Immunology Final Exam Review
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Questions and Answers

What primarily triggers localized Type-III hypersensitivity reactions in tissues?

  • Cytokine production
  • T-cell activation
  • Immune complex formation (correct)
  • Direct tissue injury
  • Which condition is associated with immune complex formation leading to corneal issues in dogs?

  • Keratoconjunctivitis
  • Blue Eye (correct)
  • Epiphora
  • Uveitis
  • What is a common consequence of immune complex disease in glomerulonephritis?

  • Enhanced glucose excretion
  • Loss of protein in urine (correct)
  • Formation of kidney stones
  • Increased blood pressure
  • Which of the following organisms is NOT associated with causing glomerulonephritis as an immune complex disease in dogs?

    <p>Feline leukemia virus</p> Signup and view all the answers

    What type of vaccine can lead to transient corneal opacities in dogs due to immune complex formation?

    <p>Modified live virus vaccine</p> Signup and view all the answers

    Which diagnostic method helps identify glomerulonephritis due to Type-III hypersensitivity in dogs?

    <p>Histologic section staining with anti-dog IgG antibody</p> Signup and view all the answers

    What is a potential sequela to Strep equi infection in horses related to immune complex disease?

    <p>Purpura hemorrhagica</p> Signup and view all the answers

    What immune response primarily contributes to the inflammation seen in localized Type-III mechanisms?

    <p>Complement activation</p> Signup and view all the answers

    What condition is associated with Streptococcus equi infection that leads to skin sloughing?

    <p>Purpura hemorrhagica</p> Signup and view all the answers

    What is the most likely result of an ELISA test for antibodies to Strep equi in a horse with purpura hemorrhagica?

    <p>High antibody titer to Strep equi</p> Signup and view all the answers

    Which type of immune reaction is primarily involved in the vasculitis observed in the affected horse?

    <p>Type III hypersensitivity</p> Signup and view all the answers

    Which treatment option is recommended for conditions caused by immune complexes?

    <p>Glucocorticoids</p> Signup and view all the answers

    What is a potential risk when treating an infectious agent with glucocorticoids?

    <p>Decreased immune responses may allow pathogen replication</p> Signup and view all the answers

    Which clinical sign might indicate a horse is suffering from purpura hemorrhagica?

    <p>Skin sloughing</p> Signup and view all the answers

    What systemic reaction is characterized by protein leakage and edema in response to blood vessel damage?

    <p>Acute vasculitis</p> Signup and view all the answers

    What could exacerbate the condition of a horse undergoing treatment for purpura hemorrhagica?

    <p>Suppression of the immune system without managing infection</p> Signup and view all the answers

    What is the primary cause of Type-III hypersensitivity reactions?

    <p>Formation of antigen-antibody complexes</p> Signup and view all the answers

    Which of the following is a common sign associated with immune complex-mediated vasculitis?

    <p>Joint pain and swelling</p> Signup and view all the answers

    What is a typical timeline for the onset of acute inflammation in Type-III hypersensitivity after exposure to an antigen?

    <p>2-8 hours after priming</p> Signup and view all the answers

    Glomerulonephritis is primarily characterized by which of the following symptoms?

    <p>Presence of protein in urine</p> Signup and view all the answers

    In the generalized Type-III hypersensitivity reaction, immune complexes are primarily deposited in which of the following sites?

    <p>Blood vessels and kidneys</p> Signup and view all the answers

    Which key immune components are mainly activated to initiate the acute inflammatory response in Type-III hypersensitivity?

    <p>Mast cells and neutrophils</p> Signup and view all the answers

    Treatment for immune complex diseases often focuses on which of the following mechanisms?

    <p>Suppressing immune complex formation</p> Signup and view all the answers

    What is a key diagnostic indicator of glomerulonephritis in animals?

