Lecture 17: Tolerance and Autoimmunity Flashcards
What type of hypersensitivity reaction is associated with:
Myasthenia Gravis,
Autoimmune Hemolytic Anemia,
Graves Disease, and
Goodpasture Syndrome?
Type 2 Hypersensitivity Reaction
What type of hypersensitivity reaction is associated with: M.S and Hashimoto’s?
Type 4 Hypersensitivity Reaction
Which type of hypersensitivity reaction is associated with:
Systemic lupus erythematosus,
Scleroderma,
and Sjorgen Syndrome
Type 3 Hypersensitivity Reaction
HLA-DR2 and HLA-DR3 is associated with which two disorders?
A. Myasthenia Gravias, Hashimoto’s
B. Graves, T1DM
C. SLE, MS
C. SLE, MS
HLA-DR3 is associated with which two disorders?
A. RA, Celiac
B. Myasthenia Gravis, Graves
C. Sjorgen, MS
B. Myasthenia Gravis, Graves
HLA-DQ2 (90%), HLA-DQ8, and IgA Deficiency are associated with:
A. RA
B. Graves
C. Celiac
D. Hashimotos
C. Celiac
HLA-DR5, DR3, and B8 are associated with which disorder?
A. RA
B. Graves
C. Celiac
D. Hashimotos
D. Hashimotos
HLA-DR4 is associated with:
A. RA
B. Graves
C. Celiac
D. Hashimotos
A. RA
True or False: Graves Disease is associated with hypothyroidism while Hashimoto’s is associated with hyperthyroidism
False
Graves = Hyperthyroid
Hashimotos = Hypothyroid
_____: Loss of nerve transmission
_____: Loss of proper insulin control
M.S: Loss of nerve transmission
T1DM: Loss of proper insulin control
Dry eyes and mouth suggests which disorder?
Sjogren’s Syndrome
Malnutrition, diarrhea, abdominal pain suggests which disorder?
Celiac Disease
Joint pain, kidney damage, and butterfly rash suggests which disorder?
SLE
Fibrosis, arthritis, arteritis, and Reynaud’s suggests which disorder?
Scleroderma
Target in MS?
Target in Celiac?
MS = myelin in CNS
Celiac = small intestinal mucosa
Target of Myasthenia gravis?
Target of Graves?
M. gravis = Ach receptor
Graves = TSH receptor
SS-A (ro), SS-B (la); and M3R muscarinic Ach are targets of which disorder?
Sjorgen Syndrome
Topisomerase, RNAP, and Centromere are targets of which disorder?
Scleroderma
Nuclear Ag, dsDNA, and anti-nuclear antibodies (ANA) are targets of which disorder?
SLE
Anemia, elevated indirect bil, and reticulolysis are symptoms of ____
autoimmune hemolytic anemia
Where does central T cell tolerance occur? Peripheral T cell tolerance?
Central = thymus
Peripheral = lymph tissues
Apoptosis occurs in central T cell tolerance under which conditions?
TCR strongly recognizes self peptides
Anergy occurs in peripheral T cell tolerance under what two conditions?
1) stimulation of T cells without secondary stimulation (B7-CD28)
2) repeated stimulation of activated T cells
____: T cells that inhibit activation of T cells by self peptide/MHC
Regulatory T cells
____: An inflammatory lesion that appears 2-6 weeks after a perforating wound to contralateral eye
Sympathetic opthalmia
True or False: Exposure of antigens in an immunologically privileged site may induce an immune response to self antigens
True
____: process by which the immune response to a pathogen or foreign antigen may cross react with self tissues
Molecular Mimicry
What are three examples in which a preceding infectious process may lead to development of an autoimmune disease?
1) Ankylosing spondylitis
2) Rheumatic Fever
3) G-Barre Syndrome
____: agents on klebsiella and other bacteria induce antibodies that cross react w host tissues causing chronic inflammation, fibrosis, and ossification of spine
Ankylosing Spondylitis
Which auto-immmune disease is associated with HLA-B27 positivity?
