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Adaptive immunity

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The ability to recognize and remember specific antigens and mount an attack on them. Memory - Second exposure elicits faster and larger response. Ex: 1. Lymphocytes: Humoral (B cells) and cell-mediated immunity (T cells). 2. Vaccines 3. Antitoxins 4. Ready-made antibodies like immunoglobulins that can boost adaptive immunity before travel to foreign country. 5. Maternal antibodies 6. Antibodies produced after exposure to antigen Two components: Humoral immunity and cell-mediated immunity. Helped by a number of other proteins and cells found in circulating blood (ex: complement system and dendritic cells).

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Adenoids

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Mass of lymphatic tissue in nasopharynx (part of throat near nasal passages).

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Antibody

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Protein produced by B cells to destroy antigens.

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Antigen

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Substance the body recognizes as foreign. Evokes an immune response (Ex: toxins, bacterial proteins, or foreign blood cells). Most are proteins or protein fragments found on surface of bacteria, viruses, or organ transplant tissue cells.

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Axillary nodes

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Lymph nodes in armpit.

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B cell (B lymphocyte)

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Lymphocyte that matures into a plasma cell to produce and secrete antibodies against antigens. Originates in bone marrow.

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Cell-modified immunity

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T cells (cytotoxic, helper, and suppressor) that respond to antigens and destroy them. A type of adaptive immunity.

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Cervical nodes

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Lymph nodes in neck region.

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Complement system

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Group of proteins in blood that help antibodies kill their target. Helps adaptive immunity system.

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Cytokines

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Proteins secreted by cytotoxic T cells to aid in antigen destruction. Ex: Interferons and interleukins.

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Cytotoxic T cell

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AKA CD8+ T cells. Lymphocyte that attaches to antigens and directly kills them. Secretes cytokines (interferons and interleukins) that aid other cells in antigen destruction.

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Dendritic cell

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Antigen-presenting cell. Shows T and B cells what to attack. Initiates adaptive immunity by presenting antigens to T and B cells, showing them precisely wha tthey need to counteract.

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Helper T cell

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AKA "CD4-positive T cell." Lymphocyte that assists B cells in making antibodies and stimulates T cells to attack antigens. Carries CD4 protein antigen on its surface. HIV binds to CD4 and infects and kills T cells with this protein. Thus, AIDS causes inadequate number of CD4+ cells.

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Humoral immunity

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B cells produce antibodies after exposure to specific antigens (viruses and bacteria). Type of adaptive immunity. Process: B cell matures into another cell (plasma cell). Plasma cell produces antibodies (immunoglobulins) to block effects of antigens. Ex: IgG - A material immunoglobulin that crosses placenta to provide immunity for newborns. IgE - An immunoglobulin that is important in allergic reactions and in fighting parasitic infections.

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Immunity

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Body's ability to resist foreign organisms and toxins that damage tissues and organs. Includes natural immunity and adaptive immunity.

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Immunoglobulins

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Protein (antibody produced by plasma cells) that act to protect the body by destroying antigens. Antibodies such as IgA, IgE, IgG, IgM, and IgD. Secreted by plasma cells (mature B cells) in response to presence of an antigen. Injections of ready-made antibodies like immunoglobulins can boost adaptive immunity before traveling to a foreign country.

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Immunotherapy

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Use of immune cells, antibodies, or vaccines to treat or prevent disease (ex: cancer). 3 Types: Monoclonal antibodies (MoAb), Vaccines, and Transfer of immune cells. Two categories: Passive (monoclonal and transfer) and active (vaccine).

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Inguinal nodes

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Lymph nodes in groin region.

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Interferons

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Proteins (cytokines) secreted by T cells and other cells to aid and regulate the immune response.

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Interleukins

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Proteins (cytokines) that stimulate the growth of B and T lymphocytes.

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Interstitial fluid

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Fluid in the spaces between cells. Fluid becomes lymph when it enters lymph capillaries. Filters our of tiny blood capillaries into the spaces between cells. Then, passes into lymph capillaries (and is, then, called lymph).