    <p>Presence of hematuria</p> Signup and view all the answers

    Study Notes

    Final Exam Information

    • 42 questions on the final exam
    • 10 questions cover pre-midterm content, including:
      • Serology
      • Titers
      • Primary and memory antibody responses
      • Seroconversion
      • Incubation period
      • Neonatal immunity
      • Vaccination of neonates
      • Passive immunity
    • 5 questions on vaccines
    • 15 questions on immunodiagnostics
    • 4 questions on sensitivity and specificity of diagnostic tests
    • 10 questions on hypersensitivities
    • Note: some questions may cover multiple topics
    • Review for the final exam will be during class on Thursday, Nov 28
    • Submit any remaining questions/topics to the class representative by Wednesday at noon.

    Lecture 27 - Hypersensitivities III and IV

    • Lecture focusing on hypersensitivity types III and IV.

    Type III Hypersensitivity

    • Caused by immune complexes
    • Immune complexes form constantly, removed by phagocytic cells
    • May deposit in blood vessels, causing vasculitis.
    • Signs include:
      • Rash
      • Protein in the urine (glomerulonephritis)
      • Joint pain
    • Multiple signs may be observed in some cases
    • Immune complex formation, deposition, and inflammation
    • Acute inflammation due to complement cascade activation
    • Timeline for acute inflammation (2-8 hours after priming).
    • The wet form of FIP infection is due to this mechanism

    Type III Hypersensitivity - Disease due to Immune Complex Formation

    • Disease attributed to soluble antigen binding with antibody.
    • Immune complexes form frequently, but disease only results when excessive complexes form
    • Usually involves IgG
    • Local Type III: Immune complexes form in the tissues.
    • Generalized Type III: Forming in circulation, depositing in blood vessels (joints and kidnyes) and causing vasculitis
    • Localized Type III Mechanism: Local immune complex formation activates inflammation
    • Pre-formed antibodies bind to antigens located in the tissues.

    Example of Localized Type III Hypersensitivity: Blue Eye in Dogs

    • Occurs in a small percentage of dogs infected with canine adenovirus type 1 or vaccinated with modified live adenovirus type 1 vaccine or infected with Infectious Canine Hepatitis virus
    • Lesion: anterior uveitis leading to corneal edema and opacity
    • Virus-antibody complexes and neutrophils are present in the lesion
    • Develops approximately 1-3 weeks after infection or vaccination

    Blue Eye (Immune complex formation)

    • Immune complex formation following virus release (canine adenovirus type 1 or modified live virus) originating from infected corneal endothelial cells
    • Resulting damage/edema of cornea
    • Attenuated vaccines can produce temporary corneal opacities

    Note:

    • Factors other than ICH or CAV-1 vaccination can cause "Blue Eye" due to immune complexes
    • Not all corneal opacities are always due to immune complex formation

    Examples of Generalized Type III Reactions

    • Glomerulonephritis
    • Purpura hemorrhagica in horses following Strep equi infection or vaccination.

    Glomerulonephritis

    • Most glomerulonephritis is caused by immune complex disease in domestic animals
    • Immune complexes lodge in glomerular capillaries causing vasculitis and protein loss.
    • Associated with the antigens of various infectious agents such as:
      • Borrelia burgdorferi (Lyme disease)
      • Ehrlichia species
      • Canine adenovirus 1 and 2
      • Feline leukemia virus
      • FIP virus (cats)

    Diagnosis of Glomerulonephritis

    • Histological section of kidney biopsies
    • Stained with anti-dog IgG antibody labeled with a fluorochrome

    Streptococcus equi Infection and Purpura Hemorrhagica

    • Purpura hemorrhagica caused by immune complex mediated type-III hypersensitivity mechanism
    • Purpura: hemorrhagic area larger than 3 millimetres in skin or mucus membranes.
    • Strep Equi infection = Non-thrombocytopenic Purpura (due to immune complex formation)
    • FYI: Purpura hemorrhagica (caused by low platelet count) is called thrombocytopenic purpura (platelet decrease due to many factors)

    Strep equi infection: Clinical Signs

    • Abscesses of submandibular lymph nodes

    Strangles (Streptococcus equi) and Purpura Hemorrhagica

    • Strangles (Streptococcus equi) can cause purpura hemorrhagica (vasculitis) 2-4 weeks post-acute infection or vaccination, more likely with modified-live vaccines.
    • Immune complexes lead to acute vasculitis

    Vasculitis lesions post Strep. Equi infection

    • Purpura hemorrhagica: Destruction of blood vessels in the skin (leading to sloughing).
    • Edema: Leaky blood vessels.

