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Autoimmunity-a review

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Information about Autoimmunity-a review
Health & Medicine

Published on February 20, 2014

Author: pvkchaitanyakiran

Source: slideshare.net

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Introduction • Immunity – It is the ability of the body to defend itself against specific invading agents such as bacteria, toxins, viruses etc.

Introduction • COMPONENTS OF THE IMMUNE SYSTEM • B - Lymphocytes • T – Lymphocytes • CD4+ cells ( T helper cells) • CD8+ cells (Cytotoxic T cells) • Memory T cells • • • • • The NKCs Macrophages Dendritic cells The MHC antigens (HLA) Cytokines

Introduction • Innate immune response : • First line of defense • Non – specific • Examples : Physical – skin, mucosa Biochemical – complement, Lysozyme, IFNs Cellular – NKCs, Neutrophils, Monocytes, Macrophages • Adaptive immune response • Specific towards a particular antigen

Tolerance • It refers to a state in which an individual is incapable of developing an immune response against a specific antigen. Self – tolerance refers to the lack of immune responsiveness to one’s own tissue antigens. • Self – tolerance mechanisms • Central tolerance - deletion of self reactive T &B lymphocytes during their maturation in central lymphoid organs • Peripheral tolerance – Back up mechanisms

Autoimmunity • Is the condition when the immune response takes place against the normal endogenous proteins. • The disease resulting from this phenomenon is called as an “AUTOIMMUNE DISEASE”. • Mainly seen in young adults. • Females are at a higher risk of developing an autoimmune response. But the reactions occurring in men are more severe.

Classification of Autoimmune diseases • SYSTEMIC (Not tissue specific) • Systemic lupus erythematosus (SLE) • Sjögren's syndrome • Scleroderma • LOCAL SYNDROMES (Tissue specific) • Endocrinologic : IDDM, Hashimoto’s disease • Gastrointestinal : Crohn’s disease • Dermatologic : Vitiligo • Hematologic : Idiopathic Thrombocytopenic purpura • Neurologic : Myasthenia gravis

Pathogenesis • Failure of Activation-Induced Cell Death • Breakdown of T-Cell Anergy • Molecular Mimicry • Dendritic cell malfunctioning • Cryptic self exposure

Triggers • GENES • INFECTIONS • Viruses : Hepatitis C virus, Hepatitis D virus, Coxsackie B virus • Bacteria : Treponema pallidum , Streptococcus pyrogenes • Other: Trypanosoma cruzi, Ochocerca volvulus • DIET • Cow’s milk • Gluten • Chemicals • Mercury, Copper, Iron, Iodine • DRUGS • Hydralazine and Procainamide • Quinidine

Diagnosis • INFLAMMATORY MARKERS • ESR • CRP • Ferretin • AUTOANTIBODIES AND IMMUNOLOGIC STUDIES • • • • ELISA Anti nuclear antibody Anti neutrophil cytoplasmic antibody Anti phospholipid antibody • FLOW CYTOMETRY • CYTOKINE STUDIES • MHC

Treatment • IMMUNOSUPPRESSANTS • Corticosteroids • Prednisone • Prednisolone • Immunophilin ligands • Cyclosporine • Tacrolimus • Sirolimus • Mycophenolate mofetil (MMF) • Thalidomide

Treatment • CYTOTOXIC AGENTS • • • • • • Azathioprine Mercaptopurine Cyclophosphamide Leflunomide Methotrexate Vincristine • IMMUNOSUPPRESSIVE ANTIBODIES • • • • • Immunoglobulin Intravenous Adalimumab Infliximab Etanercept Alefacept

Treatment • OTHER DRUGS • • • • • Chlorambucil Hydroxychloroquine Gold compounds Interleukin -1 antagonists Sulfasalazine

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