Immune Disorders
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Questions and Answers

Which autoimmune disease is classified as an organ-specific disorder?

  • Rheumatoid arthritis
  • Thyroiditis (correct)
  • Systemic lupus erythematosus
  • Multiple sclerosis

What is a common non-steroidal anti-inflammatory drug used to reduce inflammation in autoimmune diseases?

  • Ciclosporin
  • Prednisolone
  • Ibuprofen (correct)
  • Mycophenolate

What is a crucial lifestyle recommendation for patients managing autoimmune diseases?

  • Increased sugar consumption
  • Regular exercise (correct)
  • Excessive caloric intake
  • High protein diet

Which condition is considered a generalized systemic autoimmune disease?

<p>Rheumatoid arthritis (B)</p> Signup and view all the answers

What are the estimated annual direct and indirect costs for three specific autoimmune diseases in the UK?

<p>£13 billion (A)</p> Signup and view all the answers

What is a common treatment for severe allergic reactions like hay fever and asthma?

<p>Immunotherapy (A)</p> Signup and view all the answers

What characterizes a Type II hypersensitivity reaction?

<p>Involvement of IgG and IgM antibodies binding to cell surface (B)</p> Signup and view all the answers

Which of the following conditions is an example of a Type III hypersensitivity reaction?

<p>Rheumatoid arthritis (A)</p> Signup and view all the answers

In a Type IV hypersensitivity reaction, which immune cells are primarily involved?

<p>T cells (B)</p> Signup and view all the answers

What is a characteristic feature of primary immunodeficiencies?

<p>Genetically determined (D)</p> Signup and view all the answers

Which of the following is NOT a trigger for hay fever and asthma?

<p>Bacteria (C)</p> Signup and view all the answers

What is the primary immune response mechanism in secondary immunodeficiency?

<p>Environmental infection (C)</p> Signup and view all the answers

What type of hypersensitivity is primarily mediated by immune complexes?

<p>Type III (D)</p> Signup and view all the answers

What is a common sign of an allergic reaction in individuals with skin sensitivities?

<p>Urticaria (B)</p> Signup and view all the answers

Which of these statements about Type IV hypersensitivity is true?

<p>It involves cytokine release. (B)</p> Signup and view all the answers

What characterizes hypersensitivity disorders?

<p>Excessive immune response (D)</p> Signup and view all the answers

Which type of hypersensitivity reaction is characterized by rapid onset within one hour?

<p>Type I hypersensitivity (A)</p> Signup and view all the answers

In Type I hypersensitivity, which immunoglobulin is primarily involved?

<p>IgE (D)</p> Signup and view all the answers

What is the primary cause of immunodeficiency?

<p>Ineffective immune response (A)</p> Signup and view all the answers

What is a potential consequence of a systemic Type I hypersensitivity reaction?

<p>Life-threatening shock (A)</p> Signup and view all the answers

Which type of immune disorder involves an inappropriate reaction to the body's own tissues?

<p>Autoimmunity (C)</p> Signup and view all the answers

What triggers the degranulation of mast cells in Type I hypersensitivity reactions?

<p>Binding of IgE to antigens (B)</p> Signup and view all the answers

Which of the following is NOT an example of a trigger for Type I hypersensitivity reactions?

<p>Citrus fruits (A)</p> Signup and view all the answers

What is a common oral complication associated with immunosuppressant drug use?

<p>Oral candidiasis (C)</p> Signup and view all the answers

Which of the following diseases can lead to immunocompromised states?

<p>HIV infection (A)</p> Signup and view all the answers

What is a primary action of the immune system in autoimmune diseases?

<p>Mistakenly attacking healthy tissue (A)</p> Signup and view all the answers

Which factor can increase the incidence of malignancy in patients with compromised immunity?

<p>Immunosuppressant medication (B)</p> Signup and view all the answers

What is a common dental care consideration for patients with immunosuppressive therapy?

<p>Antibiotic cover before dental surgery (B)</p> Signup and view all the answers

Which condition is characterized by the immune system attacking the body's own tissues?

<p>Autoimmune disease (B)</p> Signup and view all the answers

What role do dental care professionals play in the management of immunocompromised patients?

<p>Risk assessment and liaison with the physician (A)</p> Signup and view all the answers

Which syndrome can lead to granulocyte defects and increase infection risk?

