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Locomotor Y2 > Immunology of Joint conditions > Flashcards

Immunology of Joint conditions Flashcards

1
Q

Name 2 arthritic conditions which are classed as chronic inflammatory joint conditions

A

Rheumatoid arthritis

Psoriatic arthritis

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2
Q

List 4-5 differences between the innate and adaptive immune system

A

Innate - Evolutionary old
Adaptive - Evolutionary New

Innate- Non- specific
Adaptive- Very specific

Innate- Acts immediately
Adaptive- Late in action

Innate- Does not develop memory
Adaptive- develops memory

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3
Q

List 3 natural barriers to infection, give examples for each

A

Mechanical- Skin
Chemical- stomach acid, lysozyme in tears
Microbiological- Gut microflora

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4
Q

After how many hours does the adaptive immune system kick in?

A

After 96h

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5
Q

How does the innate immune response regonise pathogens?

A

They use Pattern Recognition Receptors (PRRs) recognise Pathogen Associated Molecular patterns (PAMPs) found on the pathogen

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6
Q

List 5 cells associated with innate immunity

and 2 associated with adaptive immunity

A

Natural killer cells
Macrophages/ monocytes
Dendritic cells
Granulocytes (neutrophils)

Adaptive- T and B cells

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7
Q

Which form of immunity, adaptive or innate can recognise the most antigens?

A

Adaptive- millions

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8
Q

Give one example of Pattern Recognition Receptors (PRRs)

A

Toll-like receptors

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9
Q

How many antigens does a lymphocyte recognise?

A

Has 1 type of receptor to recognise 1 type of antigen

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10
Q

What happens when an antigen binds to a lymphocyte?

A

It divides repeatedly
Daughter cells express the same receptor
Large number of useful cells are produced

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11
Q

What is the name of the antigen recognition molecule/ receptor in B cells?

A

immunoglobulins (Ig)

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12
Q

What happens when B cells are activated by an antigen?

A

B cells differentiate into plasma cells – secrete immunglogulin (‘antibody’) with specificity identical to BCR (B cell receptor)

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13
Q

How do B cells develop so many immunglogulin receptor types and T cells develop a diverse amount of T cell receptors ?

A

random gene recombination

in variable region for B cells

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14
Q

How cen B cell and T cell develop autoreactive receptors?

A

The randomness of random gene recombination

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15
Q

Which 3 groups of gene undergo random gene recombination?

A

Variable, Diversity and joining genes

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16
Q

How is auto-reactive cell generation is prevented?

A

immunological tolerance

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17
Q

Name the two types of immunological tolerance and how they differ?

A

Central and peripheral tolerance

Central tolerance- self reactive cells are killed using AIRE plus Pro-apoptotic and signaling molecules

peripheral tolerance-  self reactive cells are killed using 
Growth limiting
mechanisms:
- lack of 2o signal
- Inhibitory signaling
- Treg cells

and

Growth overriding
mechanisms:
- Pro-apoptotic 
signals
- Treg cells
18
Q

Name 4 mediators produced by immune cells which cause inflammation

A

Lipid mediators
Cytokines
Chemokines
Complement

19
Q

Give 3 examples of lipid mediators. What effect do these mediators have?

A

Leukotriens,
PAF, PG

Increased vascular permeability and smooth muscle contraction

20
Q

What effect do cytokines have?

A

Increase vascular permeability,
fever, activate vasc.
endothelium, APP

21
Q

What effect to chemokines have?

A

Attract and activate
phagocytic cells,
V. endothelial cells

22
Q

What effect to Complement

have?

A

Attract/activate
immune cells, increases
v. permeability

23
Q

What causes inflammatory joint conditions?

A

When Immunological tolerance fails

Causing chronic inflammation in the joint

24
Q

State 4 pieces of evidence which indicate that the immune system is responsible for Rheumetoid arthritis

A

1- Patients have auto-Abs in their blood and inflamed joints.

2- Inflamed joints are enriched with immune cells, cytokines and auto-Abs.

3- The immune cells are hyper-active and proliferate continuously.

4- Rheumatoid arthritis is strongly associated with MHC genes.

25
Q

How is MHC central to T cell response and regulation?

A

Determines which peptides are presented to T lymphocytes.

Determines T lymphocyte tolerance in the thymus, i.e. what mature T cells we have in the body.

Also determine if and how mature T lymphocytes respond to antigens
upon encounter.

26
Q

Which 3 factors predispose someone to joint diseases

A

1- Genetics - Familial segregation of JDs.
- Higher concordance of JDs in identical than non identical twins.

2- Environmental- concordance rate of JDs in
homozygotic twins is not 100%.

3- Hormones- females more susceptible

27
Q

Which environmental factors are believed to contribute to joint conditions?

A

Exposure to tobacco (smoking)

Exposure to occupational dust (silica)

Air pollution

High sodium, red meat and iron consumption

Obesity

Low vitamin D intake and levels

28
Q

Which immune cells are mainly responsible for Rheumatoid arthritis?

A

T cells-

Strong association with HLA-DR4.

29
Q

Which other non joint related symptoms can develop in Rheumatoid arthritis

A

Fatigue, malaise and depression

30
Q

Which blood biomarkers are used in the diagnosis of Rheumatoid arthritis

A

Rheumatoid factor (RF) (IgG) and Anti-citrullinated peptide antibodies (ACPAs)

High ESR AND CRP

31
Q

Which diagnostic findings indicate an early, intermediate and late stage of Rheumatoid arthritis

A

Early stage
Soft tissue swelling

Intermediate stage
Mild juxta-articularosteoporosis
Narrowing of joint spaceand bone erosions

Late stage
Large erosions, anatomic deformities

32
Q

Excess production of which cytokine is strongly associated with RA?

A

TNFα

33
Q

What are rheumatoid factors?

A

antibodies that bind to the Fc region of IgG

34
Q

In which diseases can false positive rheumatoid factors be found?

A 
Sarcoid
TB
Leprosy
Infective endocarditis
Pulmonary fibrosis
Liver disease
Syphilis
35
Q

What percentage of people with RA present have rheumatoid factors, which percentage dont?

A

70% have it

30% don’t

36
Q

What are Citrullinated peptides?

A

peptides which have undergone post-translational modification of arginine residues to citrulline

37
Q

Which antibody is most specific for RA?

A

Anti-citrullinated peptide antibodies

- 90%

38
Q

Which genetic risk factor for RA is Anti-citrullinated peptide antibodies associated with?

A

HLA-DR4

39
Q

Where is CRP produced?

A

hepatocytes

40
Q

Which two genes are assocaited with RA?

A

HLA-B27 and HLA-DR4

Locomotor Y2 (8 decks)

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