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MHC and Transplantation Basics

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Why is MHC I essential in presenting antigens to CD8 T cells?

To present intracellular antigens

What is the main reason for the high diversity of MHC genes (HLA) among humans?

There are multiple possible alleles for each MHC gene

Which factors reduce the rejection of transplanted organs?

Living donor

What distinguishes hyperacute rejection from acute rejection in transplantation?

Pre-existing 'natural' antibodies causing type II hypersensitivity reaction

How does chronic rejection primarily occur in transplantation?

Through the indirect mechanism involving CD4 T cells supporting B cell activation

What is the primary reason for avoiding ABO blood group mismatch in organ transplantation?

'Natural' antibodies react with ABO blood groups

In which type of rejection do recipient APCs play a significant role?

'Indirect' rejection

Why is MHC compatibility often preferred between siblings for organ transplantation?

'Natural' antibodies are less reactive with sibling MHC antigens

'Direct' rejection in transplantation involves the presentation of antigens by which cells?

'APCs'

What is the primary reason for preventing hyperacute rejection in organ transplantation?

Blood typing and cross-matching before transplantation

What is a major reason why MHC genes (HLA in humans) are very diverse among humans?

To serve as major determinants of self/non-self recognition

Which type of rejection is primarily caused by pre-existing 'natural' antibodies reacting with blood or tissue in transplantation?

Hyperacute rejection

In transplantation, what is the function of the donor antigens that are foreign to the recipient and cause incompatibility?

Induce an immune response leading to rejection

Why does secondary rejection occur faster than primary rejection in transplantation?

Due to the presence of donor APCs presenting antigens to recipient T cells

What is the primary function of MHC I in transplantation regarding T cell interaction?

Presenting intracellular antigens to CD8 T cells

What characteristic distinguishes indirect rejection from direct rejection in transplantation?

The involvement of CD4 T cells in indirect rejection

What feature makes ABO blood group O a universal donor in organ transplantation?

'Natural' antibodies that do not react with either A or B antigens

Why is MHC II essential in presenting antigens to CD4 T cells?

MHC II presents extracellular antigens to CD4 T cells

In organ transplantation, what is the primary cause of hyperacute rejection?

Pre-existing antibodies reacting with blood or tissue

What is the main reason for allograft being the most typical graft type?

It involves MHC compatibility

How does indirect rejection primarily occur in organ transplantation?

Recipient APCs present donor antigens to recipient T cells

What distinguishes chronic rejection from acute rejection in organ transplantation?

Chronic rejection is mediated by direct mechanisms

Why is ABO blood group O considered a universal donor in organ transplantation?

'Natural' antibodies react with A or B but not O

MHC I presents intracellular antigens to CD4 T cells.

False

Each person carries 3 MHC I and 2 MHC II alleles.

False

Hyperacute rejection is primarily caused by CD4 T cells.

False

Living donor transplants are associated with increased inflammation.

False

Chronic rejection in transplantation is primarily mediated by CD8 T cells.

False

ABO blood group O is considered a universal donor because of lacking carb antigens.

True

Acute rejection in transplantation involves the accumulation of antibodies over years.

False

Direct rejection in transplantation requires no MHC similarity between donor and recipient.

False

Indirect rejection in transplantation primarily involves donor APCs presenting antigens to recipient T cells.

False

MHC compatibility is often preferred between siblings in organ transplantation due to less genetic diversity.

False

Peripheral T cell tolerance can be achieved through clonal deletion, anergy, suppression, and ignorance.

True

B cell tolerance mechanisms are more consistent and reliable compared to T cell tolerance mechanisms.

False

Younger individuals tend to be more tolerant to self-antigens compared to older ones.

True

Autoimmune diseases primarily involve T cells rather than antibodies.

False

Hormonal factors play a significant role in autoimmune diseases, with men being more prone to developing them compared to women.

False

Absence of AIRE gene function prevents positive selection of T cells.

False

Peripheral B cell apoptosis occurs if somatic hypermutation leads them to be non-self-reactive.

False

Tolerance through anergy may fail if self-antigens resemble pathogenic antigens or under certain cytokine conditions.

True

Defects in regulatory T cells (Tregs) have no impact on autoimmune diseases.

