MICROBIOLOGY & IMMUNOLOGY
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|-?-(d) IgD||Unclear function; found on the surface of many B cells & in serum|
|-?-(b) IgA||Prevents attachment of bacteria & viruses to mucous membranes, does not fix complement; monomer or dimmer; found in secretions; picks up secretory component from epithelial cells before secretion|
|-?-(e) IgE||Mediates immediate (type 1) hypersensitivity by inducing the release of mediators from mast cells & basophils when exposed to allergen; mediates immunity to worms; lowest concentration in serum|
|-?-(a) IgG||Main antibody in 2° response; most abundant; fixes complement, crosses the placenta, opsonizes bacteria, neutralizes bacterial toxins & viruses|
|-?-(c) IgM||Produced in the 1° response to an antigen; fixes complement but does not cross the placenta; antigen receptor on the surface of B cells; monomer or pentamer|
|(a) IgG (b) IgA (c) IgM (d) IgD (e) IgE|
|-?-allotype||differs among members of same species|
|-?-isotype||common to a single class of Ig|
|-?-idiotype||determined by antigen-binding site|
|-?-(d) IL-4||Secreted by helper T cells; promotes growth of B cells; enhances the synthesis of IgE & IgG|
|-?-(h) TNF-α||Secreted by macrophages; ↑ IL-2 receptor synthesis by helper T cells; ↑ B-cell proliferation; attracts & activates neutrophils|
|-?-(i) TNF-β||Secreted by activated T lymphocytes; functions similar to those of TNF-Α|
|-?-(b) IL-2||Secreted by helper T cells; stimulates growth of helper & cytotoxic T cells|
|-?-(g) γ-interferon||Secreted by helper T cells; stimulates macrophages|
|-?-(c) IL-3||Secreted by activated T cells; supports the growth & differentiation of bone marrow stem cells; has a function similar to GM-CSF|
|-?-(a) IL-1||Secreted by macrophages; stimulates T cells, B cells, neutrophils, fibroblasts, & epithelial cells to grow, differentiate or synthesize specific products; an endogenous pyrogen|
|-?-(e) IL-5||Secreted by helper T cells; promotes differentiation of B cells; enhances the synthesis of IgA; stimulates production & activation of eosinophils|
|-?-(f) IL-8||Major chemotactic factor for neutrophils|
|(a) IL-1 (b) IL-2 (c) IL-3 (d) IL-4 (e) IL-5 (f) IL-8 (g) Γ-interferon (h) TNF-Α (i) TNF-Β|
|-?-(d) macrophages||MHC II, CD14:|
|-?-(f) all cells except mature red cells||MHC I:|
|-?-(a) helper T cells||CD4, TCR, CD3, CD28:|
|-?-(c) B cells||IgM, B7, CD19, CD20:|
|-?-(b) cytotoxic T cells||CD8, TCR, CD3:|
|-?-(e) NK cells||Receptors for MHC I, CD16:|
|(a) ) helper T cells (b) cytotoxic T cells (c) B cells (d) macrophages (e) NK cells (f) all cells except mature red cells|
|-?-(b) cytotoxic||IgM, IgG bind to antigen on "enemy" cell, leading to lysis (by complement) or phagocytosis|
|-?-(a) anaphylactic & atopic||Antigen cross-links IgE on presensitized mast cells & basophis, triggering release of vasoactive amines|
|-?-(e) arthus reaction||A local subacute antibody-mediated hypersensitivity (type III) reaction; intradermal injection of antigen induces antibodies, which form antigen-anibody complexes in the skin|
|-?-(c) immune complex||Antigen-antibody complexes activate complement, which attracts neutrophils; neutrophils Release lysosomal enzymes|
|-?-(f) delayed (cell-mediated) type||Sensitized T lymphocytes encounter antigen & then release lymphokines (leads to macrophage Activation)|
|-?-(d) serum sickness||An immune complex disease (type III) in which antibodies to the foreign proteins are produced (takes 5 days); immune complexes form & are deposited in membranes, where they fix complement (leads to tissue damage)|
|(a) anaphylactic & atopic (b) cytotoxic (c) immune complex (d) serum sickness (e) arthus reaction (f) delayed (cell-mediated) type|
Bruton's agammaglobulinemia deficiency: X-linked recessive defect in a tyrosine gene associated with low levels of all classes of: -?-immunoglobulins.
