Ch. 13 - Immune System Disorders

Norman-McKay- Microbiology: Basic and Clinical Principles 2nd Edition

Norman-McKay2nd EditionMicrobiology: Basic and Clinical PrinciplesISBN: 9780137661619Not the one you use?Change textbook

Norman-McKay 2nd Edition

Ch. 13 - Immune System Disorders

Problem 11

Chapter 13, Problem 11

Which of the following is the most likely to lead to graft-versushost disease?
a. An allogeneic bone marrow transplant
b. An allogeneic liver transplant
c. A xenogeneic heart valve transplant
d. An isogenic bone marrow transplant
e. A xenogeneic skin graft

Verified step by step guidance

Step 1: Understand the concept of graft-versus-host disease (GVHD). GVHD occurs when immunocompetent donor T cells recognize the recipient's tissues as foreign and mount an immune response against them. This typically happens in transplants where donor immune cells are transferred to the recipient.

Step 2: Identify which types of transplants involve transfer of immunocompetent donor immune cells. Bone marrow transplants are a prime example because they contain many immune cells, whereas solid organ transplants like liver or heart valves generally do not transfer large numbers of immune cells.

Step 3: Differentiate between allogeneic, isogenic, and xenogeneic transplants. Allogeneic transplants are between genetically different individuals of the same species, isogenic (or syngeneic) transplants are between genetically identical individuals (e.g., identical twins), and xenogeneic transplants are between different species.

Step 4: Recognize that GVHD is most common in allogeneic bone marrow transplants because the donor immune cells recognize the recipient as foreign and attack. Isogenic transplants do not cause GVHD because the donor and recipient are genetically identical, and xenogeneic transplants usually cause rejection rather than GVHD.

Step 5: Conclude that among the options, an allogeneic bone marrow transplant is the most likely to lead to graft-versus-host disease due to the presence of donor immune cells and genetic differences triggering the immune response.

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Key Concepts

Here are the essential concepts you must grasp in order to answer the question correctly.

Graft-versus-Host Disease (GVHD)

GVHD is a condition where donor immune cells attack the recipient's tissues after a transplant. It primarily occurs when the graft contains immunocompetent cells that recognize the host as foreign, leading to immune-mediated damage. GVHD is most common in bone marrow transplants due to the presence of donor immune cells.

Types of Transplants: Allogeneic, Isogenic, and Xenogeneic

Allogeneic transplants involve genetically different individuals of the same species, isogenic (syngeneic) transplants occur between genetically identical individuals, and xenogeneic transplants are between different species. GVHD risk is highest in allogeneic transplants because of genetic differences triggering immune responses.

Role of Bone Marrow Transplants in GVHD

Bone marrow transplants contain donor immune cells capable of mounting an immune response against the host, making them the most common cause of GVHD. Solid organ transplants like liver or heart valves have fewer immune cells, reducing GVHD risk. Thus, allogeneic bone marrow transplants are most likely to cause GVHD.

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Textbook Question

List the applicable hypersensitivities (type I, II, III, IV) as they relate to the description. Note, more than one type of hypersensitivity may be listed for a given description.

IgG antibodies can mediate type _________________hypersensitivities.

T cells mediate type _________________ hypersensitivities.

Type _________________ hypersensitivities may be generated in response to pharmaceutical drugs.

Type _________________ hypersensitivities may be associated with autoimmunity.

Type _________________ hypersensitivities require a sensitizing exposure.

IgE antibodies can mediate type _________________hypersensitivities.

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Textbook Question

Which of the following is (are) true regarding type III hypersensitivity reactions? Select all that apply.

a. They involve IgG

b. They involve IgM

c. They are considered delayed reactions

d. They include autoimmune disorders like multiple sclerosis

e. They are rare compared with type I reactions

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Textbook Question

Which patient would be the most likely to benefit from desensitization immunotherapy?

a. A person suffering from serum sickness

b. A person at risk for HDN during pregnancy

c. A person with an allergy to pollen

d. A transplant patient

e. An asthmatic patient

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Textbook Question

What is the general goal of treatments used for autoimmune disorders?

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Textbook Question

Imagine that one of your patients is an emergency medical technician who has a family history of autoimmune disorders and allergy, but she does not currently suffer from either. Which of the following is (are) most likely true of your patient? Select all that apply.

a. She is at an increased risk for cancer

b. She is at an increased risk for type I hypersensitivities

c. She is at an increased risk for type III hypersensitivities

d. She is at an increased risk for latex hypersensitivity

e. She is at an increased risk for immunosuppression

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Textbook Question

Which types of white blood cells are most likely to be involved in type I hypersensitivities? Select all that apply.

a. T helper cells

b. T cytotoxic cells

c. Basophils