1
Q
Elie Metchnikoff
A
Phagocytosis
2
Q
Jules Bordet
A
Complement
3
Q
Karl Landsteiner
A
Human Blood Group Ag
- book: SSR
4
Q
Gerald Eldelman
A
Immunologic tolerance
5
Q
Rosalyn Yallow
A
Radioimmunoassay
6
Q
Susumu Tonegawa
A
Ab diversity
7
Q
Francoise Barre-Sinoussi
A
HIV
8
Q
Poxvididae pathological manifestations
A
Vaccinia virus: cowpox
Variola major: small pox
Variola minor: alastrim
9
Q
Chinese process for “immunization”
A
Variolation - inhale powder
10
Q
Year of discovery of T Cell Receptor
A
1984
11
Q
Year of Discovery of ACD
A
1943
12
Q
Year of discovery of CPD
A
1957
13
Q
Edward Jenner vs Louis Pasteur
A
Jenner: cross immunization (cowpox –> small pox)
Pasteur: attenuated vaccine; Father of Immunology
14
Q
First recipient of blood transfusion
A
Pope Innocent
3 young people - all died
15
Q
Father of Pathology
A
Virchow
16
Q
Father of Microbiology
A
Leewenhoek
17
Q
Gel Tech
A
By Yves LaPierre
Adv: standardization
Disadv: specific instruments
18
Q
Charles Drew
A
Blood preservation
Transfusion tech
From American Red Cross
19
Q
Called the Private Ag
A
Low Incidence Ag
<1% of the population
20
Q
Natural vs Acquired
A
Natural
- present at birth
- std response for all Ag
- no cell memory
- first and second line of defense
Acquired
- “adaptive”
- diverse response for each Ag
- 2nd exposure has a greater response than 1st
- with cell memory – B and T cells
- 3rd line of defense
21
Q
First Line of defense
A
Skin and mucous membrane
Secrete lysozyme to attact bacterial CW
Acidity of GIT and vagina
22
Q
Second line of defense
A
Phagocytosis – neutrocyte, monocyte, macrophage
Infammation and fever
Antimicrobial substances – complement, properdin, INF, TNF, betalysin
23
Q
Third line of defense
A
Specialized lymphocyte – B and T cel
Abs
24
Q
Cellular components of Natural Immune System
A
Phagocytes
Basophilic mast cells
Eosinophil
3rd population lymphocyte – null lymphocyte, NK cell (5-10%; CD 16 and CD 56)
25
Humoral Components of the Natural Immune System
```
Complement Major
INF
Lysozyme
Antimicrobial
Lymphokine-activated Killer Cells
```
26
Cellular component of Adaptive System
T and B cells
27
Humoral components of adaptive system
Lymphokines
| Abs
28
"Steps" in Phagocytosis
Initiation
Chemotaxis
Engulfment
Digestion
29
Describe the initiation of Phagocytosis
Initiated due to tissue damage -- result of trauma or microorganism multiplication
Activated phagocyte has increased surface receptors for adherence -- CD3; laminin receptor; larcyl-formyl-methionylphenylalanin receptor
30
First to migrate due to initiated phagocytosis
Neutrocyte
31
Role of monocyte during initiation of phagocytosis
Second to migrate
32
Complement component that acts as a chemotaxin
C5a
33
Job's syndrome of chemotaxis
Normal random act
| Abnormal directional/chemo activity
34
Lazy Leukocyte syndrome
Abnormal random and chemo activity
| Test: Boyden Chamber Assay
35
What initiates engulfment
Large capsules
36
Opsonins
Interact with surface bacteria to render them acceptable to the phagocyte
- - specfic Abs
- - complement C3b
37
Complement that acts as an opsonins
C3b
38
Process of Digesting jn Phagocytosis
Lysozyme approaches phagosome -- fuse -- rupture -- discharge hydrolitic enzymes and peroxidase
Cells become granulated as foreign materials
39
Destruction of the Antigen
- formation of phagolysosome leads to release of lysosomal contents
- activated macrophages produce nitric oxide
- activation of NADPH oxidase from phagosome membrane leading to ROXs
40
Disease with impaired NADPH oxidase
