Transplantation Immunology
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| Rejection occurs due to ? | * immune recognition and response to foreign histocompatibility antigens
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| most important antigens of rejection ? | MHC..... * but there are others, so can still reject if all MHCs all line up perfectly
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| What is the normal role of HLA antigens in the immune response? | * Present antigenic peptides to T cells
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| HLA class 1 = ? | * HLA - A, B, C.... * also expresses B2-microglobulin.... * All are in MHC-I
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| HLA class 2 = ? | * All in MHC-II.... * are HLA - DR (a/b), DP (a/b), and DQ (a/b)
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| How many different HLA molecules are on the cell? | * you have both on each cell
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| expression of alleles of HLA ? | * get codominance with Haplotype inheritance of MHC antigens.... * each person has 2 different halotypes for each HLA bc of two parents, but are codominantly expressed
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| Hyperacute Rejection ? | * happens in minutes-hrs and is from anti-donor ABs and complement
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| Acute Rejection ? | * days-weeks and is from cell mediated and humoral .... * primary activation of immune system and T-Cells recognize foreign HLA antigens.... * if Cd4+ is seen, then complement and Ab also mediates this
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| Chronic Rejection ? | * time frame is months-years and MOA is unclear
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| One of the top drugs for anti-rejection ? | * cyclosporine - but have to ween off c it can cause kidney issues
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| Testing for Donor-Recipient Compatibility in Transplantation ? | * 1. ABO Blood typing --
2. HLA identification (tissue typing) --
3. Antibody Screening (reactive with HLA) --
4. Genotyping with PCR and other molecular techniques --
5. Crossmatching – see if recipient has preformed Abs against donor
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| Why have we been using more pig transplants ? | * lack of human cadaver parts
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| Hematopoietic Stem Cell Transplantation (HSCT) use and marker for them in the blood ? | * Used to treat malignancy, immunodeficiency, bone marrow defects, autoimmunity
..... * CD34 marker
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| Graft-versus-host disease ? | * complication of allogeneic HSCT is graft-versus-host disease (GvHD) ..... * GvHD is caused by mature donor T cells contaminating the HSC inoculum, which can recognize HLA
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| How to help GVHD ? | * help eliminate as many as those mature T-cells as possible, bc once activated, it is pretty much impossible to stop
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| Acute GVHD = ? | * about 3 weeks
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| Chronic GVHD = ? | * months
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| Helps GVHD a lot ? | * matching of the HLA antigens
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