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What are the cell stages of Lymphocyte development and maturation? Where do they occur?
- Occurs in the lymph node
What are the criteria for identifying Lymphocytes?
- Morphological classification (small, medium/large)
- Functional classification (T, B, NK)
- Operational classification (response to mitogens, surface markers, rosette formation in sheep's blood)
What are the surface markers found on various T and B lymphocytes?
- T cells: CD3, CD4, CD8
- B cells: CD19, CD20, CD22
What are the basic functions of each type of lymphocyte? Name the subtypes w/ surface markers and give their basic function?
- T cells: cell mediated response
- Inflammatory- recruit macrophages and neutrophil
- Cytotoxic (CD8)- kill pathogens (viruses)
- Helper T cells (CD4)- TH1 participate in cell-mediated immunity
- Helper T cells (CD4)- TH2 participate in antibody-mediated immunity by activated B cells
- B cells: humoral response
- plasma cells
- memory cells
- NK cells: single functioned, no subsets
What are the elements of the lymphatic system?
- Primary organs: hematopoetic blood islands
- fetal liver
- bone marrow
- Secondary organs and tissues: Lymph nodes
- spleen, tonsils
- Peyer's patches
- anal opening
What is the function of the lymphatic system? Describe the "flow" of lymph throughout the body using specific names
- drainage of interstitial fluid and transport of foreign substances
- Vessels are blind-ended and fluid moves via peristalsis
- thoracic duct: collects lymph from entire left side and bottom right side of body
- delivers fluid to the left subclavian vein
- right lymphatic duct: collects lymph from upper right side of body (head, chest, neck)
- delivers lymph to the right subclavian vein
What is the percentage breakdown of B and T cells in the peripheral blood? The thoracic duct?
- Peripheral blood: 60-80% T, 20-30% B
- Thoracic duct: 85-90% T, 10-15%
What specific location are B and T cells (different for each) found in the lymph nodes? The spleen?
- T cells in lymph nodes: paracortical regions, lymphoid follicles
- B cells in lymph nodes: Germinal centers, subcapsular region, medullary cords
- T cells in spleen: periarteriolar sheaths
- B cells in spleen: germinal centers, periphery of periarteriolar sheath, red pulp
Describe the difference in kinetic and circulatory patterns of B and T cells
- B cells: mostly short lived
- T cells: mostly long lived, rapid transmit time in blood, long G0 phase
T cell education location? Process of maturation? Substances produced?
- Educated in thymus (after creation in marrow)
- Recognize antigen and dedifferentiate
- Become effector (helper or killer) cells as well as acting as inflammatory cells
- Produce communicative substances (transfer factor, lymphotoxin, interferon, migration inhibiation factor, migration activation factor)
B cell education location? Process of maturation? Substances produced?
- Educated in bursa equivalent in marrow or peyer's patches
- Dedifferenation stimulated by antigen OR T cells
- Become plasma or memory cells
- Produce humoral antibodies (A, D, E, G, M)
What are the functions of each immunoglobulin?
- A: cidal and found in secretions *dimer
- D: function uncertain
- E: binds to basophils and mast cells sensitizing them for certain allergic reactions
- G: primary Ig, transferred across placenta
- M: first antibodies to appear *pentamer
Describe the evaluation of neutrophil function
- Absolute neutrophil count: increased during infection
- Neutrophil morphology: larger during infection
- Evaluation of β-integrins (CD11, CD18): aids in diapedesis
- Evaluation of neutrophil oxidative burst
Describe evaluation of complement
- Total hemolytic complement activity (CH50)
- Specific component testing
- Immunoassay for specific components
- Functional testing for specific components
Describe B, T, and NK cell screening and secondary tests
- B cell screening: Quantitative immunoglobulins (via titers)
- specific antibody
- T cell screening: HIV testing
- lymphocyte count
- delayed-type hypersensitivity skin tests
- B cell secondary: B cell enumeration (flow cytometry)
- in vitro B cell function tests
- T cell secondary: T cell enumeration (flow cytometry)
- T cell proliferation (mitogen, antigen)
- T cell cytokine production
- T cell cytotoxicity
- NK testing: NK cell enumeration (flow cytometry)
- In vitro functional cytoxicity assay
What are the three diseases of the Lymphocytes w/ VERY brief description of symptoms
- DiGeorge Syndrome: little T cell function, hypocalcemia, and congenital heart disease
- Burton's Agammaglobulinemia: failure to produce mature B cells and gamma globulin
- Severe Combined Immunodeficiency Disease (SCID): Lack of function of both T and B cells
DiGeorge Syndrome symptoms? cause? Notable information? Treatment? Outlook?
- Little or no T cell function, hypocalcemia, and congenital heart disease
- Immunodeficiency due to hypoplasia of the thyums
- Hypocalcemia due to hypoplasia of the parathyroid glands
- Genetic disorder (microdeletion in chromosome band 22q11.2)
- Most common genetic cause of congenital heart disease next to Down syndrome
- Treatment is thymus tissue transplant
- Death by age 2 without treatment
Burton's Agammaglobulinemia symptoms? cause? Notable information? Treatment? Outlook?
- Failure to produce mature B cells and gamma globulin
- Genetic disorder (X-linked recessive trait, mutation in tyrosine kinase gene Xq21.3-q22)
- Prone to bacterial, but not viral, infections
- Treatment is IV gamma globulin and antibiotics
- Death within first 10 years without treatment
Severe Combined Immunodeficiency Disease symptoms? cause? Notable information? Treatment? Outlook?
- Little or no adaptive immune function (Both B and T cells affected)
- Various genetic defects...
- X-linked SCID
- ADA deficiency
- Purine nucleoside phosphorylase (PNP)
- MHC class II or bare lymphocyte deficiency
- "Boy in the bubble disease"
- Very rare (1/500k births)
- Death within first year of life if untreated
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