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72 Cards in this Set
- Front
- Back
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IL-1
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made by mac's
cause acute inflam cause chemokine production to recruit leukocytes endothelium to express adhesion molecules endogenous pyrogen |
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IL-2
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Secreted by Th cells
growth of helper and cytotoxic T cells |
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IL-3
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secreted by activated T cells
growth and differentiation of bone marrow stem cells, similar function to GM-CSF |
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IL-4
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Secreted by Th2 cells
Promotes growth of B cells class switching to IgE and IgG |
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IL-5
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Secreted by Th2 cells
promotes differentiation of B cells enhances class switching to IgA production and activiation of eosinophils |
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IL-6
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Secreted by Th cells and mac's
Stimulates production of acute-phase reactants and immunoglobulins |
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IL-8
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secreted by mac's
major chemotactic factor for neutrophils |
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IL-10
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secreted by regulatory T cells
inhibits actions of activated T cells |
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IL-12
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Secreted by B cells and mac's
activated by NK and Th1 cells |
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IFN-gamma
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secreted by Th1
stimulates mac's |
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TNF
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from macrophages. mediates septic shock. causes leukocyte recrutiment, vascular leak.
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Helper T cells
Surface proteins |
CD4, TCR, CD3, CD28, CD40L
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Cytotoxic T cells
Surface proteins |
CD8, TCR, CD3
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B cells
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IgM, B7, CD19, CD20, CD21, CD40, MHC II
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Macrophages
Surface proteins |
MHC II, B7, CD40, CD14
Receptors for Fc and C3b |
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NK cells
Surface proteins |
Receptors for MHC I, CD16, CD56
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All cells except mature red cells
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MHC I
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Type I Hypersensitivity
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Anaphylactic and atopic.
free Ag cross-links IgE on presensitized mast cells and basophils, that release vasoactive amines like histamine. Rxn develops rapidly after Ag exposure to preformed antibody. |
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Type II Hypersensitivity
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Antibody mediated.
IgM, IgG bind to fixed Ag on enemy cell, leading to lysis, by complement or phagocytosis Cy-2-toxic - Membrane Attack Complex |
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Type III Hypersensitivity
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Immune Complex - Ag-Ab complexes activate complement, attracting neutrophils that release lysomal enzymes
Serum Sickness - Ab to foreign proteins are produced, and immune complexes form and deposited in tissues. Arthus rx - local subacute type III rxn. Intradermal injection of Ab induces antibodies which form Ag-Ab complexes in skin. edema, necrosis, complement activation. |
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Serum Sickness
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Type of type III hypersensitivity, where Ag-Ab complexes are deposited into tissues where they fix complement and make damage.
Now mostly caused by drugs. Fever, urticaria, arthralgias, proteinuria, lymphadenopathy 5-10 days after Ag exposure |
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Type IV Hypersensitivity
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Delayed T cell mediated type.
sensitived T cells encounter antigen the release lymphokines, leading to mac activation. not antibody mediated. T lymphocytes, Transplant rejection, TB skin test, Touching (contact dermatitis) |
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Diseases assoc w/ Type I hypersensitivity
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anaphylaxis
Allergic rhinitis |
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Diseases assoc w/ Type II hypersensitivity
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Hemolytic anemia
ITP Erythroblastosis fetalis Rheumatic fever Goodpasture's syndrome Bullous pemphigoid Graves' disease Myasthenia gravis |
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Diseases assoc w/ Type III hypersensitivity
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SLE
Rheumatoid arthritis Polyarteritis nodusm Poststreptococcal glomerulonephritis Serum Sickness Arthrus rxn Hypersensitivity pneumonitis |
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Diseases assoc w/ Type IV hypersensitivity
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Type 1 diabetes mellitus
Multiple sclerosis Guillain-Barre's syndrome Hashimoto thyroiditis GvHD PPD Contact Dermatitis |
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Bruton's agammaglobulinemia
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X-linked recessive defect in tyr kinase gene assoc w/ low levels of all classes of Ig's, decreased B cells.
recurrent Bacterial infxns after age 6 (when maternal IgG decline) in boys |
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Thymic aplasia
DiGeorge syndrome |
Thymus and parathyroids fail to develop from 3rd and 4th pharyngeal pouches.
Present w/ tetany due to T cell deficiency. Congenital defects of heart and great vessels. 22q11 deletion |
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SCID
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defect in early stem cell differentiation.
recurrent viral, bacterial, fungal and protozoal infexctions. many causes = failure to make MHCII antigens, defective IL-2, adenosine deaminase deficiency |
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IL-12 receptor deficiency
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Decreased activation of T cells
present w/ disseminated mycobacterial infxns due to decreased Th1 response |
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hyper-IgM syndrome
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Decreased activation of B cells.
defect in CD40L on CD4 T helper cells, leads to inability to class switch. High levels of IgM, very low levels of IgG, IgA and IgE Presents early in life w/ severe pyogenic infxns |
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Wiskott-Aldrich syndrome
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Decreased activation of B cells
X-linked defect in ability to mount IgM response to capsular polysaccharides of bacteria. Assoc w/ elevated IgA (A for Aldrich), normal IgE, low IgM. Sx - Triad. recurrent pyogenic infxns, thrombocytopenic purpura, Eczema |
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Job's Syndrome
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Decreased activation of Neutrophils.