False

Autoimmune diseases are solely caused by genetic factors and not influenced by non-genetic elements.

False

Which mechanism of tolerance is unique to B cells?

Peripheral apoptosis

What could lead to the failure of anergy as a tolerance mechanism?

Presence of self-antigen resembling a pathogenic antigen

Which is a non-genetic factor that can precipitate autoimmune disease?

Hormonal influences

What type of autoimmune diseases involve both antibodies and T cells?

Myasthenia gravis

What is a reason that younger hosts are more tolerant to antigens?

Non-genetic factors

Which organ of the body primarily prevents negative selection of T cells?

Thymus

Which autoimmune disease involves the transfer of symptoms with antibodies?

Myasthenia gravis

'Anergy' as a tolerance mechanism may fail under what condition?

'Anergy' around inflammatory cytokines

'Peripheral apoptosis' is a unique mechanism of tolerance for which immune cell type?

B cells

Which is a characteristic feature of autoimmune diseases?

Majority are antibody-mediated.

In autoimmune diseases, which factor primarily contributes to the failure of tolerance mechanisms?

Non-genetic factors only

What distinguishes B cell tolerance mechanisms from T cell tolerance mechanisms in autoimmune diseases?

Presence of anergy in B cells

Why are younger hosts more tolerant to antigens compared to older hosts?

Tolerance induction in early life

Which organ of the body plays a crucial role in preventing negative selection of T cells?

Thymus

What type of autoimmune diseases primarily involve both antibodies and T cells?

Systemic lupus erythematosus (SLE)

Which tolerance mechanism may fail if self-antigens resemble pathogenic antigens or under inflammatory cytokine conditions?

Anergy

'Peripheral apoptosis' is a unique mechanism of tolerance for which type of immune cells?

B cells

'Absence of AIRE prevents (-) selection of T cells' - What does this statement imply about AIRE function?

AIRE induces negative selection of T cells

'AI disease caused by Ab’s, T cells, or both' - Which autoimmune disease involves antibody-mediated responses primarily?

Myasthenia gravis

Which congenital immunodeficiency disorder is characterized by the absence of B cells and antibodies?

Bruton’s X-linked hypogammaglobulinemia

What is the primary consequence of IL-12 deficiency in the immune system?

Absence of T helper cells

Which type of immunodeficiency disorder is characterized by high levels of IgM and the inability to class switch?

Hyper IgM

What is the characteristic feature of SCID among combined B and T cell immunodeficiencies?

Deficiency in lymphocyte precursors

Which complement deficiency disorder leads to dangerous laryngeal edema?

Hereditary angioedema

In which immunodeficiency disorder do neutrophils form large, obstructive granulomas due to their inability to kill ingested microbes?

Chronic granulomatous disease

What is the primary cause of T cell deficiency in DiGeorge syndrome?

No thymus present

'Chronic mucocutaneous Candidiasis' is primarily deficient in responding to which pathogen?

(Fungal) Candida

'ADA/PNP deficiency' mainly impacts which stage of immune cell development?

(Pre-thymic) Lymphocyte precursors

What is the primary reason for avoiding ABO blood group mismatch in organ transplantation?

Hyperacute rejection due to pre-existing antibodies

In organ transplantation, what is the primary cause of hyperacute rejection?

Antibodies reacting with blood or tissue

Why is ABO blood group O considered a universal donor in organ transplantation?

Lacks carb antigens that can trigger immune responses

'Peripheral apoptosis' is a unique mechanism of tolerance for which immune cell type?

B cells

'Anergy' as a tolerance mechanism may fail under what condition?

Presence of pathogenic antigens mimicking self-antigens

'Absence of AIRE prevents (-) selection of T cells' - What does this statement imply about AIRE function?

AIRE facilitates negative selection of autoreactive T cells

'AI disease caused by Ab’s, T cells, or both' - Which autoimmune disease involves antibody-mediated responses primarily?

Systemic lupus erythematosus

'Absence of AIRE prevents (-) selection of T cells' - What does this statement imply about AIRE function?

AIRE facilitates negative selection of autoreactive T cells

'AI disease caused by Ab’s, T cells, or both' - Which autoimmune disease involves antibody-mediated responses primarily?

