Immunology Final Exam Review Flashcards

Terms Definitions
What complement?
Macrophage compliment
attraction of phagocytes
slow response (days-weeks)
Cytokine release syndrome, hypersensitivity reaction
Type II Hypersensitivity
Immune-mediated thrombocytopenia
Introduction in late 1970s
-either microscopic or visible to the eye
-enter body either through ingestion (larvae found in meat or pinworm eggs found in soil) or active penetration (muddy water; will break skin and travel up leg) and arthropod bites
follicular DC
Thymus + structure!
CD 34
Stem cell marker.
Example of toxoid subunit vaccine
Second most plentiful WBC
Large, round nucleus
Very little cytoplasm
Made up of T and B cells, but can not differentiate in the differential stain we did in lab
6-11 micrometers in diamter
Treg cell
Inhibit adaptive immune response
No test dose required
Antithymocyte globulin
Enhances class switching to IgE
Stimulates B cells and mast cells
What is somatic recombination?
VDJ recmobination
Flagellin recognized by what TLR?
ttreatment of acute allograft rejection
C3 convertase
Is complex of C4b2a
HLA-DM functions by promoting the dissociation of the CLIP peptide (a place holder peptide) from MHC class II which allows endosomal peptides to bind.
Which TLR is responsible for recognizing LPS?
Arthus reaction
local subacute Type III reactionintradermal injection of Ag induces Ab = form complexes in skinedema, necrosis, activation of complement
Notch 1
Cell surface receptor on thymocytes that interacts with thymic epithelial cells
Keeps Thymocytes on T Cell development
Has an intra and extra cellular domain that get cleaved. Intra domain initiates transcription of chains.
Type IV Hypersensitivity
Mediated by T lymphocytes
Maintenance dose may need titration based on WBC (3500-6000 cells/mm)
granules in cytoplasm and multilobed nucleus
Increases class II MHC, chemotaxis & Th cell cytokines
-optimum growth temp. for most pathogens is 37 degrees
-increase temp to 40 & pathogens cannot grow
In what form is IgA found?
IgE functions?
-Plays a role in allergies
-antiparasite response
CR3 and CR4
complement receptor; alternative pathway.
lymphocytes or antibodies that react with alloantigens
Human antibicrobial peptides, rich in pos. charged arginine residues. Amphipathic so can penetrate microbial membranes & disrupt the integrity.
Name some immunologically priveleged site. What is responsible for this?
Due to anatomical barriers and environment bein intrinsically toleragenic due to production of immunoregulatory cytokines like TGF β
Process of activating ITAM's
ligand binds 
phosphorylation of ITAM's by src family kinases
phosphorylated ITAM's recruit other Tyr kinases and addaptor proteins
this forms macromolecular signaling complex
This class of antibodies is mainly mucosal
What removes encapsulated bacteria?
macrophages in the spleen
Hodgkins Disease
B Cell with lost receptor
Known as Reed-Sternberg cells
Passive immunization
Transfer of antibodies to a susceptible animal
Use began in early 1960s but declining in recent years with advances in effective less toxic agents
viruses- examples- diseases
variola (smallpox), influenza (flu), HIV (AIDS)
Present on helper T cells
Interacts w/ MHC II
Complement defends against this type of bacteria:
gram negative
What expresses AIRE?
Stromal cells in the medulla
What conditions is HLA-B8 associated with?
Graves' disease
Type Ab-Ag bonds?
Ionic bonds, Hydrogen bonds, Hydrophobic interactions, van der Waal's.
Packed cell volume or hematocrit test; Tells the proportion of blood volume occupied by red blood cells
Hyperacute prevention
cross-matching, mix donor WBCs with recipient serum
What do B-cells recognize?
native proteins, polysaccharides, glycolipids
CD4+ T Cell
another name for T helper cell
Function of cytokines
TNF alpha- induce local inflammation by upregulating endothelial expression of leukocyte adhesion molecules
IL-5- promote production of eosinophils by bone marrow
producer cell, actions
producer cells: TH2 cells, mast cells;
actions: incr. IgA (post switch), incr. eosinophil growth and differentiation, incr. CD25 on mem. B cells, incr. growth of activated B cells;
Within germinal centers two distinct regions are visible, a dark zone containing proliferating () cells and a light zone composed of B cells with () or cleaved nuclear contours, aka ()
B, irregular, centrocytes
Deficiency of C1 esterase leads to what?
Hereditary Angioedema
Regulate peptide loading for HLA-DP, HLA-DQ, & HLA-DR.
Conjugate Vaccine
Vaccine given to babies that combines proteins and carbohydrates because their immune system cant make antibodies for carbs
Tacrolimus have this effect on CSA
Decreased CSA absorption
Disseminated mycobacterial infections. Due to low activation of:
Th1 cells (IL-12 receptor deficiency)
Clonal Anergy
Anergy is a state of unresponsiveness to antigenic stimulation. Lymphocyte anergy is the failure of clones of T or B cells to react to antigen, and this may be a mechanism of maintaining immunologic tolerance to self antigens. (In clinical practice, anergy refers to a generalized defect in T cell-dependent cutaneous delayed-type hypersensitivity reactions to common antigens.)
Virus: naked vs. enveloped
1. naked
-nothing covering capsid
-naked cells survive longer than enveloped
2. enveloped
-virus obtains from host cell a cytoplasmic membrane
-do not lyse host cell but instead exit through a budding process during which they obtain the membrane
What percentage of T cells do T-reg cells comprise?
What are "RAG" proteins?
recombination activating genes encode enzymes that play an important role in the rearrangement and recombination of the genes of immunoglobulin and T cell receptor molecules during the process of VDJ recombination.
Which cytokines do TH2 cells produce?
IL-4,5,13 and Il-10
Medulla of Thymus
contains more mature cells, suggesting a differentiation gradient from the cortex to

