Autoimmune Diseases Overview Quiz

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Questions and Answers

What characterizes autoimmune diseases?

  • They only affect males.
  • They involve an immune response against self-antigens. (correct)
  • They only affect specific organs.
  • They have a single underlying cause.

Which type of autoimmune disease is primarily mediated by antibodies?

  • Type I autoimmune disease
  • Type II autoimmune disease (correct)
  • Type IV autoimmune disease
  • Type III autoimmune disease

What is the primary mechanism thought to lead to the development of autoimmune diseases?

  • Failure of self-tolerance mechanisms (correct)
  • Excessive physical exercise
  • Environmental exposure to pathogens
  • Increased production of immune cells

Which autoimmune condition is characterized by excessive secretion of thyroid hormone?

<p>Graves' disease (A)</p> Signup and view all the answers

Which gender is more commonly affected by autoimmune diseases?

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

Autoimmune reactions can resemble which types of hypersensitivity reactions?

<p>Types II, III, and IV (B)</p> Signup and view all the answers

What role do effector T cells and B cells play in autoimmunity?

<p>They are involved in developing the immune response against self-antigens. (B)</p> Signup and view all the answers

What is a significant challenge in understanding the causes of autoimmune diseases?

<p>Mechanisms breaking self-tolerance are largely unknown. (C)</p> Signup and view all the answers

What role does thyroid-stimulating hormone (TSH) play in hormone regulation?

<p>It binds to TSH receptors to stimulate thyroid hormone release. (C)</p> Signup and view all the answers

What characterizes Graves' disease in relation to TSH?

<p>Autoantibodies mimic TSH and stimulate thyroid hormone production. (B)</p> Signup and view all the answers

Which autoimmune disease is characterized by a reaction following a throat infection with Streptococcus pyogenes?

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

What type of autoimmune disease is rheumatic fever classified as?

<p>Type II autoimmune disease (A)</p> Signup and view all the answers

What type of autoimmune disease is Type I diabetes Mellitus associated with?

<p>Type IV autoimmune disease (A)</p> Signup and view all the answers

How do antibodies contribute to the inflammation seen in rheumatic fever?

<p>They cross-react with the body's tissues, leading to inflammation. (A)</p> Signup and view all the answers

Which type of cells mediate the destruction of insulin-producing cells in the pancreas in Type I diabetes?

<p>Autoreactive CD8 T cells (A)</p> Signup and view all the answers

Which blood group can serve as a universal donor?

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

What is a common physiological consequence of the lymphocytes infiltrating islets in Type I diabetes?

<p>Decreased β-cell count (A)</p> Signup and view all the answers

In systemic lupus erythematosus (SLE), what do people produce autoantibodies against?

<p>Soluble cellular components (C)</p> Signup and view all the answers

What is one of the main challenges in organ or tissue transplantation?

<p>Preventing recipient's immune response to the transplant (D)</p> Signup and view all the answers

What is the main limitation when transfusing RhD positive blood to an RhD negative recipient?

<p>It can cause the formation of anti-RhD antibodies. (D)</p> Signup and view all the answers

What complication can result from immune complexes in systemic lupus erythematosus (SLE)?

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

Which blood group can receive blood from any donor?

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

What is a common skin manifestation of systemic lupus erythematosus (SLE)?

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

Which of the following is typically not a requirement for blood transfusions?

<p>Inherited blood conditions (A)</p> Signup and view all the answers

During the ABO and RhD group testing, which result indicates a negative reaction for RhD?

<p>Negative for Anti-RhD (A)</p> Signup and view all the answers

Which group does not have A or B antigens on its red blood cells?

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

What component is responsible for the determination of blood group types?

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

What is the purpose of administering hematopoietic stem cells in a bone marrow transplant?

<p>To reconstitute a healthy hematopoietic system. (A)</p> Signup and view all the answers

Which of the following diseases can hematopoietic cell transplantation treat?

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

Which of the following is NOT a component commonly transfused?

<p>White Blood Cells (A)</p> Signup and view all the answers

What must be ensured when matching donors and recipients for bone marrow transplants?

<p>HLA matching. (D)</p> Signup and view all the answers

What might happen after an RhD- individual receives RhD+ blood?

<p>Production of anti-RhD antibodies occurs. (D)</p> Signup and view all the answers

What is a key characteristic of chronic rejection in transplanted organs?

<p>It primarily attacks the graft's vasculature. (C)</p> Signup and view all the answers

What triggers chronic rejection in a transplant?

<p>IgG antibodies against the graft's HLA. (D)</p> Signup and view all the answers

Why are immunosuppressive drugs given to transplant patients?

