immunology endocrine

Question 2

AUTOIMMUNE THYROID DISEASESsusceptibility genes: HLA-DR3, -DR4 and/or –DR5. CTLA-4CTLA-4 is an off-switch’ for ________CD28: on switchfemale:male ratio Graves’ disease is ___

Answer 2

1. T-cells2. 7:1

Question 3

CTLA-4 is a surface molecule on T-cells which binds CD__ and CD__ on antigen-presenting cells.

Answer 3

1. 80/86. this binding affinity much stronger than CD28

Question 4

Gravespartly due to modulation of theautoimmune response by oestrogens. Thyroid autoimmunity usually subsides during ____, and rebounds __________

Answer 4

pregnancypost-partum.iodine supplementation is alsoassociated with Graves’ disease

Question 5

TYPE I DIABETES –Susceptibility genes : HLA-DQ__Resistance genes : HLA-DQ___

Answer 5

86

Question 6

ADDISON’S DISEASE –Female:Male ratio 4:1Susceptibility genes: HLA-DR3 and/or DR4autoantibodies against the enzyme ______

Answer 6

1. 21-hydroxylase,

Question 7

Pituitary autoimmunityLymphocytic hypophysitis. Can be associated with pituitary hormone deficiency. Rare. Most often occurs in females, usually late in pregnancy or postpartum.

Answer 7

very rare

Question 8

IMMUNE MECHANISMS IN HASHIMOTO’SDISEASE Initiation – activation of naive ___ by antigen-presenting __ whichexpress both MHC class II , CD80 andCD86.

Answer 8

1. T helper cells2. dendritic cells Thyroid cells aberrantly expressing MHC class II can present thyroid antigens, such as the TSH -R, to activated Th-cells (but not to naive Tcells as thyroid lack the necessary costimulatory molecules).

Question 9

immune mechanisms:Activated Th1 cells secrete ___and___ ___ causes thyroid cells to aberrantly express MHC class II Activated Th2 cells secrete IL-6, IL-13 etc to help B cells ________

Answer 9

1. IL-2 and IFN-γ2. IFN-γ3. make (auto)antibodies.Autoantibodies produced by thyroid-infiltrating lymphocytes, with additionalcontributions from lymphocytes in cervical lymph nodes and bone marrow.

Question 10

GRAVES’ OPTHALMOPATHYTSH receptor is expressed on ________• eye symptoms ~ mediated by Tcells ratherthan autoantibodies.• The inflammatory cells release cytokines IL- 1, TNF and IFN-γ –> ____oedemaactivation of fibroblasts ultimately –> fibrosis

Answer 10

1. orbital fibroblasts.2. periorbital3.

Question 11

Type 1 diabetesAutoantibodies to (3):

Answer 11

 Glutamic acid decarboxylase(GAD) Insulinoma-like antigen 2 (IA2) Insulin