RA, SLE + mAb Flashcards
What is the main auto-antibody found in blood tests for RA?
Rheumatoid factor - autoantibodies to Fc portion of IgG
What other auto-antibodies can occur in RA?
anti-CCP
ACPA
Over-production of which cytokine leads to synovitis?
TNF-alpha
What can occur in the lungs in patients with RA?
Nodules
Pleural effusion, interstitial lung disease
What are three other non-articular manifestations of RA?
Pericarditis
Anaemia
Carpal tunnel syndrome
(PAC)
What type of hypersensitivity reaction is involved in SLE?
Type 3 mainly
What is pathophysiology of SLE?
Cell apoptosis - blebs carrying antigens with nuclear components, inefficient phagocytosis means they travel to lymphoid tissue, taken up by APCs and generate T and B cell response and autoantibodies.
What is the result of the auto-antibodies generated in SLE?
- Form circulating complexes or bind to tissues directly
- Activate complement, neutrophil influx causes inflammation
- Cytokine production
What is the main auto-antibody found in SLE blood tests?
Antinuclear/Anti-DNA
What other autoantibodies can occur in SLE?
Anti-Sm antibodies
Antiphospholipid antibodies
The skin is often involved in SLE. Give 5 features.
Butterfly rash on face Photosensitivity Urticaria Vasculitis Purpura
What might you find in FBC of a patient with SLE?
Anaemia
Low WBC
Low platelets
What test would help confirm if autoimmune haemolytic anaemia was present in a patient with SLE?
Coombs test
Other than skin, what other body systems can be involved in SLE?
Kidneys - glomerulonephritis Heart - pericarditis, endocarditis Lungs - pleural effusion NS - fits, psychosis Blood - anaemia, thrombocytopenia
What is the treatment for SLE?
Mycophenolate mofetil
Azathioprine
Steroids
Cyclophosphamide if severe
What lifestyle advice would you give to a patient with SLE?
Wear suncream
What is a monoclonal antibody?
Monovalent antibodies which bind to the same epitope and are produced from a single B-lymphocyte clone
How do monoclonal antibodies work in autoimmune diseases?
- Bind to cell surface receptor to activate signalling within the cell
- Bind to cell surface receptor to inhibit signalling within the cell
- Bind and internalised into cell to deliver toxins to cancer cells
- Block inhibitory effects on T cells
What monoclonal antibody is used to treat breast cancer?
Trastuzumab - inhibits HER-2 signalling
What monoclonal antibody is used to treat autoimmune conditions?
Inlfiximab
How does infliximab work?
Inhibition of TNF (inflammatory cytokine)
What is infliximab used to treat?
RA
Crohns
Psoriasis
What monoclonal antibody is used too treat B cell lymphoma?
Rituximab - against CD20, expressed on surface of B cells.