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Lymph

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Clear, watery fluid found within lymphatic vessels and collected from tissues throughout the body. Passes from lymph capillaries through larger lymphatic vessels and lymph nodes and empties into ducts in upper chest. Ducts carry lymph into large veins in the neck, where lymph enters the bloodstream. Comprised of lymphocytes, monocytes, water, lipids from small intestine, and some proteins (but less than blood). Lymph is moved along by muscle movement and valves (vs. the heart pumping blood).

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Lymph capillaries

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Tiniest lymphatic vessels. Begin at spaces around cells throughout the body. Thin-walled tubes that carry lymph from tissue spaces to larger lymph vessels.

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Lymphoid organs

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Lymph nodes, spleen, and thymus gland.

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Lymph node

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Collection of stationary solid lymphatic tissue along lymph vessels. Contains cells (lymphocytes, B and T, and macrophages) that fight infection. Also filter lymph and trap substances from infectious, inflammatory, and cancerous lesions.

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Lymph vessel

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Carrier of lymph throughout the body. Lymphatic vessels empty lymph into veins in upper part of the chest. Thicker walls than lymph capillaries. Contain valves (like veins), so lymph flows in only one direction (toward thoracic cavity).

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Macrophage

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Large phagocyte found in lymph nodes and other tissues of the body (spleen, liver, and lungs).

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Mediastinal nodes

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Lymph nodes in area between lungs in thoracic (chest) cavity.

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Mesenteric nodes

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Lymph nodes in mesentery (intestinal region).

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Monoclonal antibody (MoAb)

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Antibody produced in a laboratory by cloning techniques. Designed to attack antigens and to destroy cells. Passive form of immunotherapy. The antibody may be linked to various toxins or radioactive particles and delivered to tumor cells to enhance the killing effect. Ex: Rituximab (Rituxan) - Made to kill malignant lymphoma cells.

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Natural immunity

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Protection that an individual is born with to fight infection and is not dependent upon prior exposure to an antigen (infectious agent). Ex: neutrophils, monocytes, macrophages, and NK cells. It is not antigen-specific and does not elicit memory.

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Paraaortic nodes

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Lymph nodes near aorta in lumbar (waist) area of body. In line with belly button.

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Plasma cell

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Lymphocyte that secretes antibodies. Matures from B lymphocytes.

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Right lymphatic duct

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Lymphatic vessel in chest that drains lymph from upper right part of body (from waist and up). Empties lymph into large vein in neck.

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Spleen

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Organ in left upper quadrant of abdomen that destroys worn-out red blood cells with macrophages, filters microorganisms and other foreign material from blood, activates lymphocytes (B and T cells), and stores blood (especially erythrocytes and platelets). If spleen is damaged or has to be removed, liver, bone marrow, and lymph nodes take over its functions.

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Suppressor T cell

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AKA Treg (regulatory T cell). Lymphocyte that inhibits activity of B and T cells to prevent them from attacking the body's own good cells.

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T cell (T lymphocyte)

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Lymphocyte that acts directly on antigens to destroy them or produce chemicals (cytokines) such as interferons and interleukins that are toxic to antigens. T cells recognize and remember specific antigens and produce stronger attacks each time antigen is encountered. Originates in thymus gland.

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Tolerance

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The ability of T lymphocytes to recognize and accept the body's own antigens as "self" or friendly. Once tolerance is established, the immune system will not react against the body. If tolerance process fails, immune cells react against normal cells, resulting in various autoimmune diseases.

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Thoracic duct

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Large lymphatic vessel that drains lymph from lower and left side of body (head, neck, arm, and chest). It empties lymph into large veins in neck.

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Thymus gland

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Lymphoid organ in mediastinum between lungs that conditions T cells to react to foreign cells and aids in immune response. Early in development, lymphocytes learn in the thymus to recognize and accept body's own antigens as "self" or friendly (tolerance)

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Tonsils

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Masses of lymphatic tissue in back of oropharynx.

