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Summary (in the shape of practice questions) Mechanisms of Disease 1 (only theme 1 until theme 3B)

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Mechanism of disease 1

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Universiteit Leiden (UL)

This document contains a summary of all the lectures (and some Osmosis videos) of theme 1 until 3B of the subject Mechanisms of Disease 1. DISCLAIMER: this summary does not include all the information about the microorganisms. It is still recommended to use the table provided on Brightspace. In add...

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Geupload op 18 september 2023
Bestand laatst geupdate op 7 oktober 2023
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Content
Content in details (all added lectures/videos).......................................................................................2
Theme 1 – Immunology, inflammation and repair.................................................................................3
Introduction to the immune system..................................................................................................3
Mechanisms of innate immunity.......................................................................................................5
B and T cell generation and diversity.................................................................................................9
Mechanisms of adaptive immunity..................................................................................................11
Effector functions of antibodies.......................................................................................................18
Tissue injury and repair....................................................................................................................20
Repair mechanisms..........................................................................................................................21
Pathology of inflammatory reactions...............................................................................................24
Acute pain in the neck.....................................................................................................................27
Theme 2 – Microorganisms as cause of disease..................................................................................29
Introduction infectious diseases......................................................................................................29
Bacteria............................................................................................................................................29
Viruses.............................................................................................................................................32
Fungi and parasites..........................................................................................................................34
Introduction to bacterial diagnostics...............................................................................................35
Theme 3 – Infectious diseases.............................................................................................................37
Invader (virulence factors)...............................................................................................................37
Host versus invader..........................................................................................................................38
Immune deficiencies and infection risk............................................................................................40
Recurrent airway infections.............................................................................................................43
Pathology of infection......................................................................................................................43
Essential microorganisms.................................................................................................................44
Imported and travel-related infections............................................................................................45
Diagnostics of infectious diseases....................................................................................................46
Bacteriology and parasitology..........................................................................................................48

1

,Content in details (all added lectures/videos)
Theme 1 – Immunology, inflammation LT 2 – Introduction to the immune system
and repair OS – Introduction to the immune system
LT 3 – Mechanisms of innate immunity
OS – Complement system
OS – Innate immune system
LT 4 – B and T cell generation and diversity
OS – T cell development
OS – B cell development
OS – VDJ rearrangement
OS – MHC class I and II molecules
LT 5 – Mechanisms of adaptive immunity
OS – T cell activation
OS – B cell activation and differentiation
OS - Contracting the immune response and peripheral
tolerance
OS – B and T cell memory
OS – Cell-mediated immunity of NK and CD8 cells
OS – Cell-mediated immunity of CD4 cells
OS – Somatic hypermutation and affinity maturation
LT 6 – Effector functions of antibodies
OS – Antibody classes
LT 7 – Tissue injury and repair
OS – Atrophy, aplasia and hypoplasia
OS – Hyperplasia and hypertrophy
OS – Metaplasia and dysplasia
LT 8 – Repair mechanisms
OS – Necrosis and apoptosis
LT 9 – Pathology of inflammatory reactions
OS – Inflammation
OS – Wound healing
PD 1 – Acute pain in the neck
OS – Abscesses
Theme 2 – Microorganisms as cause of LT 10 – Introduction to infectious diseases
disease LT 11 – Bacteria
OS – Bacterial structure and functions
LT 12 – Viruses
OS – Viral structure and functions
LT 13 – Fungi and parasites
EL - Introduction to bacterial diagnostics
Theme 3 – Infectious diseases LT 14 – Invader (virulence factors)
Theme 3A – Host-pathogen interactions LT 15 – Host versus invader
LT 16 – Immune deficiencies and infection risk
PD 2 – Recurrent airway infections
Theme 3B – Clinical presentations and LT 17 – Pathology of infection
diagnostics LT 18 – Essential microorganisms
LT 19 – Imported and travel-related infections
LT 20 – Diagnostics of infectious diseases
PR 1 and 2 – Bacteriology and parasitology

