Autoimmunity and Immunosuppressives Flashcards
What is immune tolerance?
Unresponsiveness to self antigens
What is negative selection?
Self-reactive T-cell dies before it can become functionally competent
What cells are CTLA4 inhibitory receptors expressed on?
Expressed transiently on CD4+ T cells and constitutively on Treg cells
Where and when is PD-1 expressed?
on CD8+ AND CD4+ T cells after antigen stimulation
Upon phosphorylation of the PD-1 receptor what happens?
Tyrosines bind a tyrosine phosphatase that inhibits kinase-dependent activating signals from CD28 and the TCR complex
Which cytokine is the survival and function of T regs dependent on?
IL-2
What happens when B cells recognise a protein antigen but do not receive T cell help?
B cells become anergic because of a block in signalling from the antigen receptor
What are the autoantibody diagnosis?
- Antibodies to cyclic citrullinated peptides-RA diagnosis
- Anti-dsDNA antibodies-high specific for SLE
- Anti-Sm antibodies-highly specific for SLE in afro-caribbean populations
What are the prognosis for autoantibodies?
- Cyclic citrullinated peptides - poor prognosis and predictive of erosive RA disease
- Anti-dsDNA-disease activity in SLE, accompanied by falling complement levels
- Anti-cardiolipin antibodies and anti B2-glycoprotein 1 antibodies with thrombosis and miscarriage
- Anti-dsDNA antibodies with glomerulonephritis
How is pernicious anaemia metabolically corrected?
Injection of vitamin B12
How is myasthenia pharmacologically treated?
Cholinesterase inhibitors
Name some immunosuppressives.
- Corticosteroids (prednisone)
- Mycophenolate mofetil
- Cyclophosphamide and azathioprine (cytotoxic agents)
Name some bioloigics for the treatment of RA.
- Infliximab
- Etanercept
- Slituximab
- Tocilizumab
- Abatatcept
- Baricitinib
Which signalling pathway does baricitinib inhibit?
Selective small molecule reversible inhibitor of Janus kinase (JAK)1 and JAK2 intracellular signalling pathways
Where does rituixmab bind?
Binds to CD20 on B cells
