Tolerance and Autoimmune Disorders

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Questions and Answers

What are the two major types of hypersensitivity reactions involved in autoimmune diseases?

Type II and Type III hypersensitivity reactions.

Describe the chronic nature of autoimmune diseases.

Autoimmune diseases are chronic and progressive, characterized by relapses and remissions.

What factors can influence the signs and symptoms of autoimmune diseases?

Age, hormones, and environmental factors can influence symptoms.

Name a common organ-specific autoimmune disease related to the thyroid.

<p>Grave's disease or Hashimoto thyroiditis.</p> Signup and view all the answers

Identify a systemic autoimmune disease and mention its implication.

<p>Systemic lupus erythematosus, which affects multiple organs throughout the body.</p> Signup and view all the answers

How do the clinical manifestations of autoimmune diseases impact their classification?

<p>Clinical manifestations are overlapping and affect classification, complicating accurate diagnosis.</p> Signup and view all the answers

What role do autoreceptor antibodies play in autoimmune conditions?

<p>Autoreceptor antibodies can interfere with normal cellular functions, as seen in Myasthenia gravis.</p> Signup and view all the answers

What is a significant characteristic of an individual with autoimmune diseases?

<p>An individual may have more than one autoimmune disease simultaneously.</p> Signup and view all the answers

Which organs are commonly impacted by autoimmune diseases?

<p>Blood vessels, connective tissues, joints, muscles, skin, and endocrine glands.</p> Signup and view all the answers

What distinguishes organ-specific from systemic autoimmune diseases?

<p>Organ-specific diseases target individual organs, while systemic diseases affect multiple body systems.</p> Signup and view all the answers

What leads to the breakdown of T cell anergy and the subsequent activation of T cells specific for self-antigens?

<p>The upregulation of costimulatory molecules on antigen-presenting cells (APCs) causes the breakdown of T cell anergy and activates T cells.</p> Signup and view all the answers

How can molecular mimicry result in autoimmune reactions?

<p>Molecular mimicry occurs when a microbe shares an amino acid sequence with a self-antigen, leading to cross-reactive immunological reactions that target self-antigens.</p> Signup and view all the answers

What role do polyclonal B cell activation play in autoimmunity?

<p>Polyclonal B cell activation can lead to the stimulation of autoreactive lymphocytes, promoting the development of autoimmune diseases.</p> Signup and view all the answers

What are the implications of defective regulatory T-cell development in autoimmune diseases?

<p>Defective regulatory T-cell development can fail to maintain peripheral and central tolerance, increasing susceptibility to autoimmunity.</p> Signup and view all the answers

How does the release of sequestered self antigens contribute to autoimmune processes?

<p>Release of sequestered self antigens exposes hidden epitopes, often due to tissue trauma or inflammation, triggering immune responses.</p> Signup and view all the answers

What is the association between HLA alleles and autoimmune diseases?

<p>Certain HLA alleles, like HLA-B27, are strongly associated with increased incidences of autoimmune diseases such as ankylosing spondylitis.</p> Signup and view all the answers

What are the mechanisms through which infections can precipitate autoimmune diseases?

<p>Infections may cause autoimmune diseases by modifying self-antigens, leading to cross-reaction, and inducing necrosis and inflammation.</p> Signup and view all the answers

How does the familial incidence of autoimmune diseases emphasize the role of genetic factors?

<p>A familial increase in certain autoimmune diseases, such as systemic lupus erythematosus (SLE), indicates a genetic predisposition to autoimmunity.</p> Signup and view all the answers

What happens when there is a failure of T cell-mediated suppression, such as in AIDS?

<p>Failure of T cell-mediated suppression can lead to increased immune activation and the potential development of autoimmune conditions.</p> Signup and view all the answers

In what way does the presence of complex, multigenic patterns affect the understanding of autoimmune diseases?

<p>The complex, multigenic patterns suggest that autoimmune diseases cannot be attributed to single gene mutations but rather interactively involve multiple genetic defects.</p> Signup and view all the answers

What is immunologic tolerance and how does it relate to autoimmunity?

<p>Immunologic tolerance is the inability of the immune system to respond to a specific antigen, crucial for preventing autoimmune reactions against self-antigens.</p> Signup and view all the answers

Distinguish between central tolerance and peripheral tolerance.

<p>Central tolerance involves clonal deletion of autoreactive lymphocytes in the thymus or bone marrow, while peripheral tolerance addresses autoreactive cells that escape central tolerance through mechanisms like anergy and suppression by regulatory T cells.</p> Signup and view all the answers

What role do regulatory T cells play in maintaining peripheral tolerance?