Hassals' corpuscles are found in the thymic medulla, its function is unknown (contains degenerating epithelial cells)
Which portion of the antibody only has heavy chains?
chemoattractant for neutrophils and monocytes (toward site of complement activation).
Name 4 noncellular/extracellular defense systems other than complement and how they do it:
Innate immune responses to tumors
NK cells and macrophages
NFkB (nuclear factor kB)
Transcription factor activated by LPS-TLR4-CD14 complex that initiates gene trascription encoding inflammatory cytokines in macrophages.
5 immunodeficiencies that are X-linked
Chronic granulomatous disease, Wiskott-Aldrich, SCID, agammaglobulinemia, and hyper-IgM
Mechanism of action of chronic rejection
narrow vasculature
slow infiltration of immune cells
takes months to years
Role of IL-7
important for pre-T cell survival and growth
Complement System
Overview Fxn.
30 serum and cell surface proteins.  Provides innate and immediate protection to infections disease before immune response.  Major effector of the humoral immune system and mediator of inflammation.
Paracortical lymphoid hyperplasia is most often seen in:
Drug-induced reactions like Dilantin, acute viral infections esp. mononucleosis, and post-vaccine, if the reaction is especially vigorous further study is needed to rule out neoplasm
Which side is the amino terminal of the antibody?
variable (Fab)
MHC I isotype
Present antigens to CD8 T Cells and interact with NK cells.
B Lymphocytes
The cell whose major function is to secrete antibodies
Cross reactive with surface antigens onendothelial cells
Type II Hypersensitivity Reaction
Which interleukin induces naive helper T-cells to become Th2 cells?
IL-4 (cell source unknown)
Type III hypersensitivity
Immune complex mediated - IgG and IgM
Complement is activated (classic), neutrophils are activated.
Complexes deposited in skin, kidney, joints
Causes local vasculitis

