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I&I SC2 > Immuno-endocrinology > Flashcards

Immuno-endocrinology Flashcards

Thymus, thyroid and bone

1
Q

The thymus declines in time. How many percent remains and can enlarge again?

A

10%, can enlarge again

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2
Q

What happens with the feedback system when testosterone levels are very high?

A

Suppression of pituitary stimulating hormones

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3
Q

Name an example of a hormone that is produced by the thymus

A

LH

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4
Q

Why do you need your thymus for selection?

A

Selection between self- and non-self

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5
Q

You have to get rid of more then 90% of your lymphocytes, why? (2)

A
  • Autoreactivity
  • Bind with too much affinity to their receptor
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6
Q

How do you call an autoimmune disease in which the endocrine system is involved?

A

Polyendocrine autoimmune disease

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7
Q

Name and autoimmune disease in which a genetic defect affects the thymic function

A

Polyglandular autoimmune syndrome

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8
Q

In what process in substance P involved?

A

Pain

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9
Q

In which diseases does substance P play a role? (5)

A
  • Migraine
  • Chronic obstructive lung disease
  • Arthritis
  • Cystitis
  • IBD
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10
Q

What does the ‘P’ in substance P stand for?

A

Powder

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11
Q

Substance P is produced by?

A

Neurones

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12
Q

What is the advantage of radio labeling substance P?

A

When the peptide goes to search for its receptor and finds it, accumulation of radioactivity happens which can be imaged

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13
Q

Name an example of connection between your neural- and immune system

A

Radiolabeled substance P that is released by neurons bind to receptors in the thymus

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14
Q

What is the function of somatostatin?

A

Excites brain, but inhibits the release of hormones

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15
Q

What is special about the receptors for somatostatin and cortistatin?

A

They are also expressed in the immune system (Thymus, and often spleen)

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16
Q

What happens to the receptors for neuropeptides during the development from stem cell to effector cell in the thymus?

A

They change

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17
Q

Name and example of immune cell type that can be stimulated by neuropeptides

A

Thymocytes

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18
Q

Which kind of dysregulations are associated with an enlarged thymus (thymoma)? (2)

A
  • Immune dysregulation (including humoral and cellular immunodeficiency and autoimmune disease)
  • Endocrine dysregulation
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19
Q

Which three categories of thymoma’s occur in humans?

A
  • Lymphocytic
  • Epithelial
  • Mixed
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20
Q

Which catagory of thymoma occurs the most in humans?

A

Mixed

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21
Q

Which genetic defect is causing polyglandular autoimmune syndrome?

A

Autoimmune regulator (AIRE) deficiency

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22
Q

What can cause enlargement of the thymus during autoimmune disease?

A

Stimulation of the thymus by (for example) overproduction of thyroid hormones

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23
Q

Grave’s disease stimulates/inhibits your thyroid?

A

Stimulates

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24
Q

What is good syndrome?

A

Rare association of thymoma/increased thymus and immunodeficiency (immune dysregulation syndrome)

