0201101330 - Mfm Ii - Autoimmunity (Bassett)

Front 1

Are autoimmune diseases more common in men or women?

Back 1

women, which brings up the question of hormonal involvement

Front 2

What are the two cell types that are most common in autoimmunity diseases?

Back 2

1. self-reactive cytotoxic T cells directed toward normal cells
2. self-reactive helper T cells that activate B cells to make AutoAb

Front 3

What four ways does our body naturally produce self tolerance with T cells?

Back 3

1. negative selection
2. regulatory T cells induce anergy
3. lymphocytes have limited access to tissues that could produce problems
4. lymphocytes lack necessary co-stimulatory signals they need to be active in the sites of maturation

Front 4

What is AIRE?

Back 4

"autoimmune regulator." this molecule causes regulates negative selection in T cells and when defective can cause APECED (autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy)

Front 5

How does APECED present?

Back 5

negative selection is not complete so autoimmune T cells cause various tissue destruction

Front 6

What is APECED also known as?

Back 6

autoimmune polyglandular disease (APD)

Front 7

What is B cell clonal deletion?

Back 7

When a B cell interacts with self-Ag it is not allowed to leave the germinal center and will undergo apoptosis.

Front 8

What are the three categories of autoimmune diseases?

Back 8

1. autoantibodies to cell-surface molecules (type 2 hypersensitivity)
2. immune complex disease (type 3 hypersensitivity)
3. T-cell mediated (type IV hypersensitivity)

Front 9

What is autoimmune hemolytic anemia?

Back 9

IgG directed autoimmune response on red blood cells, usually against Rh factor which leads to
1. phagocytosis and RBC destruciton in the spleen,
2. complement activation and destruction of RBC in spleen
3. complement activation and RBC destruction in circulation

Front 10

How does the AutoAb act against the corresponding receptors in graves' disease, myasthenia gravis, insulin-resistant diabetes, and hypoglycemia?

Back 10

1. grave's disease thyroid-stimulating hormone receptor agonist
2. myasthenia gravis acetylcholine receptor antagonist
3. insulin-resistant diabetes insulin receptor antagonist
4. hypoglycemia insulin receptor agonist

Front 11

What is Graves' disease?

Back 11

AutoAb against thyroid stimulating hormone receptor that acts as an agonist, producing an overactive thyroid -> hyperthyroidism

Front 12

What are the four thyroid autoimmune diseases?

Back 12

1. Hashimoto's thyroiditis
2. Graves' disease
3. Subacute thyroiditis
4. Idiopathic hypothyroidism

Front 13

What are the two autoimmune diseases that effect the Islets of Langerhans?

Back 13

there are on the pancreas, yo.
1. IDMM
2. Insulin-resistant DM

Front 14

What autoimmune disease targets the adrenal gland?

Back 14

addison's disease

Front 15

What makes endocrine glands more vulnerable?

Back 15

1. very vascularized
2. systemic effects
3. unique tissue

Front 16

What are the four common symptoms of immune complex type III autoimmunity?

Back 16

1. glomerulonephritis - due to immune complex deposition in glomeruli
2. vasculitis
3. arthritis
4. unexplained fever

Front 17

What is SLE?

Back 17

immune complex type III autoimmunity caused by auto-IgG causing chronic inflammatory reactions. immune complex will be deposited into MANY types of tissues. symptoms will wax and wane.

Front 18

How does SLE present?

Back 18

butterfly skin malar rash
arthritis
unexplained fever

Front 19

What are the four most common type IV T-cell mediated autoimmunities?

Back 19

1. IDDM
2. RA
2. MS
4. celiac disease

Front 20

What is RA?

Back 20

mainly type IV T-cell mediated autoimmunity caused by anti-IgG antibodies (called rheumatoid factor), reactive T cells, and immune complexes. uniquely expresses ALL THREE TYPES OF AUTOIMMUNITY!

Front 21

What is multiple sclerosis?

Back 21

type IV T-cell mediated autoimmunity disease caused by self destruction of myelin sheaths mediated by TH1 CD4 T cells and IFN-gamma. presents with visual loss, muscle weakness, CNS impairment

Front 22

What is myasthenia gravis?

Back 22

type II autoimmunity disease caused by autoAb formed against acetylcholine receptors antagonistically. presents as face, eye, and tongue control problems

Front 23

What three autoimmune diseases have close to equal male/female distributions?

Back 23

1. MS
2. psoriasis
3. wegener's granulomatosis

Front 24

What autoimmune disease occurs in twice as many males than females?

Back 24

ankylosing spondylitis

Front 25

What is the genetic prevalence to DM?

Back 25

When the HLA-DQB locus is linked to HLA-DR3 or HLA-DR4, then there is a 25x higher risk of developing diabetes causing negative selection to fail

Front 26

What are three environmental triggers related to infection that can cause autoimmune reactions?

Back 26

1. bystander activation - infection increases effector cells and co-stimulates causing T cells to become active that are NOT specific to the disease
2. molecular mimicry - auto reaction against self that is similar to pathogen
3. inflammation - can reveal self-Ag that are not usually revealed

Front 27

What is an example of the By-stander activation effect?

Back 27

circulating anergized or suppressed T cells become re-activated by inflammatory cytokines

Front 28

What is an example of the molecular mimicry effect?

Back 28

in a streptococcal infection, some of the Ab formed against strep will cross react with cardiac muscle -> rheumatic fever

Front 29

What is an example of the inflammation trigger effect?

Back 29

sympathetic ophthalmia caused by trauma that is caused to one eye which causes a release of intraocular Ag carried to the lymph nodes and activate T cells. these T cells will target Ag in both eyes. oops!

Front 30

What interesting infection is thought to reduce autoimmune disease?

Back 30

parasitic disease because of immune system naivety