<p>Papillon-Lefevre syndrome (B)</p> Signup and view all the answers

What is a common oral manifestation seen in autoimmune diseases?

<p>Systemic lupus erythematosus (A), Sjögren syndrome (D)</p> Signup and view all the answers

Which aspect of a patient's background is essential for a dental professional to consider?

<p>Comprehensive medical history (B)</p> Signup and view all the answers

What condition results from an inappropriate immune reaction to self?

<p>Autoimmunity (B)</p> Signup and view all the answers

Which of the following is NOT an autoimmune disease mentioned?

<p>Rheumatoid arthritis (B)</p> Signup and view all the answers

Which autoimmune condition is characterized by dryness of the mouth due to immune system dysfunction?

<p>Sjögren syndrome (C)</p> Signup and view all the answers

What is a key function of the immune system?

<p>To protect and defend the body (A)</p> Signup and view all the answers

Why is ongoing education important for dental care professionals regarding autoimmune diseases?

<p>To provide comprehensive care impacting oral and systemic health (D)</p> Signup and view all the answers

Which type of immune response may lead to autoimmune diseases when faulty?

<p>Both innate and adaptive immune responses (C)</p> Signup and view all the answers

What is a common trigger for autoimmunity related to infections?

<p>Viral infections (D)</p> Signup and view all the answers

Which of the following autoimmune reactions occurs due to an immune response against hidden self-antigens?

<p>Penicillin-induced hemolytic anemia (D)</p> Signup and view all the answers

Which test is specifically designed to detect antibodies attacking the cell nuclei?

<p>Antinuclear antibody test (D)</p> Signup and view all the answers

What percentage of the population is estimated to be affected by autoimmune diseases?

<p>5-7% (C)</p> Signup and view all the answers

Which condition is known to have the highest prevalence in females compared to males?

<p>Systemic lupus erythematosus (D)</p> Signup and view all the answers

What is one potential result of T cell suppression as people age?

<p>Increased breakdown of tolerance to self-antigens (B)</p> Signup and view all the answers

Which of the following symptoms is NOT typically associated with autoimmune diseases?

<p>Increased appetite (D)</p> Signup and view all the answers

Which of the following is a factor that may lead to the emergence of autoimmunity?

<p>Emergence of normally hidden antigens (D)</p> Signup and view all the answers

Flashcards

Hypersensitivity

An exaggerated immune response that causes tissue damage when encountering an antigen for the second or subsequent time.

Type I Hypersensitivity Reaction

A rapid and excessive immune response that occurs within an hour after re-exposure to a specific allergen. Characterized by increased IgE antibodies binding to mast cells and basophils, triggering degranulation and release of mediators like histamine.

Immunodeficiency

The condition where the body's immune system fails to protect against infections, leaving it vulnerable to diseases.

Autoimmunity

A condition where the immune system attacks the body's own tissues as if they were foreign substances. This can affect various organs and systems.

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Overactive Immune Response

An immune response that is too strong and causes tissue damage. It's often triggered by allergens or antigens that are harmless in most people.

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Ineffective Immune Response

A weakened immune response that fails to protect the body from infections.

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Inappropriate Reaction to Self

A type of immune system response where the body attacks its own tissues as if they were foreign invaders.

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Allergic Reaction

A specific type of immune response characterized by an exaggerated response to allergens, triggering rapid release of histamine and other mediators.

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Allergy

An immune response that involves the immune system overreacting to harmless substances, leading to symptoms like hay fever, eczema, and asthma.

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Asthma

An allergy that affects the respiratory system, causing symptoms like wheezing, coughing, and shortness of breath.

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Skin Allergy

A type of allergy that causes skin reactions, such as itching, redness, and swelling.

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Type II Hypersensitivity

A category of immune responses that involve antibodies binding to cell surface antigens, leading to cell damage.

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Type III Hypersensitivity

A category of immune responses that involve immune complexes formed by antibodies and antigens, depositing in tissues and causing inflammation.

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Type IV Hypersensitivity

A category of immune responses that involve T cells directly attacking cells or releasing cytokines, causing inflammation and tissue damage.

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Primary Immunodeficiency

A type of immunodeficiency that is present from birth due to genetic defects in the immune system.

