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Immunology
Immunology
118
Health Care
Pre-School
11/02/2009

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Term
Cause of chronic inflammation
Definition
inability of body to clear pathogens leads to chronic response
Term
targets for antiinflammatory drugs
Definition
lipid mediators and cytokine mediators
Term
components of innate immune system
Definition
macrophages and neutrophils
Term
components of adaptive immune system
Definition
white blood cells, t cells, macrophages, b-cells
Term
components linking innate and adaptive immune system
Definition
cytokines, antibodies, complements
Term
specificity in adaptive v innate immune system
Definition
immune broad specificity, recognizing PAMPs adaptive narrow recognizing specific epitaphs
Term
PAMP types
Definition
polysaccharides, peptides, polunucleotides not found in the host
Term
epitope derivation
Definition
derived from specific polypeptides recognizing unique pathogens
Term
receptor differences between innate and adaptive
Definition
innate: prr (Pattern recognition receptors), adaptive: T-cell and B-cell
Term
response times: innate v adaptive
Definition
innate: immediate, adaptive, 3-5 days
Term
classes of species that have adaptive response
Definition
vertebrates only
Term
Fk506 and cyclosporin use
Definition
transplants inhibiting NF-kb activation
Term
role of macrophages in acute response
Definition
phagocytize bacteria as well as PMNs
Term
steps in emigration
Definition
chemoattraction, adhesion, diapadesis
Term
process by which neutrophils have their action
Definition
OCl superoxide, enzymatic activity, acidic activity
Term
protein attacked by neutrophils
Definition
C3b protein, attached by antigens to bacteria
Term
Plasma cell role in immunology
Definition
packed with ER, factory for immunoglobulins
Term
Immunoglobulin mechanism of action
Definition
bind to receptors on pathogens which prevent pathogens from binding to target cells
Term
immunoglobulins and neutrophil interaction
Definition
Fc portion of Ig is recognized by PMNs. Ig acts as (constant region)a complement to PMN, entire process known as opsonization
Term
Fab v Ac
Definition
variable region of Ig v functional region
Term
Bacteria binding site size for Ig
Definition
~ 5 amino acids in length
Term
function of complements
Definition
link adaptive and innate immune systems; can occasionally lyse cells; present pathogens for opsonization
Term
three ways that complement can be activated
Definition
alternative, classical, mannose binding
Term
intersection protein of all 3 complement activating pathways
Definition
C3b; C3b is a cleavage product of C3
Term
classical pathway
Definition
Ig bind to pathogen surface (typically IgM), C1 recognizes the bound Ig and binds to them forming complex, this complex becomes a protease cleaving C2 and C4 which bind to pathogen surface as C2b and C4b, C3 interacts with these proteins and cleaves, C3b binds to pathogen forming active complement and begins opsonization
Term
which part of complement do neutrophils recognize
Definition
C3b; C3b acts as a protease on other C-class proteins which ultimately build complex and bore pore into pathogen
Term
chemotactic factor for neutrophils
Definition
C5a
Term
pore-forming complements
Definition
C5b, C6, C7, C8
Term
alternate pathway of opsonization
Definition
C3 gets hydrolyzed and gets cleaved to C3a and C3b; Factor B binds to C3b on cell surface; Bb displaced on host surface and C3b is inert; on pathogen surface BbC3b complex yields many more C3 sites
Term
alternate pathway of opsonization
Definition
C3 gets hydrolyzed and gets cleaved to C3a and C3b; Factor B binds to C3b on cell surface; Bb displaced on host surface and C3b is inert; on pathogen surface BbC3b complex yields many more C3 sites
Term
Lectin pathway mechanism
Definition
MBL recognizes mannose residue; mannose serine proteases cleave C2 and C4; C2b and C4b form C3 and then enters the common pathway
Term
mediator of margination
Definition
integrins
Term
mediator of neutrophil adhesion
Definition
selectins
Term
mechanism of selectins
Definition
"tethering"; they recognize carbohydrates and salicylics on the surface of neutrophils
Term
mechanism of integrins
Definition
factors C5a; PAF and leukotrienes recognize receptors on neutrophil surface; drag neutrophil to site of diapadesis
Term
key molecules on endothelial surface that recognize neutrophils
Definition
MDCAM, DCAM,
Term
steroid mediation of inflammation
Definition
inhibit cleavage of cell membrane phospholipases which would lead to arachidonic acid synthesis
Term
thromboxane physiological effect
Definition
vasoconstriction
Term
prostaglandin physiological effect
Definition
vasodilation
Term
leukotriene physiological response
Definition
vasoconstriction; bronchospasm; increase permeability
