Which two memory cells can be produced efficiently even when no immune cells have been infected by the attacker?
Memory B and Memory Helper T
According to our text, what are the 3 types of vaccines?
Non-infectious
Attenuated
Carrier
T/F: Non-infectious vaccines do not cause the production of memory killer T cells.
True: non-infectious vaccines only make mem B cells and mem T helper cells
In killed (non-infectious) vaccines, how is the virus or bacteria killed?
Using chemicals such as formaldehyde
Bacterial toxin vaccines may weaken the toxin with ___, resulting in something called a ___.
Aluminum; toxoid
T/F: Non-infectious vaccines are designed to infect the host but only weakly.
False: Non-infectious designed NOT to infect the host
A ___ ____ vaccine is one that contains the weakened version of the pathogen.
Live attenuated
Live attenuated vaccines result in what types of memory cells?
Memory B Cells
Memory helper T cells
Memory killer T cells
T/F: A carrier type of vaccine yields all 3 types of memory cells.
True
What is a carrier vaccine?
A single gene from a pathogenic microbe is put into a virus that doesn’t cause disease…virus infects host’s APC and will be presented on MHC I
What is the purpose of an adjuvant?
Helps stimulate the immune system by attracting phagocytes (but should not have any antigenic effect by itself)
Th1 Helper T cells utilize what 3 classical cytokines?
TNF, INF-gamma, IL-2
Th1 helper T cells are useful in viral and ___ attacks whereas Th2 helper T cells are useful in ____ attacks.
bacterial; parasitic
What cytokines are released by Th2 helper T cells?
IL-4, IL-5, IL-13
What vaccine still contains thimerosal as a preservative?
Influenza vaccine
Alum generally induces a Th1- or Th2-biased response?
Th2
Which interleukin is the main stimulus for microglial activation?
IL-1Beta, (which is one of the cytokines produced at the site of aluminum adjuvant injection)
T/F: Aluminum accumulates in the mitochondria and the nucleus of cells.
True
How much aluminum is absorbed in the GI tract and what organ is responsible for its excretion?
Only 0.3% is absorbed; kidneys
So why’s aluminum a big deal if our kidneys just eliminate it anyway?
Vaccines bypass GI tract; 40% of Al accumulates in adults and up to 75% of Al can be retained in neonates
What is the most common environmental source of aluminum?
Antacids, (but keep in mind those pass GI tract and should be eliminated fairly successfully)
T/F: There seems to be a correlation, (not necessarily causation), between incr in aluminum adjuvants and an increase in autism spectrum disorder.
True
What type of vaccine is the Pneumococcal disease vaccine (Pc vaccine)?
Non-infectious
T/F: The meningococcal vaccine, DTaP vaccine, and hepatitis B vaccine are all infectious live vaccines.
False: …non-infectious vaccines
If the mom doesn’t have hepatitis B, is it still necessary for her infant to have the shot?
No!
The rotavirus vaccine is what type of vaccine?
Infectious live vaccine
What type of vaccine is the polio vaccine: infectious, non-infectious, or carrier?
Polio=non infectious
The MMR vaccine is a/an ____ type vaccine?
Infectious
What are the 4 types of influenza vaccines?
- Whole virus inactivated
- Subunit inactivated
- Split virus inactivated
- Live attenuated, cold-adapted
T/F: Some influenza vaccines still contain mercury.
True
One of the side effects of the flu vaccine is episodes of ___ seizures.
Febrile (1/110 kids under 5 y.o. to be exact)
Do glial cells ever help conduct nervous impulses?
No
___ are said to be the macrophages of the brain and spinal cord.
Microglia
Microglia account for what percent of the glial cells in the brain?
20%
What is the most abundant cell of the human brain?
Astrocytes
What are 2 regulatory molecules astrocytes give off?
Glutamate
Potassium
__ and __ are the preferential sites of aluminum accumulation.
Microglia and astrocytes
T/F: Astrocytes limit excitotoxic damage by clearing away excess glycogen.
False: …clear away excess glutamate. (Astrocytes store glycogen)
What are the 3 excitotoxins released by hyperactive microglia?
