Thermoregulation and Fever Pathogenesis

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Questions and Answers

What is the primary role of regulatory T cells (Tregs) in the immune system?

  • To enhance the activation of immune cells against pathogens
  • To produce antibodies in response to antigens
  • To suppress the activation of other immune cells and maintain tolerance (correct)
  • To eliminate self-reactive immune cells through apoptosis

What is the consequence of VDJ recombination in lymphocytes?

  • It eliminates self-reactive lymphocytes in peripheral tissues
  • It generates a diverse repertoire of antigen receptors (correct)
  • It leads to the activation of self-reactive immune cells
  • It promotes the production of a single type of antigen receptor

What are autoimmune diseases primarily characterized by?

  • The immune system being overly tolerant to all substances
  • The immune system attacking and damaging the body's own tissues (correct)
  • The immune system attacking foreign pathogens only
  • The immune system failing to respond to infections

Which process can lead to the elimination of self-reactive lymphocytes that escape central tolerance?

<p>Peripheral deletion through apoptosis (D)</p> Signup and view all the answers

What can occur as a result of loss of immune tolerance?

<p>Development of chronic inflammation and tissue destruction (D)</p> Signup and view all the answers

What are the primary functions of the complement system?

<p>Enhancing the immune response, opsonization, inflammation, and direct pathogen killing (B)</p> Signup and view all the answers

What is a characteristic feature of Pattern Recognition Receptors (PRRs)?

<p>They recognize specific patterns associated with pathogens. (D)</p> Signup and view all the answers

Which type of leukocytes are responsible for differentiating into macrophages?

<p>Monocytes (A)</p> Signup and view all the answers

Which type of antigens typically trigger an allergic response in individuals?

<p>Allergens (A)</p> Signup and view all the answers

Which of the following options is NOT a type of leukocyte?

<p>Erthrocytes (B)</p> Signup and view all the answers

What is the function of Toll-like receptors (TLRs) among PRRs?

<p>They recognize various pathogen-associated molecular patterns (PAMPs). (B)</p> Signup and view all the answers

Where are leukocytes primarily produced in the body?

<p>Bone marrow (C)</p> Signup and view all the answers

Which of the following best describes self-antigens?

<p>They are typically tolerated by the immune system. (B)</p> Signup and view all the answers

What is the primary pharmacological effect of chloroquine?

<p>Kills asexual erythrocytic stages of the parasite (D)</p> Signup and view all the answers

Which therapeutic use is primarily associated with artemisinin compounds?

<p>First-line treatment of uncomplicated falciparum malaria (B)</p> Signup and view all the answers

What mechanism of action is shared by both sulfadoxin and pyrimethamine?

<p>Inhibition of dihydrofolate reductase (A), Inhibition of dihydropteroate synthase (B)</p> Signup and view all the answers

What is a common adverse effect associated with chloroquine?

<p>Visual disturbances (A)</p> Signup and view all the answers

Which of the following statements about proguanil is true?

<p>It is metabolized to cycloguanil which inhibits dihydrofolate reductase (B)</p> Signup and view all the answers

What pharmacological characteristic is unique to artemisinin compounds?

<p>Mechanism involves reactive free radical generation (B)</p> Signup and view all the answers

Which option describes the mechanism of action of tetracyclines in treating malaria?

<p>Inhibition of protein synthesis (C)</p> Signup and view all the answers

Which two adverse effects are commonly associated with Fansidar?

<p>Gastrointestinal symptoms and severe cutaneous reactions (D)</p> Signup and view all the answers

What is the main function of cytotoxic T cells in the immune response?

<p>They eliminate infected or abnormal cells. (D)</p> Signup and view all the answers

What determines the efficiency of the secondary immune response?

<p>The presence of memory T cells and memory B cells. (A)</p> Signup and view all the answers

Why is immune tolerance critical for the immune system?

<p>It stops the immune system from attacking self-antigens. (C)</p> Signup and view all the answers

What does central tolerance primarily involve?

