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Immuno Lec 1

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Commensals   Normal Flora, microbes that coexist with humans without causing disease. Non pathogenic  
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Pathogens   Microbes capable of causing human disease, can attain 3 states of growth in the human body.  
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Colonization   Establishment of proliferating microbes on skin.  
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Infection   The proliferation of microbes in the tissues along with induction of the immune system. The numbers have reached a threshold level  
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Disease   Proliferation of microbes in tissues, immune response and resulting damage or impairment of body functions  
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Once Infection Occurs, what pathways can microorganisms follow   Becoming commensals, elimination, carrier state, or pathogenicity.  
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Three main levels of microbial threat response   Barriers, Innate immunity, Adaptive Immunity  
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Innate Immunity   non specific. 0-96 hours. Phagocytosis, complement, inflammation, cytokine release, NK cell killing  
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Adaptive Immunity   Specific, greater than 96 hours. Humoral - B cells and Antibodies Cell Mediated - T cells and cytokines  
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Barriers to infection   Respiratory Tract, Skin, GI Tract, Urogenital Tract.  
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Defense Mechanisms of the Skin   Sloughing of keratinocytes, fatty acids(lower pH), A-Defensins B-Defensins Cathelecidins, lysozyme, Rnase and Dnase.  
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A and B Defensins and Cathelecidins   Penetrate the bacterial cell wall, disrupt, ultimately make it die.  
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Lysozyme   Degrade Peptidoglycan which is main component of bacterial cell wall.  
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Components of Innate Immunity   Macrophages, Granulocytes, NK cells, Complement, and other chemicals (Hcl, lysozyme)  
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Characteristics of Innate Immunity   Immediate, Non Specific, Response is not enhanced on repeated exposure to pathogen.  
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Why can't you have adaptive immunity without innate immunity?   There is an interplay. Innate generates mediators required to activate the adaptive immune response.  
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Cell Lineage   Start at Hematopoeitic Stem Cell. This becomes Myeloid Lineage of Lymphoid Lineage.  
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Myeloid Lineage   Thrombocytic(thrombocytes), erthyrocytic(erythrocytes), granulocytic(eosinophils, basophils, neutrophils), monocytic(macrophages, monocytes, dendritic cells).  
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Lymphoid lineage   Dendritic Cells, NK cells, T cells, B cells  
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Macrophages   Phagocytic. Located in tissues. longer lifecycle than neutrophil. APC. Secrete cytokines to draw additional macrophages into areas to fight infection and that help activate T and B cells.  
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Neutrophils   Phagocytic. Short life cycle. Located in blood. LowGranular release of antibacterial compounds. Does not engulf, destroys membrane without having to engulf. Not an APC.  
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Pattern Recognition Receptors   Present on phagocytes. They recognize patterns on microbes, not specific features. Innate Immunity. Generally they recognize PAMP.  
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Pathogen Associated Molecular Patterns   PRR's bind to this. These are located on pathogens. They are not specific. Includes the Toll Like Receptors.  
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Phagocytosis   The PRR engages a PAMP. It then encloses the pathogen in a clathrin coated pit. Now it is a phagosome. It fuses with a lysosome. Now it is a phagolysosome.  
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Macropinocytosis   Not receptor mediated. Non specific. Cell extends out processes, engulfs fluids and any microbes present in extracellular environment. becomes cytoplasmic vesicle, then a phagolysosome.  
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What occurs after a phagolysosome is formed   Oxidative Burst and oxygen independent pathway.  
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Oxidative Burst   Key enzyme is NADPH Oxidase. Turns O2 into a superoxide (O2 radical). Then, superoxide dismutase turns that into H2O2. Then, myelo peroxidase turns that into a hydroxyl radical or a hypoclhlorite radical. These physically rupture the membrane.  
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Oxygen independent Pathway after phagolysosome is formed   Cell can produce proteases that destroy the pathogen.  
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Complement System   Innate and Acquired Immunity. Important for destroying bacterial pathogens. 20 or more proteins in serum. Can cause lysis, enhance phagocytosis and participate in inflammation.  
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Three methods of activation of complement   Bacterial Surface. Acute phase protein. Antibody. First two are Innate. Antibody is Adaptive.  
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How does complement enhance phagocytosis?   It is also called opsinization. Complement components can coat bacteria, make more attractive to phagocytic cells. Phagocytic cells have receptor for complement.  
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How does lysis occur in complement?   20 serum proteins are circulating, already made. bacterial surface is sticky to complement. they bind, initiate complement, and then lysis occurs.  
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How do acute phase proteins activate complement?   They bind to pathogen and initiate cascade.  
