Evaluating Immune Function
Clinical features of immunodeficiency
Increased susceptibility to infection
-chronic or recurrent infections
-infections of unusual severity
-infections by low-virulence organisms
Autoimmune or inflammatory disease
Common drug reactions in all patients include overdose, side effects, secondary indirect effects,
and drug interactions.
Hypersensitivity reactions include intolerance, idiosyncrasy, allergic drug reactions.
Drugs act as al
Therapy for Immediate Hypersensitivity Reactions
Targeted steps of immediate allergic hypersensitivity
The TH2 lymphocyte
These cells promote the production of IgE and the recruitment of eosinophils and basophils via
IL4 and IL13. IL4 also promo
Pathophysiology of Immediate Hypersensitivity Reactions
Type I reactions are IgE mediated reactions against normally innocuous foreign substances.
Hygiene hypothesis says that decreased exposure to microbial antigens promotes a shift from
Primary Immunodeficiency Diseases
Primary immunodeficiencies are those in which the defect is intrinsic to the immune
system, meaning it is genetically determined.
Chronic Granulomatous Disease (CGD)
CGD is a disorder in which polys and monocyte
TH1 cells aid CMI by secreting IL2, IFN-.
TH2 cells aid Ig response by secreting IL4, IL5, and IL10.
IL10 and IFN- cross-inhibit the other cell type.
(Raymond removed image depicting T helper cell differentiation.)
Bone Marrow Transplantation
Unlike solid organ transplant, in BMT the immunology goes two ways. There is host vs.
graft disease, but also graft vs. host disease (GVHD) because the marrow graft
contains functional immune cells.
To undergo BMT the
Pharmacological Manipulation of the Immune System
Factors complicating manipulation include complexity, redundancy, and interconnectedness
(feedback loops, activation cascades).
Growth factors include:
-IL3 from helper T cells
-G-CSF and GM-CSF
Autoimmune Myositis and Sjogrens Syndrome
These disease have very distinct phenotypes and pathology, but a common pathogenic process.
As with other autoimmune disease, it occurs way more in women (mostly of middle age).
This is predomi
Defining Autoimmune Diseases
Self-reactive lymphocytes are deleted by apoptosis in the thymus and bone marrow. If they
leak into periphery, they are actively suppressed by peripheral tolerance (witholding of
required activation signals, modific
Immunopharmacology of Transplantation
Take home messages:
-T cell response is responsible for organ rejection
-Inhibition of CD4 T cell activation is a major strategy to prevent rejection
-Calcineurin is the major signal transducer of calcium si
Lecture 11 and 12
- The endogenous GC is cortisol made by the adrenal glands, and follows a
- Stress (fight or flight) stimulates catecholamines, ACTH, and cortisol; this
explains why GCs help increase alertne