<p>To non-specifically suppress the immune system before and after transplantation. (D)</p> Signup and view all the answers

What happens to blood supply during chronic rejection?

<p>It gradually decreases leading to ischemia. (C)</p> Signup and view all the answers

Which type of T cells do immunosuppressive drugs inhibit after transplantation?

<p>Naive alloreactive T cells. (D)</p> Signup and view all the answers

What is an autograft?

<p>Tissue transplanted from one site to another in the same person (A)</p> Signup and view all the answers

What type of reaction occurs when the recipient's T cells attack the transplanted organ?

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

What is required for a successful organ transplant in relation to HLA?

<p>The donor and recipient must have similar tissue types (A)</p> Signup and view all the answers

What distinguishes an allograft from an autograft?

<p>Transplanted tissue is from genetically different individuals (A)</p> Signup and view all the answers

Which type of rejection occurs rapidly due to pre-existing antibodies?

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

What is graft-versus-host disease?

<p>Donor's T cells attacking the recipient's tissues (B)</p> Signup and view all the answers

What triggers the activation of the recipient’s T cells in acute rejection?

<p>Presence of donor DCs with donor HLA molecules (B)</p> Signup and view all the answers

Why is it important to ensure compatible ABO/RhD groups in organ transplants?

<p>To avoid hyperacute rejection (D)</p> Signup and view all the answers

Flashcards

Autoimmunity

A condition where the immune system mistakenly attacks the body's own cells and tissues, leading to various health problems.

Autoimmune reactions

Immune responses directed against self-antigens (Ags) leading to tissue damage.

Organ-specific autoimmune diseases

A group of disorders characterized by the immune system targeting specific organs or tissues.

Systemic autoimmune diseases

A group of disorders characterized by the immune system attacking multiple organs and tissues.

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Gender prevalence in autoimmune diseases

Autoimmune diseases are more prevalent in women than in men.

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Graves' disease

An autoimmune disease characterized by excessive and unregulated thyroid hormone secretion.

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Autoimmune reaction resembling hypersensitivity reactions

Autoimmune diseases resemble type II, III, and IV hypersensitivity reactions where the immune system attacks self-antigens, causing inflammation and tissue damage.

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Mechanisms of autoimmunity

The mechanisms responsible for breaking self-tolerance and leading to the development of autoimmune diseases are not fully understood.

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Thyroid Hormone Production Regulation

A negative feedback loop where the thyroid gland releases thyroid hormones, which then signal to the pituitary gland to stop producing TSH (thyroid-stimulating hormone).

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Autoantibodies in Graves' Disease

Antibodies produced by the immune system that mimic the action of TSH, stimulating the thyroid gland to release excess thyroid hormones.

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Rheumatic Fever

An autoimmune disease triggered by a bacterial infection, typically involving the heart, joints, and kidneys.

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Type II Autoimmune Disease

A type of autoimmune disease characterized by the body's immune system attacking its own tissues.

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Type III Autoimmune Disease

A type of autoimmune disease that occurs when immune complexes (antibodies bound to antigens) get deposited in the body and trigger inflammation.

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Systemic Lupus Erythematosus (SLE)

An autoimmune disease with a wide range of symptoms, including a 'butterfly rash' on the face, joint pain, and kidney problems.

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Autoantibodies

Antibodies that target the body's own molecules or cells, causing autoimmune reactions.

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What is chronic rejection?

Chronic rejection occurs months or years after transplantation and is caused by antibodies targeting the graft's HLA. It involves a gradual decrease in blood supply to the graft, leading to its death.

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What is the role of immunosuppressive drugs in transplantation?

Immunosuppressive drugs are medications given to transplant recipients to prevent their immune system from attacking the new organ. These drugs work by suppressing T cell activation, preventing the immune system from recognizing the transplanted tissue as foreign.

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When are immunosuppressive drugs given to transplant recipients?

Immunosuppressive drugs are administered in two phases: before transplantation to suppress the immune system and after transplantation to prevent rejection by inhibiting the activation of new immune cells.

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Why are immunosuppressive drugs given even with compatible donor and recipient?

Transplant patients are given immunosuppressive drugs to suppress their immune system even if the donor and recipient are compatible. This is done because even minor differences in HLA can trigger rejection.

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What are the consequences of chronic rejection?

Chronic rejection is characterized by inflammation and damage to the graft's blood vessels, resulting in decreased blood supply. Eventually, the graft can be damaged and die due to insufficient blood flow.

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Universal Donor

Individuals with blood type O have no antigens on their red blood cells, making them compatible with any recipient. They are known as universal donors.

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Universal Recipient

Individuals with blood type AB have no antibodies in their plasma, allowing them to receive blood from all donors. They are considered universal recipients.

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RhD Antigen

The RhD antigen is another factor considered during blood transfusions.

