What is meant by light chain restriction?
Neoplastic B-cell population will either have kappa or lambda light chains
What the generative lymphoid organs?
aka as primary or central = where T and B cells mature and become competent to respond to antigens
T-cells = thymus
B-cells= bone marrow
What is HLA testing used for?
To determine disease risk
Used in transplantation work up
What mechanisms are used to detect ligh chain restriction?
Serum protein electrophoresis, immunofixation electrophoresis, kappa/lamda in situ hybridizaiton study, B-cell immunoglobulin gene rearrangement
allows for quantification of subpopulations expressing the antigen of interes
*can distinguish T and B cells
*can distinguish kappa from lambda light chains)
Serum protein electrophoresis/ immunofixation electrophoresis
Kappa lambda in situ hypbridization study
Can do hybridization of bone marrow sections to see if kappa or lambda restricted
What are the 5 pillars of cancer treatment?
a pathological immune reaction
May be caused by enviornmental or endogenous self antigens
Reactions poorly controlled, excessive, or misdirected
What is a type I hypersensitivity?
Production of IgE antibody - mediated by IgE antibody-dependent activation of mast cells with degrandulation adn release of mast cell contents
Need sensitization first
Eosinophils secred MAJOR BASIC PROTEIN and EOSINOPHIL CATIONIC PROTEIN which is toxic to epithelial cells
Examples of Type I hypersensitivity?
the predisposition to develop immediate hypersensitivity reactions
What is the late phase reaction of a Type I (immediate) hypersensitity?
Release of mediators that amplify and sustain inflammatory response without additional exposure to the triggering antigen (characterized by an inflammatory infiltrate rich in eosinophils)
What are the treatments for localized allergic reactions?
What are some clinical findings in systemic anaphylaxis?
Drop in blood pressure
Laryngeal edema with difficulty breathing
What is Type II hypersensitivity?
antibodies that react with normal or altered cell surface antigen or with antigen in the extracellular matrix
Opsonizaiton by antibodies and complement
Induce inflammation by binding to Fc receptors on leukocytes
Distrube normal function of receptors
What is goodpasture's syndrome?
antibody direct to a non-collagenous protein in basement membrane of kidney glomeruli and lung alveioli
Nephritis and lung hemorrhage
Type II hypersensitivity
Define type III hypersensitivity
caused by deposition of antigen-antibody complexes which elicit inflammation at the sites of deposition
1. Complex formation
2. Complex deposition
3. Immune complex-mediated inflammation and tissue injury
(Lupus, reactive arthritis, serum sickness)
Define type IV hypersensitivity, and give some examples
inflammation resulting form cytokines produced by CD4+ T cells and cell killing by CD8+ T cells (no antibodies involved)
Examples: Delayed hypersensitivity reaction, TB skin test, Type 1 diabetes, MS, RA
Mechanism for granuloma formation
Focus of chronic inflammation consisting of a microscopic aggregation of macrophages that are transformed into epithelial-like cells called histiocytes