Systemic lupus erythematosus

Why are younger hosts more tolerant to antigens compared to older hosts?

Higher regulatory T cell activity

Which type of infection is commonly seen in individuals with TLR7 deficiency?

Legionella

Which condition results in common variable hypogammaglobulinemia in young adults?

Viral infection

Which virus binds to CD4 on T cells, macrophages, and dendritic cells?

HIV

Which type of vaccine expresses more than one epitope or epitopes from multiple pathogens?

Conjugate vaccine

Which statement is true about passive immunization?

It can be achieved through monoclonal antibodies.

Which is a characteristic of tumor antigens (TAA’s)?

Overexpressed proteins at the right time in the right place

Which method uses dye-tagged detection antibodies to detect antigens on live cells?

Immunofluorescence

'FACS' is a technique used to identify, count, and isolate cells from a mixed population based on what characteristic?

'Fluorescence'

'Stacking' and immobilizing Ag’s and Ab’s for detection is primarily associated with which technique?

'ELISA'

Which congenital immunodeficiency disorder is characterized by the absence of B cells and antibodies?

Bruton’s X-linked hypogammaglobulinemia

What complement deficiency disorder leads to dangerous laryngeal edema?

Hereditary angioedema

In which combined B and T cell immunodeficiency disorder does gene therapy offer a potential solution?

SCID

Which T cell deficiency disorder is primarily characterized by a lack of thymus or parathyroid glands?

DiGeorge syndrome

Which type of immunodeficiency disorder is characterized by neutrophils forming large, obstructive granulomas due to their inability to kill ingested microbes?

Chronic granulomatous disease

Which congenital immunodeficiency disorder is primarily deficient only in response to Candida?

Chronic mucocutaneous Candidiasis

Which primary immunodeficiency disorder leads to mycobacterial infections due to the absence of Th1 cells?

IL-12 deficiency

'No T cell help' is a characteristic feature of which X-linked immunodeficiency disorder affecting male infants?

Wiskott-Aldrich syndrome

Which hereditary immunodeficiency disorder involves high IgM levels and the inability to class switch due to failed CD40L?

Hyper IgM syndrome

Which congenital immunodeficiency disorder reduces lymphocyte precursors and offers the potential for gene therapy as a treatment?

SCID

Congenital B cell immunodeficiencies manifest as fungal infections.

False

DiGeorge syndrome is characterized by the absence of B cells and antibodies.

False

Hyper IgM syndrome is caused by low levels of IgM and successful class switching.

False

SCID is primarily an X-linked disorder affecting IL-2 receptors.

True

Complement deficiencies lead to chronic granulomatous disease.

False

Phagocyte deficiencies result in large, obstructive granulomas forming in the body.

True

Deficiencies in PRRs affect the recognition of bacterial flagella primarily.

False

Wiskott-Aldrich syndrome affects females due to an autosomal inheritance pattern.

False

ADA/PNP deficiency results in excessive production of lymphocyte precursors.

False

Ataxia-Telangiectasia is characterized by successful DNA repair mechanisms.

False

Monoclonal antibodies produced by fusing a spleen lymphocyte from an immunized mouse with a mouse myeloma cell are immortal and can produce antibodies to multiple epitopes.

False

Vaccines protect against all strains of a pathogen, not just the strain to which the immune response is raised.

False

Passive immunization involves transferring antibodies made in another individual or organism to confer immediate immunity.

True

Herd immunity is achieved when vaccinated individuals are unlikely to come in contact with unvaccinated individuals in their subpopulation.

True

Antigens expressed on tumor cells may be self proteins over-expressed, mutated, or expressed at the right time and place.

False

NK cells primarily target tumor cells with high MHC expression levels.

False

Flow cytometry and FACS can identify, count, and isolate dead cells from a mixed population.

False

Immunofluorescence uses radioactive detection antibodies to detect antigens on live cells.

False

Western blot is clinically important for confirming HIV infection through the initial detection by radioimmunoassay.

False

ELISA links an enzyme to a primary antibody and catalyzes a color-producing reaction detected with a spectrophotometer.

True

Test your knowledge on Major Histocompatibility Complex (MHC) and transplantation basics, including the functions of MHC I and MHC II, diversity of MHC genes, graft types, and the differences between primary and secondary immune responses.

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