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Immunology > Autoimmunity > Flashcards

Autoimmunity Flashcards

1
Q

What is autoimmunity

A

Failure of organism to recognise its own constituent part as non-self

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2
Q

What are factors involved in developing autoimmune disease

A

Genetics - HLA
Hormonal - W>M
Environment
Immune regulation

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3
Q

Examples of environment

A

UV sun = apoptosis in SLE exposing T cell to ANA Ab which as seen as foreign
Infection = breakdown in tolerance
Chemicals / drugs

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4
Q

What are the pathogenetic mechanisms of different autoimmune disease

A

Cell mediated
Ab mediated
Immune complex mediated
Mixed / atypical

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5
Q

What happens in Cell mediated

A

Breakdown in immune tolerance
T cell bypass
T / B cell discordance

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6
Q

What is T cell bypass

A

B cells usually activated by alerted T cells

Can be bypassed by polyclonal activation of B cells e.g. super antigens in infection

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7
Q

What is T / B cell discordance

A

T and B cells should respond to same antigen

If they don’t B cells use ANY T cell stimulated by antigen to do the work

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8
Q

What diseases are cell-mediated autoimmune

A

DM
Chron’s
Psoriasis
Coeliac

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9
Q

What happens in DM

A

Autoreactive T cells against pancreatic islet cell antigen = destruction

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10
Q

What happens in Chron’s

A

Foreign pathogen in gut = APC to CD4
Autoreactive T cells attack
Inflammation

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11
Q

What gene associated

A

NOD2

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12
Q

What happens in Psoriasis

A

Autoreactive T cells attack skin associated antigens leading to inflammation and thickening

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13
Q

What happens in coeliac

A

B cells for transglutmainase (anti-TTG Ab) helped by T cells to recognise gliadin (concordance)
APC picks up gladden and presents to T cell
Recognise as foreign and attacks
If can’t find gliaden attacks other cells in gut

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14
Q

What happens in Ab mediated

A

Ab binds to self antigen due to failure of B cell

Leads to damage by Fc receptor MO +- complement

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15
Q

What is it an example of

A

Type 2 hypersensitivity reaction

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16
Q

What diseases are Ab autoimmune mediated

A 
Anti-GBM
Autoimmune anaemia
ITP 
Myasthenia Gravis 
Pemphigus
Hyperactive graft rejection 
Haemolytic disease newborn
17
Q

What happens in Good pasture

A 
IgG Ab reacts to type 4 collagen
Activates complement 
Type 4 collagen destroyed in BM 
Pulmonary haemorrhage if in lung
Renal failure if kidney
18
Q

What increases risk inc HLA

A

HLA DR15
Infection
Smoking
Solvents

19
Q

What is Myasthenia Gravis

A

Autoreactive T and B cells produce ACH Ab that block or destroy Ach receptor at NMJ preventing nerve impulses
Complement = local inflammation

20
Q

What is present in majority of Myasthenia gravis

A

Ach receptor Ab

21
Q

What happens in immune complex mediated autoimmunity

A

Immune complex forms

Activates phagocytes and causes damage

22
Q

What is it an example of

A

Type 3 hypersensitiity

23
Q

What disease associated

A

SLE

24
Q

What happens in SLE

A

Failure of tolerance = self reactive B an T cells circulate
React to double stranded DNA auto-antigen
Present to B cell + T cell
Ab produced
Antigen / Ab complex made which is deposited in basement membrane
Activates complement

25
Q

Where does this occur commonly

A

Kidney and joint synovial as blood is filtered these

26
Q

What are other ways of autoimmune disease

A

Innate recruitment

Molecular mimicry

27
Q

What is innate recruitment

A

Self Ab made that cause a +VE stimulus

28
Q

Example

A

Thyroid Ab in Grave’s stimulates thyroid just like TSH binding to receptor

29
Q

What is molecular mimicry

A

Foreign antigen initiates immune response as T or B cell recognise it as self
Increases immune response

30
Q

Example of this

A

Rheumatic fever
Exogenous Group A beta haemolytic strep shares similarities to host antigens
Any Ab produced can also bind to host and amplify immune e.g. cardiac tissue

31
Q

What disease encompasses all of the above mechanism

A

Multiple sclerosis

32
Q

What is associated with MS

A

HLA-DR2

Vitamin D deficiency

33
Q

How do you treat autoimmune disease

A 
Immunosuppression
Anti-inflammatory
Plasmapheresis
Stem cell or bone marrow transplant 
Replace lost factor
Organ / tissue graft

Immunology (7 decks)

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