Autoimmune (Leitenberg) Flashcards

1
Q

Molecular mimicry occurs when..

A

-ag receptor has cross-reactivity btw microbial peptide and self peptide

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2
Q

When does molecular mimicry usually happen?

A

when pathogenic ag has components that mimic self-proteins

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3
Q

What is an example of molecular mimicry?

A

rheumatic fever - B cells make ab to strep cell wall ag; this ab then cross-reacts w/ epitopes on heart tissue

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4
Q

Bystander activation occurs because…and this happens…

A
  • more likely to occur during inflam response

- autoreactive cell (that escaped tolerance mech) is activated by newly activated APC

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5
Q

Why does bystander activation not normally occur?

A

APC express MHC molecules w/ self-peptides often, but w/o inflam cytokines, there is no T cell activation due to low co-stim molecules expression on APC

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6
Q

What is it about the inflam response that increases bystander activation?

A

APCs increase co-stim molecule expression and can then activate T cells that escaped negative selection

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7
Q

What is epitope spreading?

A

initial autoimmune T cell activation expands to additional self-ag (pathology develops over time)

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8
Q

Example of epitope spreading? What pathology is it related to?

A

citrullinated peptides - not as well degraded and presented by APCs to T cells

  • increased citrullinated peptides promotes damage and infection, promoting immune response
  • HLA haplotype related
  • rheumatoid arthritis
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9
Q

What is the most common factor for genetic risk factors predisposing to autoimmune disease?

A

MHC haplotype (can increase or decrease risk)

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10
Q

Are simple mutations a common cause of autoimune disease?

A

nope!

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11
Q

Why is MHC haplotype important for autoimmune disease?

A
  • regulates T cell repertoire during thymic selection

- regulates efficiency of peptide presentation to peripheral T cells

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12
Q

Example of how we know MHC is important predictor of autoimmune disease (Type I DM)?

A

Twins w/ HLA hap linkage more likely to present w/ type I DM than twins w/o HLA linkage

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13
Q

Example of Type I Hypersensitivity autoimmune disease

A

Atopic dermatitis and allergic asthmas

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14
Q

Example of Type II Hypersensitivity autoimmune disease

A

Pemphigus vulgaris, pemphigus foliaceus, Grave’s disease, Myasthenia gravis, acute rheumatic fever, autoimmune hemolytic anemia

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15
Q

How do Grave’s and myasthenia happen?

A
  • Grave’s: increase thyroid gland activity via ab for TSH receptor
  • Myasthenia: Ab against ACh on muscle cells inhibiting signaling at neuromuscular jn
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16
Q

Example of Type III Hypersensitivity autoimmune disease

A

mixed essential cryoglobulinemia, SLE

17
Q

Example of Type IV Hypersensitivity autoimmune disease

A

Psoriasis, type I DM, rheumatoid arthritis, MS (autoimmune demyelinating via T cells)

18
Q

Treatment of autoimmune diseases that target tolerance mechanisms (4)

A
  • CD28-B7 blocker
  • CD40-CD40L blocker
  • promote Treg
  • promote TGF-beta
19
Q

Treatment of autoimmune diseases that target effector responses (name one specifically)

A
  • Ab mediated blocking of TNF-alpha receptor (rheumatoid arthritis treatment)
  • a bunch more!