Chronic Granulomatous Disease
41
Cardinal signs of Inflammation
```
Rubor: redness
Calor: heat
Tumor: swell
Dulor: pain
Fundio laesa: loss of function
```
42
Vascular response during infamm
Vasodilation --> increase blood flow and cell permeability --> redness and heat
43
Cellular response during inflamm
Activation of neutrophils and macrophages --> fever
44
Interleukin responsible for fever
IL-2
45
Interferes with viral replicaton
Interferon
46
INF produced by virus-induced leukocyte
INF alpha
47
Major producer of INF alpha
Null lymphocyte
48
Produced by double stranded RNA fibroblast cell
IFN beta
49
Major producer of IFN beta
Fibroblasts and epith cells
50
Reactant/s that increase 1000x during inflamm
CRP and Serum Amyloid A
51
Type 2 IFN
Gamma
52
IFN produced by immunologically stimulated lympho
IFN gamma
53
Major producer of IFN gamma
T cell
54
IFN primarily produced as a component of the specific immune response to viral and other pathogens
IFN gamma
55
Cytotoxic against tumor cells and virally infected cells
TNF
56
TNF produced by macrophages
TNF alpha aka CACHETIN
57
TNF produced by CD 4+ and CD8+
TNF beta aka LYMPHOTOXIN
58
Series of protein whose overall fxn is to mediate inflamm
Complement
59
Serum protein thay exerts bactericidal and viricdal effects in the presence of C3 abd Mg++
Properdin
60
Heat stable cationic substance with bactericidal activity
Betalysin
61
Ab production is done by the body
Active immunity
62
Type of immunity: vaccination
Artificial active
63
Type of immunity: infection
Natural active
64
Type of immunity: administration of immune serum
Artificial passive
65
Type of immunity: transfer in vivo
Natural passive
66
Type of immunity: colustrom
Natural passive
67
Primary lymphoid organs
Thymus and BM
68
Secondary Lymphoid organd
Spleen, lymph nodes, peyer's patches, tonsils, appendix, adenoids, MALT, etc
69
Cells involved in Cell-mediated immunity
T cell
70
Cell involved in humoral immunity
B cells
71
Where do T cells develop?
Thymus
72
End product of activation of T cells
Cytokines
73
Antigens for T cells
CD2, CD3, CD4, CD8
74
Forms rosette formation with sRBCs
T cells
75
Region of lymph nodes where T cells are located
Paracortical
76
Organ for development of B cells
Bone marrow
77
End product of B cells
Antibody
78
Antigens for B cells
CD19, CD20, CD21, CD40, MHC Class II
79
Identified by surface immunoglobulins
B cells
80
Region of lymph nodes for B cells
Cortical region
81
Helper-inducer T cell
CD4+
82
Suppressor-cytotoxic T cell
CD8+
83
Ratio of CD4+ : CD8+
2:1
84
CD4+ : CD8+ ratio of HIV
1:2
85
Stage of T cell dev that lacks both CD4 and CD8
Double-negative thymocytes
86
Stage of T cell dev where CD4 and CD8 are both expessed
Double-positive thumocyte
87
After selection, T cells migrate to...
Medulla
88
Percent of peripheral T cells expressing CD4
2/3 = 65%
89
Life span of resting T cells in peripheral organs
Several years
90
T helper cells 1 (Th1) produce
IFN-y and TNF-B which protect cells against intracellular pathogens
91
T helper cells 2 (Th2) produce
Variety of interleukins
92
Essential role of Th2 cells
Help B cells produce antibodies against extracellular pathogens
93
Receptor of activated T cells for IL-2
CD 25
94
Secreted by sensitized T cells
Cytokines
95
Immune response by sensitized T cells
Cell-mediated immunity
96
Precursor cells in antibody production
B cells
97
Distinctive markers of this stage of B cells include CD19, CD45
Pro-B cells
98
Pro-B cells have intracellular proteins for the gene rearrangement of chromosome...