<p>Regulatory T cells inhibit lymphocyte activation and effector mechanisms through the secretion of cytokines like IL-10, contributing to peripheral tolerance.</p> Signup and view all the answers

Explain how antigen sequestration contributes to self-tolerance.

<p>Antigen sequestration involves certain tissues hiding their antigens behind blood-tissue barriers, preventing autoreactive lymphocytes from interacting with them.</p> Signup and view all the answers

Identify the factors that contribute to the failure of self-tolerance in autoimmune diseases.

<p>The failure of self-tolerance in autoimmune diseases can result from inherited susceptibility genes and environmental triggers such as infections.</p> Signup and view all the answers

Describe the process of clonal deletion in central tolerance.

<p>Clonal deletion involves the apoptosis of autoreactive T and B lymphocytes during their development in the thymus or bone marrow.</p> Signup and view all the answers

What is anergy in the context of peripheral tolerance?

<p>Anergy refers to the irreversible functional inactivation of autoreactive cells that escape central tolerance, preventing them from mounting an immune response.</p> Signup and view all the answers

How do mutations in apoptosis genes relate to autoimmune lymphoproliferative disorders?

<p>Mutations in apoptosis genes can lead to inadequate deletion of autoreactive lymphocytes, resulting in autoimmune lymphoproliferative disorders.</p> Signup and view all the answers

Illustrate how environmental factors may trigger autoimmune responses in genetically susceptible individuals.

<p>Environmental factors, like infections, can interact with genetic susceptibility genes, leading to the breakdown of self-tolerance and subsequent autoimmune reactions.</p> Signup and view all the answers

What clinical conditions can arise as a consequence of disturbances in immunologic tolerance?

<p>Disturbances in immunologic tolerance can lead to various autoimmune diseases, including rheumatoid arthritis, lupus, and type 1 diabetes.</p> Signup and view all the answers

Flashcards

Immunologic Tolerance

The ability of the immune system to specifically avoid attacking the body's own cells and tissues.

Central Tolerance

A type of tolerance that eliminates self-reactive lymphocytes within the thymus or bone marrow, preventing them from entering the bloodstream.

Peripheral Tolerance

A type of tolerance that operates in peripheral tissues, suppressing or neutralizing any remaining self-reactive lymphocytes that escaped central tolerance.

Anergy

A mechanism of peripheral tolerance that renders self-reactive lymphocytes functionally inactive, preventing them from attacking self tissues.

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Regulatory T Cells (Tregs)

A type of immune cell that suppresses the activity of other lymphocytes, crucial for preventing autoimmune reactions.

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Deletion of Autoreactive Lymphocytes

Self-reactive lymphocytes that are eliminated through cell death (apoptosis), a mechanism of peripheral tolerance.

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Antigen Sequestration

A mechanism where certain tissues physically isolate their antigens from the immune system, preventing recognition and attack.

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Autoimmune Diseases

A group of diseases that occur when the immune system mistakenly targets and attacks the body's own tissues, causing inflammation and damage.

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Self-Tolerance

A key component of the immune system that ensures it functions correctly, preventing the development of autoimmune diseases.

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Susceptibility Genes

Genes that increase the susceptibility to developing autoimmune disorders due to their role in regulating immune responses.

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T cell anergy breakdown

T cell anergy is a state where T cells become unresponsive to their specific antigen. This can be broken by upregulating costimulatory molecules on antigen-presenting cells (APCs), leading to T cell activation.

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T cell Suppression Failure

A failure of T cell mediated suppression, as seen in AIDS, can lead to autoimmune disease. This occurs because the body loses the ability to control its immune response properly.

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Molecular Mimicry

Molecular mimicry occurs when a microbe shares an amino acid sequence with a self-antigen. The immune response against the microbe can cross-react with the self-antigen, causing tissue damage.

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Rheumatic Heart Disease

Rheumatic heart disease is an example of molecular mimicry. Antibodies against streptococcal proteins cross-react with heart proteins, causing myocarditis. This is an autoimmune reaction.

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Polyclonal B Cell Activation

Polyclonal B cell activation can be triggered by various microorganisms (like EBV). Some of these activated B cells may be autoreactive, leading to autoimmune disease.

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Exposure of Hidden Epitopes

Trauma or inflammation can release sequestered self-antigens (like lens proteins of the eye or sperm), exposing hidden epitopes and triggering autoimmune reactions.