Glutamate
Aspartate
Quinolinic acid (QUIN)
T/F: Aluminum has been shown to impair gap junctional communication between astrocytes.
True
What is the idea behind herd immunity?
If all (80%) of available people were immunized, those that are unable to get immunized, such as babies and elderly, would be protected from the disease
What is the biggest con of natural immunity?
Typically must experience the infectious dz to get the immunity
What are the 2 methods of artificial immunization?
Active immunization (administered like vaccine to present antigens) Passive immunotherapy (breastfeeding transfers antibodies)
What is titer?
Effectiveness of active immunization checked by measuring the amt of IgG and IgM in the blood
What is the purpose of a booster immunization?
Titer is too low; additional administration of antigens to boost levels of antibodies
___ is the process of reducing virulence.
Attenuation
What is the most commonly used adjuvant in human vaccines?
Aluminum phosphate
T/F: Aluminum functions in synaptogenesis.
False: Al has NO physiological function in the human body
What are combination vaccines?
Simultaneous administration of antigens from several pathogens (DTaP, MMR)
T/F: Individuals with egg allergies should avoid some vaccines b/c egg is often used in the culturing process.
True
Antitoxins and antivenoms are examples of which type of artificial immunity: active immunization or passive immunotherapy?
Passive immunotherapy b/c you’re introducing preformed antibodies allowing for immediate protection
How much of the world’s population is infected with Mycobacterium tuberculosis?
1/3
Of the people infected with Tb, what percent of those people will have a lifetime risk of developing active Tb?
5-10% (so to clarify it’s 5-10% of 33%)
What is unique about the pathology created in a Tb infection?
Pathology created due to normal immune system function
What cell engulfs the Tb organism and what goes wrong to cause active infection?
Alveolar macrophage (dust cell); Tb modifies cells surface so it cannot fuse with a lysosome, (which would kill the Tb)…allowing Tb to thrive within the macrophage
What happens after the Tb cell has multiplied too many times within the alveolar macrophage?
Cell bursts, contents spill, lysozymes released into lung tissue
With whom is sepsis most common and most dangerous?
Elderly
Immunocompromised
What is the major cytokine involved in sepsis that leads to decr blood volume and pressure, leading to heart failure?
TNF
____ stimulation can decrease macrophage release of TNF.
Vagal
What percent of the US population suffers from Type 1 hypersensitivity reactions?
54%
Allergy is associated with what bias: Th1, Th2, Th17?
Th2
What antibody is associated with allergy?
IgE
The _ end of IgE binds mast cells and the _ end of IgE binds the allergen, leading to mast cell degranulation.
Fc-mast cell
Fab-allergen
What 3 things are released in the degranulation of mast cells?
Histamine
Proteases
Heparin
In order from earliest to latest, who arrives at the scene of ‘an allergy’?
Mast cells,
basophils,
eosinophils
Which cytokine is released by Th cells at the site of allergies to recruit many eosinophils from the bone marrow?
IL-5
Why is it advantageous to bias fetus away from Th1 subset to a Th2 subset?
To prevent mother’s immune system from recognizing fetus as foreign (considering 1/2 of the fetus genetic material is paternal)
What is responsible for shifting a newborn back to Th1 bias?
Contact w/ microbes from birth process, air, soil..etc
T/F: Children who grow up with dogs are more likely to experience allergies in adulthood.
False: less likely to dev. allergies
What is the downside of using glucocorticoids to treat allergies?
Blocks cytokine production by T helper cells so increases susceptibility to infectious disease overall
Regular injection of allergens in order to gain tolerance causes __ cells to class switch from IgE to another antibody class like ___.
B cells; IgG
T/F: Autoimmune diseases are more common in women.
True
___ ___ may be responsible for why infections can lead to autoimmune disease.
Molecular mimicry
What is molecular mimicry?
Receptors recognize a group of closely related antigens with varying affinities…so infections makes cells more receptive to potentially self antigens if the match is close enough (this is me attempting to paraphrase)
What are self-reactive antibodies targeting in myasthenia gravis?
ACh receptors which prevents ACh from binding–> muscle weakness and autonomic dysfunction
What disease results from T cells attacking cartilage protein in joints leading to chronic inflammation of the joints?
