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MBD/MI (Wothaya) > Autoimmune Disease > Flashcards

Autoimmune Disease Flashcards

1
Q

What is immunologically acted on in Graves’ disease?

A

TSH receptors in thyroid

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2
Q

What is immunologically acted on in type 1 diabetes?

A

Beta islet cells of the pancreas

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3
Q

What are some examples of autoimmune diseases of HLA B27-associated apondyloarthropathies?

A

Reactive arthritis
Psoriatic arthritis
Urethritis
Iritis

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4
Q

What is systemic lupus erythematosus characterised by?

A

Autoantibodies binding to nuclear antigens

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5
Q

What is autoimmunity?

A

Failure of regulatory controls to attacking host components

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6
Q

What is immune tolerance?

A

Knowing what to attack/what not to attack

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7
Q

What is central tolerance?

A

Destruction of self-reacting T or B cells before they enter circulation

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8
Q

What happens in central tolerance ?

A

Immature B cells in bone marrow encounters antigen in a form which can cross-link their IgM, triggering apoptosis

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9
Q

What is peripheral tolerance?

A

Destruction or control of any self-reactive T or B cell which do not enter circulation

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10
Q

What are the types of peripheral tolerance?

A

Ignorance
Anergy
Regulation

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11
Q

When does ignorant peripheral tolerance happen?

A

Antigen present in too low a concentration to reach the threshold for T cell receptor trigger

Immunologically privileged sites means there are T cells but they cant get to the sites

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12
Q

What causes anergic peripheral tolerance?

A

Naive T cell seeing its MHC without appropriate costimulatory protein

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13
Q

What is Anergy?

A

Naive T cells need costimulation to become activated

If they dont, they’re less likely to be stimulated in future even if costimulation is present

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14
Q

Which cells inhibit T cells?

A

Treg cells

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15
Q

Which disease has defective treg cells been observed in?

A

Multiple sclerosis

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16
Q

How does treg regulation happen?

A

Expresses transcription factor FOXP3

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17
Q

What conditions does a mutation in FOXP3 lead to?

A

Fatal autoimmune disorder
Immune disregulation
Polyendocrinopathy
Eneropathy X-linked syndrome

18
Q

What does autoimmune regulator (AIRE) do?

A

A specialised transcription factor that allows thymic expression of genes that are expressed in peripheral tissues

19
Q

How does AIRE promote self-tolerance?

A

Allowing the thymic expression of genes from other tissues

20
Q

Which autoimmune conditions are more likely in females?

A

Lupus

MS

21
Q

Which autoimmune conditions are more common in males?

A

Ankylosis spondylitis

22
Q

Which autoimmune condition is equally common in women and men?

A

Diabetes

23
Q

What is the hygiene hypothesis of autoimmune disease?

A

Exposure to different pathogens may lead to expression/non-expression of a disease

24
Q

What might trigger a breakdown of self tolerance?

A

Loss of/problem with regulatory cells
Release of sequestered antigen
Modification of self
Molecular mimicry

25
Q

How does modification of self take place?

A

Citrullination

26
Q

What is citrulline?

A

An amino acid not coded by DNA

27
Q

What may citrullination be increased by?

A

Inflammation

28
Q

What is an example of molecular mimicry?

A

Rheumatic fever

29
Q

What is rheumatic fever triggered by?

A

Infection with streptococcus pyrogen

30
Q

How does Graves’ disease happen?

A

Autoantibodies bind TSH receptor and stimulate it, causing hyperthyroidism

31
Q

How can Graves’ disease be transferred?

A

IgG antibodies

32
Q

What causes myasthenia gravis?

A

Autoantibodies binding to ACh receptors that block the binding ability of ACh

33
Q

How are immune complexes in SLE and vasculitis formed and what do they cause?

A

Autoantibodies to soluble antigens form immune complexes
Deposited in tissue
Can lead to activation of complement and phagocytic cells

34
Q

Which autoimmune diseases can be transferred across the placenta?

A

IgG mediated ones

35
Q

What is the autoimmune pathology of T cells?

A

Direct killing by CD8+ CTL
Self-destruction induced by cytokines such as TNFalpha
Recruitment and activation of macrophages leading to bystander tissue destruction
CD4 cells providing help for Ab and cytotoxicity

36
Q

What do TH17 cells produce?

A

Cytokine IL-17

37
Q

What do TH17 produce?

A

Cytokines involved in the recruitment, migration and activation of immune cells

38
Q

What anti-inflammatories are used in autoimmune treatment?

A

NSAIDs and corticosteroids

39
Q

What theraputic strategies are used to treat T and B cell depletion?

A

Anti-CD4

Anti-CD20

40
Q

What are examples of theraputic antibodies?

A

Anti-TNF

Anti-VLA-4

MBD/MI (Wothaya) (57 decks)

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