Autoimmune Concepts Flashcards

1
Q

What is autoimmunity and how does it come about

What triggers it

2 types of tissue attacked by the disease

A
  • it is a condition when the immune system responds against self antigens due to loss of tolerance ( immune system unable to differentiate between self and non-self antigens )
  • by the environment In genetically susceptible people
  • specific organ or large number of tissue. ( systematic ) due to specific antigen being attacked
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2
Q

How is autoimmunity avoided by the body

A

-elimination of auto reactive lymphocytes during development ( negative selection )

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3
Q

What is an autoimmune disease and the 2 causes

A

-a disease that occur when the immune system attacks self antigens

1 humoral ( by auto antibodies )
2 cellular ( auto reactive T cells )
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4
Q

Types of systems attacked by autoimmune diseases

A

1 specific

2 numerous organs ( systematic )

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5
Q

Function of MHC antigens

Describe MHC molecules

A
  • recognition of self from non-self by immune system

- are a product of cluster of genes in human genome known as major histo compatibility complex of chromosome 6p21

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6
Q

How do B and T cells bind to epitopes

A
  • T lymphocytes cell receptors need epitome bound to MHC to recognize
  • B cell receptors bind directly to epitomes
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7
Q

Describe MHC 1 molecules and the genes used to make them

A
  • made by all nucleated cells
  • has deep groove to bind to endogenous epitopes ( those made in cell )

-HLA ( A B C )

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8
Q

Describe the MHC 2 molecules and the genes used to make them

A
  • Made only by antigen presenting cells ( APC ) , macrophages, dendritic cells and B lymphocytes
  • deep groove to bind to exogenous epitopes

-HLA ( DR DQ DP )

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9
Q

Describe the 2 causes of autoimmunity

A

1 Changes in self antigen - are altered either by ( infection , medication or radiation ) and no longer recognized as self. Binding of self and non self. Overproduction of self.

2 changes in immune system - mutations to normal antibodies causes pathogenicity. Problems in lymphocyte development
-genetics causing central tolerance problem

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10
Q

Mechanisms by which tolerance breaks down

A
  • failure to deal with auto reactive lymphocytes ( gene mutations )
  • abnormal presentation of self antigens ( self and non bind )
  • epitope spreading ( once autoimmunity starts it spreads to other epitopes
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11
Q

Are T lymphocytes made to tolerate cells with self MHC 1 and self peptide

What do they attack instead

What causes alternated complexes

A

-yes

/non self antigens

-transformation, genetic disorders, infection

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12
Q

Why is a transplant rejected and mitigation

A

/if it has non matching MHC it is seen as non self and acted upon vigorously by immune system

  • matching donors
  • immunosuppressive medication
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13
Q

When will system fight cancer

What would the immune system fight cancer

A
  • when functioning normal and not suppressed
  • when cancerous cells are diff enough from normal tissue
  • when cancerous tumor is large enough
  • cause transformation from normal to cancerous involves metabolic, biochemical and genetic changes and immune may see it as non self and attack
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14
Q

2 other causes of autoimmunity

A

1 molecular mimicry ie cross reaction

2 epitope spreading. Ie once specific autoimmunity activated may spread to other self epitopes

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15
Q
2 types of autoimmunity 
Examples of autoimmunity for 
Thyroid 
Brain 
Stomach 
Adrenal 
Pancreas
A
1 organ specific 
2 non organ specific ( systematic ) 
- hashimoto’s thyroditis
- multiple sclerosis 
- pericinous anemia 
- addinsons disease 
- diabetes mellitus
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16
Q
Examples of autoimmunity for 
Muscle 
Kidney 
Skin 
Joints
A
  • dermatomyotositis
  • SLE
  • scleroderma
  • rheumatoid
17
Q

Polymyositis and dermatomyositis
Cause
Clinical features

A
  • inflammation of muscles and overlying skin. Skin involvement around eyes and hands
  • proximal muscle weakness
  • lethargic
  • dysphalgia
  • weight loss
  • rash on knees and dorsal hands
  • fever
  • heliotrope photosensitive rash around eyes and forehead
18
Q

Rheumatoid
Cause
Clinical features

A
  • immune system attacks bilateral joints at the synovial lining
  • pain , swelling , stiffness
  • joint deformed, damaged , inflammation Pannus
  • hypertrophic synovial and fibrous capsule
  • swan shaped hands , ulnar deviation of digits and radial of wrist
19
Q

Scleroderma
Cause
Clinical features

A
  • group of diseases that cause thick tight skin , buildup of scar tissue and organ damage
    2 types
  • systematic, blood vessels and major organs involved
  • localized , skin and maybe underlying muscle
20
Q

Systematic lupus erythematosus

A
  • antibodies attacking self DNA, histones, non histone RNA and nucleolus. Progressive inflammation to immune deposits at skin , joints , kidneys, CNS and CVS
  • butterfly rash on face , progressive renal and vascular diseases, eyes dry puffy and increased light sensitivity
  • fingers and nose turns white in cold or stress, headache , confusion and memory loss
  • persistent pain and swelling of legs , feet and joints , gastrointestinal pain and nausea
21
Q

Describe mixed CT diseases

Sjögren’s syndrome
Cause
Clinical features

A
  • when patients have characteristic features of several diseases
  • immune attacked mucus producing glands ( lacrimal and sublingual )
  • eyes and mouth dry , arthralgia , lethargy
  • increased risk of lymphoma
22
Q

Epidermolysis bullosa ( EB )
Cause
Clinical features

A
  • skin so fragile it tears or blisters due to minor bump, stumple ,or clothe friction
  • evident at birth
  • due to skin protein defects
  • may involve GI, and R tracts or bladder
23
Q

Marfan
Cause
Clinical features

A
  • due to mutation of gene regulating fibrillin 1 protein
  • eye problems ( abnormal lens ) , short torso
  • long spider like hands and feet
  • abnormal heart ( enlargement of aorta ) and lung problems
  • tall and thin body frame