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Immuno > Autoimmunity > Flashcards

Autoimmunity Flashcards

1
Q

What two mechanisms must be breached to develop autoimmunity?

A

Central and peripheral tolerance

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2
Q

What are the major factors that influence the development of autoimmune diseases?

A

Autoreactive CTLs
Microbial infections
Lymphocyte abnormalities
Genes

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3
Q

Can autoimmune diseases be tranferred to fetueses from their mothers (not genetically)?

A

Yes, but will be ~3 weeks long (IgG half life time)

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4
Q

What is epitope spreading? What begins this process?

A

Trauma induced spreading of self antigens not normally present in the blood (like d/t blood brain barrier)

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5
Q

How could viruses potentially play a role in the development of autoimmunity?

A

Similar antigens to self (“molecular mimicry”)

Allow for inflammation cytokines to be present when attempting to tolerize T cells

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6
Q

What can mycoplasma infections induce?

A

Transient autoimmunity d/t cross-reaction of antibodies to RBCs

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7
Q

What do the antibodies of rheumatic fever cross react with?

A

Heart tissue

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8
Q

How can inappropriate expression of MHC class I molecules lead to autoimmunity? What are the two example diseases for this?

A

Activate T cells inappropriately

Grave’s disease and DM I

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9
Q

What is vitiligo?

A

Autoimmune disease against melanocytes

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10
Q

How can expression of TCRs specific for MHC proteins on thymocytes bypass negative selection?

A

Expression of certain MHC proteins with self peptides during T cell selection in the thymus might allow enough binding to enable positive selection of autoreactive T cells, but might not bind with high enough affinity to elicit negative selection.

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11
Q

What are the three major ways that tissue injury can be brought about in an autoimmune disease?

A
  1. Autoreactie CTLs
  2. Circulating autoantibodies
  3. Immune complexes
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12
Q

What antibody type can cross the placenta?

A

IgG

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13
Q

What is the pathogenesis of autoimmune hemolytic anemia? (2)

A

RBC antibodies produced against RBC membrane proteins causes RBC lysis

Opsonization of RBCs prompt removal by spleen

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14
Q

What is Goodpasture syndrome?

A

Autoantibodies prodced against Type IV collagen, leading to lung and kidney damage, and death

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15
Q

What is the histological features of Goodpasture syndrome?

A

Smooth, ribbon like appearance to glomerulus

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16
Q

What is the pathogenesis of pernicious anemia?

A

Autoantibodies to intrinsic factor or gastric/parietal cells

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17
Q

What is the pathogenesis of hashimoto’s thyroiditis?

A

Hypothyroid state induced by autoantibodies and autoreactive T cells to thyroid glands proteins

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18
Q

What is idiopathic thrmobocytopenia (ITP)?

A

Platelets destroyed by autoantibodies to platelet membrane proteins, causing skin leasions/epidermal hemorrhage

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19
Q

What is the treatment for ITP?

A

IVIG

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20
Q

What is Grave’s disease?

A

Autoantibodies to TSH receptor, causing hyperthyroidism d/t over stimulation

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21
Q

What is myasthenia gravis?

A

Autoantibodies attack alpha chain of nicotinic acetylcholine receptors, blocking muscle signals

22
Q

What is the pathogenesis of DM I?

A

Autoantibodies to Beta cells in pancreas, cause CTLs to kill (type IV)

23
Q

What type of hypersensititivty is myasthenia gravis?

A

Type II

24
Q

What is the pathogenesis of MS?

A

Th1 and Th17 cells specific of myelin antigens become activated, and attack myelin nerve cells

25
Q

What are the treatments available for MS?

A

Interferon beta-1b

Interferons Beta 1a

26
Q

What is lupus?

A

A broad loss of regulatory control that sustains self tolerance.

27
Q

What is the pathogenesis of lupus?

A

Formation of immune complexes, leading to kidney problems

28
Q

Which type of hyper sensitivity could lupus be considered?

A

Type III

29
Q

How can drugs cause lupus? Is this reversible?

A

In slow drug metabolizers, the drugs could complex with nucleoproteins and generate autoimmunity.

The disease reverses upon removal of the drug.

30
Q

Why is the kidney susceptible to type III hypersensitivities?

A

Express CR1 protein that bind C3b and C4b

31
Q

What are the immunologic factors to lupus?

A

B cell hyper activity
Increased Th activity
Decreased Treg activity

32
Q

What haplotypes are assocaited with RA?

A

HLA-DR4

33
Q

What is the pathogenesis of RA? (Inflammation and tissue damage)

A

Inflammation of joints by Th1, Th17 macrophages, Bcells, and plasma cells.

Tissue damage by rheumatoid factor (IgM/IgG to Fc portion of IgG) causing immune complexes

34
Q

What is the major chemical involved in RA?

A

TNF-alpha

35
Q

What are the three treatments for RA? How does these work?

A

Etanercept-TNF-alpha type II receptor fused to IgG1

Infliximab-same as above

Adalimumab-

36
Q

What is Sjögren’s syndrome? What is its pathogenesis?

A

an autoimmune disease manifested by dry eyes and dry mouth due to the destruction of lacrimal and salivary glands.

Influx of B and T cells, but o/w not known

37
Q

What is scleroderma?

A

Excessive deposition of collagen, and antibodies produced against collagen.

38
Q

What are the major inflammatory chemicals release in scleroderma? What is the consequence of this?

A

IL-1 and TNF-alpha, leads to collagen production = vicious cycle

39
Q

What is polymyositis dermamyositis? Pathogenesis?

A

Skin rash and muscle injury possibly brought about by CD4+ and CD8+ T lymphocytes that have infiltrated the muscles

40
Q

What virus could play a role in polymyositis-dermatomyositis?

A

Coxsackie B virus

41
Q

What are the current therapies for autoimmune diseases?

A

Nonspecific immunosuppression with corticosterids/cyclosporine

42
Q

What is the mechanism of action of corticosteroids against autoimmune diseases?

A

Anti-inflammatory effects

43
Q

What is the mechanism of action of azathiporine and cyclophosphamide against autoimmune diseases?

A

interferes with DNA synthesis to eliminate dividing lymphocytes

44
Q

What are the side effects of prednisone?

A

Bone mineral loss, weight gain, DM, fluid retention, skin thinning

45
Q

What are the side effects of azathiprine and cyclphosphamide?

A

Bone marrow suppression and damage to intestinal epithelium

46
Q

What is the mechanism of action of cyclosporine and tacrolimus?

A

Blocks calcineurine, IL-2 transcription

47
Q

How can plasmaphersis help fight against autoimmune diseases?

A

Removes Ag-Ab complexes

48
Q

25% of people with polymyositis-dermatomyositis have autoantibodies to what?

A

histidyl tRNA synthetase

49
Q

What causes scleroderma?

A

T lymphocytes infiltrate the dermins prior to fibrosis, causing a hypersensitivity to collagen deposits. TNF-alpha and IL-1 are expressed to further the problem

50
Q

What is Infliximab?

A

Humanized anti-TNF-alpha monoclonal antibody

51
Q

What is Etanercept?

A

TNF-alpha receptor fusion protein

Immuno (16 decks)

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