2

,Theme 1 – Immunology, inflammation and repair
Introduction to the immune system
 Which body protection mechanisms are there?
o Physical/chemical barrier
o Innate immune system (the one you are born with)
o Adaptive immune system
 What forms the physical barrier of the body protection mechanism?
o Skin and epithelia of GI tract, urogenital tract and the respiratory tract
 What forms the chemical barrier of the body protection mechanism?
o Antimicrobial agents on the epithelium
o Bactericidal enzymes (in saliva)
o Low pH value (as in the stomach)
 Which components are important when speaking about the innate immune system?
o Leukocytes (white blood cells)
o Cytokines (molecules released to communicate)
 Interleukins: communication with other cells
 Chemokines: attract leukocytes
 Interferons: interfere with virus replication
o Proteins in blood (complements)
 What are lymphocytes?
o They are a type of leukocytes, examples of lymphocytes are B and T cells
 Which type of leukocytes are there?
o Monocytes
o Lymphocytes
o Basophils
o Eosinophils
o Neutrophils
o (Majority of leukocytes are lymphocytes and neutrophils)
 What are the characteristics of the innate and adaptive immune system?
o Innate: fast, less specific (patterns), does not improve, no memory
o Adaptive: slow, highly specific, improves with time, memory
 When does the innate immune system activate?
o As soon as a pathogen (which got through the physical barrier) is recognized
o It breaks pathogens down via the use of leukocytes and the complement system
 Which cells are important to the innate immune system?
o Myeloid/effector cells
 Granulocytes (neutrophils, eosinophils, basophils)
 Mast cells
 Dendritic cells
 Monocytes/macrophages
o Natural Killer cell (NK cell)
 Which cells are important to the adaptive immune system?
o B cells: lymphocytes with B cell receptors
o T cells: lymphocytes with T cell receptors
o Antigen presenting cells (APCs): also part of the innate immune system, they present
(after phagocytosis) the antigen of the pathogen on their cell membrane (MHC-
molecules) to T cells
 Which type of cells could present antigens to T cells?
o Macrophages, monocytes and dendritic cells

3

, o B cells can internalize antigen and present it (via MHC II) to T cells as well
 What is the difference in shape between T cell and B cell receptors?
o B cell receptors have a Y-shaped receptor, T cell receptors have a II-shaped receptor
 What happens when an antigen binds to a B cell receptor?
o The B cell releases antibodies (they have the same shape as the B cell receptor and
are able to bind to the same antigen)
 What happens when a lymphocyte binds to an antigen?
o The lymphocyte will multiply (clonal expansion)
 Where are lymphocytes produced?
o B cells and T cells are produced in bone marrow, though T cells migrate to the
thymus to continue development
 What happens to an APC during an infection?
o It will migrate towards a lymph node to get into contact with lymphocytes and
activate an immune response
 What happens during an infection?
o Macrophages and mast cells release histamine, cytokines and serotonin (results in a
higher blood vessel permeability)
o Neutrophils are attracted by chemokines, which are released around the infected
area
o The complement system labels pathogens, which makes them more recognizable for
phagocytes
o After some time the adaptive immune response will act as well
 What could go wrong, immune response wise, with an organ transplantation?
o T cells of the receiver could recognize the donor organ as foreign and attack it
o Antibodies will be formed against the new organ and together with the complement
system this will lead to rejection
 Which immune response is responsible for fevers?
o The innate immune response
 What is clonal deletion?
o Once the pathogen is destroyed, a big part of the clonal expansion cells die off
o (some stay, these are memory cells)
 What is haematopoiesis?
o Formation of white and red blood cells (primarily in bone marrow)
 What do multipotent hematopoietic stem cells become?
o Myeloid progenitor or lymphoid progenitor cells
 What do myeloid progenitor cells develop into?
o Myeloid cells: granulocytes (neutrophil, eosinophil, basophil), mast cells, dendritic
cells, macrophages and monocytes
 What are granulocytes?
o Neutrophils, eosinophils, basophils
o They have granules in their cytoplasm
 How does the neutrophil destroy pathogens?
o It uses phagocytosis to swallow a pathogen
o The pathogen enters a phagosome and can be destroyed in two ways:
 Granules: phagolysosome is formed (granules + phagosome) and that lowers
the pH (2% of pathogens die)
 Oxidative burst: when the neutrophil is full of pathogen, it produces highly
reactive oxygen-species (that destroys the pathogen)
 Which types of granules do phagolysosomes contain?

4

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