CNA and Autoimmunity Flashcards
What antibody is elevated in MS
IgG
Where is this antibody formed
In the CSF
What is the unique about this antobody
It is oligoclonal and the cells are making this IgG inside the brain
How is the prognosis of the disease if this antibody is present
Presence of oligoclonal IgG indicated a poor prognosis
What does it mean when an antibody is oligoclonal
It is made by many different B cell clones
How does SPE results differ for polyclonal, oligoclonal and monoclonal
SPE results yield a thick band for serum albumin and then there are alpha and beta bands. For monoclonal, we will see one thick band in the gamma region, for oligoclonal we may see 2 or 3 thick bands and for polyclonal we will see a thick gamma region such that we cant differentiate one band from the other.
MS has an oligoclonal appearance on SPE
What band appearence is observed in an infection
Oligoclonal
What band appearence is in autoimmunity
Oligoclonal
What is the ratio of the light chains in Ig
Kappa to lamda is 3:1
Give an example of neoplasm that is example of monoclonal gammopathies
Multiple Myeloma
Explain multiple myeloma
It is a monoclonal malignancy, one of the plasma cells in the bone marrow starts to divide aberrantly. The plasma cells make excessive same type of antibody. The cells pack up in the bone marrow to such an extent that other HSC processes are severly affected, the bone starts degrading and one of the clinical presentations of Multiple myeloma is bone fracture
What does it mean if the IgG to albumin ratio is elevated in the CSF
That means the IgG is being made in the brain as it is coming from the CNS
Expalin the causes of the lesions in the brain in MS
Follicles form in the brain which causes lesions to form right next to the follicles. During early onset of MS follicles are in greater number than the lesions
Explain the pathogenesis of MS
MS targets a range of antigens found in the brain, the most common one being myelin basic protein. APC cells present the antigen to T cells which causes differentiation into Th1 cells. Th1 cells at the brain make cytokines to activate macrophages which then causes destruction of myelin sheaths. This releases more antigens and DAMPS which are then presented by a different set of APCs which further recruit more Th1 cells. This cycle keeps going on. This phenomena is called epitope spreading.
What is the clinical significance of epitope spreading
Different patients has present with very different symptoms
