immunology mendros
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Complement
System
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Characteristics of Complement
Plays a role in cytolytic action
Inactivated in the sera
IgG and IgM only react with complement
Bound to all antigen-antibody complexes
Found in all mammalian sera and lower
animals
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Complement is non-specific
portions of the system contribute to
chemotaxis, opsonization, immune
adherence, anaphylatoxin formation and
virus neutralization
Characteristics of Complement
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*chemotaxins - C5a, C5b, C6, C7
*for immune adherence - C3b
*kinin activator - C2b
*anaphylatoxins - C3a, C4a, C5a
*opsonins - C3b, C4b, C5b
*for virus neutralization - C4b, C1
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C1q C1r C1s
Antigen-IgG-complement
complex
Antigen-IgM-complement
complex
C1q C1r C1s
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b. C4- FIRST ACTIVATION UNIT
- cleaved into C4a and C4b
c. C2SECOND ACTIVATION UNIT
- cleaved into C2a and C2b
- C2a combines with C4 to form
C4b2a complex
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d. C3 - THIRD ACTIVATION
UNIT/AMPLIFICATION
PHASE UNIT- C3b combines with C4b2a to form C4b2a3b
e. C5, C6, C7, C8, C9 MEMBRANE ATTACK
PHASE UNITS
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ALTERNATIVE PATHWAY OFCOMPLEMENT ACTIVATION
a.Factor B activated into its active form Bb withthe participation of C3
-Bb will cleave C3 into C3a and C3b and will
combine with C3b to form C3bBb
b. Factor D- cleaves Factor B into Bb in the presenceof C3 and Mg++ ions
Therefore,
Factor B + Factor D + C3 + Mg++ C3bBb
c. Properdin (Factor P)- binds to C3bBb to prevent
spontaneous decay of the complex
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ACTIVATING FACTOR: MANNOSE GROUPS OF
CHO IN MICROBIAL CELL
EFFECTORS:
MBP/MBL- MANNAN-BINDING PROTEIN/LECTIN
MASP MBP-ASSOCIATED SERINE PROTEASE
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CLASSICAL ALTERNATIVE LECTIN
ACTIVATING
SUBS.
IMMUNE
COMPLEXES(IgG OR IgM)
LPS (bacterial
capsule)
IgA
Mannose
groups onmicrobial cell
RECOGNITIONUNIT
C1q, C1r, C1s C3, Factor B,Factor D
MBP, MASP-1,MASP-2
C3CONVERTASE
C4b2a C3bBb C4b2a
C5CONVERTASE
C4b2a3b C3bBb3b C4b2a3b
MAC C5b6789
END RESULT CELL LYSIS
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CLINICAL SIGNIFICANCE:
Elevatedcomplement components - have little clinical
importance
Decreasedcomplement componentsCauses : - complement has been consumed
(e.g. in disease states)
- complement may be decreased or absent due to
genetic defect
MEASUREMENT OF COMPLEMENT COMPONENTS
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DEFICIENT COMPONENT ASSOCIATED DISEASE
C1q Sex-linked agammaglobunemia
Hypocomplementemic urticarial
vasculitisSevere combined immune
deficiency
SLE-like syndrome
Increased susceptibility to
bacterial infection
C1r URT diseases
Chronic kidney disease
SLE-Like syndrome
C1s SLE-like syndrome
Increased susceptibility to
bacterial infection
DEFICIENT COMPONENT ASSOCIATED DISEASE
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DEFICIENT COMPONENT ASSOCIATED DISEASE
C1sINH Hereditary angioneurotic
edema
C4 SLE
Glomerulonephritis
Pyogenic Infections
C2 SLEDermatomyositis
Repeated Infectious
disease
Chronic renal diseaseAutoimmune disease
Increased susceptibility to
bacterial infection
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DEFICIENT
COMPONENT
ASSOCIATED
DISEASE
C3 Recurrent pyogenic
infections
SLE-like syndrome
Post-streptococcal
glomerulonephritisPyogenic infections
C3b inactivator Recurrent pyogenic
infections
Urticaria
C5 SLE
Neisseria infections
DEFICIENT COMPONENT ASSOCIATED DISEASE
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DEFICIENT COMPONENT ASSOCIATED DISEASE
C5 dysfunction Leinersdisease
Gram Negative skin and bowel
infections
C6 Neisseria infection
SLE
Raynaudsphenomenon
Sclerodermalike syndrome
Vasculitis
C7 Neisseria infectionSLE
Raynaudsphenomenon
Sclerodactyly
Telangiectasia
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DEFICIENT
COMPONENT
ASSOCIATED
DISEASE
C8 Neisseria infectionXeroderma pigmentosa
SLE-like syndromeC9 Neisseria infection
Properdin
Factor D
Pyogenic infections
Pyogenic infections
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CLINICAL SIGNIFICANCE:
ELEVATED LEVELS (ABOVE THE NORMAL 0.6 mg/dL) indicates:
- inflammation- tissue damage
AS SEEN IN
- bacterial and viral infections- rheumatic diseases such as RA- myocardial infarction- burn injuries
- tuberculosis- renal transplantation- malignancies
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Question 1
In the heterophil antibody test, when serum is
absorbed with beef cells
A. there is a decrease in the titer of IM antibodies
B. there is an increase in the titer of GPKCantibodies
C. Serum sickness are not absorbed
D. Forssman antibodies are absorbed
ANSWER : A
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QUESTION 3
Forssman antibodies are absorbed by :
A. boiled beef cells
B. Guinea pig kidney antigen
C. neither beef cells nor guinea pig kidney antigen
D. both beef cells and GPKC
ANSWER : B
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QUESTION 4
Which of the following represents the
reported titer in quantitative VDRL test ?
