Lecture 16 - Autoimmunity Flashcards
What is tolerance
a state of immunologic unresponsiveness to a particular antigen
How is tolerance established
cells are educated to not attack self cells
What are T regulatory cells
- tone down the immune system
- CD4+, CD25+
- found in secondary lymph tissues and sites of inflammation
- secrete IL10 and IL35 which are anti-inflammatory
- inhibit APCs by binding CD80/CD86
What are regulatory CD8+ t cells
- not well understood
- not generated in the thymus
- generated in the periphery during CD8+ t-cell activation
What causes autoimmunity
genetics and HLA genes
What effects autoimmunity
- environmental factors
- drugs
- infections
- diet
- chemicals/toxins
What is the proposed mechanism of autoimmunity
- molecular mimicry
- infections that induce genetic changes
- damage/stress events that expose sequestered Ag
- foods that alter gut microbial balance
- exposure to immune privileged sites
What causes autoimmunity
genetics/environment + increased autoimmunity + decreased regulation of autoimmunity
What is hashimotos thyroiditis
- hypothyroidism
- anti TPO causes increased Nk and increased cytotoxic killing
- TSH increases because no T3/T4
What is graves disease
- thyroid receptor has ab –> produce T3/T4
What are examples of organ specific autoimmunity
- autoimmune hemolytic anemia
- pernicious anemia
- idiopathic thrombocytopenia
- goodpastures disease
What are examples of systemic autoimmunity
- systemic lupus erythematosus
- multiple sclerosis
- rheumatoid arthritis
What is the pathogenesis of lupus
- autoantibodies against nuclear, cytoplasmic or phospholipid components
- immune complex formation deposits on tissue, or tissue specific antibody damage
- acute and chronic inflammation
What is the diagnosis for lupus
any 4 of the following criteria:
- malar rash
- discoid rash
- photosensitivity
- oral ulcers
- arthritis
- serositis
- renal disorder
- neurological disorder
- hematologic disorder
- immunologic disorder
- abnormal ANA titer
What is the laboratory diagnosis of lupus
- anti-nucleic antibody
What is the treatment of autoimmune disease
- reduce autoimmune while maintaining alloimmune
- anti-inflammatory drugs
- pain control
- immunosuppressive drugs
- heading towards monoclonal therapy
- antibody removal
- IVIg
