Tolerance & Autoimmunity Overview
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Questions and Answers

What is central tolerance primarily responsible for in the immune system?

  • Inducing immune tolerance to self-antigens (correct)
  • Activating autoreactive T cells
  • Generating memory immune responses
  • Promoting response to foreign antigens
  • Which of the following best describes the concept of autoimmunity?

  • A loss of tolerance to self-antigens (correct)
  • An enhanced immune response against pathogens
  • An imbalance in immune cell populations
  • Immune non-responsiveness to self
  • Which cell type primarily undergoes thymic selection to ensure central tolerance?

  • T cells (correct)
  • B cells
  • Macrophages
  • Plasma cells
  • What aspect of tolerance is referred to as peripheral tolerance?

    <p>Tolerance acquired after leaving the thymus</p> Signup and view all the answers

    Which of the following statements about autoreactive cells is true?

    <p>Both autoreactive B and T cells can lead to autoimmunity.</p> Signup and view all the answers

    What is the role of the AIRE gene in the immune system?

    <p>It controls the expression of self-antigens in the thymus.</p> Signup and view all the answers

    Which of these is NOT a mechanism of peripheral T cell tolerance?

    <p>Activation of effector T cells</p> Signup and view all the answers

    What is the primary function of CTLA-4?

    <p>Inhibiting T cell activation and proliferation</p> Signup and view all the answers

    Why is it thought that tumors can evade immune attack?

    <p>They express PD-L1/2, which can inhibit T cell activation.</p> Signup and view all the answers

    What is the significance of an antigen's persistence in inducing tolerance?

    <p>Persistent exposure can lead to immune exhaustion and tolerance.</p> Signup and view all the answers

    Which of these factors DOES NOT contribute to the development of tolerance to self-antigens?

    <p>The genetic makeup of the individual</p> Signup and view all the answers

    What is the primary function of regulatory T cells (Treg cells) in peripheral T cell tolerance?

    <p>Suppressing the activity of self-reactive T cells</p> Signup and view all the answers

    What is the link between CTLA-4 and anergy in CD8+ T cells?

    <p>The exact mechanism of CTLA-4's role in CD8+ T cell anergy is unknown.</p> Signup and view all the answers

    What is a major challenge in overcoming autoimmunity?

    <p>Overcoming T cell peripheral tolerance</p> Signup and view all the answers

    Which of the following cytokines is not involved in the differentiation of regulatory T cells?

    <p>IL-12</p> Signup and view all the answers

    Which of the following can lead to a transient breakdown of immune tolerance?

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

    What role does CTLA-4 play in regulatory T cells?

    <p>It suppresses immune responses by inhibiting T cell activation.</p> Signup and view all the answers

    Which factor is essential for the development of auto-reactive T regulatory cells (Tregs)?

    <p>Foxp3</p> Signup and view all the answers

    What is the significance of the intensive screening that thymocytes undergo?

    <p>It promotes the development of lymphocytes capable of recognizing self-peptide:self-MHC complexes.</p> Signup and view all the answers

    What role does the AIRE protein play in the immune system?

    <p>Facilitates self-peptide presentation in thymus</p> Signup and view all the answers

    Which of the following mechanisms is NOT involved in the maintenance of peripheral B cell tolerance?

    <p>Receptor editing</p> Signup and view all the answers

    How does co-stimulation affect T cell differentiation?

    <p>It dictates the level of T cell activation and response.</p> Signup and view all the answers

    What percentage of the developed world's population is estimated to have an autoimmune disease?

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

    How does the PTPN22 risk allele contribute to the development of autoimmune diseases?

    <p>It leads to defective central B cell tolerance, resulting in accumulation of autoreactive B cells.</p> Signup and view all the answers

    Which of the following is NOT a mechanism by which regulatory T cells suppress immune responses?

    <p>Induction of T helper (Th) cell differentiation</p> Signup and view all the answers

    Which cells express CTLA-4, and what is its primary function?

    <p>Activated T cells; to induce anergy</p> Signup and view all the answers

    Which process is inhibited by the Fas protein in activated immune cells?

    <p>Apoptosis of self-reactive cells</p> Signup and view all the answers

    Which of the following statements regarding the role of IL-10 in immune regulation is correct?

    <p>IL-10 inhibits the production of IL-12 by activated macrophages.</p> Signup and view all the answers

    Which of the following is a characteristic of the Fas pathway?

    <p>It is involved in apoptosis of T cells that have been repeatedly stimulated.</p> Signup and view all the answers

    Which of the following does not describe how regulatory T cells maintain self-tolerance?

    <p>They promote the differentiation of T cells into effector cells.</p> Signup and view all the answers

    What is the main function of regulatory T cells in the immune system?

    <p>To suppress immune responses and maintain self-tolerance.</p> Signup and view all the answers

    Study Notes

    Tolerance & Autoimmunity

    • Tolerance is a state of immune non-responsiveness to self.
    • Autoimmunity reflects a loss of tolerance, involving autoreactive B and T cells.
    • Tolerance is generated by two main mechanisms: central tolerance and peripheral tolerance.

