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lecture 26 ansari

adaptive immune system T and B lymphocytes with greater specificity in their receptors to catch many types of antigens; usually is the cause along with other mononuclear cells of chronic inflammation
innate immune system is non-specific and uses germline receptors like PAMPs and TLRs to catch invading pathogens --> NK cells, dendritic cells, phagocytes, etc. Responsible for the short-lived acute inflammation response
conductor vs executor of adaptive immunity conductor - CD4+ T cells that signal other immune cells to get working executor - CD8+ T cells that kill things
type I hypersensitivity reactions IgE-mediated allergic rxns in a pre-sensitized host. Mast cells with specific IgE will react when they come in contact with invading Ag again, need Th2 cell help; cause asthma exacerbation, urticaria, etc from histamine release
atopy describes the tendency of an individual to be prone to type I hypersensitivity reactions, that is mast cell degranulation causing urticaria, etc when exposed to various Ags in environment
examples of type I hypersensitivity reactions atopic bronchial asthma, atopic dermatitis, hives/urticaria, allergic rhinitis or conjunctivitis, hay fever, even anaphylaxis
type II hypersensitivity reactions antibody-mediated; Abs bind to EC matrix or RBCs (in hemolytic anemia) with subsequent destruction by opsonization (phagocytosis) or complement activation/lysis
examples of type II hypersensitivity reactions Grave's dz, myasthenia gravis, pemphigus vulgaris, hemolytic dz of the newborn, Goodpasture syndrome
Goodpasture syndrome antiglomerular BM and lung alveolar antibody deposition causes rapidly progressive glomerulonephritis and pulmonary hemorrhage. remember LINEAR PATTERN OF AB AND COMPLEMENT DEPOSITION
type III hypersensitivity reactions mediated by deposition of immune complexes in extravascular sites or vessel walls. injury through complement activation or recruitment of neutrophils or monocytes. formation of immune complexes in the blood is not necessarily abnormal!!
examples of type III hypersensitivity reactions polyarteritis nodosa: Hep B virus antigens; SLE: Abs against DNA and nuclear proteins; serum sickness (horse antithymocyte globulin) and arthus rxns
remember LUMPY-BUMPY pattern of Ab and complement deposition type III hypersensitivity reactions
type IV hypersensitivity reactions cell-mediated delayed-type hypersensitivity over the course of days-wks; initiated by Ag-activated CD4+ T cells that activate macrophages and bring in mononuclear infiltrate. CD8+ T cells do cytotoxicity directly
examples of type IV hypersensitivity reactions contact dermatitis, skin testing (PPD), type 1 DM, MS, RA, graft rejections TB infections causing granuloma formation
systemic lupus erythematosus (SLE) Chronic, remitting-relapsing prototypical systemic autoimmune illness affecting predominantly kidney, joints, skin and serosal membranes;
screening for presence of _______ is the first step to diagnosis SLE anti-nuclear antibody (ANA)
more specific tests for definitive dx of SLE anti-dsDNA antibody and anti-Smith antibody
screening for presence of _______ leads to dx of Sjogren's syndrome anti-SS-A and anti-SS-B antibody tests (anti-ribonucleoprotein antibodies)
screening for presence of _______ leads to dx of systemic sclerosis anti-Scl-70
pathogenesis of SLE pt already has decreased lymphocyte tolerance, stresses like UV radiation and immunological factors cause cytolysis of cells, increased nuclear protein load leads to Ab formation against them --> immune complexes form on various organs (type III)
cause of death in many pts with lupus renal manifestations - deposition of DNA-anti-DNA complexes in glomerulus (class IV, diffuse proliferative GN is worst prognosis)
Sjogren's syndrome lymphocytic infiltration and fibrosis of salivary glands and lacrimal glands causing chronic dry eyes and xerostomia; usually associated with other autoimmune dz like SLE or RA (secondary form); ANA usually (+)
scleroderma abnormal accumulation of fibrous tissue in skin and other organs, either diffuse or limited type; anti-DNA topoisomerase I antibodies (Scl-70) or anti-centromere antibodies
Created by: sirprakes