Transplant immunology/ vaccination

Autograft

self graft (skin on a burn)

Allograft

donation from same species

o   Isograft

graft between two identical individuals

Xenograft

graft from another species like pig heart valves

·      Histocompatibility Systems

o   MHC ___________ encode for __________ such as ________

o   MHC I encodes for ______________________________________________

§  Span the membrane of almost every ____________    ________

§  Class I mainly presents _______________ antigens

§  Class I proteins include: __________________________

• proteins HLA, antigen presentation, peptide MHC complexes

• antigen presentation in all nucleated cells

• endogenous Ag

• HLA-A, HLA-B, HLA-C

o   MHC II encodes for ____________  ____________  _________

§  Also primarily found on ___________   ___________  ___________

§  Class II mainly presents _______________ antigens

§  Class II proteins include: _________________________

only APC

• antigen presenting cells

• exogenous ags

• HLA-DR, HLA-DQ, HLA-DP

o   MHC III encodes for ____________, ______________,  and _______________

complement, cytokines and other genes

o   HLA

§  The strongest immunologic _____________ for successful allogenic organ transplants

§  Exhibit a high degree of __________  ________________

barrier

• allelic polymorphism

·      Hyperacute Rejection:

o   _____________ and _____________ mediated response

o   Recipient has _________________ antibodies reactive with donor tissue

o   _______________ activation

o   Thrombosis and occlusion  of ______________ vessels

immediate and antibody mediated response

• pre-exsting

• complement

• grafts blood

§  Hyper acute rejection can be prevented by:

·       

·       

• ABO matching

• crossmatching the donor and recipient

·      Acute Rejection:

o   ________ mediated immune response against foreign MHC

o   Can take __________ to _____________

o   Inflammation and _____________  _______________ of graft vessels

_____________ common type

Tcell

• weeks -months

• leukocyte infiltration

• most

·      Chronic Rejection:

o   Can take __________ to _____________

o   _________ cause of long-term failure of transplantation

o   ________ mediated immune response against foreign MHC

o   Results in ______________ and ____________ of graft vessels leading to organ ____________

• months-years

• major

• T-cell

• intimal thickening and fibrosis, death

·      Graft vs Host Disease

o   The most common GVHD is from __________   ____________ transplants

o   ____________ T cells proliferate and attack _____________ tissue

o   Patients present with ______________, ___________, and _______________

bone marrow

• alloreactive, recipients

• diarrhea, rash, jaundice

·      What 4 things will a transplant recipient be tested for?

• ABO

• CMV

• HLA

• HLA antibodies

·      DNA Inhibitors or Anti-proliferatives

o   How do these work?

o    

prevent cell proliferation by interfering with DNA synthesis

o   What are the 2 common DNA inhibitor meds named?

§   

§   

Methotrexate

Mycophenolic Acid

T cell Inhibitors:

o   Help prevent ______________ rejection

o   Calcineurin inhibitors (name common meds used)

§   

§   

o   mTOR inhibitors (name common meds used)

§   

§   

allograft

• cyclosporin

• tacrolimus

  MTOR

• Sirolimus

• Everlimus

·      Corticosteroids

Inhibit inflammation in what ways?

• inhibit cytokine secretion

• nitric oxide synthase

• adhesion molecule expression

• inflammatory mediators

• induction of endonuclease

  • apoptosis of lymphs and eos

Inoculation

introduction of infectious agent into scrapped skin to try to force immunity

variolation

innoculation of small pox mater

vaccination

the process of using vaccines that artificially activate the immune system to protect against diseases

Live attenuated vaccines

weakening a virulent virus, should not cause serious illness

Inactivated viruses vaccines

inactivated virus by heat or chemicals, prevents replication

Toxoid vaccines

targets the toxin produced by a disease causing pathogen

Subunit vaccines

contain only the components of a pathogen that stimulate the immune system

Conjugate vaccines

fight off bacteria whose antigens are coated with long chains of polysacharides