Immunopathology Type 2, Autoimmunity Flashcards
What are the treatments of Dressler Syndrome?
anti-inflammatory agents
What is rheumatoid factor (RF)?
IgM anti-IgG in RA
People with SLE can make autoantibodies to _____, ____, ____, _____, _____, _____, _____, and _____.
nuclear proteins, DNA, RNA, RBCs, clotting factors, platelets, skin, T cells
When can passive antibodies cause diseases?
- hemolytic disease of the newborn 2. mismatched transfusions 3. children of mothers with myasthenia gravis or SLE
Who gets Autoimmune Hemolytic Anemia (AIHA)?
pts who recently had a viral infection; have a different autoimmune disease; hx of cancer
How does the immunofluorescence appear in Goodpasture Syndrome cells?
sharp, linear
What are the s/s of Goodpasture Syndrome?
persistent glomerularnephritis, pneumonitis, pulmonary hemmorhages
What is Dressler Syndrome?
autoantibodies to the heart post MI or heart surgery
Platelets are phagocytosed via _____ damage in autoimmune thrombocytopenic purpura.
complement-mediated
What is Goodpasture Syndrome?
autoantibodies to lung and kidney BM
What is chronic beryllium disease (CBD)?
an allergic response and lung disease due to beryllium exposure/poisoning
What is a good diagnostic marker in Celiac disease?
antibody to tissue transglutaminase
What causes Rheumatic Heart Disease?
a cross reaction of group A strep M-protein antigen and laminin on heart valves, followed by neutrophil-mediated tissue destruction
SLE is much more common in ____, pointing to an ____ effect.
females; Estrogen
Dressler Syndrome is seen in _____.
patients who had a MI or heart surgery
If you have a sample of the patient’s tissue, you can use the _____ test for autoimmunity.
direct
What is the treatment for inappropriate tachycardia?
a beta blocker (propranolol)
What is a sequestered antigen?
antigens that cannot get into the system until an immune response is started in another way
What is stimulatory hypersensitivity?
autoantibody to receptor activates it (agonist)
What is the hallmark test for autoimmunity?
immunofluorescence
What is Aire?
a thymic transcription factor
What is an innocent bystander?
normal tissue that is damaged because it’s near or associated with antigen
Name a physical sign characteristic of SLE.
facial butterfly rash
RA is linked to the gene _____.
PADI4
How does complement-mediated damage harm tissue?
lysis, phagocytosis, lysosomal enzymes and ROS
Why do disease states persist, even when the initial antigen is long gone?
autoimmune responses to normally sequestered antigens released from damaged cells
Lysis of ____ occurs in autoimmune hemolytic anemia via complement-mediated damage.
RBCs
If you have a sample of the patient’s serum, you can use the _____ test for autoimmunity.
indirect
What are the hallmarks of type 2 immune diseases?
- IgG, IgM, or IgA autoantibody mediated (harm to self) 2. can stimulate or damage the cell
Lysis of RBCs occurs in _____ via complement-mediated damage.
autoimmune hemolytic anemia
What is paroxysmal cold hemoglobinuria (PCH)?
hemolysis after exposure to cold
What is epitope spreading?
more and more epitopes and proteins become involved as the disease progresses
Forbidden clones have been ID’d as the pathogenesis of what disease?
- myasthenia gravis
____ and _____ damage cells via complement-mediated damage in myasthenia gravis and Goodpasture disease.
ROS; lysosomal enzymes
What are treatments for Myasthenia Gravis?
- thymectomy 2. immunosuppression 3. neostigmine-related drugs
The incidence of SLE is _____ and is higher in _____.
1/3500; blacks, Hispanics, Asians
Although at its earliest stages RA seems to be _____, eventually most of the pathogenesis is due to T cells.
antibody-mediated
ROS and lysosomal enzymes damage cells via complement-mediated damage in _____ and _____.
myasthenia gravis; Goodpasture disease
ROS and lysosomal enzymes damage cells via _____ damage in myasthenia gravis and Goodpasture disease.
complement-mediated
What is systemic lupus erythromatosus (SLE)?
autoimmune disease we don’t understand; might by apoptotic dysregulation; autoantibody mediated
____ are phagocytosed via complement-mediated damage in autoimmune thrombocytopenic purpura.
Platelets
Give an example of a stimulatory hypersensitivity.