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Four hallmarks of Inflammation   Rubor, Calor, Dolor, Tumor. Rumor - redness. Calor - Warmth. dolor - Pain tumor - Swelling  
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Three main effects of inflammation   increase blood flow to dilute toxic agents increase capillary permeability to facilitate transmission of large molecules across endothelium increased migration of cells into tissues to destroy bacteria, remove debris, and restore normal tissue structure  
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Six steps of inflammation   Tissue Injury, Vasodilation, Increased Permeability, Emigration of leukocytes, chemotaxis, phagocytosis.  
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Early Inflammatory Mediators   Histamine  
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Histamine   Made in mast cells. Increase vascular permeability  
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Late Inflammatory Mediators   Cytokines, released by activated macrophages. IL-1, TNF-a, IL-8, IL-12  
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Interleukin-1   Fever, induction of adhesion proteins and acute phase proteins  
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Tumor Necrosis Factor alpha   Fever, chemotactic  
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Importance of adhesion proteins   important for margination. in order to undergo diapedesis, they must emigrate.  
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Interleukin-8   Chemotactic for neutrophils  
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Interleukin-12   Activates NK Cells  
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Two phases of Inflammation   Acute, 0-72 hrs Chronic - 72+ Hrs  
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Acute Inflammation   0-72 hrs. Sequential recruitment of cells, first neutrophils (principal inflammatory cell), then monocytes/macrophages, then lymphocytes.  
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Chronic inflammation   Long Term. When causitive agents not destroyed. Formation of granulomas. To isolate or confine the inflammatory agent. Influx of macrophages, they form giant cells. Becomes encased in T lymphocytes, some B.  
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Fever   Elevated Body Temperature Produced by pyrogens. Il-1, Il-6, TNFa  
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Interferons   Proteins synthesized by many cell types in response to viral infection IFNa, IFNb. Also activate NK cells. They can degrade viral nucleic acids.  
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Natural Killer Cells   Innate Immune response. Viral infection. Generalized. Recognizes KAR and KIR. If the NK cell can only bind its KAR and not its KIR, then the NK cell destroys it by releasing granular contents.  
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KAR   Killer Activation Receptor. When infected or under stress, cells show MICa and MICb, stress molecules. KAR binds to this.  
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KIR   Killer Inhibition Receptor. This binds to MHC1 on a cell surface. If this binds to MHC1, then it will not engage.  
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Why do viruses downregulate MHC1   They do this to avoid Cytotoxic T cells because MHC1 holds out cellular contents.  
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Primary Immunodeficiency   Genetic Defect  
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Secondary Immunodeficiency   Secondary to viral infection. Decreased function. Ie. HIV.  
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Neutropenia   Decreased numbers in immunodeficiency  
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Chronic Granulomatous disease   X linked recessive - cytochrome B Autosomal recessive - NADPH Oxidase. no production of superoxide radicals. Cells can get to pathogen, engulf it, can't destroy it. formation of granulomas. Usually opportunistic microbes. Treated with gamma interferon.  
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Why is gamma interferon used for CGD   It activates macrophages, and boosts the oxygen independent pathway.  
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Why does CGD only affect catalase positive individuals?   Because Catalase degrades H2O2. H2O2 is the final step in production of the hydroxyl radical and hypochlorite. If you are catalase negative, you can use H2O2 to break down. If you are catalase positive, you break it down yourself.  
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Leukocytes Adhesion Deficiency   CD18. Autosomal Recessive. CD18 (B-integrin) required for phagocytic adhesion and migration across vessel walls. encapsulated bacteria  
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Chediak Higashi Syndrome   LYST - defect in vesical fusion with macrophage. reduced killing ability. exclusively macrophages. LYST - lysosomal transport.  
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Pathogens of Adaptive Immune System   Extracellular (HUMORAL) - bacteria, toxins, parasites, fungi Intracellular (Cell Mediated) - viruses, parasites, bacteria.  
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B cells vs T cells in the recognition of Antigens   B cells - NATIVE. T cells - PROCESSED.  
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Primary Immune Response   First time you see the pathogen. You won't see any Abs in blood until day 4-5. days 1-5, Innate system is working. First Ab at day 5 is IgM, then IgG. Not Strong. weak affinity.  
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Secondary Immune Response   Lag phase is gone. This is upon repeated exposure. IgG occurs almost immediately due to the abundant memory cells. Also, sustained much longer. Faster and more effective.  
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postulates of clonal selection hypothesis   1.Unique Specificity of Lymphocyte Receptor 2. binding with high affinity leads to lymphocyte activation 3. memory B cells formed will have identical specificity 4. Self recognizing lymphocytes destroyed.  
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