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Toxin

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Poison. A protein produced by certain bacteria, animals, or plants.

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Vaccination

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Exposure of individual to a foreign protein (antigen) that provokes an immune response (but does not make you ill, since virus is killed). Response will destroy any cells that possesses the antigen on it surface and will protect against infection.

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Vaccine

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Weakened or killed microorganisms, toxins, or other proteins given to induce immunity to infection or disease. Active form of immunotherapy. In immunotherapy, they contain antigens (proteins) from a patient's tumor cells. When injected, stimulate patient's own T cells to recognize and kill cancerous cells. May be injected or given as nasal spray.

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Functions of lymphatic system

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1. It is a drainage system to transport needed proteins and fluid that have leaked out of blood capillaries and into interstitial fluid back into bloodstream via veins. 2. Lymphatic vessels in intestines absorb lipids (fats) from small intestine and transport them to bloodstream. 3. Relates to immune system: defense of body against foreign organisms like bacteria and viruses. Lymphocytes, monocytes, lymph nodes, and organs (spleen and thymus gland) protect body by producing antibodies and by mounting cellular attack on foreign cells and organisms.

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Immune system

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System specialized to defend body against antigens. Includes phagocyte leukocytes (neutrophils, monocytes, and macrophages). Also, lymphoid organs (lymph nodes, spleen, thymus gland, tonsils, and adenoids) produce lymphocytes and antibodies.

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Antitoxin

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An immediate form of adaptive immunity. Ready-made antibodies produced in another organism that can counteract toxins that rapidly cause major damage (ex: snake venom).

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Maternal antibodies

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A form of adaptive immunity infants receive through the placenta and breast milk.

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Cell-mediated immunity

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Type of adaptive immunity that does not involve antibodies; involves 3 types of T cells with different functions: 1. Cytotoxic T cells (CD8+ T cells) 2. Helper T cells (CD4+ T cells) 3. Suppressor T cells (aka regulator T cells or Tregs)

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Transfer of immune cells

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Type of passive immunotherapy. In bone marrow transplantation, T lymphocytes from donor can replace patient's immune system with new cells that recognize tumor cells as foreign and kill them.

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Passive immunotherapy

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Immune agents are given to patient.

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Active immunotheraphy

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Patient's own immune system is stimulated to do the work.

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Autoimmune disease

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Chronic, disabling disease in which body produces antibodies against its own tissues. Ex: Rheumatoid arthritis and systemic lupus erythematosus. Signs and symptoms: Inflammation of joints, skin rash, and fever. Treatment: Glucocorticoid drugs (prednisone) and other immunosuppressants (azathioprine, methotrexate) are effective as treatment but make patients susceptible to infection.

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Immunosuppression

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Suppression (stopping) of immune response. Cause: Exposure to drugs (corticosteroids) or disease (AIDS and cancer). Risk: Immunosuppressed patients are susceptible to infection with fungi, Pneumocystis bacteria, and other pathogens.

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Lymphopoiesis

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Formation of lymph.

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Lymphedema

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Swelling of tissue due to accumulation of lymph fluid in intercellular spaces. Cause: Obstruction of lymphatic vessels and nodes. Treatment: Radiation therapy may destroy lymphatics and produce lymphedema, as in breast cancer treatment.

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Lymphocytopenia

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Deficiency of lymphocytes in blood.

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Lymphocytosis

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Abnormal condition of increase in lymphocytes.

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Lymphoid

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Derived from lymph tissue. Lymphoid organs include: lymph nodes, spleen, and thymus gland.

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Lymphadenopathy

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Disease of lymph glands (nodes).

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Lymphadenitis

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Inflammation of lymph glands (nodes).

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Splenomegaly

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Enlargement of spleen.

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Asplenia

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Absence of spleen. May be congenital or result from surgical removal.

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Hypersplenism

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A syndrome marked by splenomegaly and often associated with blood cell destruction, anemia, leukopenia, and thrombocytopenia.

