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NMSK-A II > Immunology > Flashcards

Immunology Flashcards

1
Q

What are the 3 groups of immune mediated diseases which affect the joints?

A

1) Rheumatoid arthritis
2) Juveline arthritis
3) Spondyloarthritis

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2
Q

What is Rheumatoid arthritis?

A

chronic, inflammatory disorder

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3
Q

Which tissues does Rheumatoid arthritis target?

A

1) synovial lining of joints
2) bursae
3) tendon cheaths
4) cartilage
5) bone

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4
Q

What are the characteristic antibodies for Rheumatoid arthritis?

A

1) RF (Rheumatoid factor)

2) ACPA (anti-cyclic citrullinated peptide)

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5
Q

Are males or females more susceptible to Rheumatoid arthritis?

A

females

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6
Q

What is the role of HLA in Rheumatoid arthritis?

A

DR4 subtypes of DRB1 alleles may bind pathogenic epitopes (particualrly thsoe containing citrulline) and alter negative selection in the thymus

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7
Q

What is PTPN22?

A

Protein Tyrosine Phophatase Lyp in RA; active in hematopoetic tissues

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8
Q

What is PADI4?

A

Peptidyl Arginine Deiminase type IV in RA; enzyme whcih converts arganine to citrulline

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9
Q

What is the series of events in the immunobiology of RA?

A
  1. acute initiating events (tissue damaeg)
  2. synovial fibroblasts stimulated by damage
  3. innate immune system activated
  4. stimulation of adaptive immune responsive
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10
Q

Which types of T-cells are activated in the adaptive immunity of RA?

A

CD4+ Th1 and Th17

CD8+

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11
Q

How do Th17 cells enhance inflammation in RA?

A

produce cytokines which suppress Treg cells

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12
Q

Which bacterium are Th17 cells important in providing defense against intracellular bacteria?

A

M. tuberculosis

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13
Q

What is the Rheumatoid factor?

A

IgM anti-IgG with specificity to the Fc region of IgG

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14
Q

What is citrullination?

A

post-translational modification of arganine

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15
Q

What is the purpose of citrullination?

A

HLA-DR4 molecules preferentially bind to citrullinated peptides

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16
Q

What is the anti-cyclic citrullinated peptide (ACPA)?

A

measures IgG antibodies in RA

17
Q

What does a positive ACPA test in early RA predict?

A

more severe disease with development of erosive arthritis sooner

18
Q

What is the role of IL-1 in RA?

A

activates monocytes/macrophages to cause inflammation

19
Q

What is IL-1Ra?

A

IL-1 receptor antagonist; produced constitutively and during inflammation and binds but does not activate IL-1 receptor

20
Q

What is the role of TNF-alpha in RA?

A

inflammation; fever and macrophage activation

21
Q

Which factors do monoclonal antibodies target in RA therapies?

A

1) TNK-alpha
2) IL-6 receptor
3) B cells

22
Q

Which factors do TNF-receptors target in RA therapies?

A

TNF-alpha

23
Q

Which factors do receptor antagonists target in RA therapies?

A

IL-1

24
Q

Which factors do CTLa4-Ig fusion proteins target in RA therapies?

A

CD80/86

25
Q

What is Juvenile Idiopathic Arthritis?

A

chronic arthritis occurring before 16 yo; unknown cause

26
Q

Is there a gender preference in Juvenile Idiopathic Arthritis?

A

NO

27
Q

What is the pathogenesis of Juvenile Idiopathic Arthritis?

A

Th1 mediate inflammation

28
Q

What are the autoantibodies in Juvenile Idiopathic Arthritis?

A

1) RA
2) ACPA
3) ANA

29
Q

What is the synovial inflammation of Juvenile Idiopathic Arthritis?

A

1) mononuclear cells (B, T, macrophages, dendritic cells)

2) T cells (CD4+ Th1)

30
Q

Which cytokines are released in Juvenile Idiopathic Arthritis?

A

1) IL-1
2) IL-6
3) TNF-alpha

31
Q

What is spondyloarthritis?

A

heterogenous group of inflammatory diseases which include spinal and peripheral joint arthritis

32
Q

Why do only a subset of HLA-B27 positive individuals (5%) develop disease?

A

HLA-B27 is a class I HLA molecule . While most individuals with SpA are B27 positive, not all B27 positive individuals develop disease

33
Q

What are the immune abnormalities in SpA?

A

1) increased macrophages/monocytes
2) upregulation of TLR2 and TLR4
3) infiltration of synovium with CD8+ T cells
4) presence of TNF-alpha, IL-1
5) responsive to anti-TNF treatment

34
Q

What serve as targets for immune based therapy?

A

inflammatory cytokines

NMSK-A II (10 decks)

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