Rheumatoid arthritis
What type of tolerance is broken down in lupus erythematosis?
Both B & T cell tolerance broken down
Multiple sclerosis is to CNS like ______ is to the PNS.
Guillain-Barre
What is transverse myelitis?
inflammatory process of the spinal cord that can cause axon demyelination
What happens if you have a non-functional CD40 or CD40L?
B Cells unable to class switch and secrete mainly IgM
What is DiGeorge syndrome?
Thymic tissue is missing resulting in NO T cell function
__ ___ __ is the genetic condition where neither B or T cells function.
Severe Combined Immunodeficiency Syndrome (SCIDS)
What virus causes AIDS?
HIV-1 (human immunodeficiency virus 1)
What cells are targeted in an AIDS infection?
T helper cells
Which 2 opportunistic infections are the likely killers of AIDS victims?
Pneumocystis carinii
Kaposi sarcoma
What are the 2 reasons HIV-1 can defeat the immune system?
Slowly replicating retro RNA virus that’s able to go latent for extended periods of time as a means of hiding from CTLS.
High mutation rate
What 3 cells become infected by HIV-1?
- Helper T cells
- Macrophages
- Dendritic cells
There are some people w/ HIV-1 who are able to control the infection for some periods of time; how is their immune system different?
- Low levels of detectable virus
- Quicker innate and adaptive IS
- More INF-alpha and INF-beta secreted
- CTL’s more vicious killers
What is the number 2 cause of death?
Cancer (#1 is cardiovascular disease)
What is the goal of the 2 systems that help keep cancer in check?
- Systems that promote normal cell growth
2. Safeguard to prevent uncontrolled cell growth
What two areas of the body are constantly being replaced and therefore must be carefully controlled to prevent cancer?
Skin cells
Cells of mucous membranes
A mutation to which tumor suppressor protein is commonly found in most tumors?
Mutation to p53
How many mutations are estimated to produce most common cancers?
4-7; thus takes some time to accumulate mutations
It is estimated that viral infections contribute to ___% of all human cancers.
15-20%
Which protein is necessary to assemble BCR & TCR and when absent leads to increased risk for developing tumors?
RAG-2
What are the 3 cells associated with the line of defense against cancer?
CTLS, Macrophages, NK cells
Which of the following is least effective against cancer: CTLs, macrophages, NK cells?
CTLs b/c of their restricted traffic pattern
Which of the following is most effective against cancer: CTLs, macrophages, NK cells?
NK cells
What types of cancerous cells are CTL’s most effective at killing?
Cancerous blood cells b/c likely to come in contact if cancer is in the blood
What are the 2 benefits of macrophages regarding cancer killing?
Quick acting, and located out in tissues so likely to encounter the spontaneous tumors that arise there
How do NK cells recognize cancer?
Cancer cells express low levels of MHC-I molecules and display unusual surface molecules
Hepatitis __ virus has been linked to liver cancer.
B
HPV-__ and HPV-__ have been implicated in about 70% of all cervical cancer.
HPV-16, HPV-18
What are the 2 types of HPV associated with genital warts?
HPV-6 and HPV-11
The Gardasil vaccine is made from viral coat proteins and is classified as a ___ vaccine.
recombinant
__ is the protein found on the surface of many cancer cells that impairs the IS’s ability to fight the disease.
PD-L1 (Programmed death ligand 1)
Injecting tumor with bacille Calmette-Guerin can hyperactivate ___ which can destroy tumor.
Macrophages
Of the 4 types, which hypersensitivity reactions are antibody mediated?
Types I, II, III
Which antibodies are formed in both Type II and Type III hypersensitivity rxns?
IgM and/or IgG
Which types of hypersensitivity rxns require prior exposure to the antigen?
All 4 types
What is Type I hypersensitivity and which antibody dominates the rxn?
Allergy or Immediate hypersensitivity (minutes or hours of exposure); IgE
Which 2 interleukins cause the class switching to IgE in Type I hypersensitivity rxns?
IL-4, IL-13
T/F: There is no visible response on the initial exposure to an allergen.
True
How can IgE antibodies, which are normally short lived, extend their lifetime?
