Autoimmunity

Question 1

tolerane

Answer 1

ability to recognise self tissue and antigens

Question 2

autoimmunity

Answer 2

breakdown of self tolerance

production of auto antibodies causing autoimmunity

Question 3

aetiology of autoimmunity

Answer 3

• genetic predisopsition
• triggering event such as envionment or hormones
• immune regulation break in tolerance

Question 4

what are the types of break down in tolerance leading to autimmunity?

Answer 4

1. molecular mimicry

2. defensive apoptosis B cells kill cells

Question 5

organ specific autoimmunty

Answer 5

mysasthenia gravis

haemolytic anaemia

Question 6

no organ specific autoimmunity

Answer 6

rheumatic arthiritis

SLE

Question 7

ANA

Answer 7

antinuclear antibodies

type of AB binding to the nucleus

Question 8

how are ANAs detected

Answer 8

patient serum added to slide and incubated
any ANAs in sample with bind to substrate on slide
additon o a labelled IgG will be viewed under flourscence

Question 9

what substrates are used for ANA testing

Answer 9

Hep 2/2000 or rodent tissue

Question 10

ANA substrate slides

Answer 10

slides coated with substrates for ANAs

• rodent tissue
• Hep-2 cells
• Hep 2000 ells

Question 11

outline the cell cycle

Answer 11

G0
- cell cycle arrest
G1
- cellular building blocks made and chromosomes duplicated
S
- synthesis of building blocks
G2
- cell double checks everyhing making repairs before divisoion
Mitosis

Question 12

negative ANA

Answer 12

no discernable pattern

DO NOT confuse intesitity with positive result

Question 13

Homogenous ANA result

Answer 13

• interphase cells seen
  smooth staining, nucleoi seen
• metphase

Question 14

clinical relevance of homoegeous ANA

Answer 14

SLE

Question 15

speckled ANA

Answer 15

interphase, speckled nucleus

metaphase mitotic cells

Question 16

clinical significance of speckled ANA

Answer 16

SLE and Sjogrens syndrome

Question 17

nucleolar ANA

Answer 17

interhase cells stain only nucloli

Question 18

clinical significance of nucleolar ANA

Answer 18

systemic sclerosis and polymyositsis

Question 19

centromere ANA

Answer 19

interphase cells with 4 discrene speckles evenly around nucleus
speckles can align in metaphase

Question 20

clinical relevance of centreomere ANA

Answer 20

seen in CREST

Question 21

Hep-2000 antigens

Answer 21

SS-A/RO

some interphase cells hyperexpress this antigen leading to tronger nucleolr and speckled staining

Question 22

cytoplasmic antigens

Answer 22

ANA can also be used to report cytoplasmic patterns

• cytoskeleton
• mitochinidra proteins
• ribosomal antigens
• organelles

Question 23

cytoskeltal antibodies

Answer 23

mitotic spindle stained

Question 24

mitochndrial Antibodies

Answer 24

cytoplasmic pattern

Question 25

ribosomal antibodies

Answer 25

cloudy fine speckling in cytoplam

Question 26

what is titering?

Answer 26

deterimes amount of AB present to give indication of disease | used when mixed patterns of ANA is seen and helps separate the patterns for identifcation

Question 27

what is ENA

Answer 27

extracable nuclear antigen

Question 28

what kinds of DNA testing can be done as a follow up from ANA testing

Answer 28

ELISA test - dsDNA antigen added to patient serum - series of inbuaton and washing stages - plate read at wavelengh to determine IgG DNA

Question 29

ENA testing

Answer 29

ENA antigens added to patient sereum can determine IgG ENA can quanitfy antibody amount

Question 30

what are systemic rheumatic disases

Answer 30

sytemic rheumatic diseases | non-organ specific and cause varied symptoms

Question 31

what is SLE

Answer 31

systemic lupus erythmeatous

Question 32

what does SLE affect

Answer 32

``` lungs heart kidneys arthuritis joints circulation< rayaulds ```

Question 33

aetiology of SLE

Answer 33

underlying cause not fully known

Question 34

what is drug induced SLE

Answer 34

can be cause by a hypersensitivity reaction to a medication triggering the autoimmunity

Question 35

ANA pattern for SLE

Answer 35

homogenous or speckled

Question 36

SLE symptoms

Answer 36

``` arthralgai fever arthritis skin rash anaemia renal invovlement pleuisy butterfly rash photosensitivity hari loss raynaulds seizures ulcers ```

Question 37

treatment of SLE

Answer 37

no cure nly management - protection against phosensitivtyi with cloting and creams - NSAIDS, nonsteriodial anti inflamatory meds for arthiritis and pleurisy - cortiocosteriods for rashes

Question 38

what about the more serious symptoms of SLE like aeneamie, heart invovlement and lung and liver too

Answer 38

requires high dose corticosteriods cyttoxic drugs to block cell growth specialise doctors

Question 39

SLE prognosis

Answer 39

improved over past few eyars early treatment is key for long term progress SLE in adults less serious than in children

Question 40

examples of other autoimmune disaeses

Answer 40

``` SLE sjogrens syndrome scleroderma raynaunds dermatomyosis ```