Immunoglobulins, and order B cells present them MADGE
(character from the old dishwashing liquid commercial): IgM
· Order of presentation by B cells (which is made first, IgD or IgM?) B
cells present IgMprimarily, and then IgD. Just remember why all of us are going through this pain…to become M.D’s. For a
B cell to be competent, it must get its MD.
· Finally, by the same rule, B cells must first release M then G immunoglobulin on primary exposure.
Graves disease: etiology In Graves disease, the thyroid-stimulating immunoglobulins are of the IgGclass.
Dendritic cell: function DENDRITIC CELL:
Disguised in host tissue (but still have same function!)
Nothing left to chance (ensures an immune response) Derived from bone marrow
Regulates the immune response Induces an immune response (makes it unique among antigen presenting cells)
Transfers information from the ECF into the cell
Immune tolerance (increases it)
Co-ordinates the adaptive and innate immune systems
Captures and processes antigen Expresses lymphocyte costimulatory molecules Llong processes extend from cell
Liv es in lymphoid tissue Secretes cytokine to initiate immune response
DiGeorge Syndrome: features The disease of T’s:
Third and 4th pharyngeal pouch absent. Twenty-Two chromosome
Chrug-Strauss syndrome: symptoms and signs PAVE:
Immunoglobulin response to antigens: order of IgM vs.
IgM is released first, followed by IgG.
Sjogren syndrome: morphology “Jog through the MAPLES“:
Ey es dry
Sicca (primary) or Secondary
Celiac sprue features CELIAC:
Cell-mediated autoimmune disease
European descent Ly mphocytes in Lamina propria/ Lymphoma risk Intolerance of gluten (wheat) Atrophy of v illi in small intestine/ Abnormal D-xylose test Childhood presentation
· Atrophied villi cause less absorption, so diarrhea, weight loss, less energy.
Hypersensitivity: type IV example Poison IVy causes ty pe IVhypersensitivity.
Immunoglobulins: which crosses the placenta IgGcrosses the placenta during Gestation.
Interferon gamma: action on macrophages “Th1nk BIG Mac Attack“:
Th1 and NK cells Build Interferon Ga mma. Causes Macrophages to have an augmented Attack [by better ly sosome function and increasing reactive oxy gen metabolites, nitric oxide and defensins].
Passive vs. active immunity “Pay for Passiv e, Active Ages”: Passiv e:Pay for a shot of antibodies for fast results following exposure to Rabies, etc.
Active: Slow onset (“aging”) and memory.
HLA-B27 associated diseases PAIR:
Inflammatory bowel disease Reiter’s sy ndrome
Therapeutic vaue none
Neurotransmitter/ Narrow airways IgE
T and B cells: types When bacteria enter body, T-cell says to B: “Help Me Catch Some!” B-cell replies: “My Pleasure!”:
· T-cell types:
· B-cell ty pes: Memory cell Plasma cell
MHC: loci creating class I vs. II Class 1has 1
HLA I is HLA-A, HLA-B, HLA-C.
Class 2 has 2 letters:
HLA II is HLA-DP, HLA-DQ, HLADR.
Hypersensitivity reactions: Gell and Goombs nomenclature ACID
· From I to IV:
Anaphylactic type: type I
Cy totoxic type: type II
Immune complex disease: type III Delayed hypersensitivity (cell mediated): type IV
MHC I vs. II: T cell interaction The “=8” equation:
2x4=8, and 1x8=8.
MHC IIgoes with CD4. MHC I goes with CD8.
Immunoglobulin (Ig) types: the important ones worth remembering, in order of appearance MAGDElaine
(a girl’s name):
· Magdelaine tells you the order they usually appear: M first, then A or G.
· Alternatively: IgM is IMmediate.
Acute inflammation features SLIPR: Swelling
Loss of function
· “What a cute pair of slippers” can be used to tie acute inflammation to SLIPR.
Lupus signs and symptoms SOAP BRAIN:
Serositis [pleuritis, pericarditis]
Blood [all are low – anemia, leukopenia, thrombocytopenia]
Immunologic [DS DNA, etc.]
Neurologic [psych, seizures]
Goodpasture’s Syndrome components GoodPasture is Glomerulonephritis and Pnuemonitits. · From autoantibodies attacking Glomerular and Pulmonary basement membranes.
Complement: function of C3a versus C3b C3a: Activates Acute [inflammation]. C3b: Bonds Bacteria [to macrophages-
· If wish to know more than just C3:
C3a, C4a, C5a activate acute. C3b, C4bbind bacteria.
MHC I vs. MHC II properties “Immunity helps to exterminate fun for bacteria”
HLA-DR genetic predisposition immune disease examples HLA-
Autoimmune adrenalitis/ Anemia
Complement cascade initiating items: alternative vs. classic Classic: Combined Complexes.
Alternative: Activators Alone, or IgA. · Complexes are made of Ab and Ag combined together. · Examples of activators: endotoxin, microbial surface.