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Immunology

front 1 Adaptive Immunity	back 1 Develops after exposure to specific antigen The adaptive immune response has memory Works together with inflammation Provides long-term protection Is slower than innate but more specific Recognizes foreign or “nonself” substances Antigens Pathogens: bacteria, fungi, viruses, parasites Noninfectious environmental agents: pollen, foods, bee venom Drugs Vaccines Transfusions Transplants inducible (able to be caused), specific, and long-lived, and by having memory third line of defense in the human body is adaptive (acquired) immunity, often called the immune response or immunity, and consists of lymphocytes
front 2 Adaptive Immunity: T and B Cells	back 2 End products of adaptive immunity Lymphocytes: T and B cells Antibodies: Immunoglobulins (Ig) Primary lymphoid organs: Is the thymus for T cells and bone marrow for B cells It is estimated that each person has produced a population of B and T cells with an extensive diversity of antigen receptors capable of recognizing at least 108 different antigens. This process is called generation of clonal diversity Each individual T or B cell specifically recognizes only one particular antigen Both B and T cells also develop cell surface antigen receptors B cells develop into plasma cells that become factories for the production of antibody. T cells develop into several subsets identify and kill a target cell T-cytotoxic cell [Tc cell regulate the immune response by helping the clonal selection process- T-helper cell [Th cell suppress or limit the immune response T-regulatory cell [Treg cell]).
front 3 Adaptive Immunity: Humoral and Cellular immunity	back 3 Humoral immunity *B cells and circulating antibodies are the primary cells* Antibody is primarily responsible for protection against many bacteria and viruses. Causes direct inactivation of a microorganism or the activation of inflammatory mediators Cellular immunity *Differentiates T cells* Primarily protects against viruses and cancer identify and kill a target cell T-cytotoxic cell (Tc cell) regulate the immune response by helping the clonal selection process- T-helper cell (Th cell) suppress or limit the immune response T-regulatory cell (Treg cell). Effector T cells are found in the blood and in tissues and organs and defend against intracellular pathogens (e.g., some viruses) and cancer cells. Humoral and cellular immunity work together to provide immunity and memory. Respond more rapidly and efficiently on subsequent exposure to the same antigen.
front 4 Adaptive Immunity: Active vs. Passive Immunity	back 4 Active produced by an individual either after natural exposure to an antigen or after immunization active acquired immunity is long lived Passive passive immunity occurs when preformed antibodies or T lymphocytes are transferred from a donor to the recipient occurs naturally or artificially maternal antibodies across the placenta to the fetus artificially, as in a clinic using immunotherapy for a specific disease Is temporary or short-lived.

front 5 What is an Antigen?	back 5 Is a molecule that can react with antibodies or receptors on B and T cells Is mostly protein but can be other molecules as well Antigen is a commonly used term to describe a molecule that can react with binding sites on antibodies or antigen receptors on B and T cells not all, antigens are also immunogens An antigen that is immunogenic will induce an immune response, resulting in the production of antibodies or functional T cells
front 6 What is an Antibody?	back 6 immunoglobulin, is a serum glycoprotein produced by plasma cells in response to a challenge by an immunogen Is also called immunoglobulin (Ig) Is produced by plasma cells Has several classes IgG, IgA, IgM, IgE Are characterized by antigenic, structural, and functional differences
front 7 IgG How can it be aquired? Most protective activity against __?	back 7 IgG Is the most abundant class (80% to 85%) Is transported across the placenta Maternal IgG is transported across the placenta during pregnancy and protects the newborn child during the first 6 months of life Accounts for most of the protective activity against infections
front 8 IgA Where is it mostly found?	back 8 IgA mostly in secretions Has two subclasses IgA1 molecules: Are predominantly in the blood. IgA2 molecules: Are predominantly in normal body secretions. IgA dimer inside mucosal epithelial cells and protects these immunoglobulins against degradation by enzymes also found in the secretions

front 9 IgM Characteristics? When does it respond?	back 9 IgM Is the largest of the immunoglobulins Is the first antibody produced during a response to an antigen
front 10 IgE When does IgE act? Concentration?	back 10 IgE “echuu” & “ParEEEsite” Most Rare Acts as a mediator of many common allergic responses “eechu” Defends against parasites found in low concentrations in the circulation
front 11 IgD	back 11 Not well known Functions as one type of B-cell antigen receptor.
front 12 B-Cell Maturation	back 12 Occurs in the bone marrow Stem cell matures Stem cells in the bone marrow or fetal liver. Lymphoid stem cells are precursor cells formed in the liver (in the fetus) or in the bone marrow (of a child or adult) Lymphoid stem cells destined to become B cells percolate through specialized regions of the bone marrow, where they are exposed to hormones and cytokines that induce proliferation and differentiation into immunocompetent B cells

