Immunology Final Study Guide Classify autoimmune diseases into the 3 recognized types based on the major effector mechanism that mediates pathology Autoimmune disease effector cells of adaptive immunity fight healthy tissue o Result because unable to maintain a state of self tolerance 3 mechanisms based on primary effector mechanisms o Type II antibody against cell surface or matrix antigens o Type III immune complex disease o Type IV T cell mediated disease o Type I IgE mediated hypersensitivities are not related in autoimmune diseases Auto antigen target for auto reactive T B cell these cells can be present w o autoimmune disease Treatment Autoimmune Disease ADs where Abs are major effectors plasma will be exchanged Not curative Lowers Ab levels Alpha 3 chain of type IV collagen IgG binding to basement membrane Hyperthyroidism graves disease Thyroid regulates basal metabolic rate by Graves disease TH2 break down thyroglobulin producing thyroxine release thyroxine Overproduction of thyroxine independent of the control of THS and overall metabolic needs of the body Enlargement of the thyroid gland Babies of infected mothers can be born with symptoms o Plasmapheresis treatment cures it SYM heat tolerance nervousness irritability warm moist skin weight loss Bug eyes Hypothyroidism Hashimotos disease Myasthenia gravis Auto antigen acetylcholine receptor Ab binds to acetylcholine receptors myocytes endocytosis surface receptors degrade receptors SYM Muscles less sensitive to stimulus drooping eyelids double vision Tx pyridotigmine inhibits cholinesterase acetylcholine degrader Systemic Lupus Erythematosus Th 1 dominated response thyroid antigens and lymphocytes attack thyroid tissue Drop in production of thyroid hormones SYM weight gain depression fatigue slow HR Tx thyroid replacement therapy TH3 Butter fly rash Target dsDNA small ribonuclear proteins RBCs and platelets phospholipids Leads to glomerulonephritis basement mem of glomerulus thickens loss of kidney fxn arthritis Tx prednisone anti inflamm Naprosyn Type I diabetes TH4 autoimmunity o Contains Islets of Langerhans pancreas contains lumps of endocrine cells glucagon producing alpha cells insulin producing beta cells somatostatin producing delta cells T cells Ab autoreact with insulin glutamic acid decarboxylase CD8posCTL destroy beta cells leads to insulinitis Rheumatoid arthritis TH4 autoimmunity Infiltration of T B cells neutrophils dendritic cells and macrophages secretion of TNF IL1 6 7 proteases collagenases breakdown cartilage ligaments and bone Tx anti inflamm drugs Abs that block TNF action o Infliximab neutralizes TNF o Etanercept recombinant TNF decot receptors and soaks up TNF Multiple Sclerosis TH4 autoimmunity Th1 polarized CD4 response attack protective myelin sheath of nerve cells IFN gamma macrophages produce cytokines proteases neuron demylenation sclerotic plaques Autoantigen MBP proteolipid protein myelin ologodendrocyte glycoprotein Tx IFN beta injections immunosuppressive drugs improve integrity of blood brain barrier Genetic and environmental factors that predispose toward autoimmune disease Genetic Factors o one gender is affected more than other s o mostly women tend to carry more Ads o Example HLA Expression Environmental Factors susceptibility to disease Rheumatoid arth subtypes of the HLA DRB1 allele confer o Trauma to tissues in immunologically privileged sites eyes T cells attacked the released specialized eye proteins o Infection with Streptococcus pyogenes Abs cross react with cell wall components on kidneys heart brain joints antigenic resemblance between the streptococcal antigens and the targets of autoimmunity in these various tissues has been termed molecular mimicry Small pox Caused by variola virus o vv major is the severe form of the disease o vv minor is less severe but still fatal Variolation practice introducing dried postules from healing patients to healthy individual facilitating the infection If successful they would acquire a mild form of the disease recover and become immune o used V minor when they vaccinated others and the virus was not used to going through the skin so it did not have a severe effect on the patient Lady Mary Wortley Montegu brought variolation to Europe Edward Jenner vaccinated people with cowpox to fight against smallpox o Smallpox variola virus o Cowpox and small pox have similar surface antigens o Immunization with cowpox develops antibodies against cowpox surface cowpox vaccinia virus antigens o When small pox is introduced the cowpox antibodies bind and neutralize the virus b c of matching surface antigens Luis Pasteur discovered that vaccination can relate to other diseases or viruses using viruses with lowered virulence He also developed the first rabies vaccination Developed the idea of attenuation Donald Henderson led WHO movement for smallpox Albert Sabin live attenuated vaccine Jonas Silk first polio virus Three strategies for making vaccines against pathogens Killed or inactivated vaccines o Pros induced immune response following injection of dead virus that fights against foreign proteins of the pathogenic counterpart o Cons need large amount sometimes it doesn t induce a powerful imm response sometimes induces a different imm response Attenuated vaccines growth in unnatural environment renders virus so it can t grow in original host o Pros induces stronger more localized immunity o Cons need to grow the virus in new host and be successful o Successful with tuberculosis and typhi Subunit vaccines vaccine is developed from the viral surface proteins from the virus Vaccines against bacteria Some bacteria produce such strong toxins that they can kill the host To eliminate these bacteria antibodies are generated to bind with the toxins to neutralize them immunogenicity o Toxins are purified treated with formalin destroys the toxicity remain Vaccine Adjuvants helpers inflammation New adjuvant approaches Act to enhance immunity against the proteins they are administered with by provoking May help by depot effect which delivers immunogen to antigen presenting cells Micelles fuse antigenic contents into the cytoplasm of the cell enter the ER and develop a Class 1 MHC pathway Bone marrow transplant terms Isograft graft between two identical individuals twins clones inbred Graft tissue or organ is moved from one site to another Autograft graft within same individual Allograft graft between two genetically different individuals of the same species