IM4: Immunity & Oral Diseases

Question 1

What is the most common site for mouth cancers?

Answer 1

Tongue

Question 2

Explain how the immune system can have an anti tumour effect during cancer development

Answer 2

When tumours start to grown T and B cells are activated which trigger many responses by the immune system. T cell mediated cytotoxicity begins to stop tumour growth

Question 3

Explain how the immune system can have an pro tumour effect during cancer development

Answer 3

The innate immune response will inhibit cell death and Macrophages will differentiate into M2 macrophages that promote tumour growth

Question 4

Sjögren’s Syndrome;

What is it?
Prevalence?
Cause?

Answer 4

• Autoimmune condition that affects moisture producing glands
• 40-60 Years, more common in women
• Exact cause is unclear, but believed to be mix of genetic background and infection which triggers autoimmunity

Question 5

Sjögren’s Syndrome autoimmune mechanism

Answer 5

• Virus infects epithelial and dendritic cells
• These cells then produce compounds such as autoantigens, IFN-α and IFN-b
• This activates BAFF
• Which stimulates B cell production

Question 6

What are Ectopic lymphoid structures?

Answer 6

• Cell aggregates that resemble lymph nodes
• Often develop at sites of inflammation in target tissues of autoimmune diseases
• The more ELS the more severe the autoimmune disease

Question 7

Behçet’s Disease;

What is it?
Cause?

Answer 7

• Rare autoimmune disorder that causes blood vessel inflammation throughout the body
• Expression of HLA-B51

Question 8

What are the most common signs and symptoms of Behçet’s Disease? (5)

Answer 8

• Eye inflammation
• Mouth sores
• Skin sores
• Gentital sores
• Joint pain and swelling

Question 9

What is Oral lichen planus?

Answer 9

Chronic inflammatory condition that affects mucosal membranes in the mouth.

Question 10

Describe the lesions created by Oral lichen planus

Answer 10

• White lacy patches
• Red swollen tissues
• Cause burning, pain or other discomfort

Question 11

What is the mechanism for oral lichen planus? (3)

Answer 11

• Infected keratinocytes produce IL-23
• This induces TH17 cells to secrete IL-17
• IL-17 attacks keratinocytes

Question 12

What is Pemphigus vulgaris?

Answer 12

• Chronic inflammatory skin disease. Most commonly presents with oral blisters due to acantholysis
• Recognised as an autoimmune disorder in which antibodies are formed against desmosomes

Question 13

What is acantholysis?

Answer 13

As desmosomes are attacked, the layers of skin separate and the clinical picture resembles a blister

Question 14

How do you treat Pemphigus vulgaris?

Answer 14

• Rituximab

Question 15

What is Rituximab?

Answer 15

A recombinant antibody that targets CD20 (marker expressed by B cells)