Lecture 2: General AID Flashcards
(31 cards)
Describe autoimmune disease
the failure of an organism to tolerate its own cells and tissues, resulting in an aberrant immune response by lymphocytes and/or antibodies’ causing pathological changes and dysfunction of the tissue that is the target of the self-directed immune response.
How to treat AID
treatment for autoimmune diseases generally focuses on reducing immune system activity.
Autoimmune symptoms
fatigue
achy muscles
swelling and redness
low-grade fever
trouble concentrating
numbness and tingling in the hands and feet
hair loss
skin rashes
What does a POSITIVE ANA (anti-nuclear antibodies) test mean VS POSITIVE ENA test
antinuclear antibody test (ANA). A positive test means you may have one of these diseases, but it won’t confirm exactly which one you have or if you have one for sure
ENA’s - specific autoantibodies (in nucleus) produced by certain AID
Drugs (and assosciated function) to treat AID
- Nonsteroidal anti-inflammatory drugs (NSAIDs) which help ease symptoms like pain, swelling and stiffness.
2.Disease-modifying anti-rheumatic drugs (DMARDs) (holt disease progress),
- Biologics The major category within biologics is tumor necrosis factor (TNF) blockers, which counteract high levels of inflammatory proteins.
4.Corticosteroids suppress the immune system and fight inflammation, eg methohexitone)
5.IVIg (intravenous immunoglobulin) a blood product made up of antibodies which immunomodulatory effects on immune system help get the immune system back on track without suppressing its normal function),
6.Plasmapheresis (a process that removes plasma — the part of the blood that carries antibodies — from a patient’s blood. Because it removes good antibodies along with the bad, however, it leaves the immune system less able to fight off sickness and infection
7.Surgery in rare cases, to deal with certain complications of autoimmune disease such as joint damage injuvenile idiopathic arthritisor bowel obstruction inCrohn’s disease.
Classification of AID and examples
Based on the location of the autoimmune attack: Systemic (SLE attacked kidney and skin) or organ-specific (diabetes affects pancreas, hashimoto impacts thyroid)
Define Connective Tissue
Connective tissue isthe tissue that connects, separates and supports all other types of tissues in the body.
Majorfunctionsofconnectve tissue
binding and supporting
Protecting
Insulating
storing reserve fuel
transporting substances within the body
BAPIST
Types of connective tissue (CABDHB)
dense regular connective tissue which is found in tendons and ligaments
cartilage
adipose tissue
haemopoietic tissue (bone marrow, lymphoid tissue)
blood
bone
Define connective tissue disease and examples
Connective tissue disease isany disease that affects the parts of the body that connect the structures of the body together.
Systemic lupus erythematosus
Sjögren’s syndrome
Sharp syndrome
Connective Tissue Disease markers and the markers antigens
anti-nuclear antibodies (ANA) are important serological markers for CTD
Target antigens include, for example, nucleic acids, cell nuclear proteins and ribonuclear proteins.
Describe Sjogrens Syndrome
Sjogren’s syndrome is an autoimmune disorder that destroys the glands that produce tears and saliva, causing excessive dry eyes and dry mouth.
Diagnostic parameteres of sjogrens syndrome
- Positive serum for anti-SSA/Ro and or anti-SSB/La or positive RF and ANA titre above 1:320
- Labial salivary gland biopsy with focal lymphocytic sialadenitis with focus score = or above 1 focus/4mm2
3.Keratoconjunctivitis sicca with occular staining above 3
What is Myositis and MOST common symptoms
muscle inflammation
caused by lymphocytes that infiltrate healthy muscle fibers as well as foreign invaders.
after a period of inflammation, muscle fibers are destroyed, which affects the functionality of muscle tissue and leads to fatigue and immobility.
Weakness, swelling, and pain are the most common myositis symptoms
Digram of myositis pathogenesis
Lecture slide
Describe the inflammatory myopathy forms
Polymyositis
-inflammatory cells
-Invasion of fibres by inflamm cells
In Polymyositis, inflam cells invade previously healthy muscle cells which become rounded and vary in size
Inclusion body myositis
-inclusion bodies
-vacuoles
In Inclusion body myositis muscle fibres have vacuoles and inclusion bodies (clumps of cellular material) and inflam cells are between fibres
Dermamyositis
-Shrinkage of fibres near border of fascicles
- inflam cells around fascicles and between fibres
- cut off inflam cells around blood vessel
in DM, inflam cells are concentrated arounf blood vessels at the borders of fascicles and fibres in this region shrink. Inflam cells form a cuff around blood vessels.
What is dermatomyositis and who does it affect
an uncommon inflammatory disease marked by muscle weakness and a distinctive skin rash
affects adult and children
In adults, dermatomyositis usually occurs in the late 40s to early 60s.
In children, it most often appears between 5 and 15 years of age.
What is polymyositis and who does it affect
an inflammatory disease that causes muscle weakness primarily affecting the shoulders, upper arms, pelvis and thighs
can occur at any time of life, although it is uncommon under the age of 18 years and generally occurs between the ages of 30 and 60 years
Women are more commonly affected by the condition than men.
Symptoms of dermatomyositis and polymyositis
Eyelid rash
Shawl Sign
Shoulder/peliv girdle
ground glass opacity in lungs
GI vasculopathy
pharngeal weakness
polymyositis is the same BUT NO RASH
What is inclusion body myositis and when does it develop?
aprogressive muscle disorder characterized by muscle inflammation, weakness, and atrophy(wasting)
develops in adulthood, usually after age 50
Diagnose myositis
Antinuclear antibodies (ANA) IFA methods are present in 80% of patients with polymyositis and dermatomyositis, but are not specific for either condition.
Detection of ENA - anti-SS-A (anti-Ro), anti-SS-B (anti-La), anti-Smith, or anti-ribonucleoprotein (anti-RNP) antibodies strongly suggests the diagnosis of myositis associated with overlap syndromes such as Mixed or undiffereniated connective tissue disease
ENA - Anti-Jo-1 antibodies are directed against anti-histidyl-tRNA synthetase. Anti-Jo-1 antibodies are strongly associated with arthritis, and mechanic’s hands.
What areas of the body does SLE affect
Symptoms
what age does it develop
affects many parts of the body (most commonly the skin, muscles and joints) causing inflammation and tissue damage
symptoms include fatigue, fever, muscle aches and facial rash
there is no cure for lupus so the aim of treatment is to relieve symptoms and protect body systems and organs.
Any age, typically 20-45
SLE diagnostic findings
Almost all are ANA positive (one of diagnostic criteria)
70-98% of patients will be positive for dsDNA antibodies
ENA – positive Ro, La, Sm most common
what does ANA target?
Why are ANA important?
found in healthy people?
react with various nuclear and cytoplasmic components of normal human cells
Found in healthy people
their detection is important in the diagnosis of some connective tissue diseases (CTD)—eg, SLE, Sjögren’s syndrome, scleroderma, polymyositis