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RhD+ to RhD-

Transfusing RhD+ blood to an RhD- recipient can trigger the production of anti-RhD antibodies, making future RhD+ blood transfusions dangerous.

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Blood Type A and B agglutination

Individuals with blood type A and B have anti-B and anti-A antibodies in their plasma, respectively. These antibodies react with the corresponding antigens, resulting in agglutination (blood clumping).

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Blood Type AB

Individuals with blood type AB have both A and B antigens on their red blood cells, but have no antibodies in their plasma. They can receive blood from any donor.

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Blood Typing Tests

Blood typing tests are used to determine an individual's ABO and RhD group. The test involves adding antibodies (Anti-A, Anti-B, and Anti-RhD) to a blood sample and observing agglutination reactions.

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Hematopoietic Stem Cell Transplantation

Hematopoietic stem cell transplantation is used to treat diseases affecting the blood-forming system. It involves replacing the patient's diseased hematopoietic system with healthy donor cells.

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Allograft

An organ transplant between individuals with different genetic makeup. The recipient's immune system may attack the transplanted organ due to differences in HLA (Human Leukocyte Antigen) molecules, leading to rejection.

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Alloantigen

Antigens that are different between a donor and recipient. The body's immune system recognizes these differences and may mount an attack against the transplanted organ or tissue.

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Histocompatibility

The process of matching donor and recipient tissues based on HLA type. This helps minimize the chances of rejection by the recipient's immune system.

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Hyperacute Rejection

A type of transplant rejection that occurs rapidly, often within minutes to hours, after transplantation. It's usually triggered by pre-existing alloantibodies against ABO/RhD blood groups.

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Acute Rejection

A type of transplant rejection that occurs within days to weeks after transplantation. It's caused by the recipient's T cells recognizing and attacking the donor's alloantigens in the graft.

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Chronic Rejection

A type of transplant rejection that occurs gradually over months or years. It involves a chronic inflammatory response that slowly damages the transplanted organ.

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Graft-versus-Host Disease (GVHD)

A complication that can occur after bone marrow transplantation. It happens when the donor T cells attack the recipient's tissues, causing inflammation and damage.

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What is Type 1 Diabetes Mellitus?

A type of autoimmune disease characterized by the destruction of insulin-producing cells in the pancreas, leading to type 1 diabetes mellitus. This is caused by autoreactive cytotoxic T cells attacking beta cells in the islets of Langerhans. The gradual loss of insulin-secreting cells causes insulitis, inflammation of the islets of Langerhans, leading to insufficient insulin production and the need for insulin therapy.

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What is the role of T cells in autoimmune diseases?

Autoreactive effector T cells participate in a cellular immune response against self-antigens. This process involves the recognition and destruction of specific cells, much like the immune system's attack on pathogens.

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What is transplantation?

Involves the process of replacing damaged or diseased organs or tissues with healthy donor tissue. This requires careful management to ensure the transplanted organ functions properly, the recipient's health is maintained, and the immune system doesn't reject the transplant.

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What is blood transplantation?

A common type of transplantation used to replenish blood components in cases of trauma, childbirth, blood loss, and surgery. This includes transfusions of whole blood, red blood cells, plasma, and platelets.

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What are ABO antigens?

These are glycolipids found on the surface of red blood cells, determining blood groups. The presence of A, B, or both results in blood groups A, B, and AB, respectively. The absence of both A and B results in blood group O.

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What are ABO blood antigens?

These are glycolipids composed of a carbohydrate chain and a lipid molecule. They are present on the surface of erythrocytes and act as targets for antibodies. Depending on the ABO blood group, different configurations of these antigens are present on the cell surface.

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What is autoimmunity?

This is a condition where the immune system mistakenly attacks the body's own cells and tissues, leading to various health problems. Autoimmune diseases are often chronic and can affect various organs and systems.

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What are autoimmune reactions?

These are reactions where the immune system mistakenly attacks the body's own tissues. These reactions often resemble type II, III, and IV hypersensitivity reactions, with the key difference being that the immune system attacks self-antigens instead of foreign antigens.

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Study Notes

Autoimmunity and Transplantation

  • Autoimmunity involves the immune system mistakenly attacking healthy cells and tissues.
  • There are over 80 different clinically described autoimmune diseases.
  • Autoimmune diseases can affect specific organs or be systemic.
  • Females are more prone to autoimmune diseases than males.
  • Autoimmune diseases involve dysregulation of self-tolerance, the mechanisms are still unknown.