Chromosome 14 -- codes for the heavy chain of Ab molecule
99
First synthesized heavy chains in Pre-B cells
mu chains -- IgM
100
Kappa light chain chromosome
Chromosome 2
101
Lambda light chain chromosome
Chromosome 22
102
Stage of B cell distinguished by the appearance of complete IgM
Immature B cells
103
Other surface proteins on immature B cell
CD 21, CD 40, MHC Class II
104
Target cell of EBV
CD 21
105
In addition to IgM, this stage of B cells also exhibit IgD
Mature B cells
106
Unless contact with Ag occurs, what is the life span of mature B cells
Few days
107
Upon stimulation of B cells to an Ag, it undergoes transformation into a _____
Blast stage --> forms memory cells and Ab-secreting plasma cells
108
Name of the process wherein B cells transform into Blast stage
Ag-dependent phase of B cell development
109
Site for Ag-dependent activation of B cells
Primary follicles of peripheral lymphoid organ
110
B cell characterized by abundant cytoplasmic Ig with little to no surface Ig
Plasma cell
111
Most fully differentiated lymphocyte
Plasma cell
112
Main function of plasma cell
Ab production
113
CD2
| Cell type and function?
- Thymocytes, T cells, NK cells
| - T cell activation
114
CD3
| Cell type and function?
- Thymocytes, T cells
| - Assoc. with T cell antigen receptor; TCR transduction
115
CD10 aka Calla Ag
| Cell type and function?
- B and T cell precursors, bone marrow stromal cells
| - Common acute lymphocyte -- leukocyte Ag
116
CD16
| Cell type and function?
- Macrophage, NK cells, neutrophils
| - Phagocytosis and ADCC
117
CD34
| Cell type?
- Hematopoietic stell cell
118
CD56
| Cell type and function?
- NK cells, subsets of T cells
| - Not known
119
Lab identification for Lymphocytes
1. Cell Flow Cytometry
- Forward: Cell size
- Side: Cell granulation
2. Fluorescence microscopy
3. Rosette Test
120
Genes that control expression of a large group of proteins
Major Histocompatibility Complex
121
Chromosome for gene coding of MHC in humans
Short arm of Chromosome 6
122
Genetic loci of MHC Class I
HLA - A, B, C
123
Genetic loci for MHC Class II
HLA - DP, DQ, DR
124
Chain structure of MHC Class I
Alpha chain + beta2 microglobulin
125
Chain structure of MHC Class II
Alpha chain + beta chain
126
Cell distribution of MHC Class I
All nucleated cells
127
Cell distribution of MHC Class II
B cells, APCs (Antigen Presenting Cells)
128
Antigen presentation of MHC Class I
To CD8+ --> TNF-Beta OR lymphotoxin
129
Antigen presentation of MHC Class II
To CD4+ --> Plasma cells for antibody proloferation
130
Substance that is capable of inducing an immune response and antibody production
Immunogen
131
Antigenic determinant
Epitope
132
Parts of an antigen
1. Carrier
- protein nature = high MW
- immunogenic
2. Hapten
- non-protein = low MW
- antigenic
133
Importance of HLA typing
1. Tissue/Organ transplant
2. Disease association
3. Paternity Testing
134
Factors affecting immunogenecity
1. Foreignness
2. Size
3. Chemical composition and complexity
4. Rouse, dosage, and timing
5. Adjuvants
135
Autograph/autoantigen
From same individual
136
Allogen/isograft
From different individual but same species
137
Heteroantigen/Heterograft
From different species
138
Most immunogenic transplant tissue
Bone marrow
139
Least immunogenic transplant tissue
Cornea
140
Potent Antigen size
MW >= 10 000 daltons
141
Size of a "Good immunogen"
MW >= 40k daltons
142
Size of an "Excellent immunogen"
MW >= 1M daltons
143
Function of adjuvants
To enhance immune responce
144
General functions of immunoglobulins
1. Neutralize toxic substances
2. Facilitates phagocytosis
3. Combine with antigens on cellular surfaces to destroy cells
145
