PC705: Immunity & Infection

what are examples of endogenous pyrogens?

Tumor necrosis factor alpha and IL-1

Having a reaction to blood products while receiving a blood transfusion is an example of?

Type 2 hypersensitivity reaction

Neutrophils are the primary effector cells involved in what type of hypersensitivity?

Type 3

Which hypersensitivity reaction is delayed?

Type 4

Potency, does the pathogen have the ability to invade a person's defense and cause a disease. The capacity to cause severe disease, for example measles virus is low virulence; rabies virus is highly virulent.

Virulence

What is an opportunistic infection?

are defined as infection caused by non-pathogenic microorganisms which become pathogenic when the immune system is impaired

Results from: Functional decrease in one or more components of the immune system

Immune Deficiencies

convalescence

In most instances, the individual's immune and inflammatory systems successfully remove the infectious agent and symptoms decline; alternatively, the disease may be fatal or may enter a latency phase with resolution of symptoms until reactivation at a later time. (Path 291) Ex. untreated syphilis You're better or you're dead!

The characteristic vascular changes at the site of an injury produce?

Increased permeability and leakage

what is programmed to respond to cellular or tissue damage whether the damaged tissue is septic (contaminated with microorganisms) or sterile. Rapid and Non-specific protective response to cellular injury from any cause. Occurs only in vascularized tissue?

Inflammation

Access between epithelial cells and the cells where they begin to multiply

Invasion

Involves the spread of the pathogen into surrounding tissues and cells (closely linked to tissue damage) Extracellular pathogens invade by means of direct extensions into the surrounding tissue and access the lymphatics and bloodstream - then spreading to internal organs.

Invasion

B lymphocytes (humoral immunity)

produce antibodies or immunoglobulins

What are the cardinal signs of inflammation?

redness, swelling, heat, pain, loss of function

Effects of Acute Inflammation occur with _______ and last______?

second; 8-10 days

CELL-MEDIATED IMMUNITY HELPS PROTECT HUMANS FROM?

the immune system uses cell-mediated immunity to destroy infected body cells.

incubation period

the period from initial exposure to the infectious agent and the onset of the first symptoms, during which the microorganisms have entered the individual, undergone initial colonization and begun multiplying, but are at insufficient numbers to cause symptoms. May last hours to years

Examples of Type 2 Hypersensitivity Reactions

transfusion reactions, hemolytic disease of the newborn, Grave's disease, graft rejection, autoimmune hemolytic anemia, thrombocytopenia

IgE is the antibody involved with a type _______________ hypersensitivity? And _______________ is the primary effector cell involved?

type 1; mast cells

Normal vaginal flora becoming overgrown, causing what?

yeast infection OPPORTUNISTIC INFECTION

IgA

- Awww the baby is nursing (found in breast milk and other mucosal sites) IgA can be divided into 2 subtypes IgA1 and IgA2. IgA1is found predominantly in the blood whereas IgA2 is the predominant class of antibody found in normal body secretions (secretory IgA [sIgA] - Found in breast milk and other mucosal sites) - Makes up 20% of immunoglobulin in the serum. - Serves as an opsonin which helps the phagocytes eosinophils and neutrophils to grip a bacterium easier. - Main immunoglobulin found in mucosal sites such as saliva, tears, semen, and breast milk.

Examples of primary immune deficiencies?

- Congenital (rare, often X-linked, Ex. SCID) - Predisposed to multiple deficiencies - Suspected with severe recurrent, unusual, or unmanageable infections

WHAT IS THE DIFFERENCE IN THE PRIMARY IMMUNE RESPONSE AND THE SECONDARY IMMUNE RESPONSE?

- During a primary response (first exposure to an antigen) IgM is the first responder and has the highest numbers in the serum about 7-10 days after exposure. - During a secondary response (2nd, 3rd, 4th exposure to the SAME antigen) IgG antibodies rapidly increase because of the memory cells created during the first exposure.

IgE

- Ewww parasites and AllergiEs. IgE is normally at low concentrations in the circulation. It functions as a mediator of many common allergic responses and in the defense against parasitic infections. - Makes up 0.004% of immunoglobulin in the serum. - Plays a role in the inappropriate allergy responses (peanuts, tree pollen), seasonal allergies, atopic dermatitis, and asthma. - IgE stimulates the release of mast cell granules, which contain histamine and heparin.

Examples of alloimmune disease

- Hemolytic disease of the newborn - graft rejection - transfusion reaction

IgD

- Let's Do this! Limited information on role. This class of immunoglobulin is found in very low concentrations in the blood. IgD functions as an antigen receptor on the surface of early "naive" B lymphocytes. - Signals that B-cells are ready to leave the bone marrow - Makes up less than 1% of immunoglobulin in the serum. - Appears on mature B-lymphocytes and signals they are ready to leave the bone marrow.

IgM

- Massive Medic (First responder) . Is the LARGEST of the immunoglobulins and usually exists as a pentamer - It is the first antibody produced during the initial, or primary, response to antigen. - IgM is usually synthesized early in neonatal life, but may be increased as a response to infection in utero. - Makes up about 4% of immunoglobulin in the serum. - Most effective in activating the complement system. - FIRST RESPONDER

Examples of secondary immune deficiencies?