LATS in hyperthyroidism
What is Myasthenia Gravis?
a disease of progressive muscle weakness bc of autoantibody to AChR
How are platelets destroyed in Autoimmune Thrombocytopenic Purpura (ATP)?
opsonized for destruction by the spleen
Platelets are _____ via complement-mediated damage in autoimmune thrombocytopenic purpura.
phagocytosed
Name the examples of chronic frustrated immune response diseases.
- Crohns disease 2. psoriasis 3. chronic beryllium disease 4. celiac disease
What are neostigmine-related drugs?
anticholinesterases
What is a treatment for RA?
rituximab
Platelets are phagocytosed via complement-mediated damage in ______.
autoimmune thrombocytopenic purpura
Immunopathology depends on 3 factors: ____, ____, and ____.
genetics, environment, bad luck :(
What is the treatment for Autoimmune Thrombocytopenic Purpura (ATP)?
- immunosuppression 2. splenectomy
Name 2 general mechanisms of tissue damage.
- complement-mediated damage 2. stimulatory hypersensitivity
What causes inappropriate tachycardia in about 50% of people?
autoantibodies of the Beta-adrenergic receptor
Give an example of a stimulatory hypersensitivity.
Graves disease from LATS (IgG antibody to the TSHR stimulating release of TH)
Who does RA affect?
women, 1/100 Americans; smokers and those exposed to air pollution
Who typically gets Autoimmune Thrombocytopenic Purpura (ATP)?
young people post viral-infection; old people with other autoimmunities
Lysis of RBCs occurs in autoimmune hemolytic anemia via _____ damage.
complement-mediated
____ is linked to the gene PADI4.
RA
Celiac disease is considered a type ____ immunopathology.
chronic frustrated
What is Autoimmune Thrombocytopenic Purpura (ATP)?
autoantibody to platelets, causing their destruction
What is the result of Hashimoto Thyroiditis and why?
hypothyroidism bc of thyroid destruction
What is Hashimoto Thyroiditis?
both B and T cell immunity to various thyroid antigens, including thyroglobulin, causes inflammation disease in thyroid
What does rituximab target?
CD20 on B cells
What are the hallmarks of type 3 immune diseases?
- immune complexes trapped in the BM-> complement activated->vasculitic inflammation 2. T-cell mediated when chronic
Although at its earliest stages RA seems to be antibody-mediated, eventually most of the pathogenesis is due to _____.
T cells
What is a forbidden clone?
a self-reactive cell that somehow escaped clonal deletion
The autoantibody of the AChR causes damage by ____ and ____-mediated attack.
complement and neutrophil
What is Rheumatoid Arthritis (RA)?
the most common autoimmune disease; IgM anti IgG
What is CHRNA1?
the gene for the AChR alpha subunit
What is inappropriate tachycardia?
fast heart rate without cardiac abnormalities
DM1 is considered a type ____ immunopathology.
IV
What is the antigen in Goodpasture Syndrome?
type IV collagen
What causes paroxysmal cold hemoglobinuria (PCH)?
autoantibodies that bind RBCs at 15deg C
What provides a diagnostic marker in DM1?
antibodies to islet-associated antigens
Give an example of sequestered antigen pathogenesis.
male sterility in mumps caused by mumps breaking down the blood/testis barrier, immunizing the sperm
What is a foreign + self hybrid antigen?
the coupling of self + nonself antigens that are presented to anti-self B cells that hadn’t been deleted
What are the s/s of Dressler Syndrome?
persistent cardiac pain, fever, malaise, and pericardial effusion
What drugs can induce AIHA?
- penicillin 2. methyldopa 3. chlorpromazine 4. quinidine
What are the hallmarks of type 1 immune diseases?
- IgE antibody mediated 2. Th2 cell mediated
What are the hallmarks of type 4 immune diseases?
- T cell response outcomes 2. can be normal or abnormal (inc autoimmune)
What is the chronic frustrated immune response?
the body is using the adaptive immune response to get rid of antigens that it never can
How is autoantibody to AChR made?
Aire drives the thymic expression of CHRNA1; these Th reactive cells are not deleted
What is Rheumatic Heart Disease?
heart disease from recent strep infection;
