Autoimmunity Flashcards
what is he immune system
system has self tolerant mechanisms - when breakdown autoimmunity occur
what develops in autoimmunity
autorecative T cells and Ab which recognise self antigens
what is an organ specific autoimmunity
hasjmoto’s thyroiditis
what kind of autoimmunity involves many organs
systemic lupus erythematosus
what is SLE
non organ sp
one of dominant Ab directed ag cell nucleus
what happens in hashimotts disease
enlarged thyroid
Ab directed against thyroglobulin
what is the normal pathology of thyroid gland
acing epithelial cells secerete thyroglobulin into colloid spaces
what happens to pathology of thyroid gland in hashimotos disease
normal architecture virtually destroyed, replaced by invading cells - lymphocytes, macrophages and plasma cells
in autoimmunity Ab bind to
self antigens
what are Ab said to be
in serum
what are some autoimmune thyroid diseases
hashimoto’s thyrodiditis
primary myoexedema thyrotoxicosis
what is an autoimmune disease of stomach
pernicious anaemia
what is an autoimmune disease of adrenal gland
addison disease
what is the autoimmune disease of pancreas
insulin dept diabetes mellitus
what re some non organ sp autoimmune diseases
muscle - dermatomyositis
kidney - SLE
skin - scleroderma
Joints - rheumatoid arthritis
can an individual have more than one autoimmune disease at a time
yes
rheumatoid arthritis often ass with SLE
are autoimmune diseases hereditary
can occur in families
certain HLA haplotypes predispose to autoimmunity
what are the HLA haplotypes for hashimotos
HLA - DR5
what re the HLA haplotypes for RA
HLA-DR1
HLA-DR4
what are the HLA assc fro addisons
HLA- B8
HLA- DR3
what r the assc HLA asc with IDDM
HLA- DR3
HLA- DR4
HLA- DR3/4
what are the HA assc with myasthenia gravis
HLA - DR3
what are the HLA assc fro multiple sclerosis
HLA - DR2
HLA - DQ6
what are the HLA assc with SLE
HLA - DR2/3
what is the prevalence of autoimmune diseases
3.5% population have
who are more likely to autoimmune diseases men or woman
woman
2.7 X more likely
to do with sex hormones?
what can be seen as a typical sign of SLE in the face
‘malar’ flush
what is thyrotoxicosis ( graves disease)
human Ab directly pathogenic
act on receptor stimulating thyroid cell and over prod of thyroid hormones
what causes pernicsiou anaemia
auto ab against intrinsic factor
what does intrinsic factor normally do
abs Vitamin B12
what is immunopathological damage (A)
when auoAb local to organ
type 2 hyper and cell mediated reactions
damage due to complement and phagocyte degranulation
what is immunopathological damage (B)
immune complexes = pathogenic in system
SLE deposits of IC
type 3 hyper reactions
acute tissue damage
what si the pathology of rheumatoid arthritis
inflammatory infiltrate found in synovial mem
erosion coat and bone
IC and neutrophils present in joint space
Ic = self assc of rheumatoid factors
what are some examples affecting head and neck
hashimoto thyroiditis hashimoto's persistent goiter autoimmune colloid goiter graves disease non-goitrous hyperthyroidism HT + Graves simultaneously Primary Myxedema
what does hoshimotos thyroiditis do
thyroid destruct
what does hashimotos persistent goiter do
destroy thyroid
stimulate cell div
what does autoimmune colloid goiter do
tim cell div
what does graves disease do
stim cell div
stim thyroid hormone release
what does non goitrous hyperthyroidism do
stim thyroid hormone syn
what does HT + graves simultaneously do
destroy thyroid
stim thyroid hormone syn
what does primary myxedema do
destroy thyroid
inhibit cell div
inhibit TH syn
what is cicatricial pemphigoid
chronic autoimmune disease of mucosal mess and/or skin
lining of mouth common site
what is sjogrens disease
chronic inflam auto disease
alone or asc with SLE, RA
what are the majority of sjjogrens disease pt’s
woman
4th-5th decade show symptoms start in 1st-2nd decade
how common is sjorgens disease
1-2% population
what is sjogrens disease characterised by
lymphocytic infiltrate in salivary and lacrimal glands
slow destroy and replace glandular tissue with fibrotic
what happens to saliva in sjogrens syndrome
lack of saliva and tear secretion
dental caries
oral candida
what is seen from sjogrens disease
dry lips
dry lobulated tongue
caries
what are ways of treat autoimmune disorders
metabolic control
anti inflam drugs
immunosuppressive drugs
monoclonal Ab
what is an example of metabolic control of autoimmune disorder
anti thyroid drugs in graves disease
inject vitB12 in perniciuous anaemia
what re see antiimflam drugs used ag autoimmune
corticosteroids or NSAIDs
what is an immunosuppressive drugs
cyclosporin
what do monoclonal Ab do
blockade certain cytokines or their receptors e.g. infliximab block TNF
what is monoclonal Ab
prep where all mols identical
what is rheumatoid arthritis treated with
anti-TNF(alpha) Ab and methotrexate
what does depletion of b cels do
by monoclonal Ab alleviates symptoms of SLE
what si the marker for b cells
CD20