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Anaphylaxis

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An exaggerated hypersensitivity to previously encountered foreign proteins or other antigens. Risks: Vasodilation and decrease in blood pressure can be life-threatening.

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Severe combined immunodeficiency disease (SCID)

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An immunodeficiency disorder present at birth. Affected infants are born with deficiency of B cells and T cells, resulting in lack of immunity. Sign: Small thymus.

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Acquired immunodeficiency syndrome

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AKA AIDS. Group of clinical signs and symptoms associated with suppression of immune system and marked by opportunistic infections, secondary neoplasms, and neurological problems. Cause: human immunodeficiency virus (HIV). HIV destroyed helper T cells, disrupting immune response. Allows infections to occur. Opportunistic infections - Infectious diseases associated with AIDS. HIV lowers resistance and allows infection by bacteria and parasites that are otherwise easily contained by normal defenses. Ex: Candidiasis, cryptococcal infection (Crypto), Cryptosporidiosis, cytomegalovirus (CMV) infection, herpes simplex, histoplasmosis (Histo), Mycobacterium avium-intracellulare (MAI) complex infection, Pneumocystis pneumonia (PCP), toxoplasmosis (Toxo), and tuberculosis (TB). Associated malignancies: 1. Kaposi sarcoma - Cancer arising from lining cells of capillaries that produces dark purplish (red, brown, or black) skin nodules. 2. Lymphoma (cancer of lymph nodes). 3. Wasting syndrome - Marked by weight loss, and decrease in muscular strength, appetite, and mental activity. Treatment: Several types of drugs - 1. Reverse transcriptase inhibitors RTIs) - Inhibit viral enzyme called reverse transcriptase (RT). After invading helper T cell (carrying CD4+ antigen), HIV releases reverse transcriptase to help it grow and multiply inside the cell. Ex: Zidovudine and Epivir. 2. Protease inhibitors - Inhibit another viral enzyme called protease. HIV needs protease to reproduce. Ex: Nelfinavir, amprenavir). HAART (highly active antiretroviral therapy) - Use of combinations of protease inhibitors and RTIs.

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Candidiasis

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Yeast-like fungus (Candida) that is normally present in the mouth, skin, intestinal tract, and vagina overgrows, causing infection of the mouth (thrush), respiratory tract, and skin.

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Cryptococcal infection (Crypto)

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Yeast-like fungus (Cryptococcus) causes lung, brain, and blood infections. Pathogen is found in pigeon droppings and nesting places, air, water, and soil.

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Cryptosporidiosis

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Parasitic infection of GI tract, brain, and spinal cord. The pathogen, Cryptosporidium, is a one-celled organism commonly found in farm animals.

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Cytomegalovirus (CMV) infection

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Virus causes enteritis and retinitis (inflammation of retina at back of eye). Found in saliva, semen, cervical secretions, urine, feces, blood, and breast milk. Usually causes disease only when immune system is compromised.

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Herpes simplex

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Viral infection causes small blisters on skin of lips or nose or on genitals. Herpes simplex virus can also cause encephalitis.

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Histoplasmosis (Histo)

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Fungal infection caused by inhalation of dust contaminated with Histoplama capsulatum. Causes fever, chills, and lung infection. Pathogen is found in bird and bat droppings.

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Mycobacterium avium-intracellulare (MAI) complex infection

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Bacterial disease manifesting with fever, malaise, night sweats, anorexia, diarrhea, weight loss, and lung and blood infections.

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Pneumocystis pneumonia (PCP)

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One-celled organism causes lung infection with fever, cough, and chest pain. Pathogen is found in air, water, and soil and is carried by animals. Treatment: Trimethoprim-sulfamethoxazole (Bactim), a combination of antibiotics, or with pentamidine. Prevention: Aerosolized pentamidine, which is inhaled.

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Toxoplasmosis (Toxo)

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Parasitic infection involving central nervous system (CNS) and causing fever, chills, visual disturbances, confusion, hemiparesis (slight paralysis in half of the body), and seizures. Pathogen (Toxoplasma) is acquired by eating uncooked lamb or pork, unpasteurized dairy products, or raw eggs or vegetables.