Term
vWF attracts which protein
Definition
G1b
Term
receptors that bind fibrinogen
Definition
GpIIA and GpIIIb form dimer and bind fibrinogen creating basis for clot
Term
main lipid based mediators released by platelets
Definition
thromboxane A2 and leukotriene B4
Term
receptor on glycoproteins that bind to vWF
Definition
G1b; vWF binds to exposed subendothelium, attracts glycoproteins which bind through G1b receptor, activated platelets start releasing fibronectin, serotonin and chemoattractants, dimer is formed between GPIIb and GPIIIa which binds fibrinogen
Term
Interleukin 8
Definition
released by activated endothelial cells and macrophages, chemoattractant for neutrophils
Term
TGF-beta
Definition
produced by platelets and macrophages; chemoattractant for macrophage but tends to inhibit their activation as well as inhibiting activation of t-cells
Term
SAR of carbonic anhydrase
Definition
Sulfamoyl with unsubstituted nitrogen, other sulfamoyl can be subsituted for carboxilic which may increase diureses
Term
Foam Cells
Definition
macrophages enter arterial wall and are filled with cholesterols; fibrous cap can weaken and rupture; blood clot forms at point of rupture which will occlude vessel; gp2b and gp3a come together to form fibrin; integrin interferes with this process and can be used therapeutically to prevent clot formation
Term
neutrophil clearance
Definition
neutrophils accumulate in 3-5 days and must be cleared prior to healing; neutrophils removed via apoptosis, signal undefined
Term
macrophage downregulation
Definition
macrophage remain at injury site for weeks with eventual apoptosis or possible transformation
Term
fibrin formation
Definition
factor V expressed on surface of platelet; circulating prothrombing converted to thrombin in presence of Ca++ and lipid membrane; thrombin converts fibrinogen to fibrin
Term
two mechanisms that increase connective cell proliferation after monocyte/macrophage migration
Definition
chemoattraction of mesenchymal cells (eg fibroblasts, smooth muscle cells); proliferation of mesenchymal cells
Term
potent mesenchymal chemoattractants
Definition
TGF-beta and PDGF
Term
connective tissue responsibilities
Definition
deposition of extracellular matrix, particularly collagen
Term
endogenous agents causing chronic inflammation
Definition
lipids such as cholesterols
Term
Macrophage products involved in tissue destruction
Definition
oxygen metabolites, proteases, neutrophil chemotactic factors, coagulation factors, AA metabolites, nitric oxide
Term
Macrophage products involved in fibrosis
Definition
PDGF, FGF, TGF-beta, fibrogenic cytokines, angiogenesis factors, remodeling collagenases
Term
enzymes released by activated macrophage
Definition
protease, elastase, collagenase, plasminogen activator, acid hydrolases, phosphatases, lipases, complement (C1 - C5), properdin, coags V. VIII. tissue factor, reactive oxygen metabolites, eicosanoids, cytokines, growth factors, nitric oxide
Term
Factor P (properdin)
Definition
complexes with C3b to stabilize C3b convertase which then cleaves more C3 in alternate pathway
Term
Differentiation of phagocytes
Definition
microglia, kuppfer cells, alveolar macrophages
Term
activators of macrophages
Definition
activated t cells (interferon gamma), nonimmune activation (endotoxin)
Term
autocatalytic cycle in chronic inflammation
Definition
macrophage releases cytokines which activate leukocytes which release leukokines which activate macrophage
Term
granuloma causing pathogens
Definition
tuberculosis; leprae; treponema pallidum; gram negative bacillus; schistosomiasis; cryptococcus neoformans; coccidioides immitis
Term
histological characteristics of a chronically inflamed lung
Definition
Destruction of lung parenchyma-normal alveoli are replaced by spaces lined by cuboidal epithelium
Term
mechanism of rheumatoid arthritis
Definition
synovial membrane undergoes hyperplasia; synovium vasculurized; CD4 and B cell infiltration; synovial membrane transformed to inflammatory tissue: pannus
Term
mediation of cytokine signalling pathways in rheumatoid arthritis
Definition
TNF-alpha and IL-1
Term
methods of blocking inflammatory cytokines
Definition
soluble TNF receptor fusion proteins; soluble IL-1 receptor; monoclonal antibody against TNF; monoclonal antibody against IL-6
Term
methods of receptor antagonism in blocking inflammatory cytokines
Definition
recombinant IL-1 receptor antagonist; monoclonal antibody against IL-6 receptor
Term
activation of antiinflammatory pathways to inhibit inflammatory cytokines
Definition
IL-4 and IL-10
Term
IL-1 inflammation mediation on hypothalmus
Definition
fever
Term
IL-1 inflammation mediation on muscle
Definition
release of amino acids
Term
IL-1 inflammation mediation on T-cells
Definition
production of IL-2, BCGF, IFN
Term
IL-1 mediation of hepatocytes in inflammation
