Autoimmune Diseases & Immunodeficiency Disorders

Allergic reactions and environmental allergies are part of the ___ immune response

Adaptive

___% of caucasians in Europe and North America have epidemic allergies

40

Type ___ HS reactions happen immediately

1

Type ___ reactions result in anaphylactic shock

1

Type ___ HS reactions are cytotoxic and antibody-mediated

2

Which antibody is responsible for activating type 1 and 2 HS reactions, respectively?

IgE, IgG

Type ___ reactions are immune complex-mediated

3

Immune complexes in type 3 HS reactions accumulate and deposit where?

Small vessels, alveoli

Type ___ HS reactions are caused by hyperactivation of CD4+/CD8+ T-cells

4

Which cells and antibodies work with mast cells, basophils, and eosinophils to control parasitic infestation?

Th2, IgE

If parasites are too big to phagocytose or kill using cells, what happens?

Ejected physically

“Over-hygiene” distorts presentation and response mechanisms of the immune system

Hygiene hypothesis

What are the three stages of allergic presentation?

Sensitization, early-stage response, late-stage response

Allergens do what to IgE on the surface of mast cells?

Cross-linking

During the late phase response, ___ cells release cytokines to recruit other immune cells to the area

Th2

What are the tissues most commonly exposed to allergens?

Respiratory, GI, blood, connective tissue

Amount of IgE, amount of allergen, and mechanism of entry all influences what?

Violence of reaction

Injections typically produce ___ severe reactions

More

What are three causes of systemic anaphylaxis?

Stings, injection, ingestion

When lots of mast cells are activated, ___ is released, causing ___ and anaphylactic shock due to a ___ in BP

Histamine, vasodilation, drop

How can death occur during anaphylactic shock?

Asphyxiation and swelling of epiglottis

Which epithelial layer contains an abundance of immune cells?

Submucosa

During bronchial asthma, allergens activate mucosal mast cells in the ___

Lower respiratory tract

Histamine causes what in the bronchioles?

Bronchoconstriction, inflammation

Angioedema results from allergens entering the skin with ___

Blood

Eczema is type ___, contact dermatitis is type ___

1, 4

Mutation in the filaggrin gene causes damage to the stratum ___, allowing allergens to penetrate

Corneum

Atopic people have increased ___ and ___

IgE, eosinophils

Medications ending in -ab are ___

Antibodies

Desensitization can be achieved by administering an ___ dose of an allergen

Increasing

Which types of HS reactions are used to explain autoimmune reactions?

2, 3, 4

During autoimmune hemolytic anemia, RBCs are opsonized and commonly phagocytosed where?

Spleen

Antigen/antibody complexes are formed where during type 2 HS reactions?

Cell surfaces

Antigen/antibody complexes are formed where during type 3 HS reactions?

Circulation

Type 4 HS reactions involve the activation of ___

Cells

With Grave’s disease, the body produces auto-antibodies against ___

TSH receptors

When the TSHR autoantibody binds, the thyroid responds by ___

Producing excessive thyroid hormones

During myasthenia gravis, the body develops autoantibodies to ___

ACh receptors

Grave’s and myasthenia gravis are both type ___ HS reactions

2

With Hashimoto’s thyroiditis, the body creates autoantibodies to the ___

Thyroid

During pemphigus vulgaris, the body creates autoantibodies to ___ in the skin, causing ___ to form

Desmosomes, blisters

SLE is a type ___ HS reaction

3

SLE occurs when the body produces autoantibodies against ___

Cell membranes

Antibody-autoantibody complexes are eliminated in the ___ during immunotherapy

Spleen

RA is a type ___ HS reaction

4

The body produces antibodies against ___ during RA

Citrullinated proteins

Rheumatoid factor is generally ___ against ___

IgM, IgG

After strep throat, ___ may develop

Rheumatic fever

With RF, antibodies develop against ___ in the heart, joints and kidneys

Epitopes similar to self-proteins

RF is a __ disease (no autoantigens)

Transient

Goodpasture’s disease is a type ___ HS reaction

2

During Goodpasture’s, antibodies are created against the basement membranes of the ___ and ___

Glomeruli, alveoli

During sympathetic ophthalmia, trauma to one eye can cause ___

Damage to the other eye

Trauma to the eye exposes ___ that are not recognized properly

Self-proteins

Type 1 DM results from the creation of autoantibodies to ___ and is a type ___ HS reaction

Pancreatic beta-cells, 4

Celiac disease is a type ___ HS reaction

4

Di George syndrome results in what three pathologies?

Hypocalcemia, chronic infection, congenital abnormalities

Impaired development of the thymus and parathyroid results in impairment of ___, as well as ___, respectively

T-cell maturation, hypocalcemia

SCID is primarily caused by ___

Absence of lymphoid tissue

A mismatched blood transfusion is a type ___ HS reaction

2

GVHD is a type ___ HS reaction

4

Agglutination in a cross-test of donor/recipient serum suggests the formation of ___

Antigen-antibody complexes

What are the two most common blood groups?

O+ and A+

Hyperacute rejection is a type ___ HS reaction

2

Acute rejection is a type ___ HR

4

What does acute rejection typically result from?

HLA I/II incompatibility

Acute rejection occurs over a period of ___, and hyperacute rejection occurs over a period of ___

Days, minutes

Chronic rejection is a type ___ HS reaction

3

Chronic rejection occurs over a period of ___

Months to years

Transplant of a ___ typically does not require HLA matching

Cornea

Transplantation of large organs is typically (more/less) contingent on HLA matching

Less

Transplantation of ___ can prevent graft rejection

Bone marrow

Graft vs. host disease is a type ___ HS reaction

4

In GVHD, CD8+ cells from the ___ attack the ___

Donor, recipient