A. Ankylosing Spondylitis
B. Rheumatic Fever
C. G Barre Syndrome
Ankylosing Spondylitis
_____: antigens from bacterium that cause strep. pharyngitis induce antibodies that cross react with self tissue on heart valves
A. Ankylosing Spondylitis
B. Rheumatic Fever
C. G Barre Syndrome
Rheumatic Fever
Following GI infection with Campylobacter, persons may develop an immune response against LPS. Severe paralysis and polyneuritis occurs and slowly resolves as person’s immune system wanes.
A. Ankylosing Spondylitis
B. Rheumatic Fever
C. G Barre Syndrome
C. G Barre Syndrome
Why is it believed that women are more prone to auto-immune disorders?
Estrogen receptors
True or False: Being elderly is strongly associated with loss of immune function/immune dysregulation
True
Which two Th2 cytokines inhibit Th1 responses?
IL-10 and IL-4
____ is a potent suppressor of T Lymphocyte proliferation
TGF-B
- mice with TGF-B deficiency have autoimmunity
Villus atrophy and T cell infiltration, as seen in Celiac, suggests that the disease is primarily mediated by ___
T cells
True or False: CD is associated with HLA-DQ2 and IgA deficiency
True
What is an example of an autoimmune disorder with a known environmental trigger?
Celiac Disease
True or False: Myasthenia gravis is organ specific while SLE is systemic and multi-organ
True
True or False: Myasthenia gravis is linked to complement deficiency
False - SLE is!
- Due to lack of C3b production
When C3b is incorporated into IC, it allows for?
Efficient removal by phagocytic cell
True or False: HLE is a disease resulting from loss of control of B cell system and is complicated by lack of C3b
True
____ is a systemic auto-immune disease characterized by inflammation and destruction of exocrine glands
Sjorgen’s Syndrome
M3R abnormalities have been found in which disorder?
Sjorgen’s Syndrome
In Graves Disease, which molecule mimics TSH by binding to and activating TSH-R, thereby causing hyperthyroidism?
TSI (thyroid stimulating immunoglobulin)
In Graves Disease, TBII’s can block the receptor from binding ___, leading to ___
TSH, hypothyroidism
Both MS and T1DM are ___ cell mediated autoimmune diseases
T cells mediated
Graves disease is the only ____ mediated disorder
antibody mediated
Which is the only organ specific autoimmune disease? What are the three systemic autoimmune disorders?
Organ specific
- Myasthenia gravis
Systemic
- SLE
- Scleroderma
-Sjorgren’s Syndrome
Which two disorders are both antibody and T cell mediated?
RA and Hashimoto’s
A panus is a feature of which disorder?
RA
What are the two diagnostic biomarkers for RA?
ACPA and RF (IgM antibody against IgG Fc)
True or False: RA may occur in agammaglobulinemic patients, meaning autoimmun antibody response may play a role but are not essential to pathogenesis of the disease
True
Anti-mitotic drugs, cyclosporine, and anti-inflammatory drugs are best described as:
A. Immunosuppressive Therapy
B. Targeted Treatments
A. Immunosuppressive Therapy
Two distadvantages of anti-mitotic drugs and cyclosporine?
- Immune suppression
- Increased susceptibility to infection (conventional and opportunistic pathogens)
True or False: Immunosuppressive therapy is only for treating end stage disease, but cannot reverse the process
True
IL-2R can be blocked with anti-CD25 antibody in treating ___
MS
Human monoclonal antibody that neutralizes effects of BAFF cytokine and leads to decrease in circulating B cells is approved to treat ___
SLE
Il-6 or IL-6 R blocking is effective for individuals with __
RA
IL-17 or IL-23 can be bound my a mAb, blocking their function in treatment for ___
psoriasis
Within lamina propria and Peyer’s patches of intestines, population of CD4+ T cells exist and exert a major influence on isotype switching of local B cells to induce ___ production
IgA
In the presence of low dose antigen, mucosal T cells give rise to either ___ or ___
Th2 (IL-4 and IL-10: suppress Th1)
Th3 (make TGF-B: suppresses Th1/2 lymphocyte activation and proliferation)
Ag-specific ___ cells have been found in circulation of subject following oral admin of antigen
Th3
True or False: Activation of Ag specific Th2 following low doses of oral Ag may provide a mechanism for suppressing harmful immune responses
True
____ patients treated w orally administered bovine myelin results in appearance of myelin basic protein specific Th3 in peripheral blood
M.S
___ patients treated with orally admin Type II collagen show improvement
R.A
