Autoimmunity

Front 1

Autoimmunity

Back 1

Loss of Immunologic self tolerance
cells not anergic

Hint 1

somehow escape regulation methodes of central and peripheral tolerance

Front 2

Central tolerance T cell

Back 2

Produced by negative selection
MHC molecules with self antigens in thymus present self
if T cell recognizes---death
two problems

Hint 2

1- some self antigens may not make it to thymus
2- some MHC molecules may be bad at presenting certain self antigens

Front 3

Relative Risk

Back 3

Certain MHC alleles.
numerical value based on potential for disease.

Front 4

Cryptic Epitopes

Back 4

Epitope Spreading
inefficiently presented antigen peptides during AP and are weak immunogenetically
may come out later

Front 5

Peripheral T cell Tolerance

Back 5

Some immunologically sequestered priveleged sites like in CNS come out, and react
Th1/17/2 are MHC class II mess ups
CTL autoimmunity limited by costimulatory molecules B7 (CD80/86)
inappropriate expression of co stims will increase T cell
Tregs?

Hint 5

T regs provide delicate balance of cytokines that can steer immune system away from self damage
ANERGY
Can shift too far (to much IL-4 turns of Th1 but activates Th2

Front 6

B Cell Central Tolerance

Back 6

Negative selection of IgM only B cells in bone marrow
3 problems

Hint 6

Incomplete clonal deletion of self reactive B cells due to LIMITED SELF EXPOSURE
somatic mutations in B cell now goes from invader to self reactive
Antigen mimicry- immune cross reactivity

Front 7

Antigen Mimicry

Back 7

Immune cross reactivity similar between infectious pathogens and self antigens
weak evidence for...(5)

Hint 7

Streptococcal M protein damages heart tissue
Measles virus P3- myelin basic protein
Polio VP2- acetylcholine receptor
Cytomegalo Cirus IE2- HLA-DR
papilloma virus E2- insulin receptor

Front 8

Peripheral B cell tolerance

Back 8

Antigen sequestration
CNS keeps certain self antigens hidden
Split Tolerance
Mitogens/Adjuvants

Hint 8

Split tolerance refers to B cells needing T cell activation
may be overcome by messed up anergic T cell or bypass of T cell altogether
Mitogen- activates B cell w/o T cell

Front 9

T Cell bypass mech (2)

Back 9

Mitogen/Adjuvant T cell independent nonspecific
Nonspecific inducer dep- linkage with self antigen with new foreign (extrinsic) antigen. or intrinsic neo-epitopes
"Cryptic"

Front 10

Pathogenic Effector mechanisms
self antibodies(5)
cellular (3)

Back 10

self antibodies
increase or decrease tissue activity
antibody mediated complement
immune complex disease
antibody dep cell mediated cytotoxicity (ADCC)- FcR cells (NK)eat cells bound with antibody
FcR CR attack by phagocytes

Hint 10

Cellular
cytotoxic t cell
inflammatory responses from Th1 Th17
ADCC

Front 11

Anti Receptor Diseases

Back 11

Grave's Disease
Myasthenia Gravis
Insulin-dep Diabetes Mellitus

Front 12

Grave's Disease

Back 12

Thyroid Stimulating Hormone receptor agonist

Front 13

Myasthenia Gravis

Back 13

Ach receptor antagonist

Front 14

IDDM

Back 14

Type I diabetes beta cell destruction in pancreas

Front 15

Multiple Sclerosis

Back 15

Demyelinating of CNS
inductive effect unknown
Type II and Type IV Hyper
remitting-relapsing progression-activating v. suppressing regulatong
antigenic target unclear myelin cells or myelin

Front 16

Rheumatoid Arthritis

Back 16

Mixed antibody CMI effector Type II and Type IV
lots of immune complex in joints

Hint 16

abnormal IgG in joings
anti-IgG antibody is RF

Front 17

SLE
Systemic Lupus Erythematosus

Back 17

multiple tissues
prominent ANA+/DNA reactive antibodies
sex hormones?
rash
kidney disease
LE cells
tissues?

Hint 17

RBC- hemolytic anemia
platelets- thromocytopenia
coagulants- clotting problems
lymphocytes-lymphopenia
neutrophils- neutropenia
Neuron- CNS dysfunction
SCID
DNA, IgG- renal disease

Front 18

Goodpasture's Sydrome

Back 18

Type II
antibody against type IV collagen in basement membrane of renal and pulmonary alveoli

Front 19

Multiple Sclerosis

Back 19

CNS (Oligodendrocytes)

Hint 19

Demyelination

Front 20

Acute idiopathic Polyneuritis
(Guillian Barre)

Back 20

Peripheral Nerves

Hint 20

Demyelination

Front 21

Myasthenia Gravis

Back 21

Ach Receptor

Hint 21

Destruction blocking of Ach receptor, impaired transmission

Front 22

hashimoto's thyroidosis

Back 22

Hypothyroidism

Hint 22

Anti thyroglobulin, anti thyroid epithelium

Front 23

Graves Disease

Back 23

hyperthyroidism

Hint 23

Anti TSH receptor

Front 24

Good Pasture's

Back 24

Basement membrane of renal glomeruli and pulomary alveoli

Hint 24

kidney respiratory failure

Front 25

Addisons disease

Back 25

adrenal glands

Hint 25

anti adrenal cell membranes and lymphocyte cortical infiltration

Front 26

Insuling Dependent diabeted mellitus

Back 26

Type I pancreatic islets

Hint 26

beta cell death

Front 27

Sjogren's sydrome

Back 27

salivary glands

Hint 27

glandular inflammation

Front 28

Autoimmune hemolytic anemia

Back 28

erythrocytes

Hint 28

anemia

Front 29

Thrombocytopenia

Back 29

platelet megakaryocyte

Hint 29

platelet death abnormal bleeding

Front 30

Chronic atrophic gastritis;
pernicious anemia

Back 30

gastric mucosa

Hint 30

loss of gastric secretory function, failure to absorb B12

Front 31

Crohn's Disease
intestinal granulomatous disease

Back 31

mucosal membrane of terminal ileum

Hint 31

mucosal ulceration
obstructive granuloma

Front 32

Rheumatic fever

Back 32

heart

Hint 32

myocarditis, scarring of valves

Front 33

pemphigus vulgaris

Back 33

epidermis

Hint 33

crazy lesions and blisters

Front 34

systemic lupus erythematosis

Back 34

systemic

Hint 34

lots of stuff

Front 35

rheumatoid arthritis

Back 35

intially joints, spreading to cartilage and neigboring bone and muscle

Hint 35

immune complex disease in synovium RF antibodies