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Cellular Immunology


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What is the definition of cellular immunology?
-The immune response involving effector T lymphocytes, not B.
-Responsible for allograft rejecction, viral/protozoan infectinos, intracellular organisms.
What 7 things is Cell-mediated immunity responsible for?
1. Contact sensitivity
2. Delayed hypersensitivity
3. Immunity to viral/fungal Ags
4. Immunity to intracellualr organisms.
5. Rejection of foreign tissue grafts
6. Elimination of tumor cells bearing neo Ag
7. Formation of chronic granulomas.
In contrast to cell-mediated, what is humoral immunity responsible for?
1. Elimination of SOLUBLE Ag.
2. Destruction of EXTRAcellular organisms.
What factors affect immunologic disease?
1. Age
2. Diet
3. Malignancies
4. Direct toxic/allrgc effect
What does it mean to say that Tcells are "MHC restricted"?
Antigen MUST be presented to T cells by MHC molecules, in order for an immune reaction to occur.
How does MHC relate to HLA?
The antigens are codominantly expressed, and both are located on chromosome 6.
What are:
1 = Thymocytes
2 = E-rosette marker
3 = mature Tcell, TCR - on both Tc and Th
5 = Pan Tcell (some Bcells)
what are:

4 = Thelpers
8 = Tcytotoxics

7 = Pan Tcells
What's important to remember re: Thelper cells
-CD4, recognize MHCII
-Stimulate Bcells
-orchestrate cmi, influence macrophages.
what do Tc cells recognize?
Ag associated with Class I MHC or just recognize MHCI alone.
what are the major effectors in graft rejection?
Tc cells
Can Tc cells act alone?
no; require help in the form of IL2 secreted by Th cells.
In lymphocytes what % are:
T = 70-85%

B = 10-15%
What percent are
Thelpers = 50-60%

Tcytotox = 20-25%

T4:T8 ratio is 2:1
what are B cell markers?
What is CD10?
Early pre-b cell CALLA; if elevated in kids, might imply leukemia.
What are CD19 and 20?
Pan B-cell markers
what is SIg?
Surface immunoglobulin - obviously would be on Bcells.
What is HLA-DR?
How do Bcells function?
Independent or dependent of Tcells.
What are characteristics of Bcell antibody production independent of Tcells?
-Only produce IgM
-Doesn't produce memory response
-Only works w/ some antigens
Where are higher levels of Bcells found?
-Lymph nodes
What stimulates NK cells?
IL2; same as stimulates Tc cells.
what % of t cells are NK?
What % of all lymphocytes are:
T = 70-85%
B = 10-15%
NK = 10%
What are the cell markers for NK cells?
What's an internal check for calculating T4/T8 counts?
T4 + T8 should app. = T3
How do macrophages recognize cells to ingest?
Fc receptors for Ab/opsonins
What is the function of macrophages and monocytes?
Antigen processing
Antigen presentation
What is the normal number of macrophages/monocytes in the peripheral blood?
what are the cell markers of macrophages/monocytes?
CD4 (dim)
What are 2 congenital Tcell disorders?
what is digeorge's roughly?
a hypoplastic thymus
What are 3 acquired Tcell disorders?
-Lymphoid malignancies
what are 4 congenital Bcell disorders?
-Bruton's Xlinked agammaglobulinemia
-Selective IgA deficiency
-Hyper IgM syndrome
what is CD45?
a control used in Flow cytometry to ensure cells tested are wBCs
what are mitogens?
things in nature that stimulate lymphocyte proliferation.
What is the clinical usefulness of flow cytometry in immunology?
Monitor patients with AIDS, ARC, HIV, lymphoma, leukemia, and immunodeficiency.
How does the HIV virus work?
-Binds CD4 receptor on Thelpers.
-Reverse Transcrp. converts viral RNA to proviral DNA.
-Proviral DNA integrates into host DNA.
-New viral particles form
-Viral particles bud off, cause cell death.
What 3 things allow HIV to avoid the immune system?
1. HIV can avoid the immune system.
2. Mutates very fast
3. Acts on cells that are needed to destroy it (Thelpers)
what's the simplest wayto monitor HIV patients?
monitor their T4 cells
What are the 2 stages in HIV-infection? how are their characterized?
ARC; CD4 <400/uL

AIDS; fit CDC criteria
What usually characterizes a lymphoma?
kappa or lambda gammaglobulin clonality.
What are 3 types of BMT, and what makes them that?
Autologous - from self
Allogeneic - from someone else
Syngeneic - from identical twin
What must be matched for BMT?
-Class I MHC (A and B)
-Class 2 MHC (DR and DQ)
What 2 types of rejection occur sometimes after BMT?
-GVHD graft vs host
-GVL graft vs leukemia
what is GVL?
the donor immunocompetent cells recognize patient's remaining malignant cells as foreign, and destroys them. not so bad..
what are the 2 phases of GVHD?
1. Acute - develops in immediate post-transplant period
2. Chronic - 100 days after
what are 4 types of graft rejection?
-Hyperacute (on the table!)

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