Innate Immunity II

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Immunology UNCMED 2017
Marissa Alvarez
Karteikarten von Marissa Alvarez, aktualisiert more than 1 year ago
Marissa Alvarez
Erstellt von Marissa Alvarez vor mehr als 7 Jahre
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IMMUNE EVASION 1) Molecular Mimicry: mimics the immune response in order to INVADE the immune response
IMMUNE EVASION: Protein Modifications Glycosylation: key immune proteins, such as TCR, MHC, TLR and antibodies are glycosylated **when pathogen is glycosylated, it sterically blocks the action of proteases and can ESCAPE
IMMUNE INVASION: Down-Regulate HLA TUMORS & VIRUSES target the HLA and wants to down regulate it so that the immune system cannot detect them
BRIDGING THE GAP B/W Innate and Adaptive Immunity Innate immune response drive adaptive immune responses -recognition of PRR drives inflammation and recruitment of neutrophils, macrophages, and dendritic cells -Macrophages and dendritic cells and B cells are all APC's (professional) APC's stimulate adaptive immunity (T cells)
HLA HUMAN LEUKOCYTE ANTIGENS Polymorphic Multiple loci Multiple alleles at loci Codominantly expressed Haplotypes (inherit 1/2 from mom and 1/2 from dad) Linkage disequilibrium (certain genes are found at a more than random frequency) Evolved to accommodate immune responses to enormous variety of foreign antigens (pathogens) “Self Ags” = Potent inducers of humoral and cell mediated immune responses = primary stimulus for HVG and GVH responses
CONCEPT FOR MHC CLASSES MHC CLASS ONE = ONE LETTER ABBREVIATIONS MHC CLASS TWO = TWO LETTER ABBREVIATIONS
ANTIGEN PRESENTATION TO T CELLS: MHC CLASS ONE INTRACELLULARLY derived peptides (8-10 aa) anchored at ends Expressed on ALL NUCLEATED CELLS except RBC's (phagocytes, etc.) Presents to CD8+ T cells (1*8 = 8) Ligand for KIR
ANTIGEN PRESENTATION TO T CELLS: MHC CLASS II EXTRACELLULARLY derived peptides (>13 aa) bound by peptide side chains protruding into pockets in binding groove Expressed on APC (professionals-macrophages, dendritic, and B cells) Presents to CD4+ T cells (2 * 8 = 8)
PATHWAYS OF ANTIGEN PROCESSING MHC Class I: Protein antigen in cytoplasm (INTRACELLULAR) -EX: VIRUS MHC Class II: Protein antigen in vesicles (ECTRACELLULAR)
Hypervariable Regions (HLA = responsible for enormous variety of response) MHC Class I: alpha 1, 2, and 3 MHC Class II: Beta 1 and 2 -variability on Amino Acid position
MHC RESTRICTION T cells are RESTRICTED to what they can recognize! MHC Class I: CD8+ T cytotoxic cells, intracellular (one letter abbreviations) MHC Class II: CD4+ T helper cells, extracellular (two-letter abbreviations)
Thymic Education: POSITIVE SELECTION Postive selection: will live if LOW AFFINITY (based on signaling/binding) for SELF
Thymic Education: NEGATIVE SELECTION Negative selection: if you bind with HIGH AFFINITY to SELF then you DIE (do NOT want MHC to recognize self peptides)
IMPORTANCE OF HLA IN BONE MARROW TRANSPLANT HLA molecules from a donor are recognized by the recipient's immune system -By direct and indirect methods of allorecognition triggering an alloimmune response *WANT it to be INDIRECT
INDIRECT ALLORECOGNITION (in bone marrow transplantation) the recipient APC takes up the donor peptide and presents it to T cell / MHC -BETTER because it takes more time for rejection to occur
DIRECT ALLORECOGNITION (in bone marrow transplantation) the recipient T cell and MHC DIRECTLY recognize donor peptide -WORSE b/c it immediately rejects
HLA MATCHING AND HSC OUTCOME (stem cell transplant) KEY CONCEPT: The better HLA MATCHED, the better stem cell transplant OUTCOME will be EX: using family members
CELIAC DISEASE (pathogenesis) AUTOIMMUNE LIKE DISORDER of small intestine resulting from immune response to GLIADIN Deamidation of glutamine residues (by tissue transglutaminase or TTG) in gliadin peptides generate epitopes that bind to HLA-DQ2 and DQ8 eliciting T cell responses >95% of patients possess HLA-DQ2 or DQ8 - DQ2 = strongest genetic element (increases risk fro Celiac disease) -30% of Caucasian population carry DQ2, most eat wheat but only 1 in 100 develop celiac disease - other genetic and environmental factors contribute to susceptibility GWAS studies: IL21, IL2, TENR, KIAA1109 + 7 others with known immunologic function **HLA explains 35% of heritability; other genes about 4%
IMMUNOPATHOGENESIS OF CELIAC DISEASE *Process DRIVEN by WHERE the protein came from! -in this case = EXTRACELLULAR b/c GLIADIN came from outside the cell (CD4+ T helper cells / MHC Class II)
Drug Hypersensitivity Reactions: ABACAVIR HLA-B*57:01 anti-HIV drug
Abacavir hypersensitivity = Multisystem disease Fever, constitutional symptoms, N/V/D, rash 4 – 8% of treated patients Possible Mechanisms: The hapten/prohapten model The p-i model The altered repertoire model
ABACAVIR HYPERSENSITIVITY (if (+) for HLA-B57:01, need to take another anti-HIV drug instead) Abacavir demonstrated to bind to floor of B*57:01 groove **Alters self-peptide repertoire LEADS TO POLYCLONAL T CELL RESPONSE Mediated by CD8+ T cells releasing pro-inflammatory cytokines -In vitro – IFN gamma production -Ex vivo TNF in patient cells abrogated by CD8 depletion CD8 T cells PROLIFERATE Bx of patch test/skin from AHR show CD8 T cells HLA-B*57:01 screening has 100% negative predictive value (55% PPV)
Drug Hypersensitivity Reactions: ALLOPURINOL HLA-B*58:01
Drug Hypersensitivity Reactions: CARBAMAZEPINE HLA-B*15:02
NATURAL KILLER (NK) CELLS (innate) {MHC Class I} -lymphocytes -recognize infected or stressed cells UNIQUE: b/c they can recognize your own cells if infected or have become cancerous -kill by poking a hole and releasing an enzyme to trigger APOPTOSIS SECRETE INF-GAMMA /TNF to ACTIVATE MACROPHAGES and DENDRITIC CELLS
NK (natural killer) CELL ACTIVATION Innate because it is one of the ways to further fine-tune the recognition of self and non-self -KILLS if the MHC Class I is MISSING or if there are TOO MANY stimulatory ligands
ANTIGEN PROCESSING AND PRESENTATION 1) PATHOGEN, PAMP, TLR (depending on the pathogen) 2) Particular APC depends on where the pathogen comes from: A) MHC Class I: intracellular B) MHC Class II: extracellular 3) T cell response/activation depending on corresponding MHC Class molecule A) MHC Class I = CD8+ T cytotoxic (kill) B) MHC Class II = CD4+ T helper (mediate killing, alert other T cells, etc.)
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