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25
Immune dysregulation consists of.. (4)
- Immune deficiency - Auto immunity - Allergy - Auto-inflammation
26
Name clinical manifestations in Good's syndrome (4)
- Thymoma - Infections - GI disease - Autoimmune disease
27
The principal immunological findings in Good's syndrome are... (6)
- Hypogammaglobulinemia - Few or absent B cells - Abnormal CD4:CD8 ratio - CD4 T cell lymphopenia - Impaired T cell mitogenic response - Cutaneous anergy
28
During T cell development in the thymus, the receptor of which hormone is expressed?
Thyroid stimulating hormone (TSH)
29
What is the function of TSH in T cell development?
TSH stimulates T cell development --> more differentiation
30
Which syndrome occurs when you have too much growth hormone?
Acromegaly
31
Describe the link between thymectomy and Ulcerative Colitis
After thymectomy, the percentage of patients in remission increases
32
What causes autoimmune disease?
Loss of tolerance
33
Which two categories of autoimmune diseases exist?
- Systemic - Organ specific
34
Name examples of systemic autoimmune diseases (3)
- Systemic lupus erythematosus (SLE) - Rheumatoid arthritis (RA) - Systemic sclerosis
35
Name examples of organ specific autoimmune diseases (3)
- Diabetes mellitus type 1 - Autoimmune hepatitis - Autoimmune thyroid disease
36
What are the most common clinical expressions of autoimmune thyroid dysfunction? (2)
- Hashimoto's thyroiditis (HT) - Graves' disease
37
Which three structures can be found in healthy thyroid tissue?
- Thyroid follicle - Colloid - Follicular cells
38
Of what does a follicle consist?
Colloid + surrounding follicular cells
39
What is the function of the colloid?
40
What is the function of the thyroid hormone T4?
Regulates a.o. metabolism, mood, and body temperature
41
What is the function of the thyroid hormone T3?
Regulates metabolism, digestive tract, and bone health
42
How is the thyroid hormone regulated?
THR (hypothalamus) --> TSH (pituitary) --> T4 (thyroid) --> inhibits production of THR and TSH
43
What is the immunopathophysiology of Hashimoto?
- Massive T/B-lymphocyte and NK cell infiltrate - Locally activated Tg-specific T-lymphocytes - Autoantibodies to Tg and TPO - Immune cells cause damage to thyroid tissue
44
Which immune cells play a role in Hashimoto? (3)
- Auto-reactive CD4+/CD8+ T cells - Macrophages induce damage to thyrocytes - NK cells
45
What is the immunopathophysiology of Graves' disease? (4)
- Limited immune cell (T lymphocyte) infiltrate - Locally activated TSH receptor specific T-lymphocytes - Stimulating autoantibodies against TSHR - Limited thyroid destruction
46
What is thyroglobulin (Tg)? What do you see during immunofluorescence?
Precursor protein for thyroid hormone -> thyroid follicles completely green
47
What is thyroid peroxidase (TPO)? What do you see during immunofluorescence?
Enzyme involved in iodination of Tg -> thyroid follicular cells light up green
48
To what are stimulating autoantibodies directed in GD? Causes what?
TSH-receptor (TSHR), stimulates production of thyroid hormone
49
How does antibody dependent cell mediated cytotoxicity work with respect to the thyroid? (4)
- Antibodies bind antigens on thyroid cells - Fc receptors on NK cells recognize the antibodies - Crosslinking of Fc receptors leads to NK cell activation - Thyroid cells die by apoptosis
50
Hashimoto is hyper/hypo thyroid
Hypothyroid
51
Graves' disease is hyper/hypothyroid
Hyperthyroid
52
How do you diagnose a HT patient?
- Very high levels of TPO Ab (correlate with amount of tissue damage) - Very low TSHr Ab (esp blocking) - T4, T3 go down - TSH goes up
53
How do you diagnose a GD patient?
- Almost 100% of patients has TSHr Ab (esp stimulation) - T4, T3 go up - TSH goes down
54
A patient with HT can present with hyperthyroidism (instead of hypo), why would that be?
Destruction of the follicles --> thyroid hormone is released into the system
55
What are environmental risk factors for thyroid disease? (4)
- Dietary iodine intake - Smoking - Infection - Stressful live events
56
What are susceptibility genes for GD? (2)
- HLA-DR3 - CD40
57
What are susceptibility genes for HT?
- CTLA-4 - PTPN22
58
What are the three factors of the multifactorial pathogenesis of autoimmune thyroid disease?
- Cellular interactions - Genetic factors - Environmental factors
58
How does neonatal GD come to be?
Transplacental transport of maternal IgG in the third trimester
59
Why is neonatal GD self limiting?
Maternal antibodies are broken down after birth
60
What happens in Graves' Ophthalmopathy? (2)
- Extraocular muscle enlargement - AND/OR orbital tissue/fat expansion
61
What is the immune mechanism of Graves' Ophthalmopathy?
Orbital fat: fibroblasts that express the TSHr become activated by stimulatory autoantibodies Result: Production of cytokines AND proliferation of fibroblasts/production of connective tissue components
62
Which signaling pathway is also activated in patients with Graves' Ophthalmopathy?
Stimulatory autoantibodies against the TSHr also activate indirectly IGF-1R signaling --> promotes cell proliferation, growth and survival
63
Which type of bone cells are there? (4)
- Osteoclasts - Osteoblasts - Osteocytes - Bone marrow cells
64
What is the function of osteoclasts?
Dissolve and break down old or damaged bone cells
65
What is the function of osteoblasts?
Form new bones and add growth to existing bone tissue
66
What is the function of osteocytes?
Involved in the perseverance of the bony matrix
67
What is the function of bone marrow cells?
BM releases blood cells into the bloodstream when they are mature and when required
68
Which types of bone marrow cells exist? (2)
- Mesenchymal stem cells - Hematopoietic stem cells
69
Functions of the skeletal system (5)
- Support/movement - Protection of organs - Blood formation - Calcium/phosphate balance - Source of growth factors
70
What's the function of the calcium/phosphate balance as main mineral reservoir?
Stores calcium phosphate and releases them according to the body's physiological needs
71
Describe the differentiation of osteoblast lineage cells
Mesenchymal progenitors --> pre-osteoblast --> mature osteoblast --> osteocytes
72
Which cells are marked by Sox9?
All osteoblast progenitors
73

I&I SC2 (13 decks)

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