Examples: serum sickness, rheumatoid arthritis, glomerulonephritis, sxs of malaria and SLE
How many pre-B cells are formed per day?
35x 10^6
White pulp (of spleen)
consists of lymphoid tissue that surrounds a central arteriole and it is called periarteriolear lymphoid sheath (PALS)

T cells surround arteriole

B cells are arranged into primary "unstimulated" follicles and secondary "stimulated" follicles (posess a germinal center with memory cells)

the germinal centers contain follicular dendritic cells and phagocytic cells

macrophages and B cells are found in the marginal zone-area that overlying the
secondary follicles
Which antibodies are involved in the classic pathway?
IgG and IgM
Lymphocytes --> abundance and makeup...
35% of total WBC population
Where does somatic hypermutation occur?
Secondary lymphoid organs after antigen encounter.
4 autoimmune diseases associated with type IV hypersensitivity
Insulin-dependent diabetes, rhematoid arthritis, MS, and Celiac disease.
whtare are some causes of impaired immune system in a previously normal individual?
Metabolic Dz, immunosuppression, infection, haematological Dz, surgery/trauma
Advantage and disadvantage of DNA vaccines

in vivo expression of designer vaccine
induce Ab, CD4 response, and CTL response
no risk of infection
cheap, easy production, easy transport, easy storage

less impressive results in larger animals
lower transfection efficeincy, so low protein expression
risk of chromosomal integration/oncogene activation
risk of tolerance induction (due to long term Ab)
() and () can hyperactivate macrophages via direct contact, where macrophages become solely phagocytic and growing in size, via increasing the number of () in the cytosol as well as production of (). Lysosomal contents can also be ejcted onto parasites to
LPS, mannose, lysosomes, reactive oxygen species
Interferons (alpha, beta, gamma)
Place uninfected cells in an antiviral state - induce production of ribonuclease
Alternate Complement
Does not need the antibody to be bound on the antigen, Begins when C3b is attached to the microbe surface, involves factors B and D
What occurs to both low-affinity B-cells and higher affinity B-cells produced during somatic hypermutation?
Low affinity B-cells undergo apoptosis. The B-cells that are altered cycle through the germinal center multiple times and the specificity is refined
What is the Arthus reaction?
A localized form of experimental immune complex-mediated vasculitis induced by injecting an antigen subcutaneously into a previously immunized individual that has been given IV antibody specific for the antigen. Circulating Abs bind to the injected Ag, forming immune complexes that deposit in the walls of small arteries at the injection site, giving rise to a local cutaneous vasculitis with necrosis.
Cell wall of genus Mycoplasma
-lack peptidoglycan cell wall all together
What happens to activated T cells?
They proliferate and eliminate infection
What happens in the thymus?
T cell differentiation and maturation. Encapsulated
What % of serum immunoglobulin is IgA?
10-15 % (2nd most).
gram positive --> petidoglycan outside... holds stain.
gram negative --> peptidoglycan wall surrounded by OUTER MEMBRANE (w/ LPS). doesn't hold dye.
What's the deal with IL-2?
Released from activated T-cells which stimulates others to proliferate.
4 groups of primary immunodeficiency are
B cell: infections

