clinical aspects of an autoimmune disease

Question 1

what is the 1st autoimmunity checkpoint

Answer 1

T cells recognise peptides produced by bone marrow Thymus – high affinity to self-antigens removed by negative selection
T -reg cells help to reduce the level of activation of T-effector cells
Autoreactive t cells removed in the thymus

Question 2

what is the second autoimmunity checkpoint

Answer 2

APC will find an antigen and preent on MHC-1
How the dedditic cells come across these self antigens is not always clear , could be in general circulation – could be hidden antigens – intracellular that have been exposed to the immune system – some CD4 positive t cells capable of recognising this self antigen – this is bad as they moint immune response
Check potn 2 – regulatory t cells stimulates CD8 cells to apoptose or die

Question 3

what is check point 3

Answer 3

Dendritic cell CD4 cellls and self antigen bidnign but also need CD28 to bind to CD80
Without this happening apoptosis

Question 4

who is affected by autoimmune conditions more

and what are the exceptions

Answer 4

women

Exceptions are ankylosing spondylitis
Primary sclerosing cholangitis

UC and crohns and Type 1 diabetes are the same both men and women

most diagnosed in early adulthood 18-40

Question 5

HLA DR2

Answer 5

narcolepsy
goodpastures
MS

Question 6

HLA DR3

Answer 6

myasthenia gravis

hashimotos thyroiditis

Question 7

HLA DR4

Answer 7

RA

SLE

Question 8

HLA B27

Answer 8

reactive arthritis
ankylosing spondyltiis
UC

Question 9

di-george syndrome

Answer 9

deletion of chromosome 22- thyme aplasia - thymus normally has role - immunocompromised and at risk of autoimmune conditions

Question 10

drug induced lupus

Answer 10

hydrazine not used anymore of hypertension

procainamide - rhymic drug not used anymore

Question 11

most common autoimmune disease

Answer 11

graves

Question 12

IGA secretion in saliva and tear and breast milk - dimer

what diseases

Answer 12

IgA neuropathy , HSP , coeliac disease

Question 13

IGG – most common, binds to toxins as wel as pathogens , can cross the placenta , rises 14-21 dayas after primary infection , rise 24-48hr during secondary

Ige – least foin d- parasitic , strongly associated ith allergy , atopy and anaphylaxis

Igd – second least common , immune cell signalling , b cell

Igm – pentmaer, acut infection first ,activates classical pathway , useful in diagnosing

what could IGm cause

Answer 13

acute vs chronic diseases

Can clump togyeher and cause problems eg cold autoimmune haemolytic anaemia ( waldenstroms macrogloblinemia
Agglutination in blood transfusions