The pathogenesis of Type 1 Diabetes: When the Immune System Goes Wrong Flashcards
name the microvascular issues associated with diabetes
nephropathy, neuropathy, retinopathy
name the macro vascular issues with diabetes
coronary artery disease, peripheral arterial disease, and stroke
what is type 1 diabetes broadly speaking
immunological condition in which there is an autoimmune response destroying b cells in islets of Langerhans
outline autoimmune response in diabetes
apc presents protein on mhc which activates the specific cd4 and cd8 cells. cd8 directly kill b cells and t helper cells secrete chemicals to help b lymphocytes and innate and cd8s kill b cells
what four criteria need to be met to define t1dm as autoimmune disease
needs to be evidence that immunological self tolerance is lost.
need a genetic predisposition
passive transfer of disease by immune effectors (t cells and antibodies)
if you supress immune response or restablish tolerance patient needs to improve clinically
are islet cell auto antibodies pathogenic
no they are not pathogenic, they are useful in predicting future disease(coomon exam q)
are babies of t1dm born with diabetes
no
evidence that t cell cause diabetes in man
woman with leukaemia islet cell autoantibody negative, give bobne marrow transplant from man with t1dm and is cured from leukaemia but now has t1dm
what is c peptide used for clinically
as a marker for b cell mass, less c protein , less beta cells
what is cyclosporine
it increase the length of the honeymoon period time before t1dm devlops
what type of study is used to illustrate the genetic element of t1dm
gwas
4 main molecular targets
of ICA identified
Insulin
Glutamic acid decarboxylase (GAD65)
Insulinoma-associated antigen-2 (IA-2)
Zinc Transporter 8 (ZnT8)
what are the main t helper cells in t1dm
pro inflammatory th1 and th17. not really th2
treg il10 is expressed more in those with diabetes or those without
those without because it is helping to supress the t cells causing the autoimmune response
what is ahsc
treating t1dm, take stem cells, freeze them, chemotherapy to destroy all t b cells present, re infuse the stem cells and let immune system reboot, better glucose control, however health and safety issues
