Endocrine Autoimmunity

Question 1

autoimmune disease involves an..

Answer 1

immune response of attack against a host organ

Question 2

what does epidemiology suggest about autoimmune diseases?

Answer 2

that 2.5 in 30 people in the world suffer from some type of autoimmune dz, 3-4% of the population in some countries

Question 3

what are examples of autoimmune diseases?

Answer 3

Addison’s disease,
Graves disease, type 1 diabetes, Hashimoto thyroiditis.

Question 4

what type of antibodies does Grave’s dz have to the TSH receptor?

Answer 4

agonist antibody

Question 5

what type of antibodies does Hashimoto’s dz have to the TSH receptor?

Answer 5

antagonist antibody

Question 6

many _____ organs are sensitive to _____

Answer 6

endocrine, autoimmune attack

Question 7

what organs are including in being sensitive to autoimmune attacks?

Answer 7

the adrenals, gonads,
pancreas, pituitary and thyroid

Question 8

what is a key feature of a healthy immune system?

Answer 8

the establishment and maintenance of immunologic tolerance to ‘self’

Question 9

T cells express…

Answer 9

T cell receptors

Question 10

B cells produce…

Answer 10

receptors and antibodies

Question 11

why is the diversity of recognition possibilities for T and B cell receptors not limited by the linear genome?

Answer 11

because they can rearrange their DNA during development to a wide range of recognition

Question 12

what is the estimated recognition diversity?

Answer 12

10^15

Question 13

how are potentially dangerous T and B cells eliminated?

Answer 13

they have self reactive receptors that are eliminated by negative selection in the thymus and bone marrow respectively

Question 14

the breakdown of ____ is a _____ in the development of autoimmune dz’s

Answer 14

self-tolerance, central pathogenic step

Question 15

what could be possible disruptors of self tolerance?

Answer 15

1. defects in apoptosis-related death receptor molecules of both central and peripheral T-cells
2. defects of T and B cell internal apoptosis mechanisms
3. defects of active suppression of T cells by specialized suppressive T cells
4. defects in B cell tolerance to self (host)
5. hypocortisolism (low cortisol production) may underlie pathology of diseases characterized by increased autoimmunity, inflammation, pain, fatigue, asthma or allergies

Question 16

environmental factors thought to have the greatest influence on disease development are…

Answer 16

1. infectious agents
2. diet
3. toxins

Question 17

in type 1 diabetes, what is the strongest environmental factors?

Answer 17

viruses

Question 18

what are examples of viruses associated with the development of type 1 diabetes?

Answer 18

HEV, rotavirus, mumps virus, rubella virus and cytomegalovirus

Question 19

up to ____ of children prenatally infected with ____ develop type 1 diabetes

Answer 19

20%, rubella

Question 20

why do children with rubella develop type 1 diabetes?

Answer 20

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

Question 21

children with rubella also have…

Answer 21

an increased incidence of other autoimmune disorders

Question 22

what does addison’s disease develops as an attack on?

Answer 22

adrenal cortex

Question 23

using…. studies have reported what with addison’s disease?

Answer 23

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

Question 24

in certain types of addison’s disease, what antibodies appear to be predictive in children and adults?

Answer 24

21α-hydroxylase

Question 25

there is a _________between the circadian rhythms of cortisol and the absolute numbers of total lymphocytes (back), CD3+ cells, CD4+ cells, and CD8+ cells

Answer 25

temporal relationship