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Secondary Immunodeficiency

A type of immunodeficiency that develops later in life due to factors such as HIV infection, malnutrition, or certain medications.

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Severe Combined Immunodeficiency (SCID)

A severe form of primary immunodeficiency where both B cells and T cells are deficient, leading to a severely weakened immune system.

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IgA deficiency

A type of immunodeficiency where the body produces insufficient amounts of immunoglobulin A (IgA), an antibody that protects mucous membranes.

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Autoimmune disease

A condition where the body's immune system mistakenly attacks its own tissues, leading to inflammation and damage.

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Oral candidiasis

A common oral manifestation in immunosuppressed patients, characterized by white patches on the tongue and inner cheeks.

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Gingival swelling with ciclosporin

A condition where the gums are swollen and inflamed, often seen in patients taking cyclosporine, an immunosuppressant drug.

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Poor healing

The ability of tissues to heal properly, which is often impaired in immunosuppressed patients due to weakened immune responses.

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Cost of Autoimmune Diseases

The cost associated with autoimmune diseases includes both direct (medical expenses) and indirect (lost productivity) costs.

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Autoimmune Disease Classification

Autoimmune diseases are classified based on their target. Organ-specific diseases target specific organs, while generalized systemic diseases affect multiple tissues and organs.

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Immune Response in Covid-19

The immune system's response to Covid-19 may play a role in the severity of acute illness, as well as the development of Long Covid.

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What is autoimmunity?

The body's own immune system mistakenly attacks its own tissues and cells, as if they were foreign invaders. This can lead to a variety of health problems.

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What are some factors that can lead to autoimmunity?

Genetics, infections (especially viral), emergence of hidden antigens, and certain drugs can all contribute to the development of autoimmunity.

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How can autoimmune reactions occur?

Autoimmunity occurs when the immune system attacks its own tissues, but this attack can happen in a few different ways. For example, the immune system might mistake a foreign substance for a part of the body, or it might attack altered body cells. Sometimes, even normal immune cells can malfunction and attack healthy tissues.

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How common are autoimmune diseases?

More than 80 different autoimmune diseases are known, and they affect about 5-7% of the population. Women are more likely to be affected than men.

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What are some of the effects of autoimmune diseases on people's lives??

Autoimmune diseases can lead to a wide range of symptoms, such as joint pain, fatigue, skin problems, and digestive issues. They can also cause challenges in various areas of life, making everyday activities difficult for those affected.

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What kind of tests are used to check for autoimmune diseases?

Antinuclear antibody tests look for antibodies that attack the cell nucleus, while autoantibody tests search for specific antibodies to the body's own tissues. Other tests may include a complete blood count, C-reactive protein, erythrocyte sedimentation rate, and urine tests.

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What are examples of autoimmune diseases?

Diabetes type 1 is an autoimmune disease where the pancreas is damaged. Other diseases, like systemic lupus erythematosus, affect the whole body.

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How can aging play a role in autoimmunity?

The immune system's ability to suppress T cells naturally decreases with age. This can lead to a breakdown of tolerance to self-antigens, which can trigger the development of autoimmunity.

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Oral Signs of Autoimmune Diseases

Oral manifestations of autoimmune diseases are often the initial symptom.

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Systemic Lupus Erythematosus

A chronic autoimmune disease that can affect various organs, including the skin, joints, and kidneys, and often causes oral lesions.

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Sjögren's Syndrome

An autoimmune disease that primarily affects the salivary and lacrimal glands, leading to dry mouth and dry eyes.

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Pemphigus Vulgaris

A rare, autoimmune blistering disease that most commonly affects the skin and mucous membranes, including the mouth.

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Mucous Membrane Pemphigoid

A chronic autoimmune disease that causes blistering on the mucous membranes, including the mouth.

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Study Notes

Immune Disorders

  • Focus: Overview of general immune disorders impacting the population, and their relation to oral manifestations.
  • Learning Outcomes (GDC): Explain the impact of medical and psychological conditions on patients.
  • Learning Outcomes (Intended): Discuss immunopathology (diseases of the immune system), including hypersensitivity, autoimmunity, and immunodeficiency. Define hypersensitivity and its types. Define immunodeficiency and its causes. Define autoimmune disease and its impact. Relate how autoimmune diseases manifest in the oral cavity.
  • Assessment: Formative (online quiz on Biomedical Sciences) and Summative (Biomedical Sciences Eassessment).
  • Immunopathology: Deficiencies in the innate or adaptive immune response can cause illness.
    • Hypersensitivity: Overactive immune response.
    • Immunodeficiency: Ineffective immune response.
    • Autoimmunity: Inappropriate reaction to self.

