Autoimmunity Flashcards

1
Q

Define tolerance

A

a state of immunologic unresponsiveness to a particular antigen

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2
Q

goal of the immune response with respect to tolerance

A
  • mount a response against non-self
  • maintain unresponsive state toward self
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3
Q

when tolerance is broken

A

autoimmunity

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4
Q

dfine negative selection

A

when T cells recognize self and binds too tightly to self MHC

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5
Q

define positive selection

A

Recognize self MHC and bind it ; wont survive if cant

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6
Q

T reg cells

A

CD4+ CD25+
- express IL-2Ra chains (CD25) resulting in low affinity for IL-2

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7
Q

wherre to find Treg cells

A

secondary lymph tissues and sites of inglammation
- not that abundant (FEW) but powerful

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8
Q

what do Treg cells secrete?

A

IL-10 and IL-35 TGFb which are anti-inflammatory and suppress nearby responses

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9
Q

what does Treg cells inhibit

A

APCs
- they bind CD80/86 via CTLA-4 on T cells

bind APC along with other T cells = suppressing thier activity = LINKED SUPPRESSION

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10
Q

regulatory CD8+ cells

A
  • not generated in thymus but in periphery during CD8+ T cell activation induction events
  • not well understood
  • use wide range of mechanisms like Treg to suppress activity
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11
Q

when do reg CD8+ cells appear?

A

after Ag-MHC I stimulation in the presence of TGF-B cytokine

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12
Q

CD8+ reg T cells mechanisms to suppress activity

A

lysis of APCs
inhibition of APC function
regulation of effector cells that bind the same Ag

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13
Q

this hormone promotes Th2 response to increase Ig levels

A

estrogen
- why females may have higher incidences of autoimmunity

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14
Q

Estrogen speeds up _____ cell production (extramedullary) so negative selection may be missed

A

B cell

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15
Q

drugs tha can cause autoimmunity

A

procainamide, hydralazine - lupus

methyldopa, quinidine - AIHA

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16
Q

infections that can cause autoimmunity

A

Coxsackie virus B - T1 diabetes
K. pneumonia - ankylosing spondylitis

17
Q

environmental factors that can cause autoimmunity

A

drugs
infections
diet
chemicals/toxins

18
Q

proposed mechanisms that can induce autoimmunity

A

multifactorial/several “hits”
- molecular mimicry
- infections that induce genetic changes
- damage/stress events that exposed sequestered Ag
- foods that alter gut microbial balance, promoting chronic inflammation and hypersensitivity rxns
- exposure to immune privileged sites (if damaged = can see things you weren’t exposed to in that site???)
- Th1 vs Th2 = unbalanced (more antibodies formed –> autoimmunity)

19
Q

when autoAbs bind red cells and are removed in the spleen

20
Q

pernicious anemia

A

autoantibodies to intrinsic factor = no NO B12
- macrocytic anemia

21
Q

idiopathic thombocytopenia

A

autoAbs bind platelets = removed in spleen

thrombocytopenia = bleeding, thrombosis

22
Q

Goodpasture’s disease

A
  • anti-basement membrane of glomeruli and alveoli
  • complement activation
23
Q

types of systemic autoimmunity disorders

24
Q

lab diagnosis for autoimmunity

A
  • ANA (anti-nucleic antibody)
    > detects general antibodies to DNA, RNA, proteins
  • patterns of IF suggestive of antibody type
    > homogenous = chromatin, dsDNA, hostones
    > Rim = dsDNA
    > speckled = RNP (Sm, SS-A, SS-B)
    > nucleolar (nucleolar RNA)
25
challenges posed by autoimmunity treatment
reduce autoimmune BUT maintain alloimmune
26
Treatment challenges of autoimmune
Reduce autoimmune but maintain alloimmune
27
Anti inflammatory drugs
Non steroidal drugs (NSAIDs) Corticosteroids
28
Pain control for autoimmune diseases
Acetaminophen
29
Immunosuppressive drugs
Azathiaprine Cyclophosphamide Cyclosporin
30
Antibody removal for autoimmunity
Plasmapheresis
31
IVIg for autoimmunity
Fc binding of macrophages Inhibitory signalling via membrane binding of T, B and monocytes (reduces cytokine production) Anticomplement vs procomplement Anti-idiotypic antibodies