Immunopathology

Understand the immunological principles and practical challenges related to transplantation.

Transplants e.g. kidney transplant and what currently can and cannot be transplanted. The role of the immune response, including HLAs and MHCs, to such procedures and society’s role in providing enough donor organs. Possible interventions to minimise risks e.g. use of immunosuppressant drugs and the potential consequences of doing so.

Challenges related to donor organ availability and the ways of increasing organ availability such as relaxing or changing UK law to help increase the number of donor organs etc. Xenotransplantation and the use of organs grown from stem cells.

Assessment Criteria

• 1.1

  Explain the immunology of transplantation.

• 1.2

  Outline the transplant procedure.

• 1.3

  Explain the challenges involved in a transplant procedure and how these can be minimised.

Understand how abnormal immune responses can produce disease.

The mechanisms of hypersensitivity reactions in that they are an abnormal response above and beyond the normal levels. This should include the immune reactant, effector mechanism and patient signs and symptoms as a result of these reactions e.g. Type I, IgE mediated reactions cause mast cells to release histamine potentially resulting in allergic rhinitis, asthma and systemic anaphylaxis.

Autoimmune disease caused by specific adaptive immune responses to self-antigens and that these are presented as organ specific or systems diseases. Antibody-antigen complexes and the nature of self-antigens including the role of MHC genes expressed on the cell surface membrane. Diseases such as systemic lupus erythematosus, Type I Diabetes, ankylosing spondylitis, rheumatoid arthritis and multiple sclerosis. The layers of self-tolerance, especially the importance of central tolerance and the role of regulatory T-cells and process of apoptosis.

Assessment Criteria

• 2.1

  Describe the mechanisms, and typical symptoms, of hypersensitivity reactions with particular emphasis on Type I.

• 2.2

  Explain autoimmunity.

Understand how immune deficiencies can produce disease.

Lymphocytes can be damaged by viruses such as EBV which infects B cells. The infected B cells express viral antigen causing T cells to attack them. This results in a temporary immunodeficiency i.e new antibody production is reduced until the viral infection has been overcome. If the viral infection lasts for a relatively short amount of time then the antibodies already in the blood will be enough to protect the individual. However, if the viral infection persist the immunodeficiency may become clinically significant AIDS and SCID and societal, as well as personal, consequences of an immune deficiency diagnosis including impact on life choices, family and the wider community.

Assessment Criteria

• 3.1

  Explain how viral infection can lead to transient immunodeficiency.

• 3.2

  Analyse the consequences of inherited immune deficiencies.

• 3.3

  Analyse the consequences of acquired immune deficiencies.