    Purpura Hemorrhagica associated with recent Strep equi infection

    • Most likely result of antibody ELISA test: High antibody titer to Strep equi

    General Approach to Treatment of Immune Complex Conditions

    • Treat underlying conditions
    • If pathogen present, administer antimicrobials
    • Suppress immune system (e.g., glucocorticoids)

    FYI: ZUKU review MCQ

    • A horse presents with distal limb edema in all four limbs, petechial mucous membranes, depression, and low-grade fever
    • Multiple horses in the stable recently suffered from upper respiratory infection
    • Likely responsible immune reaction type for vasculitis
    • Answer: Antigen-antibody complex (Type III)

    Type IV Hypersensitivity

    • General components include: Antigen-sensitized Th1 CD4 lymphocytes & CD8 lymphocytes, Th1 cytokines (mainly IFN-ɣ), activated macrophages.
    • Response peaks at 72 hours.

    Delayed-Type Hypersensitivity (DTH)

    • DTH with TB testing in cattle and humans is an example of Type IV hypersensitivity mechanism involving T-helper 1-specific T cells that produce IFN-ɣ, activating macrophages.

    Type IV Hypersensitivities (DTH response)

    • Mediated by Th-1 cells against antigens
    • Antigen-activated Th-1 cells produce IFN-y.
    • IFN-y activates macrophages
    • Often caused by haptens, such as poison ivy and some medications (especially antibiotics)
    • Can cause contact dermatitis

    Allergic Contact Dermatitis

    • General approach to prevention and treatment involves avoidance

    Mechanism of poison oak IV hypersensitivity

    • Specific T-helper-1 cells reacting to poison oak antigen

    Poison Ivy

    • Hypersensitivity to poison ivy (toxicodendron) due to haptens (pentadecacatechol) binding to skin proteins
    • Often characterized by pruritis (itching) and inflammation
    • Treatment may include steroids, topical ointments, and/or medications, followed by avoidance.

    FYI (Poison Ivy)

    • Not everyone is sensitive to poison ivy
    • Reaction usually within 2 days of sensitization, but can take up to 10 days, or even as early as 8 hours
    • Hyposensitization is often ineffective

    Drug-induced contact dermatitis

    • Drug acts as a hapten, binding skin proteins
    • Examples include neomycin, penicillin, and local anesthetics (e.g., novocaine)
    • Common cause (in humans) is Neomycin, often in antibiotic creams

    Topical penicillin

    • Topical penicillin can cause dermatitis in ears and nose.

    Formaldehyde and Nickel

    • Formaldehyde: found in cosmetics, textiles, furniture, and paper
    • Nickel: dissolves in weakly acidic environments of sweat
    • Both cause hypersensitivity in humans and possibly animals, manifested through contact dermatitis

    Type IV Hypersensitivities in Tissue Transplants

    • Host vs Graft rejection: T cells recognize foreign MHC molecules in graft tissue, activating cytotoxic T lymphocytes (CTLs) leading to acute rejection
    • Chronic rejection (months later): involves Th1 and macrophages activated by foreign MHC II molecules.
    • Graft VS Host rejection: occurs when foreign lymphocytes in a bone marrow transplant destroy the recipient's cells and tissues.

    Matching Disease Descriptions with Hypersensitivity Types

    • Match descriptions of diseases (e.g., vasculitis, blood transfusion reaction, immune-mediated hemolytic anemia, wet form of FIP) with the hypersensitivity type most likely associated with them (types I, II, III, and IV).

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    Description

    Prepare for the final exam covering essential immunology topics such as serology, vaccines, and hypersensitivities. This quiz includes questions on primary antibody responses, immunodiagnostics, and the sensitivity and specificity of diagnostic tests. Make sure to review your notes and clarify any doubts before the exam!

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