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
Q

what is hashimotos thyroiditis

A

antibodies destroy thyroid - lead to hypothyroidism but destruction of thyroglobulin and thyroid peroxidase

26
Q

what is graves disease

A

antibodies stimulate thyroid via anti-TSH autoantibody which resembles TSH - hyperthyroidism

27
Q

what is myasthenia gravis

A

autoantibodies block Ach receptor - muscle weakness especially in the eyes

28
Q

what is pernicious gravis

A

autoantibody binds to intrinsic factors and stops B12 binding and being absorbed

29
Q

what is SLE

A

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
Q

give four examples of connective tissue autoimmune diseases

A

SLE, scleroderma, polymyositis, sjogrens