<p>Elimination or control of self-reactive lymphocytes during development. (A)</p> Signup and view all the answers

What is the process called that eliminates self-reactive T cells in the thymus?

<p>Negative selection (D)</p> Signup and view all the answers

How does peripheral tolerance prevent self-reactivity after immune cells have matured?

<p>It leads to functional inactivation of self-reactive cells. (B)</p> Signup and view all the answers

What leads to a higher antibody titer during the secondary immune response?

<p>The rapid recognition and action of memory T and B cells. (B)</p> Signup and view all the answers

What is anergy in the context of immune tolerance?

<p>The functional inactivation of self-reactive immune cells without co-stimulation. (A)</p> Signup and view all the answers

What is the primary role of NOD-like receptors (NLRs) in the immune system?

<p>Recognizing bacterial components and activating inflammation. (D)</p> Signup and view all the answers

Which cells are primarily responsible for presenting antigens to CD8+ cytotoxic T cells?

<p>All nucleated cells via MHC I (B)</p> Signup and view all the answers

Which type of MHC molecule is primarily expressed on antigen-presenting cells (APCs)?

<p>MHC II (C)</p> Signup and view all the answers

What are epitopes primarily recognized by in the immune system?

<p>Both antibodies and T cells (C)</p> Signup and view all the answers

How are antigens processed by antigen-presenting cells (APCs)?

<p>By internalizing antigens, then processing them into peptide fragments. (D)</p> Signup and view all the answers

What defines conformational epitopes?

<p>A specific three-dimensional structure of an antigen. (D)</p> Signup and view all the answers

RIG-I-like receptors (RLRs) are crucial for which type of immune response?

<p>Detecting viral RNA. (B)</p> Signup and view all the answers

Which of the following is NOT a function of Major Histocompatibility Complex (MHC) molecules?

<p>Recognizing pathogens directly. (C)</p> Signup and view all the answers

What is the role of MHC I molecules in the immune response?

<p>They present antigens to CD8+ cytotoxic T cells. (D)</p> Signup and view all the answers

Which of the following best describes co-stimulatory molecules?

<p>They enhance T cell activation alongside antigen recognition. (A)</p> Signup and view all the answers

What does the clonal selection theory explain?

<p>How the immune system generates a specific response to antigens. (A)</p> Signup and view all the answers

Which T cell type is primarily involved in recognizing MHC II-antigen complexes?

<p>CD4+ helper T cells (A)</p> Signup and view all the answers

What characterizes the primary immune response?

<p>It takes longer to generate a response compared to secondary responses. (D)</p> Signup and view all the answers

What is the function of CTLA-4 in the immune system?

<p>It helps in regulating immune responses and preventing overactivation. (A)</p> Signup and view all the answers

What occurs during the clonal expansion of lymphocytes?

<p>A specific lymphocyte undergoes replication to create identical cells. (C)</p> Signup and view all the answers

Which of the following statements about TCRs and BCRs is true?

<p>They consist of variable regions for antigen specificity. (C)</p> Signup and view all the answers

Flashcards

What is the complement system?

A group of proteins that enhances the immune response by opsonizing pathogens, triggering inflammation, and directly killing pathogens.

Pyrimethamine's Mechanism of Action

The drug inhibits the enzyme dihydrofolate reductase, essential for folate synthesis in the parasite.

What are Pattern Recognition Receptors (PRRs)?

Proteins expressed by cells of the innate immune system that recognize molecular patterns specific to pathogens, called pathogen-associated molecular patterns (PAMPs).

Blood Schizonticide

Antimalarial drug that kills the asexual erythrocytic stage of the parasite in the blood.

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What are Toll-like receptors (TLRs)?

A type of PRR that recognizes various PAMPs, including bacterial lipopolysaccharides, viral nucleic acids, and fungal cell wall components.

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Chloroquine's Therapeutic Use

A drug used to treat uncomplicated malaria caused by susceptible Plasmodium species.

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Artemisinin's Mechanism of Action

A drug that generates reactive free radicals in the parasite, leading to its death.

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What are leukocytes?