Definition
acute phase proteins
Term
IL-1 mediation of B-cells in inflammation
Definition
stimulation and antibody production
Term
IL-1 mediation of fibroblasts in inflammatory response
Definition
proliferation and collagen production
Term
bacterial products that stimulate IL-1 production in macrophages
Definition
bacteria, lipopolysaccharide, muramyl dipeptide
Term
inert particles that stimulate IL-1 production in macrophages
Definition
silica or latex; beryllium salts
Term
immunological factors that stimulate IL-1 production in macrophages
Definition
activated T-cells; IFN-gamma; antigen-antibody complexes
Term
additional factors that stimulate IL-1 production in macrophages
Definition
phorbol myristic acetate; concanavalin A; pyran copolymers
Term
upregulation of acute phase proteins
Definition
CRP and SAA 1000X; transferrin, fibrinogen, haptoglobin, a1 antitrypsin, a1 acidglycoprotein 3X
Term
C-reactive protein
Definition
marker for chronic inflammation, up to 1000X upregulation; signals phagocytic activity to clear debris
Term
naturesis
Definition
excessive loss of sodium in urine
Term
gitelman's syndrome
Definition
flaw in NaCL channel (where thiazides normally work) preventing Na resorbtion and causing naturesis
Term
osmotic diuretics
Definition
mannitol - IV; glycerin - ocular; isosorbide - emergency glaucoma; urea - intracranial pressure
Term
NF-xb activation inhibition
Definition
cyclosporin and Fk506
Term
respiratory burst
Definition
cytoplasmic oxidase interacts with receptor in presence of NADPH; O2 becomes free radical; gets converted to H2O2; in presence of myeloperoxidase OCl free radical is formed
Term
complement
Definition
serum proteins synthesized in liver;
Term
chemoattractants
Definition
PAF; P5a; LTB4; LPS; fMLP; PDGF
Term
neutrophil chemotactic factors
Definition
bacterial products; C5a; C567; kallikrein; mast cell factor; thromboxanes; HETES; collagen breakdown products; plasminogen activator; prostaglandins; immune complexes; fibrin breakdown products
Term
histamine and serotonin mediates
Definition
vascular leakage
Term
bradykinin mediates
Definition
vascular leakage and pain
Term
C3a mediates
Definition
vascular leakage; leukocyte adhesion and activation
Term
C5a mediates
Definition
vascular leakage; chemotaxis; leukocyte adhesion and activation
Term
prostaglandin mediates
Definition
potentiates other factors; pain; faver; vasodilation
Term
leukotriene B4 mediates
Definition
chemotaxis; leukocyte adhesion and activation
Term
leukotriene C4, D4, E4 mediates
Definition
vascular leakage; vasoconstriction; bronchosonstriction
Term
oxygen metabolites mediate
Definition
vascular leakage; chemotaxis; endothelial and tissue damage
Term
PAF mediates
Definition
vascular leakage; chemotaxis; bronchoconstriction; leukocyte priming
Term
PAF mediates
Definition
vascular leakage; chemotaxis; bronchoconstriction; leukocyte priming
Term
IL-1 and TNF mediates
Definition
chemotaxis; acute phase reactions; endothelial activation
Term
IL-8 mediation
Definition
chemotaxis; leukocyte activation
Term
nitric oxide mediation of anemia
Definition
vasodilation and cytotoxicity; also leads to B-12 deficiencies
Term
chemotactic for macrophages
Definition
TGF-beta
Term
main mediators produced by macrophages
Definition
IL-1 and TNF-alpha
Term
macrophage innate receptors
Definition
mannose; LPS; glucan; TLR-4; scavenger
Term
hydroxyurea
Definition
sickle cell; for adolescents or adults w/frequent pain; 500mg 6-8 weeks
Term
transplant issues in sickle cell
Definition
reserved for adolescents; 10% mortality due to sterility issues;only 15% of children have matched sibling donors
Term
absorption of iron preparations
Definition
15%; ferrous sulfate is agent of choice
Term
oral iron preparations
Definition
ferrous sulfate agent of choice; more expensive agents ferrous fumarate and ferrous gluconate
Term
superoxide formation with Fe2+
Definition
Fe2+ + O2 -> Fe3+ + O2-
Term
parental iron preparation
Definition
iron dextran; bypasses mucus block; can lead to anaphylaxis, iron overload
Term
antidote for iron overload
Definition
deferoxamine
Term
drugs that cause B-6 deficiencies
Definition
isoniazid, pyrizinamide
Term
B-12 neurological needs
Definition
myelin sheath maintenance; methionine synthesis (DNA synthesis)
Term
B-12 analogs
Definition
cyancobalamin; hydroxocobalamin
Term
Castle's intrinsic factor deficiencies
Definition
leads to B-12 deficiencies; gastritis can lead to deficiency of this factor
Term
schilling test
Definition
radioactive B-12 to see whether it is being absorbed
Term
B-12 and homocysteine
Definition
B-12 is a cofactor converting homocystein to methionine; deficiencies lead to homocysteine accumulation which leads to platelet aggregation which can lead to infarcts in young people
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