A. Lowest dilution giving a weakly reactive result
B. Lowest dilution giving a reactive result
C. Highest dilution giving a weakly reactive result
D. Highest dilution giving a reactive result
ANSWER : D
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QUESTION 7
How can cell-mediated immunity be
transferred to a normal individual ?
A. with lymphoid cells from a hypersensitive
individual B. with transfer of specific liver cells from an
infected individual
C. with transfer of monocytes from a normal
person D. with polymorphonuclear cells from a normal
person
ANSWER : A
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QUESTION 8
The random movement of antigen or antibody
to form antigen-antibody complexes in semi-solid medium occurs in :
A. agglutination
B. immunofluorescence
C. complement fixation
D. gel diffusion
ANSWER : D
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QUESTION 9
Interferon can be produced by which of the
following ?
A. macrophages
B. T-lymphocytes
C. virus-infected cells
D. All of the above
ANSWER : D
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QUESTION 11
When a precipitation reaction is converted to
agglutination by increasing the size of antigenparticles, the test is then referred to as :
A. direct agglutination
B. capillary precipitation
C. passive agglutination
D. hemagglutination inhibition
ANSWER : C
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QUESTION 14
The basic immunoglobulin structure consist
of:
A. 1 light and 2 heavy chain
B.2 light and 2 heavy chain
C. 2 light and 1 heavy chain
D. 1 light and 1 heavy chain
ANSWER : B
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QUESTION 15
After an antibody has been fragmented, which
term denotes the antigen binding fragment ?
A. Fc
B. disulfide bond
C. Fab
D. Carboxyl terminal
ANSWER : C
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QUESTION 16
A positive reaction in a complement fixation
test is expressed as ?
A. agglutination
B. hemolysis
C. inhibition of hemolysis
D. neutralization
ANSWER : C
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QUESTION 18
What does the ASO test measure in the
patient serum ?
A. Oxygen labile streptolysin
B. antibody to streptolysin O
C. Sheep red blood cells
D. Streptococcal antibodies
ANSWER : B
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QUESTION 20
The Widal and Weil-Felix reactions are
examples of techniques used to detect :
A. heterophil antibodies
B. reagin
C. febrile agglutinins
D. Forssman antigen
ANSWER : C
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QUESTION 21
What is the incubation temperature for the
cold agglutinin test ?
A. body temperature
B. room temperature
C. refrigerator temperature
D. freezer temperature
ANSWER : C
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QUESTION 22
The RPR test is rotated at what speed for what
length of time?
A. 200 rpm for 10 mins.
B. 100 rpm for 8 mins.
C. 180 rpm for 4 mins.
D. 125 rpm for 2 mins.
ANSWER : B
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QUESTION 23
What role does cardiolipin play in the VDRL test ?
A. it is the center for absorption of tissue lipids
B. it is related to the sensitivity of the test
C. it is related to the reactivity of the test
D. all of the above
ANSWER : C
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QUESTION 24
Which of the following cold reacting
antibodies is present infections ofMycoplasma pneumoniae ?
A. anti-I
B. antii
C. anti- Lewis
D. antiK
ANSWER : A
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QUESTION 26
A hapten is :
A. A carrier molecule for an antigen that is not
antigenic alone
B. A determinant capable of stimulating an IR onlywhen bound to a carrier
C. An immunoglobulin functional only in the
presence of complement D. Half of an immunoglobulin molecule
ANSWER : B
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QUESTION 27
Which of the ff. characteristics is not true for B
cells ?
A. become memory cells
B. Contain surface immunoglobulins
C. Differentiate into plasma cells
D. secrete the C5 components of complement
ANSWER : D
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QUESTION 28
THE HLA complex is located primarily on :
A. Chromosome 3
B. Chromosome 6
C. Chromosome 9
D. Chromosome 17
ANSWER : B
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QUESTION 29
What is the predominant type of antibody
found in the serum of neonates born afterfull-term gestation?
A. Infant IgA B. Infant IgD
C. Infant IgG
D. Maternal IgG
ANSWER : D
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QUESTION 30
Which class of immunoglobulin possesses 10
antigenic binding sites ?
A. IgA
B. IgD
C. IgG
D. IgM
ANSWER : D
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