Types of Organ Rejection

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Questions and Answers

What is the primary cause of hyperacute rejection?

  • Acute cellular rejection
  • Chronic cellular reaction
  • Preformed antidonor antibodies (correct)
  • Slow monocyte/macrophages infiltration

Which type of graft rejection is characterized by an abrupt onset of oliguria?

  • Hyperacute rejection (correct)
  • Acute graft rejection
  • Chronic rejection
  • Secondary immunodeficiency

What is the primary mechanism of acute graft rejection?

  • Acute cellular rejection (correct)
  • Slow monocyte/macrophages infiltration
  • Chronic cellular reaction
  • Acute humoral rejection

What is the primary cause of chronic rejection?

<p>Antibodies and immune complexes (C)</p> Signup and view all the answers

What is the primary mechanism of prevention of rejection?

<p>All of the above (D)</p> Signup and view all the answers

What is the primary difference between primary and secondary immunodeficiency?

<p>Congenital vs. acquired (A)</p> Signup and view all the answers

What is the primary role of CD8+ CTLs in graft rejection?

<p>Inducing T cell mediated rejection (B)</p> Signup and view all the answers

What type of graft is transplanted between two genetically identical individuals?

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

What is the primary mechanism of humoral rejection?

<p>Production of antibodies (A)</p> Signup and view all the answers

What determines the rejection time of a graft?

<p>All of the above (D)</p> Signup and view all the answers

What is the primary role of MHC class I and II molecules in graft rejection?

<p>Causing strong, rapid responses (A)</p> Signup and view all the answers

What is the term for the unresponsiveness to antigens?

<p>Immunological tolerance (D)</p> Signup and view all the answers

What is the result of the failure of mechanisms to inactivate or eliminate self-reactive cells?

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

What type of tolerance occurs in the generative lymphoid organs?

<p>Central Tolerance (D)</p> Signup and view all the answers

What type of tolerance occurs in the peripheral tissues?

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

What is the term for the immune response against self antigens?

<p>Autoimmune disease (D)</p> Signup and view all the answers

What are some factors that influence autoimmune diseases?

<p>Genetic, environmental, and hormonal factors (B)</p> Signup and view all the answers

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Study Notes

Types of Rejection

  • Hyperacute rejection: occurs immediately within minutes to hours, caused by preformed antidonor antibodies (anti ABO blood group antibodies, anti HLA antibodies)
  • Acute rejection: occurs within days, weeks, or months, caused by acute cellular rejection and acute humoral rejection
  • Chronic rejection: occurs within months to years, cause unclear, involves antibodies, immune complexes, and slow cellular reaction

Characteristics of Rejection

  • Hyperacute rejection: abrupt onset of oliguria, may be associated with fever and graft tenderness
  • Acute rejection: clinical presentation varies
  • Chronic rejection: pathogenesis involves T cells inducing monocyte/macrophage infiltration into the graft, along with endothelial cells to produce growth factors and cytokines (PDGF, Insulin-like growth factor, epidermal growth factor, IL-1, IL-6, TNF, and TGFβ)

Prevention of Rejection

  • Screening of recipient and donor for blood group matches
  • Tissue matching: donor and recipient share the same MHC class I and class II antigens
  • Immunosuppressive therapy

Immunodeficiency Diseases

  • Primary immunodeficiency: congenital and hereditary, patient born with a genetic mutation that results in a defect in either the innate or adaptive immune response
  • Secondary immunodeficiency: acquired on a transient or permanent basis, examples include SLE (which affects women about 10 times more frequently than men) and injury

Graft Rejection

  • Histocompatibility antigens determine rejection between two genetically different individuals
  • Major histocompatibility complex (MHC class I and II molecules) cause strong, rapid responses, principally responsible for transplant rejection
  • Types of graft: xenograft, allograft, isograft, and autograft
  • Mechanism of graft rejection: cellular rejection (T cell mediated) and humoral rejection (antibody mediated)

Tolerance and Autoimmune Disease

  • Immune system reacts to an enormous variety of microbes but does not react against individual's own (self) antigens
  • Unresponsiveness to antigens is called immunological tolerance
  • Inability to respond to antigen stimulation or immunological unresponsiveness is tolerance
  • Failure of tolerance mechanisms leads to autoimmunity or autoimmune disease
  • Tolerance: central tolerance (inactivation or destruction of lymphocytes during early development) and peripheral tolerance (inactivation or destruction of mature lymphocytes in peripheral tissues)
  • Autoimmune disease: immune response against self-antigens as a result of breakdown of tolerance, can be either systemic or organ-specific
  • Factors influencing autoimmune diseases: genetic (MHC alleles, non-MHC genes, FcgR, Fas/FasL), environmental (microbes), and gender (hormones play a role)

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