Failure of IFNg production by T helper cells. Neutrophils fail to respond to chemotactic stimuli. Sx - coarse Facies, cold (noninflamed) staphylococcal Abscesses, retained primary Teeth, elevated IgE, Dermatologic problems like Eczema (FATED) |
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Leukocyte adhesion deficiency syndrome - type 1
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defect in LFA-1 integrin proteins on phagocytes. presents early w/ recurrent bacterial infxns, absent pus formation, delayed separation of umbilicus
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Chediak-Higashi Disease
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Autosomal recessive. Defect in microtubular function and lysosomal emptying of phagocytic cells.
Presents w/ recurrent pyogenic infxns by staph, strep, partial albinism and peripheral neuropathy |
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Chronic granulomatous disease
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defect in phagocytosis of neutrophils b/c lack of NADPH oxidase or similar enzymes.
marked susceptibility to opportunistic infxns w/ bacteria, esp S. aureus, E.coli, and Aspergillus. Confirmed w/ negative nitroblue tetrazolium dye reduction |
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Chronic mucocutaneous candidiasis
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T cell dysfunction specifically against Candida albicans. presents with skin and mucous membrane Candida infxns
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Selective immunoglobulin deficiency
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Deficiency in specific class of Ig's, maybe b/c defect in isotype switching.
Selective IgA deficiency is most common selective Ig deficiency. present w/ sinus and lung infxns, milk allergies and diarrhea common. |
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Ataxia-telangiectasia
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defect in DNA repair enzymes w/ assoc IgA deficiency. presents w/ cerebelar problems (ataxia) and spider angiomas (telangiectasias)
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Common variable immunodeficiency
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Normal number of circulating B cells, but decreased plasma cells from a defect in maturation. decreased Ig, cna be acquired in 20s - 30s.
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Cyclosporine
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binds cyclophilins, complex blocks differentiation and activation of T cells by inhibiting calcineurin, preventing production of IL-2 and its receptor.
used after transplant and w/ selected autoimmune disorders. Predisposes patients to viral infections and lymphoma; nephrotoxic (need mannitol diuresis) |
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Tacrolimus FK506
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similar to cyclosporine, binds to FK-binding protein, inhibiting secretion of IL-2 and other cytokines.
immunosuppressives used in organ transplants. Toxicities: nephrotoxicity, peripheral neuropathy, hypertension, pleural effusion, hyperglycemia |
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Azathioprine
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antimetabolite precursor of 6-mercaptopurine that interferes with metabolism and synthesis of nucleic acids. toxic to proliferating lymphocytes.
Kidney transplantation, autoimmune disorders (glomerulonephritis, hemolytic anemia) Tox - bone marrow suppression, metabolite mercaptopurine is metabolized by xanthine oxidase; toxic effects may be increased by allopurionol |
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Muromonab - CD3
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Monoclonal antibody that binds to CD3 epsilon chain on surface of T cells. Blocks cellular interaction w/ CD3 protein responsible for T cell signal transduction.
immunosuppression after kidney transplant. cytokine release syndrome, hypersensitivity rxn |
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Sirolimus (rapamycin)
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binds to mTOR. inhibits T cell proliferation in response to IL-2.
immunosuppression after kidney transplant w/ cyclosporine and corticosteroids. tox - hyperlipidemia, thrombocytopenia, leukopenia |
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Mycophenolate mofetil
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inhibits de novo guanine synthesis and blocks lymphocyte production.
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Daclizumab
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monoclonal antibody with high affinity for IL-2 receptor on activated T cells
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Hyperacute rejection
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antibody mediated due to preformed antidonor antibodies in the transplant recipient. occurs within minutes after transplantation
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Acute rejection
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cell mediated due to cytotoxic T lymphocytes reacting against foreign MHCs. occurs weeks after transplantation. Reversible with immunosuppressants such as cyclosporine and OKT3
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Chronic rejection
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antibody-mediated vascular damage (fibrinoid necrosis); occurs months to years after transplant. irreversible
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Graft versus Host disease
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grafted immunocompetent T cells proliferate in the irradiated immunocompromised host and reject cells with foreign proteins, resulting in severe organ dysfunction.
Sx - maculopapular rash, jaundice, hepatosplenomegaly, diarrhea |
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Anti-nuclear antibodies
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SLE
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Ant-dsDNA, anti-Smith (snRNP)
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Specific for SLE
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Antihistone
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Drug-induced lupus
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Anti-IgG
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Rheumatoid Factor!
Rhuematoid arthritis |
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Anticentromere
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Scleroderma CREST
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Anti-Scl70
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Scleroderma diffuse
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Antimitochondrial
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Primary biliary cirrhosis
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Antigliadin
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Celiac disease
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Anti-basment membrane
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Goodpasture's disease
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Anti-epithelial cell
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Pemphigus vulgaris
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Antimicrosomal
Antithyroglobulin |
Hashimoto's thyroiditis
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Anti--Jo-1
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Polymyositis, dermatomyositis
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Anti-SSA (Ro)
Anti-SSB (La) |
Sjogren's syndrome
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Anti-U1 RNP
(ribonucleoprotein) |
Mixed connective tissue
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Anti-smooth muscle
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Autoimmune hepatitis
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Anti-glutamate decarboxylase
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Type 1 diabetes mellitus
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c-ANCA
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Wegener's granulomatosis
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p-ANCA
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Other vasculitides
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HLA- B8
Disease association |
Grave's disease
Celiac sprue |
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HLA-DR2
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Multiple sclerosis
Hay fever SLE Goodpastures |
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HLA-DR5 associated w/
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Pernicious anemia
Hashimoto's thyroiditis |
