Autoimmunity Flashcards
What is the treatment of Wegner’s Granulomatosis (WG)?
Plasmapheresis and anti-inflammatory drugs.
What are the other symptoms of WG?
Conjunctivitis, lung infiltrates, rapidly progressing glomerulonephritis, granulomas found in all affected tissues (usually but not always).
What is the first symptom of WG?
Rhinitis: pain, stuffiness, and nose bleeds.
The vasculitis seen in WG is caused by what?
The activated neutrophils degranulate causing damage to the vasculature.
ANCAs bind to what elicting them to what?
Neutrophils. Activates them to upregulate adhesion molecules allowing them to bind to vascular endothelial cells.
T or F. The onset of WG typically follows bacterial or viral infection and the response to the pathogen elicits production of IgG that cross reacts with neutrophil determinants.
True
What type of Ig is the Ab that mediates WG?
IgG
What Ab mediates Wg?
Anti-neutrophil cytoplasmic antibodies (ANCAs).
WG uses what mechanism to elicit the autoimmune condition?
Molecular mimicry
Wegener’s Granulomatosis is what type?
Type II
What is the treatment for GBS?
Plasmapheresis and immunosuppressants.
What are the symptoms for GBS?
Symmetrical weakness of lower limbs that rapidly ascends to upper limbs and face. Difficulty swallowing and breathing. Drooling. Partial paralysis often occurs.
What is the results of the binding of the IgG in GBS?
Demyelination of nerves.
What is the Ig in GBS specific for?
Gangliosides: common components of human nerve tissue.
What Ig mediates GBS?
IgG
GBS uses what mechanism to elicit the autoimmune condition?
Molecular Mimicry
Guillain Barre Syndrome is what type?
Type II
T or F. Campylobacter jejuni induces autoimmune conditions via the action of molecular mimicry and is a diarrheal pathogen.
True
An infection of Campylobacter jejuni carries an associated risk to what autoimmune disease?
Reactive Arthritis
Is there an associated risk to autoimmune disease with certain bacterial, viral, and fungal infections?
Yes
T or F. Trauma to one eye can elicit effector T cells upon return to attack Ag in both eyes.
True
What are the 3 immunologically privileged sites of the body?
Eyes, testes, placenta/fetus
T or F. Position 57 of the HLA-DQbeta chain affects susceptibility to type I diabetes mellitus.
True
T or F. There is an increased risk of autoimmune disease in certain HLA haplotypes of MHC molecules.
True
T or F. An increased number of shared HLA haplotypes is directly related to incidence of diabetes in sibling pairs.
True
In general, do autoimmune diseases typically affect women or men?
Women
What does the diagnostic lab test result show for MS?
Presence of oligoclonal bands of IgG in CSF
What is the treatment for MS?
Immunosuppressants. IFN-beta1: reduces incidence of disease attacks.
T or F. MS is a highly variable progressive disease?
True
What are the symptoms of MS?
Motor weakness, impaired vision, lack of coordination, spasticity.
What does the destruction of myelin sheaths of nerve cells cause in MS?
Causes demyelination of white matter in the CNS forming sclerotic plaques.
In MS, the immune response is directed at what?
The myelin sheath of nerve cells.
What cell mediates MS?
Th1 Cells
Multiple Sclerosis is what type?
Type IV
What is the treatment for SjS?
No known cure. Artificial tears. Some pt’s wear goggles to increase humidity in the eyes. Punctal plugs: prevents tears from draining out of eye.
What tests are used to diagnose SjS?
Schirmer test: measures tear output. ANA and rheumatoid factor tests (bc SjS often occurs secondary to rheumatic fever and SLE).
T or F. SjS pt’s oftgen have serious dental problems?
T: caused by the dry mouth.
Is rhematoid factor required for SjS?
no
What are the symptoms of SjS?
dry eyes and dry mouth. sometimes skin, nose and vaginal dryness
Are women or men more likely to suffer from SjS?
Women 9:1
T or F. SjS is the second most common rheumatic disease?
True
What other organs are affected by SjS?
Kidneys, blood vessels liver, brain
What cell initiates the inflammation in SjS?
autoreactive T cells
Inflammation in SjS destroys what?
Exocrine glands that produce tears and saliva
Sjogren’s Syndrome is what type?
Type IV
What is the treatment for RA?
Infliximab: an anti-TNF Ab. Rituximab: an anti-CD20 Ab uses ADCC to deplete B cells.
What is the first symptom of RA?
Clubbing of the hands. At least I think that’s what it’s called. Just big bumps in joints of the fingers.