White blood cells that circulate throughout the body in the bloodstream and lymphatic system, assisting in immunity.

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Artemisinin's Therapeutic Use

A drug used as the first-line treatment for uncomplicated falciparum malaria, usually in combination with other antimalarials.

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What are pathogen-derived antigens?

Antigens derived from microorganisms like bacteria, viruses, fungi, and parasites, which are recognized as foreign by the immune system.

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What are allergens?

Antigens that trigger allergic reactions in susceptible individuals.

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Tetracycline's Mechanism of Action

A drug that inhibits protein synthesis in the parasite, ultimately killing it.

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What are self-antigens?

Antigens derived from the body's own cells, usually tolerated by the immune system.

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Proguanil's Therapeutic Use

The drug is used in combination with other drugs to treat multidrug-resistant malaria.

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Sulfadoxine's Mechanism of Action

The drug inhibits dihydropteroate synthase, an enzyme involved in folate synthesis in the parasite.

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What are autoantigens?

Antigens derived from self-components that are mistakenly recognized as foreign, leading to autoimmune reactions.

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Regulatory T cells (Tregs)

Specialized T cells that suppress the activation of other immune cells, preventing an immune response to self-antigens and maintaining immune tolerance.

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VDJ Recombination

A process that occurs during the development of B and T cells, rearranging gene segments to generate a wide variety of antigen receptors with unique specificities.

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Peripheral Deletion

The elimination of self-reactive lymphocytes in peripheral tissues, preventing them from attacking the body's own cells. This process helps to maintain tolerance to self-antigens.

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Loss of Immune Tolerance

Occurs when the immune system mistakenly targets the body's own tissues, causing inflammation and tissue damage. This can lead to a variety of autoimmune diseases.

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Allergies

An inappropriate immune response to harmless substances like pollen or certain foods. This can lead to allergic reactions, such as sneezing and skin rashes.

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Antigen Presentation

The process of displaying antigenic peptides on the cell surface in association with MHC molecules.

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MHC I Presentation

MHC I presents antigens to CD8+ cytotoxic T cells, which recognize the antigen-MHC I complex through their TCR.

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MHC II Presentation

MHC II presents antigens to CD4+ helper T cells, which recognize the antigen-MHC II complex through their TCR.

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TCR and BCR

Membrane-bound molecules on T cells and B cells that specifically recognize antigens.

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Co-stimulatory Molecules

Molecules that help regulate immune responses by providing additional signals for activation.

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Co-inhibitory Molecules

Molecules that help regulate immune responses by preventing excessive activation.

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Clonal Selection Theory

The immune system's way of creating a tailored response to specific antigens by selecting and expanding lymphocytes with matching receptors.

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Primary Immune Response

The initial immune response when the immune system encounters an antigen for the first time.

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What is immune tolerance?

The ability of the immune system to recognize and tolerate self-antigens, avoiding attacks on the body's own tissues.

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What is an autoimmune disease?

A state where the immune system mistakenly targets and attacks the body's own tissues, leading to inflammation and damage.

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What is central tolerance?

The process of eliminating or inactivating self-reactive immune cells during their development in the central lymphoid organs (bone marrow and thymus).

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What is positive selection in central tolerance?

A mechanism where developing T cells that can recognize self-MHC molecules survive and mature. MHC molecules present antigens to T cells.

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What is negative selection in central tolerance?

A process where T cells that strongly bind to self-antigens presented by MHC molecules are eliminated or inactivated to prevent autoimmune responses.

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What is peripheral tolerance?

Tolerance mechanisms that operate outside the central lymphoid organs, ensuring continued self-tolerance in mature immune cells.

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What is anergy in peripheral tolerance?

A process where self-reactive T cells or B cells become inactive when they encounter self-antigens without appropriate co-stimulatory signals.

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What is immune ignorance?

This refers to a specific type of immune tolerance where the immune system learns to ignore harmless antigens that it encounters repeatedly, like pollen or food.

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What are NOD-like receptors (NLRs) and what do they recognize?

