Week 6 - Autoimmunity Flashcards

1
Q

What is Tolerance? What is the underpinning function?

A

= failure of the adaptive immune system to respond to antigen

underpinning function:
- ability to distinguish self from non-self

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2
Q

How is diversity in antigen receptors created?

A

created by somatic recombination
- germline receptor genes are comprised of multiple V and J gene segments
- during development -> these randomly recombine to form many unique antigen receptors

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3
Q

What is good and bad about the diversity of antigens?

A
  • It is essential to have such diversity to protect us from all possible pathogens
  • However, it is inevitable some may be auto-reactive
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4
Q

What do central tolerance mechanisms do?

A

ensure that self-reactive lymphocytes are deleted during development
-> occurs in thymus for T cells
-> occurs in bone marrow for B cells

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5
Q

What is clonal selection

A

Pretty much, lymphocytes that do not react to self-antigens are selected to be proliferated so many clones of them can be made during an adaptive immune response

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6
Q

Summary of the mechanisms of tolerance

A
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7
Q

What factors affect the development of autoimmune diseases?

A

environmental factors and genetic components

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8
Q

What are some common HLA alleles associated with autoimmune diseases?

A

B27, DR2, DR3, DR4, DR5

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9
Q

What are some environmental factors that can lead to autoimmunity?

A
  1. Events that lead to breaching immunologically privileged sites
  2. Stress can induce post-translational modifications
  3. Infection and molecular mimicry
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10
Q

Whats an example of an event that leads to breaching immunologically privileged sites leading to autoimmunity?

A

Eg -> Sympathetic Opthalmia
1. Trauma to one eye -> release of sequestrated intraocular protein antigens
2. Released intraocular antigens are carried to lymph ndoes and activates T cells
3. Effector T cells return via bloodstream and encounter antigen in both eyes

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11
Q

Whats an example of how stress can induce post-translational modifications leading to autoimmunity?

A

PAD (Peptidylarginine deaminase) converts Peptidyl Arginine into Peptidyl Citrulline

  • PAD is not expressed in thymus but is expressed in periphery in response to stress and smoking
  • By converting one protein to another, PAD is creating neoantigens thus altering self
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12
Q

Whats an example of how infection and molecular mimicry can lead to autoimmunity?

A

In Rheumatic Fever:
- antibodies specific for streptococcus cross-react with self-antigens in the heart valve bc they have a molecular similarity to antigens in the heart valves -> causes inflammation in the heart

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13
Q

What is Type 1 Diabetes?

A

Autoimmune disease that attacks the pancreas

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14
Q

What is specifically targeted in Type 1 diabetes?

A

Beta cells in the Islets of Langerhans in the pancreas are targeted by CD8 T cells and CD4 T cells have a role as well

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15
Q

What are the major auto-antigens associated with Type 1 diabetes?

A
  • Insulin
  • Protein tyrosine phosphatase
  • IGRP (islet-specific glucose 6-phosphatase catalytic subunit related protein)
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16
Q

What are treatments for T1 Diabetes?

A
  • Insulin replacement
  • Islet transplant
17
Q

What is Rheumatoid Arthritis?

A

Chronic inflammatory environment of the joints -> immune cells destroying cartilage

18
Q

What are the target antigens in Rheumatoid arthritis?

A

Collagen, Proteoglycans, vimentin heat-shock protein

19
Q

What are the immune mechanisms in Rheumatoid Arthritis?

A
20
Q

What is Rheumatoid Factor

A

= Autoantibodies against IgG

21
Q

What is Systemic Lupus Erythromatosus (SLE)?

A

= an autoimmune disease of circulating immune complexes of DNA and aDNA antibodies

Immune complexes lodge in the kidneys, skin and blood vessels -> glomerulonephritis and vasculitis

22
Q

How does Vasculitis occur in SLE?

A

Immune complexes lodge in capillary beds -> activate complement pathway -> induces lysis and is pro-inflamm and recruits neutrophils

23
Q

How do TLR9 and BAFF play a role in the pathogenesis of SLE?

A
  • Unknown trigger leads to release of DNA and histones -> immune response
    -> DNA containing immune complexes stimulate the pattern recog receptor TLR9 on a plasmacytoid dendritic cell
    -> Plasmacytoid DC secrete Type 1 interferon
    -> Type 1 interferon stim monocytes/DC to produce BAFF (a cytokine that promotes B cell survival)
    -> Excess B cell survival including autoreactive B cells
24
Q

What are managements of SLE?

A

Corticosteroids
Immunosuppressants
Biologics

25
Q

What is Myasthenia Gravis?

A

= neuromuscular autoimmune disease that leaves muscles weak and fatigued

26
Q

What specifically occurs in Myasthenia Gravis?

A

Antibodies against the acetylcholine receptor interrupt neuromuscular communication

27
Q

What is Graves Disease?

A

Activating autoantibodies against the thyroid-stimulating hormone receptor lead to the overproduction of thyroid hormones