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Tuberculosis (TB)

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Bacterial disease (caused by Mycobacterium tuberculosis) involving the lungs, brain, and other organs. Signs and symptoms: Fever, cough, loss of weight, anorexia, and blood in sputum (mucus coughed up).

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HIV-positive

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Person who was exposed to HIV and now has antibodies in the blood against the virus (retrovirus). Transmission - Found in blood, semen, vaginal and cervical secretions, saliva, and other body fluids. Transmission can occur in three ways: 1. Sexual contact 2. Blood inoculation (through sharing of contaminated needles, accidental needlesticks, transfusions, or contact with contaminated blood or blood products) 3. Passage of virus from infected mothers to newborns (in utero or via breast feeding) Signs and symptoms: May remain asymptomatic for as long as 10 years. Lymphadenopathy, neurologic disease, oral thrush, night sweats, fatigue, and evidence of opportunistic infections.

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Highly active antiretroviral therapy (HAART)

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The use of combinations of protease inhibitors and RTIs to treat AIDS. Has in many cases abolished evidence of viral infection in affected people.

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Allergy

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Abnormal hypersensitivity acquired by exposure to an antigen. Allergic reactions occur when a sensitized person who has previously been exposed to an agent (allergen) reacts violently to a subsequent exposure. Varies in intensity. Types: 1. Allergic rhinitis (aka hay fever). Caused by pollen or animal dander. Least intense. 2. Systemic anaphylaxis (extraordinary hypersensitivity reaction occurs throughout body, leading to fall in blood pressure - hypotension, shock, respiratory distress, and edema of larynx). Most intense. 3. Asthma (pollens, dust, molds) 4. Hives (caused by food or drugs) 5. Atopic dermatitis (rash from soaps, cosmetics, chemicals) Atopy - Hypersensitivity or allergic state arising from inherited predisposition.

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Systemic anaphylaxis

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Type of allergy. Extraordinary hypersensitivity reaction occurs throughout body, leading to fall in blood pressure (hypotension), shock, respiratory distress, and edema of larynx. Can be life-threatening, but patient usually survives if airways are kept open and treatment is given immediately (epinephrine an dantihistamines).

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Lymphoma

answer

Malignant tumor of lymph nodes and lymph tissue. Many types, varying according to particular cell type and degree of differentiation. 1. Hodgkin disease 2. Non-Hodgkin lymphoma

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Hodgkin disease

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Type of lymphoma. Malignant tumor of lymphoid tissue in spleen and lymph nodes. Signs and symptoms: Lymphadenopathy (lymph nodes enlarge), splenomegaly, fever, weakness, and loss of weight and appetite. Diagnosis: Often by identifying a malignant cell (Reed-Sternberg) cell in lymph nodes with microscopic analysis. Treatment: 1. If localized, radiotherapy or chemotherapy. 2. If widespread, chemotherapy is given alone. High probability of cure. Stages: 1. Involvement of single lymph node or group of nodes. 2. Involvement of two or more sites on same side of diaphragm; often involves mediastinum 3. Disease on both sides of diaphragm. May include spleen. 4. Widespread extralymphatic involvement (liver, bone marrow, lung, skin). Staging involves assessing extent of spread of disease. Lymph node biopsies, laparotomy with liver and lymph node bipsies, and splenectomy may be needed to determine.

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Non-Hodgkin lymphomas

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Group of malignant tumors involving lymphoid tissue. Types: 1. Follicular lymphoma (composed of collections of small lymphocytes in a follicle or nodule arrangement) 2. Large cell lymphoma (composed of large lymphocytes that infiltrate nodes and tissues diffusely). Mostly B cell lymphomas and rarely T cell malignancies. Treatment: Chemotherapy may cure or stop progress of disease.

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Multiple myeloma

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Malignant tumor of bone marrow cells. Tumor composed of plasma cells (antibody-producing B lymphocytes) associated with high levels of one of specific immunoglobulins, usually IgG.

