Immunology

SPP 3341

Tolerance
Good or bad? For which cells? Where? Central tolerance
Positive selection Negative selection
for B cells: receptor editing

Peripheral tolerance
anergy clonal ignorance activation-induced cell death suppression

Hypersensitivity
Good or bad? Types based on immunological mechanisms:
Antibody mediated
Type I IgE mediated reaction Type II cytotoxic reaction Type III immune complex reaction

Examples
hypersensitivities
allergy transfusion reactions, rhesus incompatability serum sickness Arthus reaction

autoimmune

T-cell mediated
Type IV cell mediated immunity reaction/delayed type hypersensitivity

Link to autoimmune diseases?

Autoimmunity
Good or bad? Definition Mechanisms how it develops:
molecular mimicry polyclonal activation (superantigens) presentation of hidden self antigen modification of cell surface

Link to tolerance?

Autoimmune Disease
Good or bad? Types:
Organ-specific Systemic

General therapy:
anti inflammatories: corticosteroids immunosuppressive: cyclosporin

Types based on immunological mechanism:

Type II: autoimmune haemolytic anaemia, Graves, myasthenia gravis Type III: SLE Type IV: Type I DM, rheumatoid arthritis

Tumour Immunology
Good or bad? Controlling tumour growth
CTL NK, NKT antibody & complement
cell lysis

Tumour evasion/escape from immune system

tumour doesnt provide suitable target
no antigenic epitope reduced MHC I does not provide signal 2

antibody
ADCC

cytokines
TNF

immune system doesnt respond well

poor antigen presentation by APC

Transplantation
Good or bad?
transplantation rejection

Rejection
host versus graft
hyperacute: preformed ab/CROSSMATCHING acute: 1o T cell activation/TISSUE TYPING accelerated: reactivation of sensitised T cell chronic

autograft, syngraft, allograft, xenograft MHC

HLA Class I: A, B, C HLA Class II: D [DP, DQ, DR] polymorphic genes, codominantly expressed

graft versus host

bone marrow, skin, alimentary tract, liver

Link to tolerance?

privileged tissue
NO REJECTION

Immunosuppression

Immunity towards infection

Good or bad? Bacteria
Extracellular: antibody, phagocytes Intracellular: CTL Gram positive: not MAC but phagocytosis Gram negative: MAC, phagocytosis Mycobacterium: DTH

Virus
Intracellular: CTL, NK, Type I IFN Extracellular virus particle:

Fungi
phagocytosis

Helminths
IgE and eosinophil/mast cell activation

Immunodeficiency
Good or bad? Primary
B: X-linked agammaglobulinaemia/Brutons B: IgA deficiency B: Hyper IgM syndrome B: CVID T: DiGeorge B & T: SCID Phagocytes: CGD, Chediak-Higashi Complement
classical: lupus-like lectin: increased infections alternative: pyogenic, Neisseria sp infections

Secondary
drugs HIV burns chemotherapy/radiation chronic disease splenectomy malnutrition

Immunisation
Good or bad? Active
administration of an agent that STIMULATES immune system to become protective

Types of vaccines
killed whole attenuated toxoids subunit vaccines

Passive
administration of protective immune agents

Vaccination schedule & their types

Immunotherapy
Good or bad? Active
tumour infiltrating lymphocytes LAK DC vaccine

Passive
cytokine infusion

Aging and Immunity

Good or bad? Definition Changes to immune system
thymus innate cells adaptive cells cytokine expression haematopoiesis

Effects on immunity
infection reduced response to vaccination cancer autoimmune diseases inflammatory conditions