Immunology of the endocrine system

Question 1

What gender is most autoimmune conditions more common in

Answer 1

Females

Question 2

What are tolerogens

Answer 2

Antigens that induce tolerance

Question 3

What is immunological tolerance

Answer 3

Unresponsiveness to an antigen that is induced by previous exposure to that antigen

Question 4

What is self-tolerance

Answer 4

The bodies tolerance to self antigens

Question 5

What is an autoimmune disease

Answer 5

Failure of self tolerance

Question 6

What happens to B and T lymphocytes that have a high affinity receptor for self antigens

Answer 6

They are killed because the body does not want an autoimmune confition

Question 7

What cells maintain peripheral tolerance and how do they do it

Answer 7

Tregs - T regulatory cells that suppress the activation of lymphocytes which are specific for self-antigens

Question 8

What can cause peripheral tolerance to be overcome

Answer 8

Injury or another event that leads T cells finding the self-antigens
Increased expression of co-stimulatory molecules
Changes in the way the self molecules present to the immune system

Question 9

What is the function of HLA - human leukocyte antigens

Answer 9

codes for proteins that help differentiate between self and non-self

Question 10

What can cause autoimmune diseases

Answer 10

Environmental factors
infection
drugs
UV radiation

Question 11

How do infections and drugs cause autoimmune disease

Answer 11

Molecular mimicry - makes proteins that looks like self proteins which might make the autoimmune attack the self antigens

Question 12

What is the treatment plan of autoimmune diseases

Answer 12

Supress the damaging immune response and replace the functions of the damaged organ

Question 13

What does beta islet of langerhan secrete

Answer 13

insulin

Question 14

What does alpha islets of langerhan secrete

Answer 14

glucagon

Question 15

What does delta islets of langerhan secrete

Answer 15

somatostatin

Question 16

Describe type one diabetes

Answer 16

Inadequate insulin secretion due to destruction of beta cells
Can cause ketoacidosis

Question 17

Describe type 2 diabetes

Answer 17

More common
Normal or increased insulin secretion
Reduced number of cell surface receptors for insulin

Question 18

What genetic factors is type one diabetes associated with

Answer 18

Certain HLA types - human leukocyte antigen - helps differentiate between self and non self

Question 19

What are the complications of diabetes

Answer 19

Large blood vessels - accelerated thrombosis and associated complications - myocardial infarction

Small blood vessels - endothelial and basal lamina damage e.g retinopathy and nephropathy

Question 20

Describe the thyroid gland

Answer 20

Follicle cells lined by cuboidal cells which contain colloid in them - thyroid gland synthesises T3 and T4

C-cells of the thyroid gland secrete calcitonin

Question 21

What is the most common cause of hyperthyroidism

Answer 21

Grave’s disease

Question 22

How does Grave’s disease work

Answer 22

Has autoantibody IgG and long acting thyroid stimulator (LATS) which bind to the thyroid epithelial cells and mimic TSH

Question 23

What are common signs seen in graves thyroiditis

Answer 23

Exophthalmos, pretibial myxoedema and clubbing

Question 24

What is the most common cause of hypothyroidism

Answer 24

Hashimotos thyroiditis

Question 25

What occurs when hypothyroidism is in a new-born

Answer 25

Physical and mental growth are impaired (cretinism)

Question 26

What does autoimmune polyendocrine syndromes cause

Answer 26

functional impairment of multiple endocrine glands

Question 27

What is autoimmune polyendocrine syndrome 1

Answer 27

Autosomal recessive disorder characterised by mutations in the autoimmune regulator gene (AIRE)

Question 28

What is the function of the autoimmune regulator gene

Answer 28

AIRE - leads to negative selection - kills and B cells that have high affinity for self antigens

Question 29

What are the clinical features autoimmune polyendocrine syndrome 1

Answer 29

Chronic mucocutaneous candidiasis
Hypoparathyroidism
Addison’s disease (primary adrenal insufficiency)
Hypoplasia of enamel (small teeth)
Enteropathy - damage to small intestine which chronic diarrhoea or constipation

Question 30

What endocrine conditions are present in autoimmune polyendocrine syndrome 2

Answer 30

Type one diabetes
Autoimmune thyroid disease
Addisons disease
(Needs 2 at least to have polyendocrine syndrome 2)