Theory of antibody diversity stating that prior to contact, cells already have receptors and the antigen then binds to specific/proper receptors to break them off and enter the circulation as antibody molecules
Ehrlich's Side-Chain Theory
146
Theory of antibody diversity stating that cells produce "general" template of antibodies and antigens would act as a mold
Template theory
| - by Felix Haurowitz
147
Theory of antibody diversity stating that lymphocytes produce specific Ig
Clonal selection
| - by Niels Jerne and Macfarlane Burdet
148
Structure of IgG
Monomer
149
Structure of IgM
Pentamer
150
Structure of IgA
Serum: monomer
Secretion: dimer
151
Structure of IgD
Monomer
152
Structure of IgE
Monomer
153
Concentration % of Igs
G > A > M > D > E
154
"Heaviest" Ig and with the highest sedimentation coefficient
IgM
155
Ig with the longest half life
IgG (23 days)
156
Complement fixation of Igs
IgG: Classical
IgM: Best!; multiple binding
IgA: Alternative
157
Only Ig that is able to cross the placenta
IgG
158
Heavy chain of IgA
Alpha
159
Heavy chain of IgD
Delta
160
Heavy chain of IgE
Epsilon
161
Heavy chain of IgG
Gamma
162
Heavy chain of IgM
Mu
163
Light chain kappa:lambda ratio
2:1 or 65%:35%
164
Bond between HC and LC
Disulfide bonds
165
Flexible region of an Ig
Hinge region
| - proline determines flexibility
166
Number of domains in a light chain
2 (VL and CL)
167
Number of domains in a heavy chain
4 (VH and 3CH)
168
Ig with extra CH4 --> HC with 5 domains
IgM and IgE
169
Papain cleavage of monomer
- Cleaves above hinge
| - Results to 3 fragments = 2 Fab and Fc
170
Pepsin cleavage of monomer
- Cleaves below hinge
| - Results to 2 fragments = F (ab)2 and FC'
171
Major/general functions of IgG (5)
1. Provide immunity for newborn
2. Fixation of complement
3. Opsonization
4. Neutralization of toxins and viruses
5. Agglutination and precipitation reactions
172
IgG subclasses cross placenta except
IgG2
173
Best IgG subclass for the fixation of complement
IgG3
174
All IgG subclasses fix complement except
IgG4
175
Functions of IgM
1. Complement fixation
- most efficient
2. Agglutination
- best!
3. Opsonization
4. Neutralization of toxins
176
Subclass of IgA found in serum
IgA1
177
Subclass of IgA found in secretions
IgA2
178
What produces the secretory component of IgA
Epithelial cells
179
Function of IgD
- Immunoregulation
| - Postulated to be anti-idiotypic antibody --> feedback mechanism of B cells
180
Secondary Ig to appear on B cells
IgD
| - primary is IgM
181
Ig that mediates hypersensitivity reactions, allergies, and anaphylaxis
IgE
182
Ig generally responsible for immunity against parasites
IgE
183
IgE molecule is unique because it binds strongly to ______ to release histamines and heparin
Mast cells and basophils
184
RIST for IgE
Test for Total IgE
185
Radioallergosorbent Test for IgE
Measures specific IgE
186
Factor ___ claves C3b and C4b
Factor I
187
Cofactor of I to inactivate C3b and prevents binding of B to C3b
Factor H
188
Function of Decay Accelerating Factor
Dissociates C3 convertase
189
C2 deficiency
- Lupuslike syndrome
- Recurrent infections
- Atherosclerosis
190
Complement component/s deficiency that is/are associated with lupuslike syndrome
C1, C2, C4
191
C3 deficiency
- Severe recurrent infections
| - Glomerulonephritis
192
Complement component/s deficiency that is/are associated with Neisseria infections
C5-C8(C9)
193
Complement component/s deficiency that is/are associated with hereditary angioedema
C1INH
194
Complement component/s deficiency that is/are associated with paroxysmal nocturnal hemoglobinuria
DAF, MIRL
195
Most common complement component deficiency
C2
196
Most severe and most recurrent complement component deficiency
C3
197
Recognition unit for the complement system
C1
198
Anaphylatoxin-associated complement component/s
