Microbiology
IMMUNOLOGY
Type I Hypersensitivity reaction
Get reaction second time stung by bee; pre-existing IgE antibody specific for bee
venom is made on first sting.
Rash
Hives
IgE binds (Fe portion) to basophils and mast cells (Fe receptors).
Type II Hypersensitivity reaction -
(Cytotoxic)
Antibody Combining site; the part of the antibody that binds to the
antigenic determinant.
Antigenic determinant.
(On a complex antigen.)
Bacterial DNA
May contain integrated sex plasmids and prophage
Peptidoglycan
Cell wall prevents rupture and gives shape.
Gram +, is thick but is susceptible to lysozyme.
Resistance to osmotic shock.
Gives rigidity of membrane.
Cell membrane
No sterols except mycobacterium
Bacteriophage That replicate their nucleic acid by means of a replicative
intermediate (or replicative form) would be expected to contain:
ssDNA
ssRNA
Repair of damaged bacterial DNA by photoreactivation (photolyase)
Does NOT require a DNA polymerase nor an excision of about 20
nucleotides adjacent to the lesion
Missense mutation - Would most likely be associated with a formation of a mutant
bacterial protein which is weakly functional (partially active)
DNA transcription and DNA replication
Both require Nucleoside triphosphates (not DNA polymerase III)
Microorganisms -
Sigma factor - Specificity for promotor site recognition resides with this factor of
bacterial RNA polymerase
Mutation in the deletion of 1 base pair in the middle of a structural gene coding for a
polypeptide
Results in changes in several amino acid residue within that polypeptide.
Establishment of the state of lysogeny requires functional host bacterial cell
ATP synthesis, ribosomes
Ouchterlony test
IgA
O
IgG
O O O IgM
AntiIgG
Infection of a sensitive bacterial culture with a temperate bacteriophage might result in:
Lysis of some of the cells
Immunoelectrophoresis -
RID -
Immunofluorescence -
ELISA -
Western Blot -
RAST assay -
The mouse
Class 1 MHC: H-2K and H-2D
A nude mouse has no thymus
The mouse MHC is called H-2
Syngeneic mice are genetically identical
HLA-D
Is called the immune response region in man.
It codes for antigens Important in cell-cell communication (Not code for
class I Ags)
Its antigens are present on -cells.
(does NOT code for certain complement proteins)
An assay for HLA-A, B, -C typing performed by cytotoxicity testing requiringAbs to known alleles to MHC
Trypan blue,
Complement,
(not cytotoxic T-lymphocytes)
May prevent Graft vs. Host disease which can result from bone marrow transplantation
Match MHC antigens of host and donor before transplantation
Pretreat bone marrow to remove mature T-lympocytes prior to
transplantation.
(Not remove all lymphoid cells and precursors from the marrow prior to
transplantation,
not use bone marrow from the mother for the transplantation)
Hyperacute graft rejection results when
Preformed antibodies prevent the graft from taking
Second set graft rejection is faster that First set rejection because:
Memory cells are present to facilitate a rapid response
MHC antigens are codominantly expressed every cell that expresses antigen expresses
both alleles.
T-cells see antigen in the context of MHC antigens.
CD2:
CD3:
CD4:
Helper cell,
Small cortical thymocyte
CD8:
Suppressor cell,
Small cortical thymocyte
SRBC receptor:
CD2, T11, T cells. (NOT Fe receptor).
Valence -
Class -
Isotype
Suppressor T-cells
Regulate immune responses.
Express CD8+ (human) or Lyt 23+ (mouse) antigens.
Exert effects on helper T-cells, and B-cells to inhibit immune response.
CD3+, CD2+
(NOT activated by helper or inducer T-cells.)
Helper T-cells
CD4+
CD3+
CD2+
Lyt 1+23(-).
B-Lymphocytes
Triggered by:
Antigen binding to surface immunoglobulin,
Activated T helper cells.
Helper factors IL-1, IL-2, and BCGE.