Hypersensitivity

  • Definition: Excessive immune response to an antigen, causing tissue damage on subsequent encounters.
  • Types: Type I (immediate hypersensitivity), Type II (cytotoxic hypersensitivity), Type III (immune complex hypersensitivity), and Type IV (delayed-type hypersensitivity).
  • Type I: Allergic reactions (anaphylaxis). Occurs rapidly (within an hour)
    • Triggered by an allergen.
    • IgE antibodies bind to mast cells and basophils, causing sensitization.
    • Second exposure triggers degranulation and mediator release (e.g., histamine).
    • Impacts: Local or systemic (life-threatening). Examples- penicillin, bee stings, hay fever, asthma.
  • Type II: Cytotoxic reactions. Occurs in 2-24 hours
    • Antibodies (IgG or IgM) bind to cell surface.
    • Results in opsonization, agglutination, cell lysis.
    • Impacts: Hemolytic reactions during blood transfusions, drug reactions, autoimmune anemias.
  • Type III: Immune complex reactions. Develops over hours, days, weeks
    • Antibodies bind to soluble antigens, forming complexes that lodge in tissues.
    • Activates complement, leading to inflammation and tissue damage.
    • Impacts: Systemic Lupus Erythematosus, Serum sickness, Rheumatoid Arthritis.
  • Type IV: Cell-mediated reactions. Develops in 2 or more days.
    • T cells and monocytes/macrophages are stimulated.
    • Causes inflammation, cell death, and tissue damage.
    • Impacts: Chronic and prolonged inflammatory reactions; some allergic reactions are also cell mediated.

Immunodeficiency

  • Definition: Compromised or absent immune system response to infectious diseases.
  • Types:
    • Primary: Genetically determined (rare).
    • Secondary: Caused by other factors (e.g., malnutrition, chronic infections, drug regimens).
  • Primary (examples): B-cell immunodeficiencies, T-cell immunodeficiencies, phagocyte disorders, complement deficiencies.
    • Specific genetic defects: IgA deficiency, Severe combined immunodeficiency (SCID), Papillon-Lefèvre syndrome.
    • Increased risks: Severe infections, malignancies, autoimmune diseases,
  • Secondary (examples): Malnutrition, Chronic infections, Drug regimens (immunosuppressants).

Autoimmune Diseases

  • Definition: Chronic, progressive disorders where the immune system attacks healthy body cells.
  • Mechanism: Immune system loses tolerance (ability to distinguish self from non-self).
  • Types: Organ-specific (e.g., type 1 diabetes, Grave's disease) and generalized (e.g., systemic lupus erythematosus, rheumatoid arthritis).
  • Factors: Age, emergence of normally hidden antigens, infections, genetics, endocrinological changes, drugs.
  • Symptoms: Joint pain and swelling, fatigue, rashes, digestive issues, difficulty in daily activities.
  • Diagnosis: Blood tests (antinuclear antibodies (ANA), complete blood count (CBC)).
  • Treatment: Specific drugs to control the immune response, and mitigate complications.

Dental Implications for Immunosuppressed Patients

  • Increased Risk: Oral candidiasis, bacterial/viral infections, periodontal issues, oral ulcerations, poor healing, higher malignancy risk.
  • Dental Care Professional Role: Full history assessment; physician liaison; prevention-focused care; aggressive infection management (e.g., management of dental unit water lines); close monitoring, and follow-up.

General Information on Immunocompromised Individuals

  • Conditions: Poorly controlled diabetes, HIV infection, malignancies, malnutrition, anemia, spleen removal, vitamin D deficiency, kidney failure, sickle cell disease.

Autoimmune Diseases and Oral Manifestations

  • Oral signs are often early indicators.
  • Examples: Systemic lupus erythematosus, Sjögren's syndrome, Pemphigus vulgaris, and Mucous membrane pemphigoid.

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