Lecture 2

Question 1

Multiple sclerosis is primarily driven by…

Answer 1

T cells specific for CNS antigen

Question 2

Multiple sclerosis patients have an abundance of __ cells

Answer 2

Th17

Question 3

What type of disease is MS?

Answer 3

Chronic inflammatory demyelinating disease

Question 4

How can MS be induced in mice?

Answer 4

Inject myelin basic protein (MBP) and Complete Freund’s Adjuvant to induce T cell response (hind legs become paralysed)

Question 5

Studies have shown an increased risk of MS after infection with __

Answer 5

EBV

Question 6

Some crossover between EBV __ antigen and MBP (and other proteins involved in protecting neurons)

Answer 6

EBV nucelar antigen

Question 7

How is anti-CD20 mAb one of the most effective treatments for MS?

Answer 7

It depletes circulating memory B cells, which are the primary site of persistent latent EBV infection

Question 8

Possible prophylactic treatment for MS

Answer 8

EBV vaccine

Question 9

Myasthenia gravis is caused by…

Answer 9

anti-AChR autoantibodies that block receptor function at NMJ, causing muscle weakness

Question 10

How do antibody immune complexes deposited in tissues cause tissue destruction?

Answer 10

by activating complement

Question 11

Autoimmune diseases transferred across the placenta to the fetus and newborn infant

Answer 11

• Myasthenia gravis
• Grave’s disease
• Thrombocytopenic purpura
• Neonatal lupus rash and/or congenital heart block
• Pemphigus vulgaris

Question 12

Thrombocytopenic purpura is caused by __ which leads to…

Answer 12

anti-platelet antibodies (Gp IIb:IIIa)
bruising and haemorrhage

Question 13

The blistering rash associated with pemphigus vulgaris is caused by…

Answer 13

anti-desmoglein-3 (epidermal cadherin) antibody

Question 14

How is the fetus affected by the mother having Grave’s disease?

Answer 14

Pregnant mother transfers their anti-TSHR Abs across placenta to fetus. The newborn infant will also suffer from Grave’s disease. Symptoms usually disappear as maternal Abs are degraded. Plasmapheresis removes maternal anti-TSHR Abs and cures the disease.

Question 15

Acute rheumatic fever can lead to arthritis, myocarditis and late scarring of heart valves due to antibodies to __ cross-reacting with cardiac muscle

Answer 15

Streptococcal cell wall antigens

Question 16

Autoimmune diseases that are T-cell mediated

Answer 16

T1DM, RA, MS, Crohn’s disease, psoriasis

Question 17

Autoimmune diseases involving T cells and B cells

Answer 17

SLE, T1DM, myasthenia gravis, MS

Question 18

How does chronic autoimmune disease develop?

Answer 18

through positive feedback from inflammation, inability to clear the self-antigen, and a broadening of the autoimmune response

Question 19

Initial autoAbs in SLE are specific for __

Answer 19

DNA (capture histone proteins), eventually autoAbs to protein components of chromatin

Question 20

In SLE, B cells express __ in their MHC, which are recognised by its corresponding CD4+ T cell to initiate an immune response.

Answer 20

histone epitopes

Question 21

Where are immune complexes in SLE patients deposited?

Answer 21

in renal glomerular basement membranes, joints & organs

Question 22

How do immune complexes cause damage in SLE patients?

Answer 22

Immune complex depositions activate phagocytic cells and increase the chance of activating low-affinity self-reactive lymphocytes, causing tissue damage and the release of more nucleoprotein

Question 23

__ essentially do the damage in autoimmune haemolytic anaemia

Answer 23

Macrophages

Question 24

How can haemolytic anaemia be treated?

Answer 24

By splenectomy or intravenous immunoglobulin therapy

Question 25

__ are providing new insight into the immunogenetic basis of autoimmunity

Answer 25

Genomics-based approaches