NOD-like receptors (NLRs) are a family of PRRs that recognize bacterial components, such as peptidoglycans and flagellin, found within the cytoplasm of immune cells. They activate signaling pathways that lead to the production of inflammatory cytokines, promoting inflammation and antimicrobial defenses.

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What are RIG-I-like receptors (RLRs) and what do they recognize?

RIG-I-like receptors (RLRs) are a family of PRRs that detect viral RNA in the cytoplasm of infected cells. They trigger antiviral immune responses by activating signaling pathways that lead to the production of interferons, which interfere with viral replication and activate other immune cells.

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What are Epitopes?

Epitopes are specific regions or sites on antigens that are recognized by the immune system. They can be linear, involving a continuous sequence of amino acids, or conformational, involving a specific three-dimensional structure.

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What are linear epitopes?

Linear epitopes are formed by a continuous sequence of amino acids within an antigen, recognized by the immune system due to the specific arrangement of these amino acids.

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What are conformational epitopes?

Conformational epitopes are formed by a specific three-dimensional structure within an antigen, involving interactions between amino acids that are not necessarily adjacent in the sequence.

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What are Major Histocompatibility Complex (MHC) molecules?

Major Histocompatibility Complex (MHC) molecules are cell surface proteins responsible for displaying antigens to T cells, enabling the immune system to recognize and respond to pathogens.

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What are MHC I molecules and what do they present?

MHC I molecules are expressed on the surface of all nucleated cells and present antigens derived from intracellular pathogens to CD8+ cytotoxic T cells, triggering their destruction.

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Study Notes

Thermoregulation and Pathogenesis of Fever

  • Heat Production:
    • Basal metabolic rate (BMR): Energy needed for bodily functions at rest.
    • Muscle activity: Generates heat through muscle contraction.
    • Thermogenesis: Heat production by brown adipose tissue.
  • Heat Loss:
    • Radiation: Transfer of heat as infrared waves from the body's surface.
    • Conduction: Transfer of heat through direct contact with a cooler surface.
    • Convection: Transfer of heat through air or water currents.
    • Evaporation: Cooling effect from sweat evaporating.
    • Respiration: Heat loss from exhaled warm air.
  • Mechanism of Thermoregulation and the Role of Hypothalamic Set Point:
    • Hypothalamic Set Point: Hypothalamus maintains a core body temperature set point.
    • Monitors core temperature using temperature receptors.
    • Hypothalamus uses the autonomic nervous system to initiate responses.
  • Heat Conservation:
    • Vasoconstriction: Reduces blood flow to the skin to conserve heat.
    • Shivering: Involuntary muscle contractions to generate heat.
  • Heat Dissipation:
    • Vasodilation: Increases blood flow to the skin to promote heat loss.
    • Sweating: Facilitates evaporative cooling.
  • Application of Thermoregulation Principles to Fever:
    • Elevated hypothalamic set point due to infection.
    • Behavioral changes (shivering, vasoconstriction) increase body temperature.
    • Sweating occurs while body temperature approaches the new set point.
    • Medical intervention may be required to manage fever and prevent complications.

Bacterial and Viral Causes of Fever and Skin Rash

  • Bacterial Causes:
    • Streptococcus pyogenes (Group A Streptococcus)
    • Staphylococcus aureus
    • Neisseria meningitidis
    • Borrelia burgdorferi (Lyme disease)
    • Rickettsia rickettsii (Rocky Mountain spotted fever)
  • Bacterial Infection Signs and Symptoms:
    • Fever
    • Skin rash (various forms)
    • Localized redness, swelling, tenderness
    • Systemic symptoms (headache, body aches, fatigue)
  • Bacterial Infection Diagnosis:
    • Clinical evaluation and medical history review
    • Laboratory tests (blood cultures, skin swabs, biopsies)
    • Serological tests (antibodies)
    • Polymerase chain reaction (PCR) testing
  • Viral Causes:
    • Measles virus
    • Rubella virus
    • Varicella-zoster virus (chickenpox and shingles)
    • Dengue virus
    • Zika virus
  • Viral Infection Risk Factors:
    • Lack of vaccination
    • Close contact with infected individuals
    • Travel to endemic regions
    • Certain age groups (children, pregnant women)
  • Viral Infection Pathophysiology, Signs and Symptoms:
    • Viral replication and invasion of host cells
    • Immune response triggering inflammation and systemic effects
    • Fever, skin rash, malaise, headache, joint pain, respiratory symptoms.

