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Human Diseases > Autoimmunity and immunologically mediated disease > Flashcards

Autoimmunity and immunologically mediated disease Flashcards

1
Q

What are the differences between innate and adaptive immune system?

a) type of response
b) lag time
c) components
d) memory
e) life forms

A

Innate = non-specific, immediate maximal response, cell mediated and humeral components , no immunological memory
found in newly all forms of life
Adaptive = pathogen and antigen specific response, lag time between exposure and maximal response
cell mediated and humeral components
exposure leads to memory
Found only in jawed vertebrates

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2
Q

What is self tolerance?

A

Inherent property that allows response against foreign antigens without attacking self

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3
Q

Which immune system is related to self tolerance?

A

Adaptive

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4
Q

How is tolerance monitored?

A

Checkpoints

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5
Q

What occurs if tolerance is not monitored and goes wrong?

A

Autoimmunity

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6
Q

What are the 2 mechanisms of tolerance?

A

Central and peripheral

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7
Q

What is central tolerance?

A

Induced during development of T cells in thymus

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8
Q

What is peripheral tolerance?

A

Control of auto-reactive cells through non-thymus dependent processes

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9
Q

How does central tolerance develop?

A

In the thymus, autoimmune regulator element (AIRE) is expressed whilst the T cells develop.
This expresses a variety of peripheral tissue antigens.
Recognition of self antigens by immune lymphocyte leads to negative signal causing death or inactivation

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10
Q

Where is peripheral tolerance most commonly found?

A

In immune privileged sites (eye/brain)

Naturally less subject to the immune response

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11
Q

How can tolerance be achieved in the periphery?

A

Anergy - T cell receptors can be engaged without co-stimulation
Regulation - Treg cells can suppress other effector functions and enforce tolerance

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12
Q

Failure to develop tolerance means T cells and antibodies are directed against self-antigens what is the result of this?

A

Tissue damage and altered physiological function.

Tissue damage causes released of more self-antigen = more reaction

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13
Q

Why does autoimmune disease tend to be active for a very long time?

A

Autoantigens are very difficult to clear

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14
Q

Why are older adults more at risk of autoimmunity?

A

Smaller thymus with fewer functional lymphocytes

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15
Q

What are the consequences of autoimmunity over time?

A

Increased incidence of infection

Higher levels of autoimmunity (increased T cells for self antigens)

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16
Q

What can cause autoimmune disease?

A

Genetic factors

Infection and environment

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17
Q

How can genetics effect autoimmunity?

A

Affect availability and clearance of auto antigen

Affect expression of co-stimualtory molecules

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18
Q

Why is it suggested that genetic and environmental factors are reacquired to cause autoimmunity?

A

Many people with genetic factors predisposing them never get the disease

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19
Q

How can autoimmune disease be classified? Why is this imprecise?

A

By nature of immune response e.g. antibody mediated (type II, III), T cell mediated (type IV)
Imprecise because the immune response is interlinked - problems with antibody production linked to T cells

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20
Q

What is a type II autoimmune response?

A

Antibody against cell surface antigens

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21
Q

What is a type III autoimmune response?

A

Antibody complex against circulating antigen

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22
Q

Name a type III autoimmune disease?

A

Rheumatoid arthritis

23
Q

Name a type II autoimmune disease?

A

Autoimmune haemolytic anaemia, pemphigus vulgaris

24
Q

What is a type IV autoimmune response?

A

T-cell mediated

25
Q

Name a type IV autoimmune disease?

A

Type I diabetes (insulin dependent)

26
Q

Other than by nature of immune response how can autoimmunity be classified? What are the problems with this?

A

Organ specific or systemic
e.g. type I DM is organ specific, Rheumatoid arthritis is systemic

Not all autoimmune disease can be classified this way e.g. autoimmune haemolytic anaemia can occur in isolation or in association with SLE (lupus)

27
Q

Autoimmune diseases of the endocrine system can affect glands in what 4 ways?

A

Destruction
Cellular infiltration
Uncontrolled stimualtion
Blockade of stimulation

28
Q

What is Addisons disease?

A

Autoimmune disease caused by adrenal insufficiency

29
Q

What are the consequences of Addisons disease?

A

Fatigue, depression, collapse, increased pigmentation of skin folds and buccal mucosa, other endocrine diseases accompany

30
Q

What causes T1DM?

A

Immunological destruction of pancreatic islets of Langerhans by T cells

31
Q

How can T1DM affect dentists?

A

Cause candida, dry mouth, dialysis, severe periodontitis may upset glycemic control

32
Q

How can autoimmune disease affect the thyroid?

A

Thyroid disease e.g. hypothyroidism, hyperthyroidism

33
Q

What are the symptoms of hypothyroidism?

A

weight gain, hypothermia, dry skin, anaemia

34
Q

How can hypothyroidism affect dental care?

A

Analgesics and GA can cause coma

35
Q

What are the symptoms of hyperthyroidism?

A

Weight loss, anorexia, diarrhoea, sweating, exopthalamus (protruding eyes)

36
Q

Carbimazole is used to treat hyperthyroidism, what are the effects of this?

A

Can cause agranulocytosis which can cause oral and oropharyngeal ulceration

37
Q

Are typhoid disease, T1DM and Addisons disease endocrine or non-endocrine disease?

A

Endocrine

38
Q

What is coeliac disease?

A

Sensitivity to gluten causing activation if immunological mechanisms leading to small intestinal damage (enteropathy)

39
Q

How does coeliac disease effect the small intestine?

A

Loss of villi
Crypt hyperplasia
Chronic inflammatory infiltrate

40
Q

What are the clinical features of coeliac disease?

A

Low energy, diarrhoea, oedema, anaemia

41
Q

How is coeliac disease managed?

A

Strict gluten free diet

42
Q

Name 3 autoimmune haematological disease

A

Autoimmune haemolytic anaemia
Autoimmune neutropenia
Autoimmune thrombocytopenia purpura

43
Q

What is associated with autoimmune neutropenia?

A

Oral ulceration

44
Q

How can the skin be affected by autoimmune disease?

A

Bullous pemphigoid, pemphigus vulgaris

45
Q

Goodpastures syndrome is an autoimmune disease of the kidney, what kind of reaction is this?

A

Type II hypersensitivity

46
Q

What is the risk of autoimmune kidney disease?

A

Can progress to chronic renal failure = bleeding tendencies, impaired drug excretion, hypertension, anaemia

47
Q

What is the difference in symptoms between organ and non-specific organ autoimmune disease?

A

Symptoms are more widespread and non-specific

48
Q

Name some extra-articular manifestations of rheumatoid arthritis?

A

Nodules, GI problems, Sjogrens syndrome

49
Q

Name 2 systemic autoimmune diseases?

A

Rheumatoid arthritis

SLE (lupus)

50
Q

How can SLE effect dental treatment?

A

Anaemia, bleeding, predisposition to thrombosis, drug reactions e.g. tetracylines

51
Q

How does Sjogrens syndrome present, what is it associated with?

A

Dry eyes, dry mouth, associated with arthritis

52
Q

How should non-organ specific autoimmune disease be treated?

A

Anti-inflammatories
Steroids
Immunosuppressants
Monoclonal antibodies

53
Q

What are the side-effects of immunosuppressants?

A

Poor wound healing
Increased risk of infection
oral candidiasis

Human Diseases (37 decks)

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