Quiz 2 - Autoimmunity & Serological Techniques Flashcards
When autoimmunity is suspected, we perform this test…
Anti-nuclear antibodies (ANA)
Are men or women more predisposed to autoimmune disorders?
Women
When antigen-antibody complexes deposit in tissue, they attract…
Complement
- rupture/lyse cells
- autoimmune diseases cause tissue injuries
3 steps of process of disease
- Autoantibodies complex with patient’s own DNA
- Immune complexes deposited in vascular systems - organs & tissues
- Immune-mediated tissue injury due to complement
ANA vs Crithidia luciliae - which is the screening test and which is the confirmatory test?
ANA = screening
Crithidia luciliae = confirmatory
ANA test uses these cells as the substrate
HEP-2
- epithelial cell line
- ANA reacts with nuclear DNA/RNA
Why do different ANA patterns appear?
Due to different stages of nuclear DNA mitosis
How is the ANA test performed?
Patient sera placed on slide with HEP-2 cells and labeled with conjugate antibody with fluorescence tag
- ie FITC
- “sandwich” assay
The ANA test is an example of a “sandwich” assay. What is being sandwiched?
Patient’s antinuclear antibodies
-between HEP-2 DNA and conjugate antibody with fluorescence tag
An ANA test result showing a homogeneous pattern indicates this autoimmune disease
SLE = Systemic lupus erythematosus
An ANA test result showing a centromere pattern indicates this autoimmune disease
CREST syndrome
-form of scleroderma
An ANA test result showing a speckled pattern indicates this autoimmune disease
Sjogren syndrome
An ANA test result showing a nucleolar pattern indicates this autoimmune disease
Scleroderma
SLE - shows this ANA test pattern. What do the autoantibodies target (3)?
Homogeneous
anti-dsDNA
anti-ssDNA
Histones
-includes anti-Sm abs
Sjogren - shows this ANA test pattern. What do the autoantibodies target?
Speckled
anti-RNP (ribonuclear protein)
Scleroderma - shows this ANA test pattern. What do the autoantibodies target?
Nucleolar
anti-nucleolar
CREST - shows this ANA test pattern. What do the autoantibodies target?
Centromere
anti-centromere
After performing an ANA test for SLE, we confirm our results with this test. What does the confirmatory test target in the organism?
Crithidia luciliae
Kinetoplast
- mitochondria rich in dsDNA
- highly sensitive to HEP-2 substrate
The hereditary component sometimes involved in autoimmune disease involves the…
HLA
SLE - laboratory findings
Anemia - 50% leukopenia
Thrombocytopenia - 25-50%
Elevated erythrocyte sedimentation rate (ESR)
ANA positive - anti-dsDNA and anti-Sm. Targets nucleoprotein antigens
Overuse of this causes a SLE-like syndrome. The autoantibodies developed target…
Drugs
Histones
-milder SLE
SLE vs drug-induced SLE - what would the Crithidia luciliae test results be?
SLE = positive
Drug-induced SLE = negative
-absence of anti-dsDNA antibodies
SLE - clinical manifestations
Arthritis - chronic inflammation - skin, joints, kidneys, lungs, CNS
Butterfly rash across nose/upper cheeks
Raynaud’s syndrome
Renal disorders
Pulmonary manifestations
CNS disorders - depression, psychosis, convulsions
What is Raynaud’s syndrome. Which autoimmune disorders is it associated with?
Cyanosis on cold temperatures. Stress-induced vasoconstriction on extremities
SLE, CREST (the “R”)
Sjogren’s syndrome - 90% of autoantibodies are called…
Rheumatoid factor
-anti-RNP associated with ANA stain
Sjogren’s syndrome - laboratory findings
ANA - anti-La
Labial salivary gland biopsy for definite diagnosis
Dry mouth and dry eyes are symptoms associated with…
Sjogren’s syndrome
-affects lacrimal, salivary & excretory glands
Scleroderma has 2 forms
Progressive diffuse
Systemic = CREST
What are the acronyms of CREST?
Calcinosis - bone formation Raynaud - vasoconstriction of hands/feet Esophageal involvement Sclerodactyly - harden finger skin Telangiectasia - spider veins