 functions do activated CD4 T cells bring about
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produce CYTOKINES
activate CD8 help AB prod recruit PHAGOCYTES |
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what hypersensitivity reaction is ACTE CELLULAR REJECTION
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type 4 delayed Tcell-mediated GRANULOMATOUS inflam with NECROSIS & scarring
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3 methods of CD8 cytotoxic killing mechanisms
which specific molecules |
TOXIN release- granzyme B
punch holes - perforin apoptotic- Fas-L & Th1 cytokines |
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if T cell activation persists...which other immune component is activated
how |
B cell activation;
- co-stimulatory signals - ab's |
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biopsies of acute cellular rejection show influx of which cells
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T cells (incl: granzyme B, perforin, Fas-L)
phagocytes B cells NK cells (activated by B cells) |
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4 types of transplant rejection
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hyperacute
acute cellular acute vascular chronic allograft failure |
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when does each 4 types of transplant rejection occure (time period)
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hyperacute: mins-hrs
acute cellular: 5-30d acute vascular " " chronic allograft failure: >30d |
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hyperacute transplant rejection:
- pathology - mechanism - treatment |
PATH: thrombosis, necrosis
MECH: PREFORMED ab-antigen (prev exposure) Rx: none! |
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acute cellular rejection:
- path - mech - Rxx |
PATH: cellular infiltration (type 4 hypersensitivity)
MECH: CD4&8, B cells, phag Rx: immunosuppression |
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acute vascular rejection
- PATH - MECH -Rx |
PATH: vasculitis
MECH: lymphocytes (T&B) Rx: immunosuppression |
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chronic allograft failure >30d post-transplant
-PATH -MECH -Rx |
PATH: fibrosis, scarring
MECH: immune & non-immunes Rx: minimise drug toxicity, HTN & hyper lipidaemia |
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eg of hyperacute rejection
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incompatible blood groups (body naturally have ab's to other blood groups)
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what happens to blood vessel walls in chronic allograft failure
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proliferation of smooth muscle--> occlusion of lumen
interstitial fibrosis & scarring |
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indications for lung transplant
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advanced resp failure
life expectancy <3yrs CF, COPD, restrictive lung disease, a1-antitrypsin def, po HTN FIT for surgery! |
