Autoimmune disease Flashcards Preview

Clinical Pathology > Autoimmune disease > Flashcards

Flashcards in Autoimmune disease Deck (29):
1

What are the features of MHC I?

- Encoded by genes in HLA-A, HLA-B, HLA-C
- On all nucleated cells
- Presents antigen to CD8+ T cells

2

What are the features of MHC II

- Encoded by genes in HLA-DP, HLA-DQ, HLA-DR
- On dedicated APCs
- Presents antigen to CD4+ T cells

3

Where does central tolerance take place?

Thymus for T cells
Bone marrow for B cells

4

What are the features of peripheral tolerance?

Regulatory T cells (express FOXP3)

5

What are the common risk factors for autoimmune disease?

- Sex (hormonal influence)
- women >> men
- Age
- autoimmunity more common in elderly
- Sequestered Antigents
- May be recognised as foreign by the immune system (e.g. cell nucleus, eye, testis)
- Environmental triggers
- Infection
- Trauma-tissue damage
- smoking

6

What is the relevance of molecular mimicry in autoimmune disease?

In rheumatic fever antibodies against M protein of Streptococcus also react against the glycoproteins of the heart

7

How might changes in amount or nature or autoantigens cause autoimmunity?

- Citrullination of proteins make them more immunogenic (rheumatoid arthritis)
- Tissue transglutamase alters gluten to help it bind to HLA-DQ (coeliac disease)
- Failure to clear apoptotic debris increases availability of sequestered antigens inside the cell (systemic lupus erythamatosus)

8

What is the potential pathophysiology of autoimmune disease?

- Autorective B cells and autoantibodies
- Directly cytotoxic
- Activation of complement
- Interfere with normal physiological function
- Autoreactive T cells
- Directly cytotoxic
- Inflammatory cytokine production
- General inflammation and end-organ damage

9

What is thought to be the aetiology of SLE?

Defects in apoptosis?

10

What causes the malar rash?

Sunlight - Anti-nuclear antibodies bind to skin cells that have been damaged by UV light and form immune complexes with their antigen.

11

How does lupus become systemic?

Immune complex deposition in other organs.

12

How might T cells contribute to autoimmunity?

Cause inflammation by inflammatory cytokines or by helping B cells make autoantibodies

13

What is the pathophysiology of Hashimoto's Thyroiditis?

- Destruction of thyroid follicles by autoimmune process
- Associated with autoantibodies to thyroglobulin and to thyroid peroxidase
- Leads to hypothyrodism

14

What is the pathophysiology of Grave's disease?

- Inappropriate stimulation of thyroid gland by anti-TSH-autoantibody
- Leads to hyperthyrodism

15

What is the pathphysiology of myasthenia gravis

Autoantibodies block the muscarinic ACh receptor and target it for destruction.

16

What is the pathophysiology of pernicious anaemia?

anti-IF or anti-IF receptor autoantibodies block the uptake of B12 from the gut.

17

What kind of autoantibodies are formed in SLE?

anti-nuclear

18

Which part of the immune system is involved in autoinflammation?

Innate

19

Which part of the immune system is involved in autoimmunity?

Adaptive

20

Are autoantibodies usually present during autoinflammation?

No

21

What are the clinical features of autoinflammation?

Recurrent and unpredictable attacks

22

What are the clinical features of autoimmunity?

Continuous progression

23

What is the conceptual understanding of autoinflammation?

Tissue-specific factors/danger signals

24

What is the conceptual understanding of autoimmunity?

Breaking of self-tolerance

25

Where is the main genetic susceptibility for autoinflammation?

Cytokine and bacterial sensing pathways

26

Where is the main genetic susceptibility for autoimmunity?

MHC II, adaptive response genes, anti B and T cell

27

Give examples of autoinflammation.

Monogenic hereditery periodic fevers, polygenic Crohn’s disease, spondylarthropathies

28

Give examples of autoimmunity.

RA, SLE, IPEX

29

Give and example of an autoimmune disease that leads to ischaemia and fibrosis.

Scleroderma

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