Week 9 - Autoimmunity Flashcards

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1
Q

Define autoimmunity.

A

Immune response against self (auto-) antigen

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2
Q

What are the 4 general principles of autoimmunity?

A

Pathogenesis: the development of autoimmunity reflects a combination of susceptibility genes and environmental triggers (usually infections)

Different autoimmune diseases may be systemic or organ-specific; may be caused by different types of immune reactions

Vary by age, gender and race.

Financial burden

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3
Q

What is the etiology of autoimmune diseases?

A

Genetic predispositions, endocrine effects, and environmental factors work together

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4
Q

What are the 5 environmental factors of autoimmunity?

A

Microorganisms

Xenobiotics

Apoptosis

Microbiota

Nutrition

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5
Q

What 2 environmental factors form “molecular mimicry”? Give four examples of each factor

A

Microorganisms: bacteria, viruses, parasites, fungi

Xenobiotics: tobacco smoke, ultraviolet light, pharmaceuticals, and heavy metals

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6
Q

What 1 environmental factor leads to autoantigens?

A

Apoptosis

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7
Q

Give examples of microbiota and nutrition.

A

Microbiota: skin, respiratory mucosal barrier, and GI tract

Nutrition: gluten, iodine, and vitamin D

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8
Q

How do molecular mimicry and auto antigens work together? What types of autoimmune diseases do they cause?

A

They both lead to auto reactive T or B cells or APCs which are linked to epitope spreading and also causes auto reactive T or B cells

Mimicry/auto antigens directly leading to auto reactive T or B cells lead to organ specific autoimmune diseases
The APC to epitope spreading to auto reactive T or B cell lead to systemic autoimmune diseases

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9
Q

What are 3 details about organ-specific autoimmune diseases?

A

Autoimmune attack vs. self-antigens of given organ

It results in a damage of organ structure and function

Treatment is focused on the replacement of organ function

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10
Q

What are 3 details of non organ-specific (systemic) autoimmune diseases? (In general)

A

Widespread self-antigens are targets for autoimmune attack

Damage affects such structures as blood vessels, cell nuclei, etc.

Treatment is aimed to inhibit excessive activation of the immune system

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11
Q

Give examples of organ-specific and non-organ-specific autoimmune diseases and the body parts they affect.

A

Organ specific:

Brain: multiple sclerosis
Thyroid: Hashimoto’s thyroiditis, primary myxoedema, thyrotoxicosis
Stomach: pernicious anaemia
Adrenal: Addison’s disease
Pancreas: insulin-dependent diabetes mellitus

Non-organ-specific:

Muscle: dermatomyositis
Kidney: SLE
Skin: scleroderma, SLE
Joints: rheumatoid arthiritis

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12
Q

Give 4 details about organ specific auto-immune diseases.

A

Multiple sclerosis: disease where the immune system attacks the protective coating around the nerves

Hashimoto’s thyroiditis: autoantibodies against many thyroid proteins

Pernicious anemia: non-absorption of vitamin B12 which is essential for red blood cell development

Type 1 diabetes: cytotoxic T-lymphocytes destroy insulin-producing Beta-cells in pancreas

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13
Q

What are 3 details about non-organ specific auto-immune diseases?

A

Dermatomyositis: muscle disease that is characterized by inflammation and a skin rash; type of inflammatory myopathy

Lupus: disease that damages the joints, skin, kidneys, heart, lungs and other parts of the body; most prevalent autoimmune disease in developed countries; individuals develop antibodies to the DNA of the double-stranded molecules

Rheumatoid arthritis: Ag-Ab complexes deposited in joints and lead to inflammation

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14
Q

What are 4 details about the diagnosis of autoimmune diseases?

A

Based on symptoms and detection of antibodies

Antibodies against cell/tissue associated antigens are detected by immunofluorescence

Antibodies against soluble antigens are normally detected ELISA or radioimmunoassay

Biological and biochemical assay also used

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15
Q

What are 4 preventions and treatments of autoimmune diseases?

A

Immunosuppression (e.g., prednisone, cyclosporine A)

Removal of thymus

Plasmapheresis (remove Ab-Ag complexes)

Block MHC with similar peptide

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16
Q

What sex experiences autoimmune diseases more?

A

Women

17
Q

What are 4 statistics regarding gender and autoimmune disease?

A

Among leading causes of death for young and middle aged women

For some diseases like lupus, scleroderma, and thyroiditis, more than 85% of individuals affected are women

Insulin dependent diabetes: affects men and women equally

In cases like myocarditis and ankylosing spondylitis, men are affected more frequently

18
Q

What are 3 statistics regarding age and autoimmune disease?

A

Best-studied autoimmune diseases like lupus and MS are most common in women during child-bearing years

Certain autoimmune thyroid diseases like Hashimoto’s and autoimmune diseases like rheumatoid arthritis, Grave’s disease, and thyroiditis are more common in older women

Insulin-dependent diabetes and rheumatic heart disease are often seen in juveniles

19
Q

What are 2 statistics regarding race/ethinicity and autoimmune diseases?

A

African Americans: more at risk for lupus and scleroderma when compared to European Americans; lower risk of thyroiditis, insulin-dependent diabetes, and multiple sclerosis

Asians: initially have lower rates for autoimmune diseases like thyroiditis, multiple sclerosis, and insulin-dependent diabetes