Autoimmunity

Question 1

what is autoimmunity?

Answer 1

immune system mistakenly attacks its self, targeting the cells, tissues and organs of a persons own body

Question 2

how many different types of disease are caused by autoimmunity?

Answer 2

more than 80

Question 3

what is the most common autoimmune disease?

Answer 3

graves disease

Question 4

which sex is more susceptible to autoimmune disease?

Answer 4

female - not entirely sure why

Question 5

what factors can lead to an autoimmune condition?

Answer 5

genetic factors
infection and environmental exposure
immune regulation altered

Question 6

what is the fundamental problem of an autoimmune disease?

Answer 6

imbalance between immune activation and control

Question 7

what is the type of disease controlled by?

Answer 7

the type of dominant immune response

Question 8

what is central immune tolerance?

Answer 8

initiation or development of immune system in immune organs, educate immune system

Question 9

what is peripheral immune tolerance?

Answer 9

cells have matured and can leave to secondary immune systems, mechanisms which can supress immune response but may be lost

Question 10

what is molecular mimicry?

Answer 10

when a bacterial epitope looks very simiar to something we naturally present, response can be generated but it is actually self

Question 11

what is an inappropriate activation?

Answer 11

when something happens and sets of an unnecessary response cascade

Question 12

what is the regulation in the central immune system?

Answer 12

positive selection
negative selection

Question 13

what is the regulation in the peripheral immune system?

Answer 13

regulatory T and B cells
dendritic cells and danger
co stimulation
ignorance
privilege

Question 14

what are the genetics of autoimmune diseases?

Answer 14

-complex polygenic traits
-identified by genome wide association mapping
-single gene mutations are useful for pathway analysis

Question 15

what can some polymorphisms be associated with?

Answer 15

multiple diseases
may control general mechanisms of tolerance and immune regulation

Question 16

what can other genetic associations which are disease specific influence?

Answer 16

end organ damage

Question 17

what genetic factors can increase risk of autoimmunity?

Answer 17

-smoking
-pollution
-drugs
-infectous agents

Question 18

how do we know infection can be linked with autoimmunity?

Answer 18

-cilincal prodomes, animal models
-autoimmunity develops after infection is eradicated
-ie the autoimmune disease is precipitated by infection but is not directly caused by the infection

Question 19

which autoimmune diseases have been seen to be prevented by infection?

Answer 19

-type 1 diabetes
-MS
-the hygiene hypothesis

Question 20

what is the hygiene hypothesis?

Answer 20

if we live in clean environment and immune system does not get correct exposure to mature and educate itself in the correct way can make individuals susceptible to infection

Question 21

what are immune mediated inflammatory diseases?

Answer 21

chronic diseases with prominent inflammation, often caused by failure of tolerance or regulation
-affect 2-5% of people, incidence is increasing

Question 21

what is the pathogenesis of autoimmune disease?

Answer 21

-susceptible genes
-failure of self tolerance e
-persistence of functional self reactive lymphocytes
-activation of self reactive lymphocytes
-environmental triggers

Question 22

what may be causing immune mediated inflammatory diseases?

Answer 22

-immune response against self antigens or microbial antigens
-may be T cells and antibodies
-may be systemic or organ specific

Question 23

what are autoantibodies?

Answer 23

-often present in autoimmune conditions
-may or may not be pathogenic
-specific examples apparantly significant
-may be associated with specific disease states

Question 24

what are some examples of specific targets of autoantibodies?

Answer 24

graves disease - TSH receptor
myasthenia Gravis - acetyl choline receptor
ITP- platelets
GBS - gangliosides

Question 25

what causes graves disease?

Answer 25

-thyroid hormones regulated by TSH
-TSH binds to receptor and stimulates synthesis of thyroid hormone
-GD results in non regulated activating auto antibodies that bind to TSH receptor leading to overstimulation of thyroid hormone s
-auto antibodies are long acting thyroid stimulating hormones

Question 26

what can T cells specific for auto antigens help?

Answer 26

generate anti host response

Question 27

what is the anti host response in Graves disease?

Answer 27

T cells to thyroid follicular epithelial cells

Question 28

what is the anti host response in myasthenia Gravis?

Answer 28

T cells to acetyl choline receptor

Question 29

how is organ specific immune disease characterised?

Answer 29

-widespread self antigens are targets for autoimmune attack can be presented all over body
-damage affects such structures as blood vessels, cell nuclei ect

Question 29

how is organ specific immune disease characterised?

Answer 29

-autoimmune attack vs self antigens of given organs
-results in damage of organ structure and function

Question 30

what happens in Guillian Barre syndrome?

Answer 30

-transient autoimmune disease
-example of molecular mimicry
-auto antibody mediated autoimmune disease of peripheral nerves
-triggered by infections including campylobacter jejune
-common cause of acute paralysis
-pathogenesis incompletely understood

Question 31

what are the stages of evolving pathogenesis of RA?

Answer 31

pre-articular or lymphoid phase
transition phase
articular plase

Question 32

what happens during pre articular/lymphoid phase of RA?

Answer 32

autoimmunity
CCP- specific antibody rheumatoid factor
collagen-specific response
GP39 specific response

Question 33

what happens during the transition phase of RA?

Answer 33

microbial insult
bio-mechanical events
neurological events
microvascular dysfunction