Immunology 5 - Autoinflammatory and autoimmune disorders Flashcards
What is the difference between auto-immune and auto-inflammatory diseases?
Auto-inflammatory involves innate immune system
Auto-immune involves adaptive immune system
Which type of cell can produce IL1 and NFkappaB?
Neutrophil
What is the role of cryopyrin in inflammation?
Induces IL1/NFkB secretion by neutrophils
What is the role of pyrin-marenostin in inflammation?
Inhibits IL1/NFkB secretion by neutrophils (reduces inflammation)
FMF involves loss of function mutation in MEFV, which encodes pyrin-marenostrin, thus less inhibition of inflammatory cytokines
What is the inheritance pattern of Familial Mediterannean Fever?
Autosomal recessive
What is the mutation that causes Familial Mediterannean Fever?
MEFV mutation - this is the gene that codes Pyrin-marenostrin (inhibitory of inflammation)
Cryopyrin therefore not opposed
What are the symptoms of Familial Mediterannean Fever?
Periodic fevers of about 2-3 days duration
Pleurisy
Arthritis
Rash
What is the long-term risk of Familial Mediterannean Fever?
AA amyloidosis
What is the treatment for Familial Mediterannean Fever?
Colchicine
This binds tubulin on neutrophils
Autosomal recessive
What is TRAPS?
TNF-Receptor Associated Periodic Syndrome
What is the defect that causes APECED?
AIRE
- -> Defect in T cell tolerance
- -> autoreactive T cells
What does APECED stand for?
Autoimmune PolyEndocrinopathy Cabndidiasis Ectodermal Dystrophy
What is the role of AIRE?
Upregulates expression of self antigen by the thymus to promote T cell apoptosis
What are the symptoms of APECED?
Auto-immune diseases - mostly hypoparathyroidism and Addisson’s, vitiligo
Auto-immune polyendocrinopathy-candidiasis-ectodermal dystrophy
syndrome (APECED)
Aut recessive
Defect in AIRE
What is the pathophysiology of candida susceptibility in APECED?
Auto-antibodies vs IL17 and IL22 are produced, which are interleukins that are important in candida immunity
What does IPEX stand for?
Immune polyendocrinopathy enteropathy X-linked syndrome
What is the mutation that causes IPEX?
FOXP3
What is the usual role of FOXP3?
Required for T reg cell development and function
What is the pathophysiology of IPEX?
FOXP3 mutation –> failure to negatively regulate T cell responses –> lots of autoreactive B cells
X-linked
‘Diarrhoea, diabetes and
dermatitis’
What are the symptoms of IPEX?
Diarrhoea, Diabetes, Dermatitis
What does ALPS stand for?
Autoimmune Lympho Proliferative Syndrome
What mutation causes ALPS?
Fas pathway mutation
What are the symptoms of ALPS?
Defect in lymphocyte apoptosis –> splenomegaly and lymphadenopathy
Autoimmune cytopaenias
Lymphoma
Recall 2 mutations associated with Crohn’s disease
IBD1
NOD2/CARD15
What is the HLA association of ankylosing spondylitis?
HLA-B27