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Susceptibility Genes in Autoimmunity

Certain genetic predispositions, such as those involving HLA alleles, can increase susceptibility to autoimmune diseases.

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HLA-B27 and Ankylosing Spondylitis

Ankylosing spondylitis is strongly associated with the HLA-B27 allele. Individuals with this allele have a greatly increased risk of developing the disease.

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Apoptotic Pathway Defects

Genetic defects in apoptotic pathways can contribute to the development of autoimmune diseases. This is because faulty apoptosis can allow self-reactive lymphocytes to survive and attack.

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Role of Infection in Autoimmunity

Viral infections can contribute to autoimmune diseases by modifying self-antigens, sharing similar epitopes (molecular mimicry), or inducing inflammation that exposes hidden antigens.

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Organ-Specific Autoimmune Disease

A type of autoimmune disease that targets specific organs or tissues, like the thyroid gland or pancreas.

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Systemic Autoimmune Disease

A type of autoimmune disease that affects various organs and tissues throughout the body.

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Type II Hypersensitivity Reaction

A type of autoimmune reaction where antibodies bind to and destroy specific cells, like red blood cells in autoimmune hemolytic anemia.

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Type III Hypersensitivity Reaction

A type of autoimmune reaction where immune complexes, formed by antibodies and antigens, deposit in tissues, causing inflammation.

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Antireceptor Antibodies

Antibodies that bind to and block receptors on cells, interfering with their function. Example: Myasthenia gravis where antibodies block acetylcholine receptors on muscle cells.

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Autoimmune Thyroid Disease

A type of autoimmune disease where the immune system attacks thyroid tissue, causing either hyperthyroidism (Grave's disease) or hypothyroidism (Hashimoto's thyroiditis).

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Type 1 Diabetes Mellitus

An autoimmune disease that destroys insulin-producing cells in the pancreas, leading to insulin deficiency and diabetes.

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Myasthenia Gravis

An autoimmune disease affecting the neuromuscular junction, where antibodies block acetylcholine receptors on muscle cells, leading to muscle weakness and fatigue.

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Systemic Lupus Erythematosus (SLE)

A systemic autoimmune disease characterized by inflammation and damage to multiple organs, including joints, skin, kidneys, and heart.

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Study Notes

Tolerance and Autoimmune Disorders

  • Tolerance is the immune system's inability to mount a response against self-antigens.
  • Self-tolerance is crucial for avoiding immune responses against our own cells and tissues.
  • Central tolerance involves the elimination of autoreactive T and B lymphocytes in the thymus or bone marrow.
  • Peripheral tolerance involves mechanisms that remove or inactivate autoreactive cells that escape central tolerance, including anergy, suppression by regulatory T cells, and deletion via apoptosis.
  • Autoimmune diseases occur when self-tolerance breaks down, allowing immune responses against self-antigens.

Mechanisms of Autoimmunity

  • Failure of self-tolerance: Inheritance of genes contributing to a breakdown of self-tolerance or the regulation of immune responses.
  • Breakdown of T cell anergy: Up-regulation of costimulatory molecules on antigen-presenting cells (APCs), leading to the activation of T cells specific to self-antigens.
  • Failure of T cell-mediated suppression: Occurs in conditions like AIDS, affecting the regulation of T cell responses.
  • Molecular mimicry: Similar amino acid sequences between a pathogen and a self-antigen, leading to cross-reactivity, where the immune response is directed at the self-antigen.

Role of Susceptibility Genes

  • HLA alleles are associated with autoimmunity, such as HLA-B27 and ankylosing spondylitis.
  • Genetic defects in apoptotic pathways can influence tolerance.
  • Defective regulatory T-cell development contributes to autoimmune diseases.

Role of Infection

  • Viral infections can play a role in triggering autoimmune diseases by modifying self-antigens.
  • Cross-reactivity: Pathogens may share epitopes (surface features) with self-antigens.
  • Microbial agents causing necrosis and inflammation upregulate co-stimulatory molecules, exposing hidden antigens, and causing polyclonal activation of lymphocytes.

Classification of Autoimmune Diseases

  • Organ-specific autoimmune diseases target specific organs (e.g., Grave's disease of the thyroid gland, Type 1 diabetes mellitus, myasthenia gravis).
  • Systemic autoimmune diseases affect multiple organs (e.g., Systemic Lupus Erythematosus, rheumatoid arthritis, inflammatory bowel diseases).

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