Macrophages
Have a role in induction and amplification of immune response by:
Presenting antigen in an appropriate form to B and T-cells.
IL-1:
Is produced by macrophages
Is a genetically unrestricted and an immunologically nonspecific factor,
Is a polypeptide cytokine and is stable at temperatures (-750C to +560C)
and pH (3 to 11).
Known as LAF (lymphocyte activating factor),
Excites T-cells for IL-2 production, reaction to injury and other purposes.
Induces differentiation of T-lymphocytes by increasing metabolism.
(Not only effects T-lymphocytes)
(NOT MHC restricted
NOT heat labile at high temp.)
IL-2:
Normal regulation of an immune response, the following events may occur to dampen
the response:
Induction of anti-idiotype antibodies
Production of high affinity IgG antibody to remove antigen from the
system.
Neutrophils have receptors for: IgG, C5a, and C3b (opsonins)
Metabolic stimulation of neutrophils includes:
H2O2 production,
Incr. Glycolysis,
Incr. Oxygen consumption.,
Decreased phagolysosomal pH
(Not incr.. enzyme synthesis)
TdT+:
Marker on pre-B and immature T-cells
Least mature T-cell.
Helper cells required for the activation of the following effector cells:
DTH and CTL (not macrophages and NK)
Suppressor cells are
CD8+
T8+
Ltl 23+
CD3+
Involved in regulation of B-cell response,
Regulate DTH and CTL responses
Decreased in patients with autoimmune disorders, but not absent.
CTL -
Cytotoxic T-Lymphocytes
CD8+
CD3+
Lyt1-23+
CD2+
IL-2
(gamma) IFN
Interferons
Are anti-viral substances
Augment NK activity, CTL and macrophage cytotoxicity.
IFN- is most species specific, and is heat and acid Labile lymphokine.
Are produced by leukocytes or fibroblasts
(Not susceptible to low or high dose tolerance, not induced by antiidiotype or anti-allotype antibodies.)
TNF
TNF- = cachectin.
TNF- = Lymphotoxin/
Lymphokine
BCDF -
(Interferon)
Increase NK activity, therefore used in immunotherapies,
Have anti-proliferation activity against tumor cells,
Immunoregulatory activities.
(NOT lymphokines)
Mediated by:
K cells (by expressing receptors for the Fe portions of IgG)
NK cells,
Macrophages.
(NOT B-cells)
Avidity -
Affinity
Codominant expression
Products of both alleles are expressed on all positive cells.
Magnitude of T-cell clonal expansion is dependent upon
IL-2 concentration,
IL-2 receptor density,
The duration of IL-2, IL-2 receptor interaction,
Affinity of the receptor for IL-2.
Cyclosporin A
Inhibits helper T-cells.
Prevents IL-2 synthesis
(Not a potent suppressor T-cell activator, not inhibit B-cells)
Non-immune early response to viral infections involve:
Interferons,
Natural killer cells,
Complement,
(Not cytotoxic T-lymphocytes)
Hybridoma technology produces Monoclonal antibodies which
Can cross react with tow different antigens
Can be made without having a pure antigen.
Important as a research tool, and has application for clinical medicine,
(Not Increased specificity following absorption with cross-reacting
antigens).
Western Blot
Used to confirm HIV antibodies.
Known HIV antigens separated using electrophoresis.
Goal is to confirm a positive ELISA.
Positive bands when antibodies from patient serum binds to HIV antigens.
T cell Receptors
Both alpha and beta chains, have variable and constant domains.
Recognize antigen in the context of MHC class I or classes II.
(MHC Class II or la antigen do NOT fix complement)
(CTL doesnt recognize and kill specific virus-infection target cells
because CTL recognize mainly virus antigens in the context of MHC class
II antigen.)
It is easier to induce tolerance in neonates than adults.
Felton demonstrated dose dependent tolerance.
If mother had measles or measles vaccination, her baby may not respond well to the
measles vaccine before 12 months of age.
Suppress and immune reaction by
Antigen specific suppressor cells
Nonspecific suppressor cells,
Monocytes,
B-cell products.