    Aims of Sessions

    • Promote awareness of: developmental aspects of autoimmunity, induction and loss of central tolerance, thymic selection, peripheral tolerance mechanisms, and an overview of autoimmune disease.

    Cross Section of the Thymus

    • The thymus is a crucial organ in immune development.
    • Images show the main parts of the thymus (capsule, cortex, medulla, interlobular septum and thymic lobule).
    • Inside the thymus are "thymic corpuscles".

    Migratory Route of Developing T Cell

    • T cells develop in different stages, migrating from the subcapsular region through the cortex and into the medulla of the thymus.
    • Immature thymocytes progress through different stages (DN1, DN2, DN3, DN4) and then double-positive and mature.
    • T cells are released into circulation after maturation.
    • Different cell types are shown at each stage (macrophage, dendritic cell and epithelial cell).

    T Cell Developmental Outcome

    • Positive selection of T cells occurs when T-cell receptors (TCRs) with moderate binding to major histocompatibility complex (MHC) molecules are retained.
    • T cells that bind too weakly are eliminated (neglect).
    • Cells that bind too strongly are eliminated (clonal deletion).
    • Some T cells that bind strongly to MHC develop into regulatory T cells.

    +ve & -ve Selection in a Nutshell

    • Positive selection in the thymus cortex involves selecting T cells that react to self-MHC, in a moderate range.
    • T cells with weak binding to MHC die (in the cortex).
    • Negative selection in the thymus medulla involves selecting T cells that intensely bind self-antigen, and these are also eliminated.

    Autoimmune Regulator (AIRE) Gene

    • AIRE modulates the transcription of peripheral self-antigens displayed in the thymus.
    • This allows maturing T cells to learn about and tolerate a wide range of self-antigens.
    • Immature thymocytes with a high affinity for self-antigens undergo apoptosis.

    Central Tolerance in T Cells

    • Central tolerance does not delete T cells that are autoreactive to organ-sequestered antigens and cryptic epitopes.
    • A subset of these T cells are potentially pathogenic:
    • Deletion
    • maintenance of immunologic ignorance
    • functional inactivation (anergy)
    • suppression

    A Quick Reminder

    • Two signals are needed for full T-cell activation: specific signal and co-stimulatory signal.
    • Specific signal alone leads to anergy (failure to activate).
    • Co-stimulatory signal alone has no effect on T cells.

    Peripheral T Cell Tolerance Overview

    • Mature T cells that recognize self-antigens in peripheral tissues are rendered unresponsive.
    • Mechanisms of action include anergy (unresponsiveness), engagement of inhibitory receptors (like CTLA-4), and suppression by regulatory T cells.

    Suppression via Regulatory T Cells

    • Regulatory T cells suppress autoreactive T cells by interacting with antigen-presenting cells (APCs).
    • Deletion and non-co-stimulation are also methods of activation induced death.

    Inhibitory Receptors (Cytotoxic T Lymphocyte Antigen-4)

    • CTLA-4 is an inhibitory receptor on CD4+ T cells that binds B7 proteins on APCs.
    • It hinders activation and proliferation of T cells.
    • CTLA-4 binds B7 with greater affinity than CD28.

    Programmed Death-1

    • PD-1 has two ligands, PD-L1 and PD-L2.
    • PD-1 impacts both central and peripheral tolerance.
    • May work with CTLA-4 to regulate T cell activation and cytokine production.
    • A possible mechanism of tumour immune evasion is the expression of PD-L1/2.

    Important Points to Note

    • Persistence, Location and characteristics of APCs, and presence of adjuvants may influence tolerance over an immune response to protein antigens.

    Regulatory T Cells

    • Regulatory T cells are a subset of CD4+ T cells that express IL-2 receptor α chain (CD25) and Foxp3, a forkhead transcription factor.
    • High levels of CTLA-4 are also expressed.
    • Two types are known (natural-thymus and adaptive-induced).

    Maintenance & Mechanisms of Action of T Regs

    • Regulatory T cell function relies on TGF-β and IL-2.
    • TGF-β encourages Foxp3 presence.
    • IL-2 promotes regulatory T cell differentiation.
    • IL-2 activates STAT5.
    • T cell activation can be suppressed in lymphoid organs and tissues, in the effector phase, through multiple mechanisms.

    How Are Regulatory T Cells Generated?

    • TCR signal strength influences T-cell development: strong signals lead to regulatory T cell (Treg) formation; weak signals give rise to conventional T cells.
    • Deletion of T cells and production of Tregs are influenced by factors like IL-2, and the strength of TCR signaling.

    Recap 1

    • Many lymphocytes have some degree of self-reactivity and can respond to foreign antigens.
    • If all self-reactive lymphocytes are removed, the immune system is impaired.
    • Autoreactivity happens because self-recognition is less exact.

