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Immunology: hypersensitivity, autoimmunity, immunodeficiency > Autoimmunity > Flashcards

Autoimmunity Flashcards

1
Q

What do all autoimmune diseases involve?

A

Self peptide recognized as foreign; breakdown of T and B cell tolerance; loss of regulatory mechanisms

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2
Q

Which plays a role in autoimmune disease: environment or genetics?

A

Both- genetics can predispose, environmental can trigger

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3
Q

Generally a trigger leads to an autoimmune disease, what is meant by this trigger and how does it lead to the autoimmune disease?

A

Trigger such as an infection- get reactive T/B cells that then get misdirected to self-Ag

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4
Q

If a B cell gets out of the bone marrow but is found to be autoreactive in the periphery, how is it regulated so that it doesn’t autoreact?

A

Anergy- doesn’t receive the second costimulatory signal from T cells, or eliminated by T cells by Fas binding

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5
Q

What will a defect in AIRE result in? Why?

A

Autoimmune disease because don’t get peripheral protein presentation in the thymus

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6
Q

If a T cell that is autoreactive makes it into the periphery, how is it normally regulated so that autoimmune diseases don’t occur?

A

Anergized- doesn’t receive the costim signal (B7 to CD28)

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7
Q

What population that is important in turning off the immune response might be missing when there’s autoimmune diseases?

A

Tregs (CTLA4 binding to B7) turning off the cell

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8
Q

What cytokine released by T cells is believed to be the link between infection and autoimmunity? To which cells does it bind?

A

IL-17- binds to fibroblasts, epithelial cells, and keratinocytes initiating inflammation

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9
Q

What is the dominant genetic factor that make you susceptible to autoimmune diseases?

A

HLA

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10
Q

What are immune privileged sites? If these are damaged then what might happen?

A

Places where antigens are sequestered or hidden from the immune system (such as in the brain/eye); trauma can cause T cells to see these proteins that aren’t normally seen and therefore get an autoimmune reaction

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11
Q

How is autoimmunity generated with Celiac’s disease?

A

Alter the self protein so that it looks foreign; do this by digesting the gluten to produce fragments that are then deaminated and activate CD4 cells

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12
Q

Group A strep infection can lead to what autoimmune disease?

A

Rheumatic fever (carditis/ polyarthritis)

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13
Q

Enteric bacteria (Salmonella/Shigella/Yersinia) can lead to what autoimmune disease ? What MHC makes them susceptible?

A

Reactive arthritis; HLA-B27

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14
Q

Chlamydia can induce what autoimmune disease? What MHC makes them susceptible?

A

Reiter’s arthritis; HLA -B27

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15
Q

Coxsackie viruses, echoviruses and rubella can lead to what autoimmune disease?

A

Type I diabetes

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16
Q

What is the concept of molecular mimicry? How does this lead to autoimmune disease?

A

Pathogen invades that looks similar to self; body mounts a response to the pathogen and after being cleared reacts with self

17
Q

Inflammatory tissue damage can lead to the bystander effect, what is the bystander effect?

A

Autoreactive cells are stimulated because of inflammation

18
Q

One of the first cytokines released following infection causes increased expression of MHC Class I and II on cells that do not normally express MHC. What is this cytokine?

A

IFN-gamma

19
Q

What environmental factors might increase the predisposition to autoimmune diseases?

A

Diet, chemical exposure, stress, hormones

20
Q

What type of hypersensitivity is responsible to antibody mediated autoimmune diseases?

A

Type II

21
Q

What are some antibody mediated autoimmune diseases?

A

Goodpasture’s, Acute rheumatic fever, autoimmune hemolytic anemia, autoimmune thrombocytopenia, myasenthia gravis, insulin resistant diabetes

22
Q

What are some autoimmune diseases where antibody binding stimulates the antigen?

A

Graves disease, hypoglycemia

23
Q

In Graves disease where do antibodies bind? How does this lead to autoimmune disease?

A

TSH receptor, leads to overproduction of T3/T4 because mimics TSH

24
Q

In Myasthenia gravis what do antibodies bind to? How does this lead to the symptoms?

A

Binds to Anti-ACh receptors; leads the destruction of anti-ACh receptors so have decreased sensitivity and muscle weakening

25
Q

What autoimmune diseases can be transmitted from a mother to a fetus?

A

Antibody mediated since IgG can pass through the placenta

26
Q

What type of hypersensitivity is associated with immune-complex autoimmune disease?

A

Type III

27
Q

What are some immune-complex autoimmune diseases?

A

Lupus, subacute bacterial endocarditis, mixed essential cryoglobinemia

28
Q

What is diagnostic of SLE?

A

High anti-dsDNA titer, butterfly rash on face, fatigue, headaches

29
Q

What are some T cell mediated autoimmune diseases?

A

MS, Rheumatoid arthritis(may also be classified as immune complex), Type I diabetes

30
Q

What cells are responsible for killing the pancreatic beta cells in type I diabetes?

A

CD8+

31
Q

Do the symptoms arise immediately for Type I diabetes?

A

No- don’t occur until there are too few cells to produce insulin

32
Q

In Rheumatoid arthritis, what are antibodies made against?

A

The constant regions of other antibodies (the rheumatoid factor)

33
Q

Why can Rheumatoid arthritis be considering both an immune complex mediate and a T cell mediated autoimmune disease?

A

Have both antibodies and T cells- the antibodies are against rheumatoid factor and the T cells infiltrate the joint synovium

34
Q

What is attacked with MS? What cells are responsible?

A

Myelin sheath; TH1 cells secrete IFN-gamma which activates macrophages and mast cell/complement activation

35
Q

Normally the brain is an immune privileged site. How do cells attack the myelin within the brain with MS?

A

Inflammation may act as a trigger resulting in increased permeability of the BBB and giving T cells access to the brain

36
Q

What are some potential treatments for autoimmune disease? Have they been effective?

A

Physical removal of the antigen. Ab, Ag:Ab complexes, IV IgG, anti-inflammatory drugs, block cytokines, replacement therapy- not very successful

Immunology: hypersensitivity, autoimmunity, immunodeficiency (4 decks)

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