B cell tolerance
May occur if a single signal is received by a B cell
Is easier to induce in immature B-cells than mature B-cells
May be mediated by anti-idiotypic Ab.
May be either low zone or high zone or high zone tolerance.
Severe combined immunodeficiency
(Not complement/B/T-cell immunodefic.)
is suggested by the combination of overwhelming and repeated viral,
fungal, Hemophilus and Streptococcus infections.
IgG:
IgG molecule:
The light and heavy chains are identical.
The carbohydrate is in the constant region of heavy chains.
(The hinge region does not join heavy and light chains.)
The IgG and the fragments of IgG were isolated from anti.- sheep red
blood cell antiserum: Agglutination occurs if IgG and sheep red blood cells
F(ab)2 and sheep red blood cells
(not Fab and sheep rbc, not Fc and sheep rbc)
In a secondary antibody response IgG >IgM.
IgA:
IgM-
A pentamer.
Immunoglobulin class with greatest molecular weight.
Is Initially produced by most B cells.
(NOT produced by switching from IgA.
not encoded by 12 centimorgans 5 of the centromere of chromosome 4)
Serum IgM:
Has J chain
Is a pentamer
(Does NOT have 2 Ab combining sites per molecule,
Not fix complement less efficiently than igG)
IgE-
Secretory component is found in secretory IgA (not serum IgA only, not secretory IgG,
not IgE)
In most organ specific autoimmune diseases there is a strong association between the
disease an d HLA allele.
Immune responseImmunogen injected in the muscle > Immunogen taken orally.
If immunogen given to a 25 yr. old > If administered to a 10 year old.
Foreign immunogen > self immunogen.
Particulate immunogen > soluble immunogen
In rheumatic fever, the possible mechanism for inducing the autoimmune phenomenon isInfection with Streptococcus group A, a bacteria similar to host antigen.
To prove by Witebskys postulates that Juvenile Diabetes is an autoimmune disease,
Antibodies to the pancreas must beFound in most affected individuals.
Capable of causing the destruction of the pancreas when injected into
another member of the animal model.
(Not capable of Inducing anti-idiotype Abs when injected into an animal not
able to Interact with MIHC molecules)
Brutons agammaglobulinemia X-Unked.
Pyogenic bacterial infections.
Pt. has recurrent infections with extracellular organisms.
Pt. has IgG levels less than 0.5 mg/ ml (50 mg/dl).
(not usually female, not unusually high T-suppressor cell counts.)
(NOT intracellular, not infections from viruses)
DiGeorge Syndrome- pt. has...
Failure to produce IgG In response to T-dependent antigens, causes a
Decrease in the number of helper T cells.
Little or no thymic tissue.
Few lymphocytes (<1500/cu mm). Decreased or absent T-lymphocytes.
Depressed or no IL-2 production.
(Not extremely high IgG levels,
NOT failure of bone marrow to develop normal,
NOT secondary immunodeficiency,
B-Cell lymphomaCell has DNA rearrangement detected by Southern blot using an
immunoglobulin DNA probe.
T-Cell lymphoma
Cell has DNA rearrangement detected by Southern blot using T-cell DNA
probe.
Target antigen
DNA
Neural tissue
Thyroid
Acetylcholine receptor
Pancreas
DO NOT Suspect a primary immunodeficiency for a 65 yr. old with recurrent infections,
total immunoglobulin levels are 35 mg/mi with a monoclonal spike by serum protein
electrophoresis.
Rh(-) woman is pregnant with her first Rh+ childIf fetal blood enters her circulation it will initiate a primary immune
response.
IgM and IgG antibodies will be produced in response to Rh antigens. Second
Rh+ child may have erythroblastosis fetalis if she did not prevent
immunization against Rh of first child with passive immunization.
(NOT since she is Rh- she has preformed anti-bodies to Rh antigens,
not Ab to Rh antigens is exclusively IgG)
Antibodies against Rh isoantigens cause erythroblastosis fetalis
Since can bind to and agglutinate rbcs of an Rh baby.
