Lagarteja, Regrine
MICRO 202
Autoimmune Diseases
Criteria, Pathogenesis, Types
Autoimmune Disease
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Lack of recognition of self from non-self Diseases that arise from an inapppropriate response of the body against substances and tissues normally present in the body
Witebsky postulates
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Source: nfs.unipv.it
Pathogenesis
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Sex MHC Haplotype Self reactive T-cell clones not destroyed Polyclonal B-cell activation Molecular mimicry Others:
Hormones Environment Defect in NK cells Secretion of Cytokines
Immunological Tolerance
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Definition:
specific unresponsiveness to an antigen that is induced by exposure of lymphocytes to that antigen (implies antigen specificity, in contrast to nonspecific immunosuppression)
All individuals are tolerant of their own antigens (selftolerance); breakdown of self-tolerance results in autoimmunity Therapeutic potential: Inducing tolerance may be exploited to prevent graft rejection, treat autoimmune and allergic diseases, and prevent immune responses in gene therapy, perhaps stem cell transplantation
Significance:
Normal: reactions against pathogens Pathologic: inflammatory disease, e.g. caused by reactions against self
Central Tolerance
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Peripheral Tolerance
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T-cell Anergy
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Tregs
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Genome wide association studies are revealing genetic polymorphisms associated with autoimmune diseases
Crohns disease:
NOD-2: microbial sensor in intestinal epithelial and other cells IL-23 receptor: involved in TH17 responses PTPN-22 (tyrosine phosphatase): may control kinasedependent lymphocyte activation CD25 (IL-2 receptor): role in T cell activation and maintenance of regulatory T cells
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AUTOIMMUNE DISORDERS
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SYSTEMIC ORGAN-SPECIFIC
Chronic systemic inflammatory disease marked by alternating exacerbations and remissions 10:1 More common among African Americans
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About 90% of SLE sufferers are women while about 10% are men and children. About 90% of women with SLE are in their childbearing years, within the range of 15 to 50 years old. Ratio of SLE sufferers : In the West, among Afro-Carribeans 1 in 250500 people USA - 1 in 2,000 people China - 1 in 1,000 people
HLA DR and DQ Inherited deficiencies of complement components C1q, C2, and C4 Abnormalities of Fcy receptor UV light Hormones Estrogen-containing contraceptives
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Source: doctortripster.com
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Symptoms
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SYMPTOMS Achy joints / arthralgia Fever of more than 100 degrees F / 38 degrees C Arthritis / swollen joints Prolonged or extreme fatigue Skin Rashes Anemia Kidney Involvement Pain in the chest on deep breathing / pleurisy Butterfly-shaped rash across the cheeks and nose Sun or light sensitivity / photosensitivity Hair loss Abnormal blood clotting problems Fingers turning white and/or blue in the cold Mouth or nose ulcers
PERCENTAGE (%) 95 90 90 81 74 71 50 45 42 30 27 20 17 12
Diagnosis
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Clinical
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Malar rash Photosensitivity Arthritis Renal Disorder Hematologic Disorder Presence of ANA
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Immunologic Findings
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LE cell
Immunologic Findings
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Rheumatoid Arthritis
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Chronic, symmetric, erosive arthritis of the peripheral joints Associated with MHC Class II genes
Rheumatoid Arthritis
Description
Morning stiffness Arthritis of 3 or more joints Arthritis of hand joints Symmetric arthritis Rheumatoid nodules Serum rheumatoid factor Radiographic changes
A person shall be said to have rheumatoid arthritis if he or she has satisfied 4 of 7 criteria, with criteria 1-4 present for at least 6 weeks
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Immunologic Findings
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Immunologic Findings
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Interleukin 1, 6, 8
TNF-
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Source: nutritionremarks.com
Rheumatoid Factor
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antibody
antibody
Other names:
Autoimmune
Definition
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Type of Diabetes Mellitus that results from autoimmune destruction of beta cells of Islets of Langerhans, causing insufficient insulin production Differentiated from Diabetes Mellitus by:
GADA-
Glutamic Acid Decarboxylase Antibodies ICA- Islet Cell Autoantibodies IA-2- Insulinoma Associated Autoantibodies ZnT8- Zinc Transporter Autoantibodies
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Risk Factors
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Diagnostic Criteria
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Fasting glucose level at or above 7.0 mmol/L (125 mg/dL) Plasma glucose at or above 11.1 mmol/L (200 mg/dL) two hours after a 75 g oral glucose load in a glucose tolerance test Symptoms of hyperglycemia and causal plasma glucose at or above 11.1 mmol/L Glycated Hemoglobin (HbA1c) at or above 6.5
Multiple Sclerosis
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Source: Wikipedia
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Source: Wikipedia
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Source: Wikipedia
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Myasthenia Gravis
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Myasthenia Gravis
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Autoimmune disease affecting the neuromuscular junction Not a brain disorder brain functions normally Characterized by fluctuating muscle weakness and fatigability Disease may be generalized or ocular specific
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Diagnosis
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Edrophonium test (Tensilon) Blood analysis Repetitive nerve stimulation Single-fiber electromyography (EMG) Imaging scans
Affects any of the muscles that you control voluntarily, certain muscle groups are more commonly affected than others
Difficulty speaking (dysarthria) Difficulty swallowing (dysphagia), Drooping eyelids (ptosis) Double vision (diplopia) Nasal-sounding speech and weak neck muscles that give the head a tendency to fall forward or backward.
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Pernicious Anemia
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Graves Disease
Symptoms of Hyperthyroidism
Heat
intolerance Increased metabolism and weight loss Palpitations Fatigue Nervousness Ophthalmia
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