- Non-immune system disorders - Infection with HIV - May be caused by poor nutrition, stress, drugs, surgery that secondarily affects the immune system

The normal microbiome:

- RELEASES CHEMICALS THAT DECREASE THE PH - INHIBITS PATHOGEN COLONIZATION - RELEASES CHEMICALS TO PREVENT INFECTION

WHAT ARE SOME FUNCTIONS OF ANTIBODIES?

- Toxin neutralization - Complement Activation - Opsonization (coat microorganisms and make them more susceptible to phagocytosis by binding then more tightly to the phagocyte) - Long-term immunity - Agglutination (is the clumping of particles) -B-Cell receptor - Protection against allergies and worms

B cells

-Cells manufactured in the bone marrow that create antibodies for isolating and destroying invading bacteria and viruses. - White blood cells that produce antibodies and aid in immunological memory

IgG

-Generational (passes from mom to fetus), and Generous (most abundant). the most abundant class of immunoglobulins consisting of 80%-85% of those circulating in the body and accounting for most of the protective activity against infection. -Smallest of the antibodies. -The only antibody that can cross the placenta. -Maternal IgG is transported across the placenta during pregnancy and protects the newborn child during the first 6 months of life

Active or Passive Immunity? Inactivated vaccine (flu shot that hospital employees get every fall)

Active

Examples of autoimmune diseases

-Graves' disease -Type 1 diabetes -Multiple sclerosis -Hemolytic anemia - Lupus - RA

What is an antigen?

-Molecule that stimulates an immune response -is a commonly used term to describe a molecule that can react with binding sites on antibodies or antigen receptors on B and T cells. Most, but not all antigens are immunogens. An antigen that is immunogenic will induce an immune response resulting in the production of antibodies. "pathogen" "Invader"

Active or Passive Immunity? MMR vaccine

Active

Which hypersensitivity reactions are immediate?

1,2,3

benefits of inflammation

1. Prevention of infection and further damage 2. Limit and control the spread 3. Interact with adaptive immune system to elicit a more specific response 4. Prepare area for healing

When is IgG lowest in infants?

5-6 months

How long does acute inflammation last?

8-10 days

AN APRN SUSPECTS A TYPE I HYPERSENSITIVITY WHEN A PERSON REPORTS:

ATOPIC DERMATITIS

Active or Passive Immunity? A child develops measles in Washington state

Active

Active or Passive Immunity? Attenuated Vaccine (varicella at 12 months of age)

Active

Stick to the surface of the cell

Adherence

During a Type I Hypersensitivity you know that the release of ____________ will lead to an increase in vascular permeability.

Histamine

Polysaccharide coating on a bacterial cell

Antiphagocytic factors

Why are infant's immunoglobulin levels at the lowest around 5-6 months of age?

At birth the maternal antibodies start decreasing in numbers and the infant slowly to produce their own IgG At 5-6 months the infant is at their lowest level of IgG, and will have an increase in URIs

May degrade tissues Ex staph aureus

Bacterial enzymes

passive immunity

CAN BE TRANSFERRED FROM A DONOR TO A RECIPIENT

WHICH INFORMATION IS CORRECT REGARDING THE SECONDARY IMMUNE RESPONSE?

IgG IS SIGNIFICANTLY INCREASED.

T LYMPHOCYTES - CELL MEDIATED IMMUNITY

Cellular immunity is mediated by a population of "effector" T cells that can kill targets (cytotoxic T cells) or regulate the immune response (T-regulatory cells), as well as a population of memory cells (memory T cells) that can respond quickly to a second challenge with the same antigen

Measles is spread very easily whereas legionella pneumonia is not. This ability to spread is known as?

Communicability

What are the three key plasma protein systems that mediate inflammation?

Complement system Clotting system Kinin system

IgG IMMUNOGLOBULINS ARE:

DETECTABLE IN THE FETUS AND NEWBORN.

Normal flora of the GI tract?

E. Coli H. Pylori

Resting state of bacteria within the cell and can be reactivated

Endospores

First line of defense: biochemical barriers secrete what?

Epithelial cells secrete a complex array of proteins that destroy potential pathogens. Secretion of antimicrobial peptides that line the GI, GU, and resp. tract..

IgA IMMUNOGLOBULINS ARE:

FOUND IN SALIVA AND OTHER BODY SECRETIONS.

What are the three primary systemic manifestations of acute inflammation?

Fever Leukocytosis Plasma Protein synthesis

What are the two lines of defense that compose the innate immunity?

First line: Mechanical, biochemical, normal microbiome second line: Inflammatory response

What are some clinical manifestations of inflammation and what is the pathogenesis of these manifestations?

Heat: Vasodilation and ↑ blood flow and ↑ RBCs Redness: Vasodilation and ↑ blood flow and ↑ RBCs Swelling: Occurs as exudate (fluid and cells) accumulates Pain: Caused by pressure excreted by exudate accumulation Loss of function: at cellular, tissue, or organ level is associated with these manifestations.