Is rheumatoid factor required for RA?
no
RA pt’s produce what 3 Ig’s that are specific for the Fc region of Ab molecules?
IgG, IgM, and IgA
Are women or men more likely to be affected by RA?
Women 3:1
T or F. RA is the most common of the rheumatic diseases
True
Inflammation in RA damages what?
Cartilage and ligament tissue of joints
The inflammatory disease of the joints seen in RA is initiated by what cell?
Autoreactive T cells
Rheumatoid Arthritis is what type?
Type IV
What is the drawback for the use of human recombinant insulin in DM patients?
it is more expensive
What is the alternative therapy for patients w/ IDDM?
the use of human recombinant insulin
Can some patients make an immune response to the treatment for IDDM?
Yes. The immune response is directed against the “foreign” insulin and makes the disease much worse.
What is the treatment for IDDM?
Daily injections of pig or bovine insulin
If IDDM is left untreated, what can happen to the pt?
coma and death
What ethnic group does IDDM primarily affect?
people of european descent
T or F. Lymphocytic inflammation is characteristic of IDDM.
True
The answer to #104 has specificity for what?
An unknown component of the Beta cells
What are the effector cells of IDDM?
CTL’s
IDDM results in destruction of what cell type?
Beta cells in the islets of Langerhan’s in the pancreas, the insulin-producing cells.
Insulin-Dependent Diabetes Mellitus is what type?
Type IV
What is the treatment for SLE?
Anti-inflammatory drugs
T or F. In SLE, a B cell that internalizes a macromolecular complex can present Ag’s to T cells specific for any of the proteins of that complex.
True
T or F. In SLE, CD4+ T cells specific for one epitope of a macromolecular complex can provide help to B cells specific for other accessible epitopes of the complex.
True
What does immunofluorescent staining with anti-IgG show in SLE pt’s?
shows the presence of autoAb’s
What happens to the basement membranes of glomeruli in SLE pt’s?
They thicken due to immune complex deposition
T or F. SLE is most common in women, especially Asian and African women.
True
T or F. SLE is a progressive disease with episodic inflammation.
True
The initial sign, characteristic rash of SLE forms where?
Butterfly rash on the face
Where are immune complexes deposited in SLE?
Blood vessels, kidneys, joints. This deposition leads to even more inflammation.
The damaged cells in SLE release what? Forming what?
They release soluble macromolecules forming immune complexes when autoAb’s bind.
What leads to tissue destruction in SLE?
The autoAb’s bind to cell surface components and initiate inflammation that leads to the tissue destruction.
What are some examples of the SLE autoAb’s specificity?
DNA, histones, ribosomes.
SLE is mediated by autoAb’s specific for what?
Many self macromolecules.
Systemic Lupus Erythematosis is what type?
type III
What are the symptoms of MEC?
Purpura, arthralgia, myalgia= Meltzer’s triad.
What causes the immune complex disorder seen in MEC?
The cryoglobulins bound to Fc regions of Ab molecules. Note: cryoglobulins act similar to rheumatoid factor.
MEC often follows what infection?
Hep C
T or F. Cryoglobulins are most often produced by patients that have a B cell proliferative disorder.
T: such as multiple myeloma or Waldenstrom macroglobulinemia.
If the cryoglobulin is only composed of light chains, what name is it given?
Bence Jones Proteins
What is a cryoglobulin?
An Ig that becomes insoluble at reduced temperature
Mixed Essential Cryoglobulinemia is what type?
Type III
What 2 things are responsible for the inflammation seen in SBE?
Phagocytes that recognize opsonized bacteria (IgG and complement) and anaphylatoxins produced as a result of complement cascade activation.
The inflammation in SBE is initiated by Ab’s that bind to Strep viridans that have colonized what?
Damaged heart valves. Note that pt’s that get SBE have withstanding damaged heart valves.
Which Ig mediates SBE?
IgG
Subacute Bacterial Endocarditis is what type?
Type III
What is an alternative treatment to MG?
Pyridostigmine: inhibits acetylcholinesterase longer lived acetylcholine competes better for receptor binding
How do you treat MG?
Anti-inflammatory drugs.
When muscle cells lose receptors, are they less sensitive or more sensitive to neuronal stimulation?
Less sensitive: leads to the severe muscle weakness seen in MG.
The binding of Ab’s in MG results in what? Antagonism or agnoism?
- The binding causes the receptors to be endocytosed and degraded. Antagonism
The Ab’s in MG are specific for what?
- The IgG binds to acetylcholine receptors on muscle cells.
What Ig mediates MG?
IgG
Myasthenia gravis is what type?
Type II