    Recap 2

    • A high percentage of thymocytes (98%) undergo apoptosis in the thymus due to intensive screening.
    • Thymocytes are tested for their ability to recognize self-peptide within self-MHC complexes This is key for self-tolerance.
    • Self-antigens manifest in different forms: cell surface antigens, intracellular antigens and soluble antigens.

    Inhibitory Cytokine Release

    • Interleukin-10 (IL-10) inhibits the production of IL-12 by activated macrophages and dendritic cells.
    • IL-10 hinders co-stimulator and MHC Class II expression.
    • IL-10 has broad roles in immune control (e.g., in mucosal tissues).
    • Tumour Growth Factor- β (TGFβ) suppresses T-cell proliferation and macrophage activation.

    Activation-Induced Cell Death

    • Fas/FasL ligation drives activation-induced cell death (AICD).
    • Repeated stimulation can trigger cell death in mature T cells, triggered by self-antigens.
    • Defects in AICD pathways correlate with autoimmune conditions like lymphoproliferative syndrome.

    B Cell Central Tolerance

    • Central B cell tolerance occurs in the bone marrow.
    • This process is crucial for maintaining unresponsiveness to thymus-independent self-antigens.
    • Immature B cells that strongly bind self-antigen go through receptor editing or deletion.
    • B cells with weak self-antigen binding become anergic.

    B Cell Receptor Editing

    • Immature B cells that recognize self-antigens in high concentrations can undergo receptor editing.
    • Cross-linking of self-antigens activates RAG1 and RAG2 (recombination-activating genes).
    • This process leads to VJ recombination in the Ig κ locus, allowing self-antigen-specific BCRs (B cell receptors) to re-specificity.

    Peripheral B Cell Tolerance

    • Mature B cells outside the bone marrow can become anergic or die by apoptosis in the absence of specific T helper cells.
    • Encountering strong self-antigen crosslinking leads to clonal deletion.
    • Continual presence of soluble self-antigen can result in B cell anergy.

    PTPN22 Risk Allele

    • PTPN22 encodes lymphoid protein tyrosine phosphatase (Lyp).
    • Lyp is found exclusively in immune cells.
    • Location is on chromosome 1p13.3-13.1.
    • Reduced B-cell signaling causes defects in central B-cell tolerance, leading to an accumulation of autoreactive B cells.
    • Possibly involved in T-cell selection.

    Immune Privilege

    • Sequestered antigens in certain tissues shield these tissues from immune responses.

    How Does Tolerance Break Down?

    • Tolerance breakdown may involve numerous mechanisms, with the overcoming of T-cell peripheral tolerance appearing to be a significant hurdle in some circumstances.
    • Potential breakdowns include reversal of active tolerance mechanisms or the overcoming of protective processes
    • Tolerance breakdowns can happen in infections and tissue damage, and may lead to more specific tissue damage.

    Molecular Mimicry

    • Molecular mimicry occurs when antibodies that are stimulated by a microbial antigen cross-react with human tissue causing subsequent diseases.

    Co-stimulation Requirements Vary with Differentiation of T Cells

    • The activation requirements for various T-cell types involving specific signal and co-stimulatory signals are different.
    • Two signals are needed for full T-cell activation.

    A Concept of Tolerance Breakdown

    • Breakdown of tolerance can involve tissue damage, changes in self-antigen presentation, and alterations of co-stimulators and MHC molecules.

    Loss of Tolerance

    • AIRE protein involvement (self-peptide presentation):
    • CTLA-4 expression on activated T cells (binding to B7, inducing anergy)
    • Foxp3's importance in Treg cells; its presence relates to autoreactive T-reg cell development.
    • The transitioning or shift between regulatory and other T-cell types.
    • Fas expression and apoptosis induction

    Overview of Autoimmune Disease

    • Autoimmune disease affects 5-7% of the developed world's population. Women are more likely to be affected.
    • Autoimmune disorders show familial clusters and rising incidence rates.
    • Clinically, they are often categorized as systemic or organ-specific.

    Autoimmune Disease is Multifactorial

    • Genetics and environmental exposures (including infections) are contributors as well as imbalances in immune regulation cause autoimmunity.

    Criteria for Definition of an Autoimmune Disease

    • Criteria for diagnosis include serum autoantibodies/cell-mediated activity, the presence of both at sites of tissue damage, and the association of levels of autoantibody/T cells with disease activity; and the improvement of the disease following reduction of the autoimmune response.

    Additional Criteria for Autoimmune Disease

    • Transfer of autoantibodies/T cells can cause the disease in a recipient.
    • Immunization with an autoantigen can induce an autoimmune reaction.

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    Description

    Explore the concepts of immune tolerance and autoimmunity through this quiz. Understand the mechanisms behind central and peripheral tolerance, as well as the thymus's role in T cell development. Gain insights into autoimmune diseases and the importance of immune non-responsiveness.

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