What 3 thing induce the liver to release acute phase proteins?

IL-1 IL-6 tumor necrosis factor alpha

Which antibody/antibodies are passed to an infant via breastmilk?

IgA

What antibody is associated with Type 1 hypersensitivity reaction?

IgE

What antibodies are involved with Graves (Type II) and Lupus (Type III)?

IgG & IgM

What antibody is associated with Type 2 hypersensitivity reaction?

IgG & IgM

What antibody is associated with Type 3 hypersensitivity reaction?

IgG & IgM

normal flora of vagina?

Lactobacillus

An increase in the number of circulating white blood cells. During many infections, leukocytosis may be accompanied by a left shift in the ratio of immature to mature neutrophils, so that the more immature forms of neutrophils, such as a band cells, metamyelocytes and occasionally myelocytes are present in relatively greater than normal proportions. IL-1 stimulates the release of neutrophils/WBCs from the bone marrow (Left shift) ↑ in neutrophil bands (immature neutrophils)

Leukocytosis

Examples of Type 3 Hypersensitivity Reactions

Lupus, post-streptococcal glomerulonephritis, arthritis, Raynaud's - Serum sickness, degenerative joint disease and vasculitis, Arthus reaction (Localized)

Principal precursor effector cell for type 4 hypersensitivity reaction?

Lymphocytes and macrophages

Principal precursor effector cell for type 2 hypersensitivity reaction?

Macrophages in tissues

Principal precursor effector cell for type 1 hypersensitivity reaction?

Mast cells

Mobility of the organism

Mobility

Microorganisms multiply in the warm, nutrient-rich host cell or tissue Viral pathogens replicate within cells

Multiplication

Principal precursor effector cell for type 3 hypersensitivity reaction?

Neutrophils

Adaptive immunity is mediated by _________________ and __________________.

T cells & B cells

MHC (HLA) - MAIN FUNCTION?

The function of MHC molecules is to bind peptide fragments derived from pathogens and display them on the cell surface for recognition by the appropriate T cells.

Autoimmunity occurs when

The immune system recognizes self-antigens as foreign.

A mother breastfeeding her infant is providing the infant with ______________ immunity?

Passive

Active or Passive Immunity? IgG deficient individual receiving IgG therapy

Passive

Active or Passive Immunity? Rabies immunoglobulin

Passive

The synthesis of many plasma proteins, mostly products of the liver is increased during inflammation. These proteins can be either proinflammatory or antiinflammatory in nature, and are referred to as acute-phase reactants. Acute-phase reactants reach max circulating levels 10 to 40 hours of initial infection. IL-1 is indirectly responsible for the synthesis of acute-phase reactants through the induction of IL-6, which directly stimulates liver cells to synthesize most of the acute-phase reactants.

Plasma protein synthesis

Normal flora of the skin

Pseudomonas aeruginosa

Successful spreading requires the ability to evade immunity Virulent factors: adhesion molecules, toxins, ability to evade immunity of host

Spread

Alloimmunity occurs when:

THE IMMUNE SYSTEM PRODUCES A RESPONSE TO TISSUES OF ANOTHER INDIVIDUAL.

prodromal stage

The occurrence of initial symptoms, which are often very mild and include a feeling of discomfort and tiredness.

invasion stage

The pathogen is multiplying rapidly, invading farther and affecting the tissues at the site of initial colonization as well as other areas, the immune and inflammatory responses have been triggered; symptoms may be specifically related to the pathogen or to the inflammatory response. Now you're full blown sick

What do endogenous pyrogens do?

act on the hypothalamus to increase body temp to kill temp sensitive bacteria. Ex syphilis and gonococcal urethritis

Examples of Type 1 Hypersensitivity Reactions

allergies, hay fever, allergic rhinitis, ATOPIC PERSON, anaphylaxis

What begins when the microorganism stabilizes adherence to tissue through specific surface receptors (the adherence helps protect the microorganism from mechanical removal such as coughing) Break through barrier of epithelial cells?

colonization

The ability to spread from one individual to others and cause disease (measles and pertussis spread very easily; HIV is of lower communicability)

communicability

Most common antigen presenting cells (APC's)?

dendritic cells monocytes macrophages

Examples of Type 4 Hypersensitivity Reactions

graft rejection, skin tests (PPD), poison ivy rash, metal skin reactions (nickel)

During inflammation ESR rate will?

increase

Elderly patients tend to have a(n) ______________________ level of circulating autoantibodies?

increase

ANTIGEN PROCESSING OR PRESENTING CELLS?

most antigens do not react directly with T or B cells, but require processing and presentation in the appropriate fashion; which is what APCs do. Most cells have the capability to present antigen to some degree but dendritic cells, macrophages and B lymphocytes are so efficients that that are considered the "professionals"

Is inflammation specific or non-specific?

non-specific

Is innate immunity specific or non-specific?

non-specific

What antibody is associated with Type 4 hypersensitivity reaction?

none, its cell mediated