Selective immunoglobulin deficiency: Deficiency in a specific class of immunoglobins-possibly due to a defect in -?-isotype switching.
thymic aplasia (DiGeorge syndrome): thymus & parathyroids fail to develop owing to failure of the development of the 3rd & 4th -?-pharyngeal pouches.
chronic mucocutaneous candidiasis: T-cell dysfunction specifically against -?-Candida albicans; presents with skin & mucous membrane
B- and T-cell deficiencies:
Severe combined immunodeficiency: defect in early stem-cell differentiation; presents with recurrent viral, bacterial, fungal, and -?-protozoal infections; may have multiple causes.
Wiskott-Aldrich syndrome: X-linked defect in the ability to mount an -?-IgM response to capsular polysaccharides of bacteriua.
Ataxia-telangiectasia: Defect in DNA repair enzymes with associated IgA deficiency; presents with -?-ataxia and telangiectasia.
Chronic granulomatous disease: defect in phagocytosis of neutrophils owing to lack of -?-NADPH oxidase activity or similar enzymes.
Chédiak-Higashi disease: autosomal recessive; defect in microtubular function & lysosomal emptying of phagocytic; presents with recurrent -?-NADPH infections by staphylococci & streptococci.
Job's syndrome: failure of -?-γ-interferon production by helper T cells; neutrophils fail to respond to chemotactic stimuli.
Leukocyte adhesion deficiency syndrome: defect in -?-LFA-1 adhesion proteins on phagocytes; presents early in life with severe pyogenic infections.
Hyper-IgM syndrome: defect in CD40 ligand on CD4 T helper cells leads to inability to class switch; presents early in life with severe -?-pyogenic infections.
IL-12 receptor deficiency: presents with disseminated -?-mycobacterial infections.
Active immunity: induced after exposure to foreign -?-antigens; slow onset; long-lasting protection (memory).
Passive immunity: based on receiving performed -?-antibodies from another host; rapid onset; short life span of antibodies.
|-?-(g) anti-Scl-70||Scheroderma (diffuse)|
|-?-(l) antimicrosomal||Hashimoto's thyroiditis|
|-?-(a) ANA (antinuclear antibodies)||SLE|
|-?-(b) anti-dsDNA, anti-Smith||Specific for SLE|
|-?-(k) anti-epithelial cell||Pemphigus vulgaris|
|-?-(c) antihistone||Drug-induced lupus|
|-?-(d) anti-IgG||Rheumatoid arthritis|
|-?-(f) anticentromere||Schleroderma (CREST)|
|-?-(h) antimitochondrial||1° biliary cirrhosis|
|-?-(j) anti-basement membrane||Goodpasture's syndrome|
|-?-(i) antigliadin||Celiac disease|
|(a) ANA (b) anti-dsDNA, anti-Smith (c) antihistone (d) anti-IgG (e) antineutrophil (f) anticentromere (g) anti-Scl-70 (h) antimitochondrial (i) antigliadin (j) anti-basement membrane (k) anti-epithelial cell (l) antimicrosomal|
|-?-(d) graft-vs-host disease||Grafted immunocompetent T cells profliferate in the irradiated immunocompromised host & reject cells with "foreign" proteins, resulting in severe organ dysfunction; major symptoms include a maculopapular rash, jaundice, hepatosplenomegaly & diarrhea|
|-?-(c) chronic rejection||Antibody-mediated vascular damage (fibrinoid necrosis); occurs months to years after transplantation; irreversible|
|-?-(b) acute rejection||Cell mediated due to cytotoxic T lymphocytes reacting against foreign MHCs; occurs weeks after transplantation; reversible with immunosuppressants such as cyclosporine & OKT3|
|-?-(a) hyperacute rejection||Antibody mediated due to the presence of preformed anti-donor antiboidies in the transplant recipient; occurs within minutes after transplantation|
|(a) hyperacute rejection (b) acute rejection (c) chronic rejection (d) graft-vs-host disease|