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Immunology
Unit 2 Factoids
27
Medical
Graduate
11/14/2010
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Term
multiple sclerosis immune mechanism
 Definition
o Type IV Hypersensitivity—delayed-type hypersensitivity; depends on T cells
Term
regulatory T cells
 Definition
• IL-2 is especially important for the development and maintenance of ***
Term
molecular mimicry
 Definition
pathogens present an epitope that is similar to self-epitope; cross-activates autoreactive T cells
Term
bystander activation
 Definition
activation of T cells specific for an antigen X during an immune response against antigen Y
Term
 Tumor Necrosis Factor alpha (TNF-alpha)
 Definition
stimulates acute phase inflammation
• A local increase in concentration of this will cause the cardinal signs of Inflammation to occur: heat, swelling, redness, and pain.
• Macrophages produce more *** than T cells
Term
 IFN-gamma
 Definition
CD4+ TH1 produce ***, activates macrophages.
Macrophages produce TNF-alpha
Term
IL-17
 Definition
o CD4+ TH17 produce ***, promotes inflammation (with TNF-alpha)
Term
LFA-1
 Definition
(binds ICAM-1 on endothelium)
Term
VLA-4
 Definition
(binds VCAM-1 on endothelium)
Term
multiple sclerosis dx
 Definition
immunodiagnosis: CerebroSpinal Fluid (CSF) elevated IgG (high IgG/albumin ratio)
Term
MS dx
 Definition
 oligoclonal bands on protein electrophoresis (90% of patients)
Term
MS treatment
 Definition
• Glatiramir acetate (aka Copolymer I or Copaxone)
• IFN-beta
• Fingolimond (o Causes retention of lymphocytes in lymph nodes so they can’t go to CNS)
• Mitoxantrone
(Prevents DNA unwinding,Prohibits proliferation of immune cells)
• Monoclonal antibody against VLA-4 (Alemtuzumab) (Reduces migration of lymphocytes across BBB)
Term
• Guillain-Barre syndrome (GBS)—
 Definition
An acute immune-mediated demyelinating neuropathy (with ascending paralysis¬) in which peripheral nerves are infiltrated with lymphocytes & macrophages
Term
• Guillain-Barre syndrome (GBS) dx
 Definition
 Anti-GM1 & anti-GD1 auto-antibodies
 In CSF: Elevated protein (due to inflammation), Oligoclonal bands may be present
Term
CIDP Immunodiagnosis
 Definition
 Elevated protein in CSF (due to inflammation)
 No auto-antibodies
 Oligoclonal bands are not regularly found
Term
myasthenia gravis immune mechanism
 Definition
o Type II hypersensitivity
 Auto-antibodies against acetylcholine receptor (AChR)
 Classical pathway: complement binds to antibodies
 Affects post-synaptic membrane
 anti-cholinesterase drugs can help
Term
Lambert-Eaton immune mechanism
 Definition
o Type II hypersensitivity
 Auto-antibody against voltage-gated calcium channels
 Affects pre-synaptic membrane
 anti-cholinesterase drugs do not help
Term
• Lambert-Eaton myasthenic syndrome
 Definition
a disease of the neuromuscular junction, characterized by proximal muscle weakness and difficulty walking
Term
• Myasthenia Gravis (MG)
 Definition
—a disease of the neuromuscular junction, characterized by generalized muscle weakness & fatigue of voluntary muscles due to impared neurotransmission, caused by auto-antibody-mediated loss of actylcholine receptors
Term
• Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)Immune mechanisms
 Definition
 Type IV hypersensitivity
• Myelin-specific CD4+ TH1 cellsproduct IFN-gammaactivate macrophagescause demyelination
• Caused by infection
 Type II hypersensitivity
• Auto-antibodies from B cells may also contribute to disease process
 But, it is rarely preceded by infection
Term
• Guillain-Barre syndrome (GBS)— immune mechanisms
 Definition
 Type IV hypersensitivity
• Myelin-specific CD4+ TH1 cellsproduct IFN-gammaactivate macrophagescauase demyelination
• Caused by infection
 Type II hypersensitivity
• Auto-antibodies from B cells may also contribute to disease process
Term
MS immune mechanisms
 Definition
o Type IV Hypersensitivity—delayed-type hypersensitivity; depends on T cells
o Immune reaction to myelin antigens.
Term
polymyositis
 Definition
chronic inflammation of the muscles, seen mostly in adults
o Causes is unclear
o Muscle damage may be caused by CD8+ CTLs
Term
dermatomyositis
 Definition
chronic inflammation of the muscles and skin; involves distinctive skin rashes, including discoloration of the eyelids.
o Cause is unclear r
o Type II (cyotoxic) or type III hypersensitivity (immune complex)
Term
polymyositis dx
 Definition
• anti-Jo 1 (anti-histidyl transfer RNA synthetase)
o auto-antibody seen in **
• anti-SRP (anti-signal recognition particle)
o auto-antibody seen in **
Term
dermatomyositis dx
 Definition
• anti-Mi-2 (anti-Mi-2 nuclear antigen)
o autoantibody seen in **
Term
Lambert-Eaton syndrome
 Definition
can be caused by small cell carcinoma of the lungs
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