Endocrine Autoimmunity Flashcards
autoimmune disease involves an..
immune response of attack against a host organ
what does epidemiology suggest about autoimmune diseases?
that 2.5 in 30 people in the world suffer from some type of autoimmune dz, 3-4% of the population in some countries
what are examples of autoimmune diseases?
Addison’s disease,
Graves disease, type 1 diabetes, Hashimoto thyroiditis.
what type of antibodies does Grave’s dz have to the TSH receptor?
agonist antibody
what type of antibodies does Hashimoto’s dz have to the TSH receptor?
antagonist antibody
many _____ organs are sensitive to _____
endocrine, autoimmune attack
what organs are including in being sensitive to autoimmune attacks?
the adrenals, gonads,
pancreas, pituitary and thyroid
what is a key feature of a healthy immune system?
the establishment and maintenance of immunologic tolerance to ‘self’
T cells express…
T cell receptors
B cells produce…
receptors and antibodies
why is the diversity of recognition possibilities for T and B cell receptors not limited by the linear genome?
because they can rearrange their DNA during development to a wide range of recognition
what is the estimated recognition diversity?
10^15
how are potentially dangerous T and B cells eliminated?
they have self reactive receptors that are eliminated by negative selection in the thymus and bone marrow respectively
the breakdown of ____ is a _____ in the development of autoimmune dz’s
self-tolerance, central pathogenic step
what could be possible disruptors of self tolerance?
- defects in apoptosis-related death receptor molecules of both central and peripheral T-cells
- defects of T and B cell internal apoptosis mechanisms
- defects of active suppression of T cells by specialized suppressive T cells
- defects in B cell tolerance to self (host)
- hypocortisolism (low cortisol production) may underlie pathology of diseases characterized by increased autoimmunity, inflammation, pain, fatigue, asthma or allergies
environmental factors thought to have the greatest influence on disease development are…
- infectious agents
- diet
- toxins
in type 1 diabetes, what is the strongest environmental factors?
viruses
what are examples of viruses associated with the development of type 1 diabetes?
HEV, rotavirus, mumps virus, rubella virus and cytomegalovirus
up to ____ of children prenatally infected with ____ develop type 1 diabetes
20%, rubella
why do children with rubella develop type 1 diabetes?
due to development of antibodies against proteins in the β-cells of the pancreas that share a similar molecular architecture to rubella viral proteins and thus autoimmune Type 1 Diabetes
children with rubella also have…
an increased incidence of other autoimmune disorders
what does addison’s disease develops as an attack on?
adrenal cortex
using…. studies have reported what with addison’s disease?
using sensitive assays based on the immune precipitation of radiolabeled recombinant 21α hydroxylase, studies have reported positive tests for 72% of sera from patients with Addison’s disease
in certain types of addison’s disease, what antibodies appear to be predictive in children and adults?
21α-hydroxylase
there is a _________between the circadian rhythms of cortisol and the absolute numbers of total lymphocytes (back), CD3+ cells, CD4+ cells, and CD8+ cells
temporal relationship