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Autoimmunity and Autoimmune Disease (AID)

Autoimmunity and Autoimmune Disease (AID). I. Summarization II. Mechanisms and models of AID III. Nosogenesis of AID IV. Therapy of AID. I. Summarization 1. Concepts of Autoimmunity & AID 2. Characters of AID 3. Classification of AID.

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Autoimmunity and Autoimmune Disease (AID)

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  1. Autoimmunity and Autoimmune Disease (AID) I. Summarization II. Mechanisms and models of AID III. Nosogenesis of AID IV. Therapy of AID

  2. I. Summarization 1. Concepts of Autoimmunity & AID 2. Characters of AID 3. Classification of AID

  3. 1. Concepts of Autoimmunity & AID Autoimmunity: Inappropriate response of the immune system against self-components Autoimmune disease, AID: Diseases induced by inappropriate response of the immune system against self-components

  4. 2. Characters of AID 1 High titer auto-antibody in serum and self-reactive T cells against self-components 2 Damage to organs and tissue destruction caused by auto-antibody & self-reactive T cells 3 close relationship between disease prognosis and auto-immune 4 Repeat,chronic persistent 5 Animal model replication and adoptive transfer 6 Inherited tendency, female susceptible 7 No reasons Among them, no.1 and no.2 could not be absent.

  5. 3. Classification of AID • Organ specific • Hashimoto's thyroiditis • Primary myxoedema thyrotoxicisis • Insulin-dependent diabetes mellitus • Non-organ specific • Systemic lupus erythematosus(SLE) • Rheumatoid arthritis (RA)

  6. Rheumatoid arthritis Characterized by the presence of rheumatoid factor (antibodies against IgG)

  7. II. Mechanisms and models of AID • （1）AID caused by type II hypersensitivity reactions • AID with Cell destruction caused by auto- antibodies • AID caused by auto- antibodies against receptors on surface of cells • AID caused by auto- antibodies against extra-cell component

  8. 1） AID caused by auto- antibodies against cell surface antigen immunologic thrombocytopenic purpura, ITP 2） AID caused by auto- antibodies against receptors on surface of cells toxicdiffuse goiter、myasthenia gravis myasthenia gravis： （1）thymocytepathological changes （2）   IgG increase, Auto-antibody to AChR 3） AID caused by auto- antibodies against extra-cell component Lung- Kidney syndrome

  9. （2） AID caused by type III hypersensitivity reactions IC with auto-antibodies

  10. SLE（Non-organ specific） many auto-antibodies: anti-nucleus antibodies, anti-DNA, RNA ... immune destruction：Lupus cells formation, Joint, cardiovascular, Kidney, Liver … Reasons： （1）Slow virus continuous infection （2）Ag-Ab complex sediment （3）Medicine application

  11. Animal model Part III a.Negative b.Homogeneous pattern c.Peripheral pattern d.Cytoplasmic pattern e.Nucleolar pattern f.Cytoplasmic+nucleolar pattern Immunofluorescent staining of ANAs(400)

  12. Animal model Part III a. Negative b.  400 c.  100 d.  40 Immune complexes deposit in glomeruli

  13. （3）AID caused by type IV hypersensitivity reactions Inflammatory damage caused byT cells against self-antigen

  14. Activated CNS-specific T cells infiltrate the CNS, Become reactivated and Contribute to MS B7-1 CD28 CD28 B7-1 auto-reactive auto-reactive MBP or mimic auto-reactive Th 1 IL-12 Th 1 BBB

  15. III.Nosogenesis of AID 1. Self-antigen alteration/associated antigen 1）covert antigen release（lens, sperm, hypothyroid） 2）self-antigen alteration Ag denaturalization, Metabolization alteration, Ag expression alteration, Medicine effect a-methyldopamine: RBC membrane e antigen, anti-RBC Ab, autoimmune hemolytic anemia Hydrazinebenzenepyridazine: Alter nuclear component, Anti-nucleus Ab, SLE-like syndrome Virus infection：Insert DNA, Auto-Ab, interfere FasL expression, T、B hyperplasia

  16. 1. Self-antigen alteration/associated antigen 3）Cross antigen effect: A β Hemolytic streptococcus vs. human cardiac muscleAg type 12 streptococcus vs. glomerulo basement membrane 4）Molecule mimic effect: the similar Aa sequence between pathogen and human 5）Determinant Spreading Dominant Epitope Epitope in primary immune response Cryptic Epitope Epitope in continuous immune response

  17. 2. Immune regulation abnormity 1）Alternative activation by multi-clone stimulator : microbes or its products directly induce B cells to produce auto-antibodies 2）MHC II expression abnormity: IFN-g、IL-1、IL-2、 MHCII 3）Assistant stimulator expression abnormity: 4）Th ratio or function unbalance: Th1/Th2 deviation 5）Fas、FasL expression abnormity:

  18. Diseases caused by Fas/FasL abnormity lpr(lymphoproliferation) gld(generalized lymphorpoliferative disease) Lymphadenopathy and spleen swell, many IgG and IgM, including anti-DNA antibodies and rheumatoid factor Immune complex glomerulonephritis and arthritis five months after animals born, many auto-reactive CD4+T cells, help B cells produce antibodies, without AICD

  19. Autoimmune Lymphoproliferative Syndrome and Perforin Rieux-Laucat, F., Le Deist, F., De Saint Basile, G., Clementi, R., Ferrarini, M., Bregni, M. (2005). Autoimmune Lymphoproliferative Syndrome and Perforin. N Engl J Med 352: 306-307

  20. 6）Others 1     Thymus function abnormity Tumor, slow virus infection in thymus thymus abnormity,thymus hormone deficiency Obstruction of thymus T cells differentiation sthenic B cells function auto-antibodies 2Idiotype-anti-idiotype network regulation abnormity Ab2b, internal image(antibodies with same effect), Auto-immune 3  Endocrine Child-bearing women： E2 4 Heredity

  21. IV. Therapy of AID   Defend and control pathogeny infection           Immunosuppressant        Anti-inflammation treatment Cytokine treatment              Therapy with specific antibodies            Oral auto-antigen

  22. Grasp characters of AID • Familiar with mechanisms of AID • Familiar with nosogenesis of AID • Know about therapy of AID

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