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Waldenstrom macroglobulinemia

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A disorder of malignant B cells. Involves B cells that produce large quantities of IgM (a globulin of high molecular weight). Increased IgM concentration impairs passage of blood through capillaries in brain and eyes, causing hyperviscosity syndrome (thickening of blood).

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Thymoma

answer

Malignant tumor of thymus gland. Often associated with myasthenia gravis (aneuromuscular disorder). Many patients with thymoma have other associated autoimmune disorders, such as systemic lupus erythematosus and rheumatoid arthritis. Treatment: Surgery. Postoperative radiation therapy is used for patients with evidence of spread of tumor.

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Allergen

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Substance capable of causing a specific hypersensitivity reaction in body. A type of antigen.

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Protease inhibitor

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Drugs that treats AIDS by blocking production of protease, a proteolytic enzyme that helps create new viral pieces for HIV.

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Reverse transcriptase inhibitor (RTI)

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Drugs that treats AIDS by blocking reverse transcriptase, an enzyme needed to make copies of HIV.

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CD4+ cell count

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Measures number of CD4+ T cells (helper T cells) in bloodstream of patients with AIDS. Normal count is usually between 500 and 1500 CD$+ cells per cubmic mm. If CD4+ count falls below 250 to 200, it is recommended to start treatment with anti-HIV drugs.

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ELISA

answer

"Enzyme-linked immunosorbent assay." Screening test to detect anti-HIV antibodies in bloodstream. Antibodies to HIV begin to appear within 2 weeks of infection with HIV. If result is positive, it is confirmed with a Western blot test, which is more specific (test used to detect the AIDS virus in the blood).

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Immunoelectrophoresis

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Test that separates immunoglobulins (IgM, IgG, IgE, IgA, and IgD). Detects presence of abnromal levels of antibodies in patients with conditions like multiple myelom and Waldenstrom macroglobulinemia.

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Viral load test

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Measurement of amount of AIDS virus (HIV) in bloodstream. Two viral load tests are a PCR (polymerase chain reaction) assay and an NASBA (nucleic acid sequence-based amplification) test.

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Computed tomography (CT) scan

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X-ray imaging produces cross-sectional and other views of anatomic structures. Show abnormalities of lymphoid organs, such as lymph nodes, spleen, and thymus gland.

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AIDS

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Acquired immunodeficiency syndrome

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CD4+ cell

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Helper T cell

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CD8+ cell

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Cytotoxic T cell

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CMB

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Cytomegalovirus - Causes opportunistic AIDS-related infection

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Crypto

answer

Cryptococcus - Causes opportunistic AIDS-related infection

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G-CSF

answer

Granulocyte colong-stimulating factor - cytokine that promotes neutrophil production.

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CM-CSF

answer

Granulocyte-macrophage colony-stimulating factor - cytokine secreted by macrophages to promote growth of myeloid progenitor cells and their differentiation to granulocytes

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HD

answer

Hodgkin disease

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Histo

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Histoplasmosis - Fungal infection seen in AIDS patients

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HSV

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Herpes simplex virus

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IL1 to IL15

answer

Interleukins

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KS

answer

Kaposi sarcoma

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MAI

answer

Mycobacterium avium-intracellulare complex - Group of pathogens that cause lung and systemic disease in immunocompromised patients.

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MoAb

answer

Monoclonal antibody

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NGL

answer

non-Hodgkin lymphoma

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PCP

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Pneumocystis pneumonia - Opportunistic AIDS-related infection

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PI

answer

Protease inhibitor

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RTI

answer

Reverse transcriptase inhibitor. Ex: Zidovudine (Retrovir) or lamivudine (Epivir)

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SCID

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Severe combined immunodeficiency disease

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Treg

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Regulatory T cell (suppressor T cell)

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Toxo

answer

Toxoplasmosis - Parasitic infection associated with AIDS.

Ch. 14 – Lymphatic and Immune Systems – Flashcards

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