T cell: Viral


Complement disorders: causing SLE or infections such as neisseria
Example of Rag mutation: Omenn's syndrome pathology
associated with Th2 allergioc type inflammatory syndrome
few T cells present have restricted TCR repertoire and expand and differentiate
MBL binds with (), which together bind the surface of the pathogen and convert C3 into C3b and regenerating the cycle.
mannose-binding lectin associated serine protease
Name and describe the different kinds of defensins.
There are alpha-defensins and beta-defensins. Defensin molecules are amphipathic (both hydrophobic and hydrophilic regions), which allows them to penetrate microbial membranes and disrupt their integrity.
- Alpha-defensins are expressed mainly by neutrophils and Paneth cells (specialized epithelial cells of the small intestine) There are at least 6.
-Beta-defensins are expressed by a broad range of epithelial cells, particularly those of the skin, respiratory tract, and the urogenital tract, at least 4
-To prevent defensins from disrupting human cells, they aresythesized as part of longer, inactive polypeptides that are cleaved to release the active fragment
-Set of defensins varies - number of copies of genes an indiviual inherits varies greatly
Describe the function of Src kinases
Specifically they recognize a complex composed of ligand binding domains, and ITAM bearing a signal incompetent domain, and 1 or more additional tyrosines kinases
Insulin-Dependent Diabetes Mellitus (IDDM)
A disease characterized by a lack of insulin, which leads to various metabolic and vascular abnormalities. The insuline deficiency results from destruction of the insulin-producing β cells of the islets of Langerhans in the pancreas, usually as a result of T-cell mediated autoimmunity.
What is a related disease to immunodysregulation polyendocrinopathy enteropathy x-linked syndrome in mice?
Scurvy is related to immunodysregulation polyendocrinopathy enteropathy X-linked syndrome
How do macrophages present peptides?
They may prresent peptides from their phagocytosed foreign material
What is anergy?
A state when B and T cells become inactive
T cells can do this if they do not receive a co-stimulatory signal
B cells can becomes anergic too but it is less complete than with T cells
What does T-cell immunity involve? (also include what the target cells are)
T cell-mediated killing of target cells

such as - Tumor cells, virus infected cells and chronic infections
Alternative pathway WRT complement (general/overall schematic).
1. C3 spontaneous hydrolysis --> iC3. CATALYZED BY PROXIMITY OF BACTERIA.
What's the role of the small fragments C3a & C5a?
Anaphylatoxins that increasing inflammation. Sometimes induce anaphylactic shock. C5a more potent. Induce sm. m. contraction, degranulation of mast cells & basophils = inc. cap. permeability.
Mechanism of action of CTLA-4 inhibition of T cell activation

competes with CD28 for binding with B7 molecule
has 100x higher affinity for B7 than CD28
transmit a negative signal that block CD28 signaling pathway
transmit signal to dendritic cell via B7 to induce indoleamine 2,3 dioxygenase (promote Trp metabolism); block T cell activation
Why is the advantage of using aluminum hydroxide as an adjuvant?
advantage- it can induce Th2 cells, which promote Ab response
disadvantage- not good at inducing Th1 cells
What does the superficial inguinal LN drain?
Anal canal below pectinate linescrotum (NOT TESTES)superficial thigh
The commitment of lymphocytes progenitor to become a B lymphocyte is associated with
recombination of one Ig V gene segment with one D and one J segment
What are the three major features of the antigen-independent stage of B-cell development?
1. DNA rearrangements (provides diversity)2. Allelic exclusion (express 1 Ab on surface)3. Delection of self-reactive clones (tolerance)
Exogenous Ligand for TLR4
LPS, F protein of RSV, E coli, Mouse mammary tumor virus envelope proteins, Taxol, Glucurononoxylomannan (Crypto)
What is the role of perforin?
It perforates and creates channels in the target cells through which products like granzymes can navigate through
How are parts of the adaptive immune system made?
V(D)J recombintation during lymphocyte development
What APCs are involved with humoral immunity?
B cells, macrophages and/or dendritic cells
b) cytokine secretion, primarily IFNgamma (via stim. w/ macrophage derived IL12).
IFNgamma - what produces it? what does it do?
4 subclasses of type IV autoimmune disease mechanisms
a. molecular mimicry, b. epitope spreading, c. polyclonal activation of B-cells, d. . Induction of class II MHC molecules on tissues usually not expressing them due to viruses secreting IFN-gamma
CD 40 does what two things
1. increase affinity between B and Th cells2. Increase signal transduction in those cells
What are the two major divisions of the immune system? Compare and contrast.
Innate and Acquired.
Innate is passed genetically from parent to offspring. It responds the same way every time to every disease. It has a rapid, fixed response, and limited specificity.
Acquired develops during the host's lifetime based on the host's exposure to infectious diseases that overcome the innate immune system. It has a "memory" and reacts stronger and faster each time the host is exposed to the pathogen. It is highly specific, but takes a while to kick in the first time (~1 week).
Both use common effector mechanisms for the destruction of pathogens.
four phases of life of a B cell
(1) born in bone marrow(2) elimination of self-reactive B cells in bone marrow(3) activation in secondary lymphoid tissue(4) differentiation to plasma or memory cells in secondary lymphoid tissue
What is an autologous graft?
A tissue or organ graft in which the donor and recipient are the same individual. (Autologous bone marrow and skin grafts are commonly performed in clinical medicine.)
How does FoxP3 induction by Il-10 resistance, susceptibility compare to IFN-gamma producing effector cells?
In Il-10 FoxP3 cells, there is increased susceptibility to infection, but a complete resistance to secondary infeciton
In IFN-gamma producing T cells, there is an increased resistance to primary infection, but a high susceptibility to secondary infection
What are found with in the white pulp of the spleen?
follicles that have B cells!
αβ T-cells

