15 - Hypersensitivity and Auto Immunity 2 Flashcards
An immune reaction against self antigen is the definition of _. When is this not a bad thing?
Autoimmunity Tumors
What are the 3 criteria for diagnosing autoimmunity?
-presence of autoimmune rxn-evidence that rxn is not secondary to tissue damage-absence of well defined cause of disease
A break down of what process leads to pathologic autoimmunity?
Self tolerance
A state where the individual is incapable of developing an immune response to a specific antigen is _. What are the 2 types?
- Immunological tolerance
- Central and peripheral tolerance
One mechanism of central tolerance is clonal deletion. What happens during clonal deletion?
Deletion of self reactive clones of cytolytic and helper T-lymphocytes
Why is it thought that clonal deletion of B cells is of minor importance?
Because there is a relatively high rate of auto-antibodies documented
Within the thymus, where are each of the following cells found? Lymphoid cells,epithelial cells, dendritic cells, macrophages? Which express MHC1? Which express MHC 2?
Lymphoid cell - Thymus - MHC1
Epithelial cells - Cortex - MHC1
Dendritic cells - Corticomedullary junction - MHC1 and 2 Macrophages - medulla - MHC1 and 2
Regarding central tolerance, the process where thymocytes are selected for their ability to bind self MHC molecules is _
Positive selection
Regarding central tolerance, the process of elimination of clones of thymocytes that bind self antigens is _. This also known as _
Negative selection Clonal deletion
Clonal anergy is a tolerance mechanism important is central or peripheral tolerance?
Peripheral tolerance
What are 2 signals required for maximal stimulation of a T cell?
Recognition of MHC2 on antigen presenting cell (APC)
Costimulators presented by APC
What happens when T cells are presented with antigen in the absence of costimulators?
No activation / immune response, anergy of the T cell, essentially its elimination
Another mechanism for peripheral tolerance is suppression. What cells are characteristically involved with this process? What are the 2 major cytokines involved?
- CD4+/CD25+ cells
- IL-10 and TGF-beta
Another mechanism of peripheral tolerance is activation induced cell death. How does this happen? What receptor / ligand pair is associated with this process?
- High antigen dose + chronic stimulation leads to elimination of T-cells- Fas receptor and fas ligand (FasL)
Which is more highly expressed in the human body, self antigens or foreign antigens? What does this mean for self reactive lymphocytes?
Self antigens Self reactive lymphocytes will be maximally and continually stimulated, leading to their apoptosis and elimination (activation induced cell death)
What is the number 1 cause of acquired immune deficiency globally?
Malnutrition
Another mechanism of peripheral tolerance is sequestration. What does this mean? What are the 3 examples provided in the lecture?
Antigens are kept in immuno-priviledged areas Eye, testis, brain
What disease is associated with defect in Fas/FasL?
ALPS - Autoimmune lymphoproliferative syndrome
What are 2 ways infection can cause breakdown of self tolerance?
- Alteration in levels of co-stimulators (e.g. on fibroblasts and epithelial cells)
- Molecular mimicry
What are the 2 broad categories of autoimmune disease?
- Systemic multi organ disease
- Organ systemm of cell type specific
Regarding lupus, is it more common in men that women? What is thought to underlie this difference in gender prevalence?
- More common in women
- Estrogen - make more tolerant
In what stage of life are people more likely to be affected by lupus?
Child bearing years, mainly women
What are the HLA types associated with lupus? A congenital deficiency in what 2 complement proteins may promote lupus development?
- HLA types DR2 and DR3
- Deficiency of C2 and C4 complement components
A hallmark of SLE is B lymphocyte hyperactivity. What are 3 antibodies that are diagnostic for lupus?
- Anti-nuclear ab
- Anti-native DNA
- Anti-Sm
A hallmark of SLE is B lymphocyte hyperactivity. What are 3 antibodies that are mentioned in our notes that alter the symptomatology of SLE disease?
- Anti-RBC
- anti- lymphocyte
- Anti-phospholipid (e.g. anti cardiolipin)