autoimmune diseases Flashcards

1
Q

what is the difference between the innate and the adaptive immune system

A

innate - inflammation target tissues, macrophages, dendritic, mast, neutrophils, complement
no memory, amplification, fast response and short duration

adaptive - learned response - T/B cells
highly specific, strong memory and amplification - slow response

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2
Q

how do cells of the adaptive help the innate immune system and vice versa

A

innate APC’s present to T cells

T cell cytokines and B cell antibodies activate innate cells to cause inflammation

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3
Q

what are the 5 components of the innate immune system

A
phagocytic cells 
histamine producing cells 
complement 
cytokines 
chemokine
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4
Q

what are three types of phagocytic cells and what is their role

A

neutrophils - eat and destroy - pus
macrophages - produce chemokine
dendritic cells - present to T cells

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5
Q

what is the role of histamine producing cells and what are they

A

mast cells, basophils and eosinophils
produce histamines and other chemokines/cytokines
vasodilation and attract other immune cells
protect against parasites, wound healing, anaphylaxis and allergy

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6
Q

how does complement work in the innate immune system

A

directly attacks pathogen via alternative and lectin pathways
may be activated by adaptive immune system via antibodies

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7
Q

what is the role of cytokines and chemokine in the innate immune system

A

cytokines - signal between different cells (adaptive to innate etc)

chemokine attracts immune cells to sites of inflammation

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8
Q

what is autoimmunity defined as

A

the adaptive immune system recognises and targets the bodies own molecules cells and tissues

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9
Q

what are the main characteristics of autoimmunity

A

T cells that recognise self antigens
B cells and plasma cells that make autoantibodies
inflammation at targeted sites

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10
Q

what is the definition go autoinflmmation

A

not adaptive immune system - dysregulation of innate immune system

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11
Q

what are the main characteristics of auto inflammation and what are some examples

A

spontaneous systemic inflammation - no infection - no high tire autoantibodies or t cells ie no adaptive immune system

Traps - TNF receptor associated pyrexia - fever due to TNF releases

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12
Q

what are examples of auto inflammatory diseases compared to autoimmune

A

autoinflamamiton - hereditary periodic fevers, polygenic crohns

autoimmune - monogenic ALPS, SLE, polygenic RA

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13
Q

what is the conceptual basis of autoimmunity

A

breakdown of self-tolerance

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14
Q

what are the three causes of autoimmune disease

A

genes - won’t present till middle age
immune regulation
environment

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15
Q

describe central tolerance by the thymus

A

T cells in thymus develop receptors via random coding - some will be autoimmune
thymus then tests anybody to see if auotreactive then gets deleted (negative selection) - if doesn’t match normal antigen it gets rebased into circulation (positive circulation)

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16
Q

how are Treg cells made and what do they do

A

T cells with intermediate recognition with self-antigens

regulate suppression and expression of different T cells

17
Q

what is the difference between MHC1 and MHC2

A

MHC1 - on all nucleated cells - presents antigen to CD8 cells which is cytotoxic

MHC2 only found in immune system eg APC takes antigen to lymph node

18
Q

what do mutations in FOXP3 and PTPN22 cause

A

FOX - causes failure to develop regulatory T cells - severe autoimmunity from birth

PTP - T cells activated more easily - stronger immune response general

19
Q

what are some causative associations with autoimmunity

A

sex ie more women than men
risk increases with age
sequestered antigens
environment triggers

20
Q

what is molecular mimicry

A

in rheumatic fever - antigen on pathogen was similar to those on heart valves so they attack them as well as pathogen

21
Q

describe three examples of how autoantgnes may cause autoimmunity

A

citrullination of proteins make them more immunogenic

tissue transglutamase alters gluten which binds to MHC - coeliac

failure to clear apoptotic debris (SLE) - more sequestered antigens in cells

22
Q

what is the difference in role of TH1 vs TH2

A

TH1 - makes cytokine which stimulate macrophages to make more cytokines

TH2 - help B cells - to make antibodies

both lead to inflammation though

23
Q

describe the pathophysiology of autoimmune disease

A

auto reactive b cells and autoantibodies - directly cytotoxic - activate compliment to own cell - general inflammation and end organ damage

24
Q

what are the two types of autoimmune thyroid disease

A

hashimotos thyroiditis

graves disease

25
what is hashimotos thyroiditis
antibodies destroy thyroid - lead to hypothyroidism but destruction of thyroglobulin and thyroid peroxidase
26
what is graves disease
antibodies stimulate thyroid via anti-TSH autoantibody which resembles TSH - hyperthyroidism
27
what is myasthenia gravis
autoantibodies block Ach receptor - muscle weakness especially in the eyes
28
what is pernicious gravis
autoantibody binds to intrinsic factors and stops B12 binding and being absorbed
29
what is SLE
cell debris is not cleared quick enough - immune system recognises nuclear components as foreign antibodies w antigens forms complex which actives complement and causes inflammation
30
give four examples of connective tissue autoimmune diseases
SLE, scleroderma, polymyositis, sjogrens