Attach to mast cells (half life of several weeks)
Upon re-exposure to the antigen, what causes typical allergy symptoms?
Degranulation of mast cells releasing histamine, proteases, and prostaglandins
What are the cells present at the sight of allergies and what order do they arrive?
Mast cells, basophils, eosinophils
What cell is the prominent player in chronic allergy reactions?
Eosinophils
What is the hygiene hypothesis?
Improved hygiene leads to decreased exposure to allergens–>increased allergies later in life
What are the 3 means of destruction in Type II hypersensitivity rxns?
- Antibody-dependent cell mediated cytotoxicity
- Complement
- Functional derangements
Which 2 antibodies are good at fixing complement? Which doesn’t fix it at all?
IgM & IgG; IgA doesn’t fix at all!
What is functional derangement?
Antibodies acting as agonists/antagonists to cell receptors (ex: myasthenia gravis)
What is hemolytic anemia resulting from?
Ab bind to molecules present on RBC, RBC’s are then phagocytized and lysed
What causes rheumatic heart disease?
Helper T cells that were primed from a strep throat infection cross react with protein present on the mitral valve of the heart causing an inflammatory attack on the heart.
What are Type III hypersensitivities?
Antibody-antigen complexes that are normally cleared begin to accumulate, deposit in tissues, and cause inflammation
T/F: Two common places for Ab-Ag complexes to deposit are the vascular walls and joints.
True
Which autoimmune disease affecting mostly women has self Ab-Ag complexes that form and commonly target the lungs, joints, and kidneys?
Lupus Erythematosus
What are the 2 subtypes of Type IV hypersensitivity rxns?
Delayed type (T helper) Cell mediated cytotoxicity (T killer)
What cell causes most of the damage in delayed-type hypersensitivity rxns: T helpers, T killers, macrophages, NK cells?
Macrophages, T helpers only secrete the INF-gamma that brings the macrophages in
T/F: Contact dermatitis, Crohn’s Dz, and multiple sclerosis are all examples of Delayed Type IV hypersensitivity rxns.
True
Which type of hypersensitivity rxn accounts for rejection of organ transplants?
Cell Mediated Cytotoxicity; Type IV hypersensitivity
Why should we be cautious of studies obtained using isolated cells of the immune system?
B/c isolating takes away a lot of the bodies natural chemistry that would be intact in most humans
What are PAMP’s?
Pathogen associated molecular patterns; commonly seen on pathogens and can be used by IS to recognize foreign cells
__ cells scan MHC I and ___ cells scan MHC II.
T killer; T helper
T/F: Every cell has both MHC I and MHC II molecules
False only APC have MHC II presented
Why is the vagus nerve so important to the immune system?
Vagus controls systemic release of TNF, a cytokine needed for the innate immune response
T/F: Both pre-gang and post-gang sympathetic nerve fibers utilize acetylcholine.
False that would be parasympathetic
What neurotransmitters does the sympathetic nerves utilize?
Pre-gang: ACh
Post-gang: NE
Adrenergic alpha receptors cause vaso__ and beta receptors cause vaso__.
alpha-vasoconstriction
beta-vasodilation
What are the 2 types of acetylcholine receptors?
Muscarinic, nicotinic
T/F: Muscarinic receptors are found at the post-gang end of cholinergic neurons and they work with G Protein complexes.
True
Where do you find nicotinic receptors?
Synapses between pre-gang and post-gang neurons of both the SympNS and ParasympNS
Which type of acetylcholine receptor forms an ion pore: muscarinic or nicotinic?
Nicotinic
Baroreceptor reflex results in SNS ___.
Inhibition
Sexual stimulation relies on which autonomic system: Symp, Parasymp, or both?
Both
A deficiency in __ nerve activity or deficient nicotinic ______ receptors would make one sensitive to inflammatory challenges.
Vagal; alpha7-acetylcholine receptors
T/F: Most immune cells have nicotinic ACh receptors.
True
Heart Rate Variability is positively correlated w/ what?
Longevity in cancer, better cognitive function in Alzheimer’s (in this case, variability is a good thing)
Increased Heart Rate Variability means there is a/an ___ in parasympathetic tone.
Increase