front 13 T-Cell Maturation	back 13 Thymus is the central lymphoid organ of T-cell development T cells move from the thymic cortex to the medulla they are instructed by interactions with various thymic cells (epithelial cells, macrophages, and dendritic cells), thymic hormones (e.g., thymosin, thymopoietin, thymostimulin, and others produced by the thymic epithelium), and the cytokine IL-7 to undergo proliferation and progressive development of the characteristics of immunocompetent T cells T cells are released into the blood and take up residence in the secondary lymph organs to await antigens.
front 14 What are some Secondary Lymphoid Organs	back 14 Include: “ T PALS” spleen lymph nodes adenoids tonsils Peyer patches (intestines) appendix Immunocompetent lymphocytes are released to the circulation and many reside in secondary (peripheral) lymphoid organs (e.g., spleen, lymph nodes, adenoids, tonsils, Peyer patches). After maturation in the central lymphoid organs, these stem cells develop into immunocompetent cells with antigen-specific receptors without encountering foreign antigen.
front 15 Primary Response	back 15 Primary immune response Occurs during the initial exposure After 5–7 days, an IgM antibody for a specific antigen is detected An IgG response equal to or slightly less follows the IgM response The immune system is primed there is a latent period, or lag phase. After approximately 5 to 7 days, IgM antibody specific for that antigen can be detected in the circulation followed by the production of IgG against the same antigen amount of antibody in a serum sample is frequently referred to as the titer lag phase is a result of the time necessary for clonal selection, including processing and presentation of antigens, induction of Th cells, interactions between immunocompetent B cells and Th cells, and maturation and proliferation of the B cells into plasma cells and memory cells
front 16 Secondary response	back 16 Is more rapid than the primary response. Larger amounts of antibody are produced. IgM is produced in similar quantities to the primary response, but IgG is produced in considerably greater numbers. rapidity of the secondary immune response is the result of the presence of memory cells that require little further differentiation into plasma cells

front 17 Fetal and Neonatal Immune Function	back 17 Newborns have a poorly developed immune response. Antibody function of the newborn is deficient. Is capable of primary IgM response, but is unable to produce an IgG challenge. Immunity is provided by maternal antibodies
front 18 Aging and Immune Function	back 18 Decreased T-cell activity Thymic size is 15% of its maximum size Decreased production of specific antibodies Decreased circulating memory B cells Increased circulating immune complexes Increased circulating autoantibodies
front 19 Antigen	back 19 Is an exaggerated response against an environmental antigen
front 20 Autoimmunity	back 20 Is a misdirected response against the host’s own cells disturbance in the immunologic tolerance of self-antigens

front 21 Alloimmunity	back 21 Iimmune response directed against beneficial foreign tissues, such as transfusions or transplants
front 22 Immune deficiency	back 22 Immune response is insufficient to protect the host
front 23 Hypersensitivity	back 23 Is an altered immunologic response to an antigen that results in disease or damage to the host.
front 24 Sensitization	back 24 Adequate amount of antibodies or T cells is available to cause noticeable reaction on re-exposure to antigen Hypersensitivity reactions require sensitization against a particular antigen that results in primary and secondary immune responses Usually a sensitization process involving multiple exposures to the allergen occurs before adequate amounts of antibody or T cells are available to elicit a hypersensitivity response

front 25 Immediate hypersensitivity reaction	back 25 Reaction that occurs within minutes to a few hours Anaphylaxis: systemic or cutaneous
front 26 Delayed hypersensitivity reaction	back 26 Reaction that takes several hours to appear Maximum severity occurs days after re-exposure to the antigen
front 27 Anaphyslaxis	back 27 most rapid and severe immediate hypersensitivity reaction occurs within minutes of re-exposure to the antigen can be either systemic (generalized) or cutaneous (localized) Severity depends on the level of sensitization Systemic anaphylaxis include itching, erythema, headaches, vomiting, abdominal cramps, diarrhea, and breathing difficulties most severe reactions may include contraction of bronchial smooth muscle, laryngeal edema, and vascular collapse and decreased blood pressure that can lead to shock and death EX of systemic reactions: Bee stings, peanuts, eggs, and shellfish, among others, can cause anaphylaxis Cutaneous anaphylaxis results in local symptoms, such as pain, swelling, and redness, which occur at the site of exposure to an antigen
front 28 Type I Hypersensitivity	back 28 Is immunoglobulin E (IgE) mediated Is against environmental antigens (allergens) IgE binds to mast cells; causes the release of histamine from mast cell degranulation H1 and H2 receptors Manifestations from H1 Bronchial constriction Edema Vasodilation Manifestations from H2 Increases gastric secretions Decreases the release of histamine from mast cells and basophils Tx with Benadryl or Zantac

front 29 Type II Hypersensitivity	back 29 Tissue specific Specific cell or tissue (tissue-specific antigens) is the target of an immune response Examples Graves disease Hemolytic transfusion reactions Rh incompatibility Drug induced hemolytic anemia
front 30 Type III Hypersensitivity	back 30 Is immune (antigen-antibody) complex mediated Complexes are formed in the circulation and deposited later in vessel walls or extravascular tissues Is not organ specific Examples Lupus, Rheumatoid Arthritis, Raynaud's serum sickness, post-streptococcal glomerulonephritis
front 31 Type IV Hypersensitivity	back 31 Is mediated by T lymphocytes or is cell mediated Examples Acute graft rejection, skin test for tuberculosis (TB), contact allergic reactions, and some autoimmune diseases