Term
| Primary autoimmune disease |
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Definition
response directed against normal host constituents (self-antigens)
loss of tolerance to normal self antigens |
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Term
| Secondary autoimmune diseases |
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Definition
destruction of normal host constituents secondary to immunolig event (foreign antigens)
bacteria, viruses, drugs |
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Term
| Hormone Influences on Autoimmunity |
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Definition
predilection for females
female sex hormones may promote autoimmunity (estrogen and progesterone) |
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Term
| Type II Direct Cytotoxicity |
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Definition
damage to target cells mediated by IgG, IgM, C2
examples: systemic lupus erythematosus, bullous pemphigoid, some drug reactions |
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Term
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Definition
| immune complexes are deposited in tissues and attract neutrophils that cause inflammation |
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Term
| Type IV Delayed Hypersensitivity |
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Definition
| tissue damage from activated T cells cytotoxic action |
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Term
| Type V Antibody Activated Cell Damage |
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Definition
autoantibodies target desmogleins that are between cells in the juncions
cause destruction of cytoskeleton/desmosomes result in acantholysis |
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Term
| Therapy for Immune Mediated Diseases |
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Definition
can be life threatening
treatments must be individualized
medication side effects are common
don't stop therapy abruptly
sunlight exacerbates condition |
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Term
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Definition
supportive care with antiseptic and antiseborrheic
glucocorticoids and tacrolimus |
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Term
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Definition
most commonly used and highly effective
affect cell-mediated and humoral immunity
inhibits cytokines
inhibits chemotaxis
inhibits phagocytosis |
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Term
| Glucocorticoids Side Effects |
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Definition
PU/PD
polyphagia
weight gin
dull hair coat
alopecia
muscle atrophy
thinning of skin
increased risk of infections
steroid hepatopathy
increased risk of diabetes mellitus |
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Term
| Monitoring Glucocorticoids |
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Definition
monthly monitoring during induction
CBC and chemistry profiles
urinalysis and culture
watch for diabetes in cats |
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Term
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Definition
| dexamethasone > triamcinolone > Methylprednisolone > Prednisone > Hydrocortisone |
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Term
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Definition
antimetabolite
interferes with synthesis of nucleic acids
cytotoxic to T cells
slow onset of action
often combined with steroids to decrease the dose
do not use in cats |
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Term
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Definition
alkalating agent
suppressed both humor and cell-mediated immunity
used for refractory cases of pemphigus |
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Term
| Cyclophosphamide Side Effects |
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Definition
bone marrow suppression
sterile hemorrhagic cystitis
bladder fibrosis and neoplasia
vomiting/diarrhea, hair loss
infections |
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Term
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Definition
alkalating agent
suppresses both humoral and cell mediated immunity
may combine with steroids and/or azathioprine |
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Term
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Definition
antibiotic that has anti-inflammatory effects
decreases complement activation
decreases antibody production
decreases chemotaxis
decreases lymphocyte proliferation
decreases synthesis of prostaglandins, lipases, and collagenase |
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Term
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Definition
used in combination with tetracyclines for anti-inflammatory effects
blocks antigen and IgG-induced histamine released
inhibits mast cell degranulation and mediator release |
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Term
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Definition
potent immunosuppressive
calineurin inhibitor which blocks gene transcription and alters mediator synthesis
targets T-cells and inhibits T helper cells and T cytotoxic cells
decreases cytokine production, antigen processing, macrophage activity, neutrophil adherence, mast cells in skin, eosinophil production, NK cell activity |
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Term
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Definition
metabolized by P450 enzymes in liver
need to consider other drugs that may increase/decrease P450 enzymes |
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Term
| Cyclosporine Side Effects |
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Definition
anorexia, vomiting, diarrhea
gingival hyperplasia
cutaneous papillomas, hisutism
nephrotoxicity, hepatotoxicity, bone marrow suppression
secondary infections, neoplasia |
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Term
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Definition
topical calcineurin inhibitor
inhibits activation of T cells and mast cells in skin
useful for treating localized lesions
owners need to wear gloves when applying |
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Term
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Definition
inhibits purine synthesis
decrease DNA and RNA synthesis
cytotoxic to proliferating T and B cells
decreases antigen processing
decreases macrophage function |
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Term
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Definition
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Term
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Definition
NOT FOR CATS
used when other treatments fail
decreases complement activation
decreases mast cell degranulation
decreases antibody production
decreases lysosomal enzyme synthesis
decreases neutrophil chemotaxis and respiratory burst
decreases leukotrienes
decreases bacterial growth |
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Term
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Definition
decreases neutrophil chemotaxis
decreases bacterial growth
decreases purine synthesis
anti-inflammatory
used to treat neutrophilic vasculitis
watch for KCS, drug allergies, hypothyroidism
used to treat colitis |
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Term
| Human Immunologlobulin Therapy |
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Definition
| used for serious diseases not for skin diseases |
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Term
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Definition
around claw beds, foot pads, around the lips
around periocular region, nose and face |
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Term
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Definition
predisposed breed
middle aged to older animals affected
other body system signs
sunlight exposure is an environmental factor that can affect these
often not pruritic