C4a, C3a, C5a
199
Chemotoxin-associated complement component
C5a
200
Opsonin-associated complement component/s
C3a
201
C3 convertase classical cascade
C4b2a OR C4b2b
202
C3 convertase alternative cascade
C3bBb
203
C5 convertase classical cascade
C4b2a3b OR C4b2b3b
204
C5 convertase alternative cascade
C3bBb3b
205
Ions associated with the complement system
Ca++ and Mg++
206
Autoimmune disease associated with HLA-DR3
- SLE Class 2
- Scleroderma (weak association)
- Sjogren's syndrome
207
Autoimmune disease associated with HLA-DR4
Rheumatoid arthritis
208
Autoimmune disease associated with Complex Age dependent
Myasthenia Gravis
209
Antibodies associated with Grave's disease
Anti-TSH receptor antidobies --> hyperthyroidm
210
Antibodies associated with pernicious anemia
Anti-parietal cell antibodies and anti-intrinsic factor antibodies
211
Antibodies associated with Goodpasteur's syndrome
Anti-glomerular basement membrane
212
Antibodies associated with Primary Billary Cirrhosis
Anti-microbial antibody
213
Antibodies associated with Chronic Active Hepatitis
Anti-Smooth Muscle antibody --> hypothyroidism
214
Antibodies associated with Hashimoto's thyroiditis
Antimicrosomal antibody
215
Initial force of attraction that exists between a single Fab site on Ab and a single epitope/determinant on Ag
Affinity
- Ionic bond
- H-bond
- Hydrophobic
- Vander waals forces
216
Sum of all attractive forces between a multivalent Ag and a multivalent Ab
Avidity
217
Smooth curve in Ouchterlony Double Diffusion
Serological identity
218
Crossed lines in Ouchterlony Double Diffusion
Non-identity
219
Spur formation in Ouchterlony Double Diffusion
Partial identity
220
Chromosome coding for ABO Blood Group
Chromosome 9
221
Chromosome coding for Rh
Chromosome 1
222
Chromosome coding for MNS
Chromosome 4
223
Chromosome coding for Kell
Chromosome 7
224
CChromosome coding for Kidd
Chromosome 18
225
Chromosome coding for H, Lewis, Lutheran
Chromosome 19
226
Genes for the ABH antigens code for:
a. enzyme
b. sugar
Enzyme
227
H gene codes for what enzyme?
L-fucosyltransferase
228
A gene codes for what enzyme?
N-acetylegalactosaminyltransferase
229
B gene codes for what enzyme?
D-galactosyltransferase
230
L-fucosyltransferase attaches to what sugar?
L-fucose
231
N-acetylegalactosaminyltransferase attaches to what sugar?
N-acetyl-D-galactosamine
232
D-galactosyltransferase attaches to what sugar?
D-galactose
233
Individuals who did not inherit the H antigen and are mistaken to be Group 0
Bombay individuals
234
Amount of H Antigen in ABH phenotypes
o > A2 > B > A2B > A1 > A1B
235
Acquired A antigen is associated with infections caused by __________
Proteus mirabilis
236
Acquired B antigen is associated with infections caused by __________
Proteus vulgaris and E. coli O86
237
Acquired B antigen : EPIC
E. coli O86
Proteus vulgaris
Intestinal obstruction
Carcinoma of colon / rectum
238
Predominant Ig of antibodies produced by Blood Group A and B
IgM
- naturally occuring
- react at room temp
239
Predominant Ig of antibodies produced by Blood Group O
IgG
- immune antibodies
- react at 37C
240
Rh Blood Factor of D
Rho
241
Rh Blood Factor of d
None
242
Rh Blood Factor of C
rh'
243
Rh Blood Factor of c
hr'
244
Rh Blood Factor of E
rh"
245
Rh Blood Factor of e
hr"
246
Mechanism wherein D antigens expressed appear to be complete but are few in number
Genetic Weak D
247
Mechanism wherein the allele carrying D is trans to the allele carrying C
C Trans
248
Mechanism wherein one or more parts of the D antigen is missing
D Mosaic or Partial D
249
Rh with the highest D antigen
Rh deleted
250
RBC morphology of Rh null individuals
Stomatocyte
RMT BY MARCH 2017!!!
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