3.5.2 CNS and Autoimmunity Flashcards
Which of the following cytokines is most effective at promoting the production of IgG?
A.IFNƔ
B.IL-4
C.IL-10
D.IL-17
E.TGFβ
A.IFNƔ
Which of the following cytokines are most directly linked to the tissue damage associated with rheumatoid arthritis?
A.IL-4
B.IL-10
C.IL-17
D.TGFβ
E.TNFα
E.TNFα
23-year-old previously healthy woman presents to the clinic with sudden onset weakness in both legs and is unable to stand. She also complains of numbness and decreased sensation in her feet. The pathogenesis of which of the following diseases is most similar to that of this patient?
A.Hay fever
B.Poison ivy
C.Sepsis
D.Serum sickness
E.Systemic lupus erythematosus
B. Poison Ivy
Compare immunologic pathogenesis of multiple sclerosis and SLE-induced vasculitis. What type of HS is each of these?
Multiple Sclerosis: Type IV - T Cell-mediated destruction of myelin in the CNS
SLE-induced vasculitis: Type III - Ab’s bind soluble Ag’s (in this case, DNA) and desposit in capilary beds of brain
What are these white plaques indicative of? What do they show up on MRI?
The white plaques are indicative of multiple sclerosis. In these areas, T cells have caused demyelination as well as caused the BBB to become leaky. The leaky BBB allows the contrast stain (gadolinium) to pentrate the BBB allowing for the formation of these white spots.
Which three tests can aid in the diagnosis of multiple sclerosis?
Symptomology, MRI, and CSF
Is the presence of oligoclonal IgG antibodies associated with a good or poor prognosis?
Poor prognosis
What are oligoclonal Ab’s?
Ab’s that arose from a limited number of multiple B cell clones
What is the standard light chain ratio?
3:1 Kappa:lambda
What is the term for asymptomatic monoclonal gammopathies that result in an abnormal kappa:lambda light chain ratio? What is its associated malignancy?
monoclonal gammopathies of unknown significance (MGUS)
Maligancy: multiple myeloma
Pocket guide to polyclonal gammopathies
When attempting to check oligoclonal bands, what tests do collect, what info do you look at, what are you looking for?
Collect serum and CSF simultaneously.
Compare IgG/albumin ratio for both.
Increased ratio indicates CNS production of IgG.
Where can ectopic lymphoid follicles be found in MS?
The CNS, including the brain
What is the primary epitope in MS? Describe epitope spreading.
Myelin Basic Protein (MBP)
APCs present the primary epitope to Th1 cells. The Th1 cells and monocytes move into the tissue to mount an immune response. During destruction of tissue in the immune response, the APC latches onto some of the tissue fragments and goes on to present the new epitope to another Th1 cell. This phenomenon can happen multiple times leading to epitope spreading, yielding oligoclonality.
What are the four main roles of B cells in MS?
Ag presentation, Ab production, Cytokine production, Tertiary lymphoid follicles