many are chronic and slowly progressing
may be brought on by drugs or vaccines |
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Term
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Definition
alopecia, pustules/blisters
crust/scale, erosions/ulcers
nodules/papillomas
depigmentation
loss of normal texture of nose
hyperkeratosis
nail abnormalities |
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Term
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Definition
pemphigus foliaceus is the most common
primary target of autoantibodies are desmoglein 3 in lower epidermis and desmoglein 1 in upper epidermis
desmoglein 3 is most common at mucocutaneous junctions and in oral cavity
desmoglein 1 is highest in skin on face
Pemphigus vulgaris - attacks desmoglein 3 |
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Term
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Definition
pemphigus antibodies bind to pemphigus antigens (desmosomes) on keratinocytes
internalization of antibody
activation and release of proteolytic enzymes (plasmingogen activator)
plasminogen converted to plasmin
plasmin hydrolyzes cell adhesion molecules and causes acantholysis
acantholysis: loss of intercellular connections |
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Term
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Definition
most common pemphigus disease
affects many species
any age possible although more common as middle aged |
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Term
| Pemphigus foliaceus cause |
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Definition
underlying cause may be spontaneous, secondary to trichophyton
drug induced
paraneoplastic
some breeds are predisposed (chows and cocker spaniels) |
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Term
| Pemphigus foliaceus Signs |
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Definition
alopecia, scale, erythema
erosions, nasal depigmentation
hyperkeratosis of pads
+/- pruritis, otitis externa
papules, pustules, vesciles, ulcers
may have fever/anorexia
distributed on faces, ears, feet/pads, nails(cats), around nipples (cats), generalized |
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Term
| Pemphigus foliaceus Diagnosis |
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Definition
impression smear, skin scraping, DTM culture, biopsy
will see acantholytic keratinocytes
immunofluroescence |
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Term
| Pemphigus foliaceus Treatment |
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Definition
need to treat many months past clinical resolution or for life
induction phase includes immunosuppressive doses of glucocorticoids
may need to add other immunosuppressive drugs for induction phase
then gradually taper dose during maintenance phase to lowest effective dose
antibiotics and topicals also |
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Term
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Definition
Collies and German Shepherds are predisposed
sunlight exacerbates condition |
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Term
| Pemphigus erythematosus Signs |
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Definition
most of the lesions are on the face and start on the nose
pustules with oozing crusts, erythema, alopecia
erosions, nasal depigmenttion, hyperkeratosis
distributed on face, ears, nose, paws, genitalia |
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Term
| Pemphigus erythematosus Treatment |
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Definition
photoprotection
topical glucocorticoids/tacrolimus
tetracycline/niacinamide
omega 3 FA
glucocorticoids
rarely more potent immunosuppressive drugs |
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Term
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Definition
no age or breed predilections
dogs and cats |
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Term
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Definition
vesicles/bulla
erosions and ulcers
may have pruritis
oral and mucocutaneous lesions common
axilla, groin, clawbed, paw pad, concave pinna
fever, anorexia, depression, lymphadenopathy, pain |
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Term
| Pemphigus vulgaris Diagnosis |
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Definition
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Term
| Pemphigus vulgaris Management |
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Definition
corticosteroids
supportive care |
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Term
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Definition
autantibodies are different than pemphgius diseases
antibodies directed to hemidesmosomes in basement membrane zone
creates separation between epidermis and dermis
don't see acantholytic keratinocytes
clefts and vesicles form below stratum basale |
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Term
| Mucous Membrane Pemphigoid |
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Definition
rare
autoantibodies against collagen and laminin 5
around mucous membranes |
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Term
| Discoid Lupus Erythematosus |
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Definition
common in dogs
young to middle aged
affects long nosed dogs
especially areas of white around their nose or muzzle |
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Term
| Discoid Lupus Erythematosus Signs |
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Definition
nose, muzzle, face, ears, lips
depigmentation, erythema, alopecia, scaling, crusting
loss of cobblestone texture of nasal planum
erosions, ulcers, scars |
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Term
| Discoid Lupus Erythematosus Management |
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Definition
sun avoidance
topical gluocorticoids or tacrolimus
topical antibiotics
tetracycline/niacinamide
omega 3 FA
vitamin E
oral corticosteroids |
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Term
| Uveodermatologic Syndrome |
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Definition
antibodies attack melanin and melanocytes
causes depigmentation of the nose
predisposed breeds are arctic breeds |
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Term
| Uveodermatologic Syndrome Signs |
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Definition
uveitis, photophobia
depigmentation of planum nasale, lips, eyelids
erosions/ulcers |
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Term
| Uveodermatologic Syndrome Diagnosis |
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Definition
biopsy
rule out other causes of uveitis |
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Term
| Uveodermatologic Syndrome Management |
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Definition
topical corticosteroids, tropine
systemic corticosteroids, azathioprine
cyclophosphamide |
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Term
| Symmetric Lupoid Onychodystrophy |
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Definition
German Shepherds, Rottwielers
3-8 years old
antigen unknown
may have underlying food allergy, drug reaction, immune mediated disease |
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Term
| Symmetric Lupoid Onychodystrophy Signs |
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Definition
may initially involve one claw and later multiple ones
secondary paronychia
misshapen, brittle claws, pain on palpation |
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Term
| Symmetric Lupoid Onychodystrophy Diagnosis |
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Definition
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Term
| Symmetric Lupoid Onychodystrophy Management |
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Definition
avulse loose nails
keep nails trimmed short
pain management
omega 3 fatty acids
novel protein diet tril
vitamin E
tetracyline + niacinamide
glucocorticoids
declawing |
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