What else does T-Helper 2 do?
T-Helper 2 helps with both specific and polyclonal B-cell response but does not exhibit suppression, DTH, or killing functions. (involved in humoral responses)
Are gammadelta T cells MHC restricted?
no, so are functional from person to person
Describe what is ment by the hygeine hypothesis
those who are in low hygeine environments get more microbial infections (means higher Th1 response), so decreased atopy (low Th2)
those who are in high hygeine environments get lesss microbial infections (lower Th1), so there is an increased atopy (high Th2)
expression of Ig on membrane of B cell requires what add'nl proteins?
Ig-alpha and Ig-Beta -- these two proteins are responsible for signal transduction after the antigen is bound
Where do B cells mature and develop?
B cells develop in the bone marrow. Mature B cells are found mainly in lymphoid follicles in secondary lymphoid tissues, in bone marrow, and in low numbers in the circulation.
What does the downregulation of L-selectin expression in T cells that have encountered Ag allow?
The T cell can migrate away from the lymph nodes and remain in the tissue
What does the Fc part of an antibody do?
Constant, carboxyl terminal (at the end), complement binding (at Ch2 only IgM and IgG), carbohydrate side chains, Determines isotype (IgM, IgD, IgG etc.)
What happens if the plasma cell tumor invades the bone marrow?
It can destroy bone, reulting in osteolytic lesions and ultimately lead to pathologic bone fractures
NK Cells are inhibited by a receptor that recognizes () molecules on cell surfaces, which are found everywhere in the human body except RBCs. THey lack () cell receptors and thus do not use MHC to identify infected cells. They are activated by the cytokin
MHC 1, T cell receptors, LPS, IFN alpha, IFN beta, TNF, IL-12
when amino acids fold, the region at amino acid 30, 50, 95 in both heavy and light chain are the regions that _______________.
the regions that reach out for the antigen.
How does 1 in 100000 cells bind to foreign peptide / MHC complexes with high affinity?
If the MHCs arent compatibile, the overall affinity is low
If the MHC does not have an affinity for the peptide being presented, the affinity is low
However, sometimes, the MHC has high affinity for the MHC and this results in a response
Why were HLA-A, HLA-B and HLA-C first investigated?
As a means of predicting the success of renal transplants. (Info from book: They are called leukocyte antigen genes because they were discovered through the antigenic differences between white blood cells from different individuals during the renal transplant)
How many amino acids compose the binding pockets found on MHC molecules?
Pockets B and F are made up of 8 amino acids.
What does the Fc receptor bind to when a particle is getting phagocytozed?
Fc portion of the antibody binds to the Fc receptor on the phagocyte
Where is the antigen receptor of IgM?
on the surface of B cells - can be a monomer or a pentamer on B cells
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