CSIM - 1.57 - Autoimmunity 1

Question 1

In basic terms how do auto-immune diseases arise?

Answer 1

Breakdown in tolerance

Question 2

Where and how does central T-cell tolerance take place?

Answer 2

Thymus

Tissue specific Ag (AIRE genes) are tested with the maturing T-cells, if any react they are subsequently apoptosed

Question 3

What can having auto-antibody against IgG lead to?

Answer 3

Rheumatoid factor

Question 4

Which sites within the body are immune privileged?

Answer 4

Brain
Eyes
Testes
Uterus

Question 5

Which sequestered Ag do not have central tolerance checked against them?

Answer 5

DNA
Sperm
Eyes

Question 6

What type of cell is diabetes dependent upon?

Answer 6

T-helper cells

Question 7

What type of cell is psoriasis dependent upon?

Answer 7

Th17 cells

Question 8

Name the islets of Langerhan and their secretions?

Answer 8

alpha-cell - Glucagon
Beta-cell - Insulin
delta cell - Somatostatin

Question 9

Describe how type 1 diabetes occurs?

Answer 9

Effector T-cells recognises peptides on Beta islets of Langerhan and kills the Beta-cell
No insulin is therefore made

Question 10

Name the two types of T-regulatory cells and describe their functions?

Answer 10

Natural T-reg cell - secretes FOXP3 which inhibits self-Ag T-cells
Induced T-reg - peripheral tissues recognises Ag on immature dendritic cells

Question 11

Which cytokine defects may give arise to SLE?

Answer 11

Over-expression of IFN-Y

Under-expression of TNF-a

Question 12

AIRE gene deficiency may lead to which condition?

Answer 12

Chronic mucocutaneous cadadidiasis

Question 13

What is IPEX syndrome?

Answer 13

FOXP3 (natural T-reg) mutation leading to severe GI disease

Question 14

What is ALP syndrome?

Answer 14

FAS and FAS-L mutations - important in signalling apoptosis leading to huge lymphadenopathy

Question 15

A mutation of the MHC gene - HLA-B27 leads to which condition(s)?

Answer 15

Ankylosing spondylitis

Acute anterior uveitis

Question 16

A mutation of the MHC gene - HLA-DR2 leads to which condition(s)?

Answer 16

Multiple sclerosis

Goodpasture’s syndrome

Question 17

A mutation of the MHC gene - HLA-DR3 leads to which condition(s)?

Answer 17

Grave’s disease
Myesthenia gravis
SLE
Type 1 diabetes

Question 18

A mutation of the MHC gene - HLA-DR4 leads to which condition(s)?

Answer 18

Rheumatoid arthritis

Pephigus vulgaris

Question 19

A mutation of the MHC gene - HLA-DR5leads to which condition(s)?

Answer 19

Hashimoto’s thyroiditis

Question 20

Describe Crohn’s disease?

Answer 20

Inflammed bowel from an over-responsiveness to normal gut flora by abnormal Th1 and Th17 cells

Question 21

Which hypersensitivity reaction gives arise to haemolytic anaemia?

Answer 21

Type 2 - antibody (IgG) against cell surface/matrix

Question 22

Which hypersensitivity reaction gives arise to type.1 diabetes/multiple sclerosis/Chron’s disease?

Answer 22

Type 4 - cell mediated

Question 23

Which hypersensitivity reaction gives arise to rheumatoid arthritis?

Answer 23

Type 3 - IgG immune complexes (activating complement)

Question 24

Name 5 organ SPECIFIC autoimmune diseases?

Answer 24

Type 1 diabetes
Good Pasture's syndrome
Multiple sclerosis
Chron's disease
Grave's disease

Question 25

Name 4 SYSTEMIC autoimmune diseases?

Answer 25

Rheumatoid arthritis
Scleroderma
SLE
Primary Sjogren’s syndrome