How Autoimmunity Happens

  • Autoimmunity occurs when the immune system identifies self-antigens (self-Ag) as a threat.
  • Effector T cells and B cells play a role in autoimmunity.
  • Autoimmune reactions resemble hypersensitivity reactions (type II, III, and IV).
  • Autoimmunity is triggered by a collective failure of self-tolerance.
  • The mechanisms responsible for breaking self-tolerance leading to autoimmune diseases are still not fully understood.

Mechanisms of Immunological Self-Tolerance

  • Negative selection of B cells in the bone marrow.
  • Negative selection of T cells in the thymus.
  • Lymphatic exclusion from brain, eye, and testes.
  • Expression of tissue-specific proteins in the thymus.
  • Induction of anergy in autoreactive B and T cells.
  • Treg cell suppression of autoimmune responses.

Type II Autoimmune Diseases

  • These diseases resemble type II hypersensitivity reactions.
  • Antibodies attack components of cell surfaces or extracellular matrices.
  • Examples include hemolytic anemia, thrombocytopenia, pemphigus, rheumatic fever, Graves' disease, myasthenia gravis, and type 2 diabetes.

Graves' Disease

  • Graves' disease is an autoimmune disorder caused by excessive thyroid hormone secretion.
  • It involves antibodies mimicking TSH (thyroid stimulating hormone), stimulating thyroid cells to produce excessive thyroid hormones.
  • Symptoms include bulging eyes, goiter, sweating, palpitations, skin lesions, weight loss, and agitation.

Rheumatoid Fever

  • Rheumatoid fever is an autoimmune disease caused by an immune response to infection, usually a Streptococcus pyogenes throat infection.
  • The symptoms often develop 2-3 weeks after the infection.
  • The disease specifically attacks heart tissues.

Type III Autoimmune Diseases

  • These diseases involve the deposition of immune complexes in blood vessels.
  • Examples include bacterial endocarditis, bacterial antigen-mediated glomerulonephritis, and systemic lupus erythematosus (SLE).

Systemic Lupus Erythematosus (SLE)

  • SLE is an autoimmune disease where antibodies attack a broad range of soluble cellular components (“autoantigens”).
  • Symptoms include fatigue, headaches, ulcers, butterfly rash, joint pain, hair loss, pleurisy (inflammation of lining of lungs), photosensitivity, and possible Raynaud’s disease, weight loss, or weight gain.
  • Immune complexes deposit in various tissues leading to inflammatory reactions.
  • Kidney glomerulonephritis, arthritis, and purpura (small blood vessels) can be symptoms.

Type IV Autoimmune Diseases

  • These diseases are caused by autoreactive effector T cells.
  • Examples include type 1 diabetes, rheumatoid arthritis, and multiple sclerosis.

Type 1 Diabetes Mellitus

  • Type I diabetes is an autoimmune disease that damages insulin-producing beta cells within islets of Langerhans in the pancreas.
  • Autoreactive CD8 T cells destroy beta cells.
  • The disease leads to reduced insulin production resulting in difficulties in blood glucose regulation and requiring insulin injections to manage blood sugar.

Transplantation

  • Transplantation can be a vital treatment option.
  • Transplantation involves introducing transplanted tissue to maintain normal physiological function and recipient health.
  • Recipient immune response needs to be managed to prevent rejection.
  • Common types of transplants include blood, tissue, and organs.

Blood Transfusion Considerations

  • ABO blood group system is critical in blood transfusions.
  • Antigens A and B are similar to carbohydrates that exist on the surface of commensal bacteria.
  • Group O individuals are universal donors, while AB individuals are universal recipients.
  • Rh factor (D antigen) is another key element, as individuals with Rh-negative blood can't receive Rh-positive blood without risk.
  • Blood typing is essential to identify compatible blood for transfusion.

Transplantation Terminology

  • Autograft: transplantation within the same person.
  • Isograft: transplantation between genetically identical individuals.
  • Allograft: transplantation between genetically different individuals.
  • Alloantigen: antigens that differ between donor and recipient.
  • Alloantibody: antibodies made against alloantigens.
  • Histocompatibility: similar tissue types between donor and recipient.

Rejection

  • Rejection of transplanted organs occurs due to allogenic immune responses against foreign antigens.
  • Hyperacute rejection: rapid response due to pre-existing antibodies towards donor antigens.
  • Acute rejection: T cells attack the transplant shortly after transplantation.
  • Chronic rejection: longer-term, gradual immune response that damages the organ over time.
  • Immunosuppressant drugs are crucial for reducing or eliminating rejection processes.

Immunosuppressive Drugs

  • Immunosuppressants inhibit T-cell activation, reducing the chances of rejection.
  • Patients receive immunosuppressants prior to and after transplantation.

Other key terms/concepts

  • BM transplant (bone marrow transplant)
  • HLA (human leukocyte antigen) matching for transplants

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