Pod Exam 3 Chapter 11 - Autoimmunity

Front 1

Do males or females have a higher incidence of autoimmune disease?

Back 1

females

Front 2

What is the defining characteristic of autoimmune diseases?

Back 2

Presence of antibodies and T-cells specific for antigens of a targeted tissue

Front 3

Are autoimmune diseases ever caused by IgE?

Back 3

No!

Front 4

Autoimmune hemolytic anemia:

Back 4

IgG and IgM antibodies to components of the erythrocyte surface

Leads to classical complement activation.
This is a type II hypersensitivity

Front 5

Can blood cells that have antibody and complement bound to them still function?

Back 5

Yes!

Front 6

Which type of hypersensitivity reaction is glomerulonephritis?

Back 6

Type III hypersensitivity

Front 7

Systemic lupus erythematosus (SLE)

Back 7

IgG made against common intracellular macromolecules leading to soluble complexes

Front 8

How does chronic thyroiditis lead to diminished capacity to make thyroid hormones?

Back 8

This involves a TH1 response as well as antibodies and effector T-cells against the thyroid

Front 9

What is Graves disease?

Back 9

Condition where antibodies bind to the TSH receptor

Leads to HYPERthyroid

Front 10

How does Graves' disease compare to Hashimoto's disease in terms of tissue destruction?

Back 10

Graves' tends to bias towards a TH2 response and leads to LESS tissue destruction

Front 11

Why don't babies born to mothers who have T-cell mediated autoimmune disease show any symptoms of the auto-immune disease?

Back 11

Because lymphocytes cannot cross from maternal to fetal circulation

Front 12

Selective destruction of the insulin-producing cells of the pancreas causes which autoimmune condition?

Back 12

Insulin dependent diabetes mellitus IDDM

Front 13

What is insulitis?

Back 13

Situation where islets of Langerhans becomes infiltrated with lymphocytes

Front 14

Which type of leukocytes would you see in the joint synovium of someone with rheumatoid arthritis?

Back 14

CD 4 cells, CD 8, B cells, lympohoblasts, plasma cells, neutrophils, macrophages

Front 15

What are the major mediators of inflammation in Rheumatoid arthritis?

Back 15

Prostaglandins and leukotrienses

Front 16

What is the name given to the antibodies specific for the Fc region of IgG as seen in rheumatoid arthritis?

Back 16

Rheumatoid factor

Front 17

What is multiple sclerosis?

Back 17

An autoimmune disease against myelin sheath of nerve cells
Leads to sclerotic plaques of demylenated tissue in the white matter of the CNS

Front 18

What is myasthenia gravis?

Back 18

Autoimmune disease in which autoantibodies bind to Ach receptors inducing their degradation.

Leads to progressive muscle weakening

Front 19

In general, what are the most important genetic factors for autoimmune diseases?

Back 19

HLA genes (both class 1 and class 2)

Front 20

HLA types that confer highest susceptibility to Insulin-dependent diabetes mellitus:

Bonus question: Which genes is IDDM associated with?

Back 20

DR3 and DR4

Associated with HLA-DQ class II beta chain

Front 21

What is Goodpasture's syndrome?
What environmental factor contributes to the damage caused by the disease?

Back 21

Goodpasture's syndrome is a disease characterized by antibodies against type IV collagen of basement membranes.

Cigarette smokers develop lung damage in the alveoli basement membranes
(smoking allows circulating antibodies to access these previously inaccessible membranes)

Front 22

Although (most/few) autoimmune diseases are associated with HLA class II, the (strongest/weakest) diseases are associated with class I.

Back 22

Although MOST autoimmune diseases are associated with HLA class II, the STRONGEST diseases are associated with class I.

Front 23

Give an example of a condition where following an injury, the immune system gained access to an anatomical site that it previously did not have access to:

Back 23

Sympathetic ophthalmia

Upon a blow to the eye, proteins in the anterior chamber can flow to the lymph nodes and be subject to autoimmunity.
This condition also affects the undamaged eye as well.

Front 24

In Wegener's granulomatosis, what event triggers the autoimmune damage to small blood vessels?

Back 24

This disease is characterized by autoantibodies to neutrophil granules (specifically proteinase-3).

Normally the granules aren't accessible to the auto-antibodies, but upon infection, neutrophils are activated and expose proteinase-3 to the auto-antibodies.

Front 25

Which of these conditions does the book say can trigger symptom exacerbation in multiple sclerosis?

A. Smoking
B. Damage to muscles through trauma
C. Viral infections
D. Eating foods high in protein

Back 25

C. Viral infections

Front 26

How many weeks does it take for Rheumatic fever to develop?

Back 26

2 - 3 weeks

Front 27

Why is rheumatic fever considered a transient autoimmune disease?

Back 27

Auto-antigens cannot continue to stimulate antibody synthesis due to a lack of T-cell help.
T-cells that served in the anti-bacterial response are not stimulated by auto-antigens.

Front 28

Is there any bacterial/viral infections that have been implicated in contributing to the development of insulin dependent diabetes?

Back 28

Yes….

The coxsackie B virus, which affects beta cells of the pancreas has been implicated in triggering IDDM.

Front 29

If a person has T-cells specific against myelin basic protein, can we infer that the person has multiple sclerosis?

Back 29

No….

T-cells against MBP are also found in healthy people, indicating that T-cells alone are not sufficient.

Front 30

The greatest susceptibility to SLE is associated with HLA-_____:

Back 30

HLA-DR3

Front 31

What is pemphigus vulgaris?

Which HLA type is frequently associated with this condition?

Back 31

This is an autoimmune condition due to auto-antibody attack on desmosomes, leading to skin blistering.

It has been associated with HLA-DR4

Front 32

What happened when scientists tried to transfer myelin basic protein specific TH1 cells to healthy unimmunized animals?

Back 32

The healthy animals developed experimental autoimmune encephalomyelitis (EAE)

Front 33

How is it that T-cell tolerance can also provide B-cell tolerance?

Back 33

High affinity antibody responses require T-cell responses to the same antigen.
Thus, when T-cells are negatively selected against, the response of B cells is diminished as well.

Front 34

How can T-cells circumvent the requirement of B-7 co-stimulatory molecules to be activated (thus allowing them to react against non-professional APC's)?

Back 34

In conditions such as infection, damaged cells are eaten by professional APC's which DO carry the B-7 signal.
Thus auto-immune T-cells could be activated in this way. .

Front 35

Which of the following signals can induce MHC Class II expression on cells that normally do not express these molecules? (Leading to new targets for T-cell activation)

A. IFN-Alpha
B. IFN-Gamma
C. TNF-Alpha
D. TGF Alpha
E. IL-1

Back 35

B. IFN-Gamma

Front 36

What happens when mice are fed myelin basic protein instead of being injected with it?

Back 36

The mouse produces a TH2 response which stops the TH1 response that leads to autoimmunity.

Front 37

What happens when autoreactive B cells encounter their specific autoantigens during proliferation in the germinal center?

Back 37

The B cells die