LG3.3 Immunology of Joint Pain – Dr. Moticka Flashcards
What is characteristics of rheumatoid arthritis?
-A chronic progressive disease causing inflammation in the joints and resulting in painful deformity and immobility, especially in the fingers, wrists, feet, and ankles.
What are the characteristic antibodies in rheumatoid arthritis?
RF and ACPA (Anti-citrullinated protein antibody)
In Rheumatoid arthritis what immune cells are auto reactive?
-Auto-reactive T-cells
Defining characteristics of Juvenile arthritis
-Chronic arthritis occurring before 16 years of age, unknown cause.
Environmental factors of Juvenile arthritis
Molecular mimicry with viral antigens
Genetics of Juvenile arthritis
Both HLA and non-HLA associations exist
Gender relations for Juvenile arthritis
-Systemic arthritis-no gender preference
Pathogenesis of Juvenile arthritis
Th1 mediated inflammation
Gender relations for RA
Female more dominate
Environmental factors of RA
Smoking and bronchial stress
Infectious agents of RA
Through molecular mimicry Epstein Barr, Cytomegalovirus, proteus species, E.Coli
Genetics of RA
HLA-DR4 and DRB1
PTPN22-Protein tyrosine phosphate Lyp
PAD14- Peptidyle arginine deiminase type IV
What is the innate mechanism of RA?
Damage, followed by increase of cytokines/chemokines, neutrophils, monocytes, mast cells, and finally chronic inflammation.
What cell stimulates damage?
Synovial fibroblasts stimulate damage
What is Spondyloarthritis?
Heterogeneous group of inflammatory diseases
- Spinal and peripheral oint arthritis
- Inflammation of attachments of tendons and ligaments to bones
What are the antigens involved in RA?
1) IgG filagren
2) Vimentin
3) Collagen
4) Fibronectin
5) G-6 phosphate isomerase
6) Proteoglycan
(NO single antigen found in all cases)
What is Citrullination?
Post translational modification of arginine
What molecule preferentially binds to citrullinated peptides?
HLA-DR4
What parallels frequency of Ankylosing spondylitis?
HLA-B27
What are immunologic targets of RA?
Cytokines, cells, and target immune components
What area FDA approved therapies?
1) TNF-alpha
2) IL-6
3) IL-1
What is the functions of IL-1 in RA?
1) Activates macrophages
2) Induces fibroblast proliferation
3) Activates chondrocytes to breakdown cartilage
4) Activates osteoclasts
5) CD80/86
What is molecule causes the development of Th1 cells?
IL-12 and IFN-gamma
What do Th17 cells produce?
IL-17, IL-21, IL-22, and TNF- Alpha
What is the function of Th17 cells?
They suppress T-reg cells and enhance inflammation.
Function of Th1?
Induce inflammation