Since they are IgG antibodies and can cross placenta
(NOT IgM)
.
Type B blood
ABO blood typing, serum will agglutinate blood from a type A
individual
Has anti-A antibodies in serum.
Rbcs will agglutinate in the presence of an equivalent concentration of
anti-B antiserum. (Agglutinates with anti-B antibodies.)
NEGATIVE agglutination will look like a button of rbcs on the bottom of the
tube.
(Serum does not have anti-B anti bodies in it.)
Type AB bloodHas NO antibodies to ABO blood.
Will agglutinate if incubated with anti-A or anti-fl antiserum, since it has
both A and B antigens.
Hapten- Can be immunogenic if attached to a carrier molecule,
Small
DNP
Epitope and an antigen (but N01 an immunogen/ mitogen)
(Not LPS)
Monoclonal Antibody binds to 2 complex antigens with different avidities
This could result from the antibody binding to similar determinants on the
2 antigens.
The same determinant could be present In different concentrations on the
2 antigens.
This is possible.
(Not result from the monoclonal Ab binding to 2 completely different
determinants on the antigens.)
Need an antibody with a valence of 2 or more for
Agglutination
Precipitation
Hemagglutination
Lattice formation
The following cells can respond to specific AntigenActivated 0 cell
(NOT cortical thymocyte, plasma cell, nor Ia positive macrophage)
Anti-mumps titer of serum from A Is 1,520 and the anti-mumps titer of serum front B I:
2; the following are possible individual A has had mum~.
Individual A has been vaccinated against mumps.
Individual B has not been exposed to mumps.
Individual B has not been vaccinated against mumps.
In Laboratory, in the Pregnancy assayUrine was tested for the presence of Human Chorionic Gonadotropin
(HcG).
If no HcG was present In the urine, anti-HcG would agglutinate HcG
coated latex particles.
If HcG was present in urine, reactivity of antibody was removed.
Results can be obtained In a matter of a few minutes.
Positive if NO agglutination, because urine HcG neutralized the anti-HcG.
C3b:
T-cells-
Fixes complement
Antigen interacts with IgE - (atopy)
Causes hay fever and Prausnitz-Kustner reaction.
IL-1:
Fever,
NOT pain.
PGE2:
Pain
LTD4:
Neutrophil activation
Antigenic drift
Many times involves single nucleotide base change in a virus genome.
Contributes to minor antigenic changes in hemagglutinin, and
Neuraminidase of influenza viruses.
T cell maturation
Rearrangement of DNA which codes for T-cell receptor.
Migration to cortex to the medulla
Migration to periphery.
Division in response to stimulating antigens.
Anamnestic response is faster and more specific, longer lasting and greater then primary
immune response.
Infection -
BACTERIOLOGY
Gram Positive bacteria
Have teichoic acids,
Have muramic acid
Have greater peptidoglycan than gram negative bacteria
Can convert to protoplasts
Gram Negative bacteria
Have peptidoglycan,
Have muramic acid,
Have flagella, O-antigens, pili, mesosomes,
Have endotoxin with outer membranes
(do NOT have endospore)
Staphylococcus aureus
Gram + cocci,
Produces coagulase,
Catalase positive
Mannitol fermentation
Perform a catalase test, the an accustaph test
Certain strain produces an exfoliative toxin and a disease called Scaled Skin
Syndrome
Outbreak of Staph food poisoning from contaminated common food supply.
Strep. Pneumonia Gram + cocci, alpha-hemolytic, bile+, Optochin + (zone of inhibition)
Cryptococcosis -
Cryptococcus neoformans
(Not acid-fat,
Not cause chronic subacute mycosis
Not cause mycetoma, dermatomycosis, not griseofulvin D.O.C.)
Rheumatic Fever -
Prions
Lipopolysaccharide = an Endotoxin
Endotoxin -
Lipid A
Causes gram (-) sepsis
Fever and endotoxic shock
Hypotension and anoxia of organs like heart, lung and brain