Autoimmunity

Question 1

Types of adaptive immunity

Answer 1

Cell Mediated

Humoral immunity

Question 2

Defects in what can trigger autoimmunity?

Answer 2

Any part of the immune system

Question 3

What is the bodys first line of defence?

Answer 3

Sentinel cells

Question 4

Where are sentinel cells found?

Answer 4

Kupffer cells (liver) 
Langerhans cells (skin / mucosa) 
Alveolar macrophages (in lungs) 
Microglia (brain) 
Dendritic cells 
Mast cells and specialised T cells (blood) 
Macrophages

Question 5

What do sentinel cells lead to?

Answer 5

Increased temperature
Complement cascade
Inflammation

Question 6

Adaptive immunity consists of ….

Answer 6

T cells

B cells

Question 7

Central control of tolerance features

Answer 7

Thymus
inactivation of cells required for initiation of immune response
Negative selection ensures only those that work make it out of the thymus

Question 8

Peripheral control of tolerance features

Answer 8

Inhibition of the expression of the immune response

Treg cells - Th17 cells

Question 9

Types of antigen presenting cells (APCs)

Answer 9

Professional

Atypical

Question 10

Types of professional APCs

Answer 10

DCs
Macrophages
B cells

Question 11

Types of atypical APCs

Answer 11

Mast cells
Basophils
Eosinophils
ILC3s

Question 12

What makes up the major histocompatibility complex?

Answer 12

Human leucocyte antigen (HLA)

Chromosome 6

Question 13

What does a working immune system have?

Answer 13

Recognition 
Interaction 
Response
Elimination 
Control and regulation

Question 14

Does autoimmunity equal autoimmune disease?

Answer 14

NO

Question 15

What is autoimmunity?

Answer 15

Physiological autorecognition with secondary epiphenomena

The failure of an organism in recognising its own constituent parts as non self OR you having immunity to you

Question 16

Pathology of autoimmunity

Answer 16

Cell mediated 
Antibody mediated 
Immune complex autoimmunity 
Environmental 
Genetic

Question 17

Autoimmunity and T1DM

Answer 17

Autoreactive T cells against pancreatic islet cell antigens leading to destruction and non-production of insulin

Question 18

Autoimmunity and Crohn’s disease

Answer 18

Triggered by a foreign pathogen leading to APC presentation
Autoreactive T cells against intestinal flora antigens leading to lymphocyte infiltration of exocrine glands
Can be familial (NOD2 gene)

Question 19

Autoimmunity and psoriasis

Answer 19

Autoreactive T cells against skin associated antigens

Question 20

What occurs in autoimmune disease?

Answer 20

Immune response contributing directly to tissue / organ damage

Question 21

Which gender is more at risk of getting an autoimmune disease?

Answer 21

F > M

Question 22

Causes of autoimmune disease

Answer 22

Unknown 
Immune regulation 
Hormonal 
- F > M 
Genetic factors
- HLA
Environmental 
- UV / sun 
- Bacterial 
- Chemical agents

Question 23

What is myasthenia gravis a disease against?

Answer 23

The NMJ

Question 24

Pathology of myasthenia gravis

Answer 24

Autoreactive T cells and B cell ACH receptor antibodies

Question 25

Presentation of myasthenia gravis

Answer 25

Weakness | Fatigability

Question 26

What is myasthenia gravis associated with?

Answer 26

Thymoma

Question 27

Pathology of MS

Answer 27

T cells specific to myelin, cross the BBB and release cytokines BBB damage, macrophage and Tc cell migration attacks oligodendrocyte Despite Treg cells allowing healing, eventually the damage becomes worse

Question 28

What is MS associated with?

Answer 28

HLA-DR2 | Vit D deficiency

Question 29

Features of organ specific autoimmune disease

Answer 29

Antigens are localised to given organ or tissue Lesions are confined to target organ or tissue They overlap with other organ specific antibodies and diseases

Question 30

Features of non organ specific autoimmune disease

Answer 30

Antigens have widespread distribution throughout the whole body Multiple organs and tissues are affected Immune complexes deposit in joints, skin and kidneys Overlaps with other non organ specific antibodies and diseases

Question 31

Examples of organ specific autoimmune diseases

Answer 31

``` Autoimmune thyroid disease - graves - hashimotos Myasthenia gravis Pernicious anaemia Diabetes mellitus ```

Question 32

Examples of non organ specific autoimmune diseases

Answer 32

SLE RA systemic sclerosis Systemic vasculitis

Question 33

Treatment of autoimmune disease

Answer 33

``` Immunosuppressive therapy Anti-inflammatory therapy Plasmapheresis Stem cell / Bone marrow transplant Replacement of lost physiological factor Organ / tissue / mechanical graft ```