Session 3: Autoimmunity

Question 1

Define autoimmunity.

Answer 1

Immune response against the host due to the loss of immunological tolerance of self-antigen.

The host should not react but it does for some reason.

Question 2

Define autoimmune disease.

Answer 2

Disease caused by tissue damage or disturbed physiological response due to an autoimmune response.

Question 3

Classifications of autoimmune disease.

Answer 3

Organ specific

Non-organ specific

Question 4

Explain organ specific autoimmune disease.

Answer 4

One or multiple self antigens within one single organ or tissue.

Question 5

Explain non-organ specific autoimmune disease.

Answer 5

Wide distributed self antigens throughout the body causing problems.

Question 6

Give examples of organ specific autoimmune diseases.

Answer 6

Hashimoto’s

T1DM

MS

Anti-GBM syndrome

Addison’s

Graves’

Myasthenia gravis

Pernicious anaemia

Question 7

Give examples of non-organ specific autoimmune diseases.

Answer 7

Autoimmune haemolytic anaemia

RA

SLE

Sjogren’s syndrome

Autoimmune thrombocytopenic purpura

Question 8

Answer 8

Question 9

What are the different autoimmune disease drivers?

Answer 9

It can be autoantibody driven or autoreactive T cell driven.

Question 10

Primary Autoantibody in Graves’

Answer 10

Anti-TSHR (e.g. TSI)

Question 11

Primary Autoantibody in Myasthenia gravis

Answer 11

Anti-acetylcholine receptor

Question 12

Primary Autoantibody in Anti-GBM syndrome

Answer 12

Anti-anti-Glomerular basement membrane

Question 13

Secondary autoantibody in SLE

Answer 13

Anti-nuclear

Question 14

Secondary autoantibody in pernicious anaemia.

Answer 14

Anti-gastric parietal cell

Question 15

Secondary autoantibody in hashimoto thyroiditis

Answer 15

Anti-thyroid peroxidase antibodies (E.g. Anti-TPO)

Question 16

Secondary autoantibody in RA

Answer 16

Anti-rheumatoid factor

Question 17

Set of criteria for the diagnosis of a disease as autoimmune.

Answer 17

Presence of autoantibodies/autoreactive T cells

Autoantibodies/autoreactive T cells found at the site of tissue damage

Transfer of auto-antibody or autoreactive T cells to a healthy host will induce the autoimmune disease.

Clinical benefit is provided by immunomodulatory therapy

FH

Question 18

How does levels of auto-antibodies relate with disease severity.

Answer 18

Positively linear.

More autoantibodies -> more severe disease.

Question 19

What triggers autoimmunity?

Answer 19

Genetic factors such as family history (sibling and identical twins makes it more common) and also mutations.

Environmental factors

Question 20

Give examples of environmental factors that can trigger autoimmune disease.

Answer 20

Hormones

Infections

Drugs

Question 21

What infection causes rheumatic fever?

Answer 21

Streptococcus pyogenes M protein with an antigen in cardiac muscle.

Question 22

What infection can cause Guillain-Barré syndrome?

Answer 22

Campylobacter jejuni glycoproteins with myelin-associated gangliosides.

Question 23

What infection can cause T1DM?

Answer 23

Coxsakieviruse B4 nuclear protein

Question 24

D-penicillamine is a drug given sometimes for RA.

What autoimmune diseases can they cause?

Answer 24

Myasthenia gravis

Pemphigus

SLE

Glomerulonephritis

Question 25

Methyl-dopa is a drug that can be given as an anti-hypertensive.

What autoimmune disease can this cause?

Answer 25

Haemolytic anaemia

Question 26

Which drugs can cause SLE?

Answer 26

D-penicillamine

Hydralazine

Procainamide

Isoniazid

Minocycline

Question 27

How might you detect autoantibodies or autoreactive T cells at the site of tissue damage?

Answer 27

Biopsy

Indirect immunofluorescence

Immunofluorescence

Radioimmunoassay

Coombs test

Agglutination