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26 Cards in this Set
- Front
- Back
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adaptive immune defenses in eye
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IgA (tears), IgG (tears), activated T and B cells
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immune privilege
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suppressed immune responses; protects from inflammatory immune responses which could potentially damage sensitive areas (brain, testes, fetus, eye)
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immune privilege in eye mechanism
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Avascular cornea; limited lymphatic drainage; low/absent MHC expression; local production of anti-inflammatory neuropeptides, cytokines (TGF-b) and other anti-inflammatory molecules (IL-1 receptor antagonist); high expression of complement regulatory proteins; expression of FasL by eye tissues
Il-1R antagonist; binds to IL-1R receptor not letting it signal downreg of complement FasL expressed by eye tissues low/absent MHC expression |
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FasL:fas interaction
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activates caspase-8 in Fas-expressing immune cells induces apoptosis;
immune cells contact eye tissue which may have FasL = apoptosis |
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Immune privilege and corneal transplantation
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immune privilege facilitates this; since normal cornea has noblood supply immune cells can't arrive and theres no MHC antigens to act as targets
mcc of graft failure is rejection; rejection by CD4+ T cells does occur bottom line = immune privilege delays but does not prevent rejection |
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5 mechianms fo rimmune privilege in eye
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limited lymphatic drainage; low/absent MHC; anti-inflammatory neuropeptides; cytokines TGF-B and IL-!Ra; presence of coplement regulatory proteins; FasL expression
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why antibiotic prednisolone drops given?
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empirical tx for post surgical infection/inflammation
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why give cyclosporine?
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inhibis T cell activation (rejection caused by activated T cells)
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Amphotericin B
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antifungal
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Cyclosporine inhibits calcineurin (dephosphorylates/activates NFAT); dont activate NFAT and is a huge player in transplantation medicine
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hypersensitivities in conjunctivitis
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Pemphigoid
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autoantibody against skin hemidesmosome can cause conjunctivitis
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FCRI is a high affinity receptor on Mast Cells, how does this affect IgE levels
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serum IgE does not need to be high for IgE to bind FC-gamma-RI
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ankylosis spondylitis
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sarcoidosis uveitis
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behcets disease
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juvenile idiopathic arthritis (JIA)
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lens induced uveitis
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trauma or cataract extraction (especially in the presence of bacteria* like Propionibacterium acnes) may initiate an autoimmune reaction
bacteria activates PRR which activates T cells for autoimmune response to own tissue infection causes autoimmune dz |
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Sympathetic ophthalmia:
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- penetrating injury (or surgery) to one eye sets up an autoimmune reaction to an ocular antigen that can damage both eyes
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hypopyon
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neutrophillic pus that settles out in the anterior chamber; not specific; can be caused by anything causing inflammation in the anterior chamber
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bahcets disease
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vasculitis triad; mouth ulcers, genital ulers, eye inflammation
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etanercept
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synthetic TNF receptor-like molecule; sucks up TNF
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anakinra
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IL-1 R antagonist
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most likely cause of immune mediates scleritis (9)
when you think scleritis think vasculitis |
1/3 is RA
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most common feature of idseases that cause immune mediates scleritis
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immune mediated systemic vasculitis
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anakinra and immune privilege in theey have in common
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IL-1Ra
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