PMI02-3001 Mechanisms of Autoimmunity & Hypersensitivity Flashcards

1
Q

What is autoimmune disease?

A

Loss of immunological tolerance to self

Disease may involve self-reactive T cells or B cells

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2
Q

What factors predispose autoimmune disease?

A

Gender
Genetics
Self reactive B or T cells

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3
Q

Why is there higher prevalence of autoimmune disease in females?

A

Incomplete X chromosome inactivation- there is a high number of immune response genes of X chromosomes that can escape inactivation

Hormones: oestrogen stimulates innate immune receptor expression

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4
Q

How does the potential for self-reactive B and T cells come about?

A

Through recombination of germ line DNA and mutagenesis

Because it is so random, it is likely that self antigen receipts may be generated

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5
Q

Where does Central T cell Torrance occur?

A

during development in the thymus

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6
Q

What transcription factors in the thymus medulla induce expression of proteins that mediates negative selection?

A

Aire

Fez2f

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7
Q

What are the mechanisms of central T cell tolerance?

A

Direct inactivation of effector T cells by clonal deletion
Conversion to Treg cells
Induction of anergy

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8
Q

How do Treg cells operate?

A

They remove activating ligands from the APC
The TCR complex with CTLA-4
Treg FAS ligand binds to Th Fas and undergoes apoptosis
Treg secretes inhibitory cytokines

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9
Q

Why is MHC strongly associated with autoimmune disease?

A

Enhanced presentation of auto antigens or insufficient presentation in the thymus

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10
Q

What are the precipitating events of autoimmune disease?

A

Molecular molecular mimicry: antigens of infectious agents may resemble self antigens and stimulate cross reactive B, T cells
Innate immunity: ligation of T cell receptors and BCRs which may prompt auto reactive B cells without the activation of T cells

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11
Q

What occurs to the nucleic acid complexes during production of antibodies?

A

Binding of nucleic acid complex to sIg induces the first signal
sIg traffics to endosome
Nucleic acid binds to TLR7, 9
TLR signal via nucleus triggers production of type I interferon
IFN binding to receptor provides second signal
B cell proliferates

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12
Q

How do activated B cells act as antigen presenting cells to T cells?

A

Activated B cells takes up nucleic acid/ protein complex
The protein component undergoes antigen processes and peptides are displayed on the MHC class II
CD4 Th cell recognises MHC II/ peptide- 1st signal from the B cell
The B cell delivers the 2nd signal via CD40
B cell secretes cytokines
Activated T cell stimulates other B cells, dendritic cells

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13
Q

What is a hypersensitivity reaction?

A

An exaggerated immune response that damages host tissues

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14
Q

What types of hypersensitivity are involved in autoimmune damage?

A

II, III, IV

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15
Q

What types are known as immediate type hypersensitive?

A

I-III

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16
Q

What type is known as delayed hypersensitivity?

A

Type IV

17
Q

What is type I hypersensitivity mediated by?

A

IgE bound to high affinity Fc receptors on mast cells, basophils and activated eosinophils

18
Q

What occurs during type I hypersensitivity?

A

Cross linking of IgE/ Fc receptor complex by antigen causes degranulation- release of histamine, serotonin, leukotrienes, proteases
Later there is cytokine release, which activates macrophages
This all induces vascular permeability, smooth muscle contraction, bronchoconstriction
Activates eosinophils, neutrophils, macrophages

19
Q

What occurs during an extreme type I hypersensitivity reaction?

A

Anaphylactic shock

20
Q

What is type II hypersensitivity mediated by?

A

IgG binding to an antigen on the individuals own tissues

21
Q

What occurs during type II hypersensitivity?

A

IgG Fc binds to Fcy receptors of macrophages
IgG Fc also activates complement- opsonisation and activation of phagocytic cells
Degranulation or phagocytosis induces tissue damage

22
Q

What is type III hypersensivity mediated by?

A

IgG forming an immune complex with soluble antigens

23
Q

What occurs during type III hypersensitivity?

A

Accumulation of immune complexes in blood vessels, synovial fluid
This activates complement and attracts neutrophils
Degranulation. and increased vascular permeability

24
Q

Is type III organ specific?

A

It is non-organ specific

25
Q

What is Type IV mediated by?

A

T cells

26
Q

What occurs during type IV?

A

Activated T cells secrete chemokine, cytokines to recruit and activate macrophages
Activated macrophages further secrete inflammatory cytokines
Formulation of granuloma

27
Q

Is Type IV organ specific?

A

yes