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SGU Immuno Post MT: Autoimmunity
SGU Immuno Post MT: Autoimmunity
43
Medical
Professional
01/04/2013

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Term
Which disease has NO rheumatoid factor ?
Definition
Ankylosing Spondylitis
Term
Which disease is "Autoimmune like" ?
Definition
Psoriasis
Term
T cell tolerance induction results from ?
Definition
Negative selection in the thymus
Term
In B cells, tolerance induction occurs at the ?
Definition
Immature B cell stage
Term
Tolerance induction of B cells leads to what two things ?
Definition
Clonal anergy or apoptosis
Term
Central tolerance of T and B cells occurs where ?
Definition
During maturation in thymus and bone marrow
Term
Peripheral mechanisms for tolerance induction include what 5 things ?
Definition
1) Deletion
2) Suppression by T cells
3) Lack of T-cell help for B-cell activation
4) Absence of appropriate MHC molecules for antigen presentation
5) Absence of co-stimulatory molecules like CD28 on T cells
Term
Autoimmunity, following loss of self-tolerance can occur in what 5 ways ?
Definition
1) Genetic defects leading to defects in lymphocyte regulation
2) Loss of apoptotic stimuli
3) Antigen related mechanisms
4) Hormonal influences
5) Superantigen related mechanisms
Term
Loss of self-tolerance via antigen-related mechanisms can happen in what two ways ?
Definition
1) Molecular mimicry / cross reactivity with a microbial epitope
2) Release of previously sequestered antigens
Term
Loss of self tolerance caused by molecular mimicry occurs why ?
Definition
Because host tissues share an antigenic epitope identical with an infecting virus or bacteria
Term
Can loss of self-tolerance occur if immune system comes in contact with previously sequestered antigen ?
Definition
Yes
Term
Immunopathology of autoimmune disorders generally reflects what two things ?
Definition
Presence of autoreactive antibodies or activation of T cells secreting Type 1 cytokines, which activates phagocytes
Term
When autoreactive antibodies are specific for soluble antigens, what is formed in serum ?
Definition
Large immune complexes
Term
Autoreactive Abs to intrinsic factor (IF) block its binding to what ?
Definition
Vitamin B12
Term
Abs that block the vitamin B12 binding site of intrinsic factor cause what ?
Definition
Pernicious anemia, b/c the individual is unable to absorb vitamin B12
Term
Pernicious anemia can be caused by destruction of what cells ?
Definition
Destruction of gastric parietal cells that secrete intrinsic factor
Term
List two autoimmune disorders of T cell etiology or cell mediated ?
Definition
Hashimoto's Thyroiditis
Multiple Sclerosis
Term
What contributes to inflammation and tissue damage seen in Hashimoto's Tyroiditis ?
Definition
Unregulated Type 1 cytokine secretion
Term
3 types of immunotherapy for autoimmune diseases ?
Definition
1) Non-specific immunosuppression
2) Specific immunosuppression
3) Cytokine modulation
Term
List some non-specific anti-inflammatory agents ?
Definition
NSAIDS, prednisone, methotrexate, and imuran
Term
How do non-steroidal anti-inflammatory drugs mediate their effects ?
Definition
Through inhibition of products (prostaglandins or leukotrienes) of the arachidonic acid pathway
Term
4 examples of T-cell specific agents ?
Definition
Cyclosporine
Abs to CD3
Abs to IL-2R
Abs to the TCR beta chain variable segments

These T cell specific agents inhibit the CD4+ T cell population so that IL-2 is not transcribed or secreted
Term
Pathology associated with MS and Hashimoto's Throiditis often results from what ?
Definition
Unregulated production of Type 1 cytokines
Term
If pathology is due cytokine secretion by Th1 cells, then you can give what as trt ?
Definition
Type 2 cytokines (IL-4, TGF-B, and IL-13)
Term
Oral feeding of antigen promotes "tolerance" to what diseases ?
Definition
Diseases associated with Type 1 cytokines
Term
Anti-thyroglobulin and anti-microsomal proteins are seen in what disorder ?
Definition
Hashimoto's Thyroiditis
Term
Anti MBP + CNS oligoclonal Abs are found in what disease ?
Definition
MS
Term
Anti-GMB Abs (Glomerular basement membrane) are found in what disease ?
Definition
Goodpasture's Syndrome
Term
What disease has blocking Abs which bind and destroy parietal cells ?
Definition
Pernicious anemia
Term
Does Graves' disease have a stimulating Ab ?
Definition
Yes
Term
Anti-Ach Abs are found in what disease ?
Definition
Myasthenia Gravis
Term
What Abs are found in Cold Agglutinin disease ?
Definition
Anti-Ii (Glycophorin)
Term
What disease can lead to megaloblastic anemia ?
Definition
Pernicious anemia
Term
What Abs found in Grave's disease ?
Definition
Anti-TSH Abs (Thyroxin Stimulating Hormone)
Term
Males are 9 times more likely to get this autoimmune disease ?
Definition
Ankylosing Spondylitis
Term
Prior infection to Klebsiella Pneumoniae has been found in what autoimmune disease ?
Definition
Ankylosing Spondylitis
Term
This autoimmune disease only occurs at temp below 37 degrees celsius and affects only the extremities when exposed to cold temps ?
Definition
Cold Agglutinin Disease

Has Anti-Ii (Glycophorin) Abs
Term
Is SLE organ-specific ?
Definition
No, it is systemic
Term
Anti-DS-DNA, anti-leukocyte, and anti-phospholipid Abs are found in what autoimmune disease ?
Definition
SLE (Systemic Lupus Erythematosus)
Term
Which autoimmune disease has primary pathology due to cell mediated and immune complexes ?
Definition
RA (Rheumatoid Arthritis)
See excessive Type 1 cytokines
Term
Which autoimmune disease is specific to brain and spinal cord and has Abs to MBP ?
Definition
MS (Multiple Sclerosis)
Term
Which autoimmune disease is 50 times more likely to be seen in females than males ?
Definition
Hashimoto's Thyroiditis

Manifests as goiter and/or hypothyroidism
Term
Which autoimmune disease is 4 times more likely to be seen in males and has two peaks, in young and elderly ?
Definition
Goodpasture's Syndrome
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