Das Versagen der Immunantwort

Appendices

Aufgaben

1 13.1 Bitte zuordnen

Welcher der folgenden Gendefekte hängt mit welcher Immunschwäche zusammen?

A.	Mutationen der gemeinsamen γ-Kette _____	i.	Omenn-Syndrom
B.	hypomorphe Mutationen in RAG-1 oder RAG-2 _____	ii.	SCID in Kombination mit einer anormalen Entwicklung des Thymus
C.	Defekte in DNA-PKcs oder Artemis _____	iii.	X-gekoppeltes SCID-Syndrom
D.	Mutationen in FOXN1 _____	iv.	Autoimmun-Polyendokrinopathie-Candidiasis-Ektodermale Dystrophie-Syndrom
E.	Mutationen in TAP1 oder TAP2 _____	v.	MHC-Klasse-I-Defekt
F.	Defekte in AIRE _____	vi.	RS-SCID

1 13.2 Richtig oder falsch

Personen, die Mutationen in den Genen tragen, die die IL-12-p40-Untereinheit codieren, sind nicht nur für Krankheitserreger wie M. tuberculosis anfällig, für deren Bekämpfung eine T_H1-Reaktion erforderlich ist, sondern es sind auch Typ-3-(T_H17-)Reaktionen betroffen.

1 13.3 Kurze Antwort

Welche zwei genetisch bedingte Defekte führen zum Fehlen von CD8⁺-T-Zellen, während die CD4⁺-T-Zellen erhalten bleiben, und welcher genetische Defekt führt zum Fehlen der CD4⁺-T-Zellen, während die CD8⁺-T-Zellen erhalten bleiben?

1 13.4 Kurze Antwort

Sowohl der CD40L-Defekt als auch der AID-Defekt führen zu einem Hyper-IgM-Syndrom, aber beim CD40L-Defekt ist die T-Zell-Funktion stark beeinträchtigt, während sie beim AID-Defekt erhalten bleibt. Warum ist das so?

1 13.5 Richtig oder falsch

Das variable Immundefektsyndrom (CVID) beeinträchtigt sowohl die T-Zell- als auch die Antikörperreaktionen.

1 13.6 Multiple Choice

Welche der folgenden vererbbaren Krankheiten hat keinen autoimmunen oder autoinflammatorischen Phänotyp?

• A. Autoimmun-Polyendokrinopathie-Candidiasis-Ektodermale Dystrophie-Syndrom (APECED), hervorgerufen durch Defekte im AIRE-Gen

• B. familiäres Mittelmeerfieber (FMF), hervorgerufen durch Mutationen im Pyringen

• C. Omenn-Syndrom, hervorgerufen durch hypomorphe Mutationen in RAG-1 oder RAG-2

• D. Wiskott-Aldrich-Syndrom (WAS), hervorgerufen durch einen WAS-Defekt

• E. Hyper-IgE-Syndrom (Job-Syndrom), hervorgerufen durch Mutationen in STAT3 oder DOCK8

• F. chronische Granulomatose (CGD), hervorgerufen durch die Produktion von reaktiven Sauerstoffspezies in den Phagocyten

1 13.7 Multiple Choice

Pyogene Bakterien sind durch Polysaccharidkapseln vor der Erkennung durch Rezeptoren auf Makrophagen und neutrophilen Zellen geschützt. Die antikörperabhängige Opsonisierung ist einer der Mechanismen, durch deren Wirkung Phagocyten diese Bakterien in sich aufnehmen und zerstören können. Welche der folgenden Krankheiten oder Defekte betrifft direkt einen Mechanismus, durch den das Immunsystem Infektionen dieser Bakterien kontrolliert?

• A. Il-12-p40-Defekt

• B. Defekte im AIRE-Gen

• C. WASp-Defekt

• D. Defekte in C3

1 13.8 Multiple Choice

In welchem der folgenden Gene führt ein Defekt zu einem ähnlichen Phänotyp wie Defekte im ELA2-Gen, das die Neutrophilen-Elastase codiert?

• A. GFI1

• B. CD55 (codiert DAF)

• C. CD59

• D. XIAP

1 13.9 Bitte ergänzen

Welches Protein hängt mit welcher Funktion von phagocytotischen Zellen zusammen?

A.	Kindlin-3 _____	i.	Produktion
B.	Neutrophilen-Elastase _____	ii.	Adhäsion
C.	Myeloperoxidase _____	iii.	Aktivierung
D.	MyD88 _____	iv.	Abtöten von Mikroorganismen

1 13.10 Multiple Choice

Welcher der folgenden Krankheitserreger entkommt dem Immunsystem primär durch eine Variabilität der Antigene?

• A. Influenza-A-Virus

• B. Herpes-simplex-Virus 1

• C. Cytomegalievirus

• D. Trypanosoma brucei

• E. Plasmodium falciparum

• F. Hepatitis-B-Virus

1 13.11 Multiple Choice

Das humane Immunschwächevirus (HIV) produziert verschiedene Immunevasine. Eines davon, Nef, ist ungewöhnlich pleiotrop und ein wichtiges Zielmolekül für CD8⁺-T-Zell-Reaktionen. Welche der folgenden Funktionen hängt nicht mit Nef zusammen?

• A. Hemmung des Restriktionsfaktors SAMHD1

• B. Herunterregulieren von MHC-Klasse-I

• C. Herunterregulieren von CD4

• D. Herunterregulieren von MHC-Klasse-II

• E. Aufrechterhalten der T-Zell-Aktivierung

1 13.12 Bitte ergänzen

Das humane Immunschwächevirus (HIV) wird den Retroviren zugeordnet, da es das Enzym _______ enthält. Das Virus infiziert Wirtszellen, indem es über seine Hülle an den _______-Rezeptor und entweder an den _______- oder den _______-Corezeptor bindet. Wenn ein Individuum infiziert wird, entwickelt sich eine Immunantwort, die zur Produktion von Anti-HIV-Antikörpern führt; diesen Vorgang bezeichnet man als _______. Es entwickeln sich auch CD8⁺-T-Zell-Reaktionen, aber HIV kann _______ entwickeln, die es dem Virus ermöglichen, diesen CTL zu entkommen.

1 13.13 Multiple Choice

Welche der folgenden Konstellationen ist keine genetische Variante, die die Anfälligkeit gegenüber einer HIV-Infektion verringert oder das Voranschreiten von AIDS verlangsamt?

• A. mutiertes CCR5-Allel

• B. mutiertes CXCR4-Allel

• C. bestimmte HLA-Klasse-I-Allele

• D. KIR-3DS1 mit bestimmten HLA-B-Allelen

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