医学免疫学资料：2003-7-A-da

　 The final examination of medical immunology for seven year students of Grade 2003(2005/12/6) Paper A

　题号

　一

　二

　三

　四

　五

　总分

　统分人

　得分

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　 评卷人

　I. Explain the following items

　(2 points for each, 18 points) 1.Lymphocyte recirculation: is the process by which lymphocytes continuously move between sites throughout the body(1) through blood and lymphatic vessels, and it is critical for the initiation and effector phases of immune responses(1).

　2. CDR: Complementarity-determining

　region (0.5)

　the three

　HVR

　of L chain and

　 H chain are brought together to form antigen-binding surface, so HVR is

　also called CDR(1)

　3. cytokine: A group of(0.5)

　low molecule weight proteins(0.5) which are secreted by activated immunocytes or some matrix cells(0.5) and take effects by binding corresponding receptor on cells(0.5).

　 4.MHC restriction: In interaction of T cell and antigen-presenting cell(APC) or target cell(0.5) ,T cell not only recognizes specific antigen peptide, but also recognizes polymophic residue of MHC molecules(0.5).

　5. Pattern recognition receptor(PRR): The receptor on macrophage(0.5) which can recognize and bind specific molecular structure on some

　 pathogens , injured or apoptotic cells(0.5).

　 6. Immune tolerance a specific nonreactivity

　 1.0 towards a given antigen

　 0.5 in other circumstance is able to induce cell-mediated or humoral immunity

　 0.5

　 7. ITAM immunoreceptor tyrosine-based activation motif

　0.5 transduct activation signal

　1.0 composed of two tyrosine residues separated by around 18 amino acid-----when antigen binds, the tyrosine become phosphorylated by the receptor associated tyrosine kinases to transduct activatory signal

　0.5

　 8.APC cells that can capture（0.5）, process antigen （0.5）, and present the antigenic peptide/MHC class I or II molecules （0.5）

　to T cells （0.5）

　are called antigen-presenting cells. They are also called A cell (Accessory cell).

　9. TI-Ag (thymus independent Ag) : Ag which can stimulate B cells to produce Ab(0.5)

　 without the help of T cell and MФ(0.5).

　 II. Choose all correct answers

　(1 point for each, 15 points)

　No. 1 2 3 4 5 6 7 8 Answer ACD CD AC ACD BCD ABD BD BD No. 9 10 11 12 13 14 15

　Answer ABD BCD ABC ABC ABCD ABCD ABC

　 Ⅲ． ．Answer the following questions briefly (5 point for each, 30 points)

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　 1. How can T helper cells play important roles in an antibody mediated response. (1) Express CD40L(0.5),combine with CD40 expressing on B cell(0.5),provide co-stimulation signal during the activation of B cell(1). (2) Secrete IL-4,5,6(0.5) etc. to promote proliferation and differentiation of B cell(1) (3) Secrete cytokines to promote Ig isotype switching(1.5).

　2.What cells express the HLA II molecules? What are the functions of HLA II molecules on these cells?

　cells express the HLA II molecules (2)

　professional APC(macrophage, dentritic cell and B cell),

　activated T cell,

　thymus epithelial cell et al. the functions of HLA II molecules (1 point each)  Participate in controlling Th cell- APC recognition in immunoreaction  Participate in processing and presenting of antigen  Participate in inducing the differentiation and development of T cell in thymus

　3.If we want to label the antibody with enzyme for ELISA experiment, what part of antibody does enzyme should bind to? Why?

　Fc fragment(2),because: Fab binds to Ag specifically(1) Fc has no effect on Ag binding, so Fc can be labeled to detect Ag-Ab complex without effection on its Ag binding activity(2)

　 4.How do effector specific CTLs kill tumor cells? What are the

　 characteristics for this process? • Specific recognition and binding of target cell by CTL

　 • Lethal hit to target cell

　• Perforin

　1 • Granzyme

　1 • Fas/FasL pathway—apoptosis

　 0.5 • Specific killing

　 1 • classⅠMHC molecule restriction

　1 • Continuous killing of target cells in short time, and no injury of CTL

　0.5

　5. How are endogenous antigens recognized by CD8 + T cells?  By class I MHC pathway

　 1  Processing of endogenous Ag：proteosome -LMP2, LMP7，antigen peptides(8-13aa)

　1  Transporting of antigen peptide into ER：TAP(transporter associated with antigen processing)

　1  Peptide loading of MHC I molecules：ER，antigen peptide—class Ⅰ MHC complexes

　 1  Presenting to CD8 + T cells：TCR-peptide, CD8-α3

　1

　6. What is Neonate hemolysis? Please describe its mechanism. Definition: Maternal IgG specific for the fetal blood groups crosses the placenta and destroys the fetal red blood cells

　 1 Mechanism: Mainly induced by Rh antigen. It is Type II hypersensitivity

　 0.5 Rh antigens on the surface of fetal red blood cells induce IgG antibody production within mother body---the first pregnancy.

　 1 IgG crosses the placenta and bind with Rh antigen to form Ag-Ab complex---the second pregnancy.

　 1 Cell lysis: Ag-Ab complex activates complement by classic pathway.

　 MAC

　 0.5 ADCC

　0.5 Oposinization by C and Ab promotes macrophages function.

　0.5

　 IV. Answer following question (12 points)

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　1. How do the innate and adaptive immunity act in cooperative and inter-dependent ways to protect the host? Innate immunity → adaptive immunity( 8 points) (1)macrophage and DC participate in antigenic presentation and initiate adaptive immunity

　3 points (2)macrophage,NK,Complement etc. participate in effector phage of adaptive immunity

　3 points (3)macrophage and NK secrete cytokines regulate types of adaptive imunity

　2 points Adaptive immunity→Innate immunity(4 points) (1) Ab-Ag complex situmulate activation of complement by classical pathway

　1 points (2) Activated T cells secrete cytokines to participate in innate immunity 1 points (3) Activated T cells secrete cytokines to activate NK cell

　1 points (4) Activated T cells secrete cytokines to activate macrophage

　1 points