Drug Treatment of Malaria

  • Quinolines and Related Compounds (Chloroquine, Quinine/Quinidine):
    • Mechanism: Inhibits heme polymerase.
    • Pharmacological effect: Blood schizonticide (kills asexual erythrocytic stages of the parasite).
  • Artemisinin Compounds:
    • Mechanism: Generates highly reactive free radicals in the parasite.
    • Pharmacological effect: Rapidly acting blood schizonticide, effective against multidrug-resistant strains.
  • Fansidar (Sulfadoxine + Pyrimethamine):
    • Mechanism: Inhibits dihydropteroate synthase and dihydrofolate reductase.
    • Pharmacological effect: Slow-acting blood schizonticide.
  • Tetracyclines/Clindamycin:
    • Mechanism: Inhibits protein synthesis.
    • Pharmacological effect: Slow-acting blood schizonticide.
  • Proguanil:
    • Mechanism: Metabolized to cycloguanil, which inhibits dihydrofolate reductase.
    • Pharmacological effect: Slow-acting blood schizonticide, effective against primary liver forms.
  • Atovaquone:
    • Mechanism: Interferes with mitochondrial functions.
    • Pharmacological effect: Antiparasitic activity.
  • Primaquine:
    • Mechanism: Inhibits respiratory processes.
    • Pharmacological effect: Effective against primary and latent hepatic stages.

Innate Immunity

  • Physical Barriers: Skin and mucous membranes prevent pathogen entry.
  • Cellular Components:
    • Phagocytes (neutrophils, macrophages): Engulf and destroy pathogens.
    • Natural Killer (NK) cells: Eliminate infected or abnormal cells.
    • Dendritic cells: Capture antigens, initiating adaptive immune response.
  • Chemical Barriers:
    • Antimicrobial peptides: Directly kill pathogens.
    • Complement system: Enhances immune response (opsonization, inflammation, pathogen killing).
  • Pattern Recognition Receptors (PRRs): Recognize pathogen-associated molecular patterns (PAMPs).

Adaptive Immunity

  • Epitopes: Specific regions on antigens recognized by the immune system.
  • MHC (Major Histocompatibility Complex):
    • MHC I: On all nucleated cells, displaying intracellular antigen peptides to CD8+ cells.
    • MHC II: On antigen-presenting cells (APCs), presenting extracellular antigen peptides to CD4+ cells.
  • Antigen-Presenting Cells (APCs):
    • Dendritic cells are potent APCs, crucial for initiating adaptive immune responses

Immune Tolerance

  • Immune tolerance: The immune system's ability to distinguish between self and non-self antigens.
  • Central tolerance: Mechanisms in the thymus and bone marrow to eliminate or control self-reactive lymphocytes.
    • Positive selection: Allows T cells to recognize self-MHC molecules.
    • Negative selection: Eliminates self-reactive T cells.
  • Peripheral tolerance: Mechanisms outside central lymphoid organs to maintain self-tolerance in mature immune cells.
  • Anergy, regulatory T cells (Tregs), peripheral deletion: Various mechanisms to control self-reactive lymphocytes (B cells and T cells).

VDJ Recombination

  • Mechanism of generating a diverse repertoire of B cell and T cell antigen receptors (BCRs and TCRs) . It involves rearrangement and recombination of gene segments.

Consequences of Loss of Tolerance:

  • Loss of immune tolerance can lead to autoimmune diseases (e.g., rheumatoid arthritis, lupus, multiple sclerosis, type 1 diabetes) and allergies (e.g., allergic reactions to pollen or certain food).

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