Question

Case Studies Tasks:

Susan and Joe had a wonderful little boy named Daniel, but he had been having an awful lot of bacterial infections and he was barely a year old. It seemed that the antibiotics cleared up one bacterial respiratory infection only to have another follow shortly. The scary thing was that Daniel had just fought off a case of pneumonia caused by Pneumocystis carnii, a fungal infection that was usually found in people with HIV. Waiting for the test results of an HIV test for their little boy was one of the worst experiences ever. Thank goodness it came back negative. However, it seemed that their troubles were just beginning. After this last lung infection, the fungal one, and a negative HIV test, their doctor had ordered a number of other blood tests, including a genetic test that Susan didn’t fully understand. Apparently the doctor was worried about Daniel’s immune system functions. Susan had also met with a genetic counselor who collected a family history of any immune disorders. The details were vague, but Susan’s mother, Helen, knew that one of her three brothers had died young from an unexplained lung infection. Unfortunately, Grandma Ruth had passed away a few years ago, leaving them with numerous unanswered questions. Susan and Joe had an appointment with their doctor that afternoon to go over the results. When they arrived Dr. Dresdner led them into an office where Ms. Henchey, the genetic counselor, waited. This can’t be good, thought Susan. The doctor began by explaining that they had analyzed Daniel’s blood and found that while he had normal levels of B cells and T cells, his antibody levels were anything but normal. The levels of IgG, IgA, and IgE were very low, almost undetectable, and Daniel had abnormally high levels of IgM and IgD. It appears that his immune system failed to undergo immunoglobulin isotype switching due to a CD40 ligand mutation in Daniel's DNA.

1.Diagram an antibody response graph for a normal 1st and 2nd exposure with the antibodies correctly labeled for each exposure. Then diagram what Daniel's graph would look like, based on his situation.

2.Diagram and/or explain why IgG is low and what CD40's role is? Why is a mutation in that gene a problem? (There is no specific diagram I am looking for here, either diagram it or explain it, depending on which you prefer.)

Charlotte: A 60-year-old woman was fit and well until late in the summer she was out tending to her lovely tulip garden when she was stung on the back of her right hand by a pesky wasp. This was nothing new, unfortunately as she had been stung a couple times in the last two weeks. With in minutes after this sting Charlotte fell to the ground and looked as though she was becoming pale/grayish and was gasping for air. After five minutes it was getting worse, but likely a neighbor doctor rushed over and administered an epinephrine shot, which provided support until the ambulance could arrive.

1.Which antibodies and cells are involved in this allergic reaction and how does it lead to anaphylaxis?

2.Why didn't this happen on the first stings? How does anaphylaxis impact the body and how did the epinephrine help?

Jessalyn: Jessalyn regularly goes in for blood transfusions. Jessalyn's blood type is A-. Normally her blood transfusions go well and her nurse, Traci, does a great job of double checking the blood type she is receiving. This time Traci is out of town and she gets a nurse who was able to skate through school doing the bare minimum and doesn't really care that much about his job. He doesn't double check the blood type for her transfusion and . . . The blood type was incorrect.

1.Diagram and/or explain what happened.

2.Which blood types could Jessalyn receive, why?

Answer 1

ANSWER to 1st question:

The IgG or IgA and IgM are the commonly released antibody resposes after exposure to antigens or infections.

During 1st exposure, IgM antibody releases first and then IgG present in serum responds .

During 2nd exposure, due to the presence of immunological memory the antibodies respose will be stronger than during in first exposure.

During 1st and 2nd exposure, the IgG levels are high and IgM levels are low.

Daniel's immune response shows high level of IgM and low level of IgG antibodies releases during exposure to infections.

IN this cases, Daniels immune system has High IgM levels and Very Low IgG levels present and these antibodies are responded whenever the infection happens.

ANSWER to 2nd question:

IgG or immunoglobulin G are normally present in high levels and the reason for IgG low levels is mostly due to genetics. There are further reasons like malnutrition, taking drugs related to chemotherapy and prolonged use of corticosteroids , if person exposure to HIV infection then IgG levels will reduced.

CD40's role is regulating the activities of B cells , this gene helps in cell cycle entry, in the process of isotype switching .It also plays vital role in IgG secreation , activation of Monocytes and ability in memories generation.

Due to the high level of IgM antibodies present , the mutations in CD40 gene indicates the gentetic defects develops into Autosomal recessive type and Autosomal dominant types. Due to this , the production of IgG levels decreases which results in increasing more chances to exposure to infections and weak immune system develops which leads to life threatening conditions. Also, there is no switching to isotype occurs due to this mutations.

Case study of Charlotte:

ANSWER to 1st question:

The immunoglobulin E or IgE antibodies are involved in allergic reaction

The mast cells and Basophils are cells involved in this allergic reaction

After the stung for multiple time, the releasing of multiple chemicals to that surface develops into Anaphylaxis. It happens by the antigens from stung realised by the body immune system releases Immunoglobulin G antibodies binds on the surface of mast cells receptors and Basophils and they secreats inflammatory chemicals like Histamine and other chemicals which affects the smooth muscles result in difficulty in the breathing.

ANSWER to 2nd question:

During the first time sting happens, the immune system releases antibodies to fight against this and mostly doesnot shows any symptoms. but it often happens , the body releases chemicals at a time leads body into shock which is known as Anaphylaxis shock,

Anaphylaxis leads to cause breathing difficulty beacuse of brochi swelling , decrease in the blood pressure, itching and also happens unconsciousness.

Epinephrine is the first choice medication in the therapy to Anaphylaxis. This drug makes the blood vessels constrict which helps in the enhancing blood flow and this drug also relaxes muscles and provides the condition of norml breathing state.