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DISORDERS OF IMMUNITY II: AUTOIMMUNE DISEASES. R. HUGO MARTÍNEZ LOZANO, M.D. Aug-12-2009. LEARNING OBJECTIVES. K & U: - GENERAL FEATURES - IMMUNOLOGIC TOLERANCE - MECHANISMS OF AUTOIMMUNITY THE MOST IMPORTANT CHARCT. OF: - LES - RA - SS - SYSTEMIC SCLEROSIS
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DISORDERS OF IMMUNITY II: AUTOIMMUNE DISEASES R. HUGO MARTÍNEZ LOZANO, M.D. Aug-12-2009.
LEARNING OBJECTIVES • K & U: - GENERAL FEATURES - IMMUNOLOGIC TOLERANCE - MECHANISMS OF AUTOIMMUNITY • THE MOST IMPORTANT CHARCT. OF: - LES - RA - SS - SYSTEMIC SCLEROSIS Ref: 223-239 & lecture’s information
GENERAL FEATURES • FRECUENCY: • DISEASE VS NORMALITY (Pathologic vs physiologic autoimm.)
CRITERIA FOR DX OF AUTOIMMUNE DISEASES • AUTOIMMUNE REACTION • NOT SECONDARY TO TISSUE DAMAGE • NO OTHER CAUSE
IMMUNOLOGIC TOLERANCE • CENTRAL: DEATH OF SELF-R LYMPH (APOPTOSIS) • PERIPHERAL: - ANERGY: NO COSTIMULATORS B7 INHIBITORY R CTLA-4 - SUPPRESSION BY REGULATORY T - CLONAL DEL. BY ACTIVATION OF INDUCED CELL DEATH (FASL-FAS)
MECHANISMS OF AUTOIMMUNE DIS. ROLES: - GENETICS - INFECTION/INFLAMMATION MUTATIONS: -AIRE -CTLA-4 -ETC.
ROLE OF INFECTIONS C. EPITOPE EXPOSITION & SPREAD.
SLE: GENERAL FEATURES • INCIDENCE: 1:700 • SEX: 9:1 • ETHNIC GROUP • AGE:
CLINICAL CRITERIA:(TABLE 6-8. p. 228) • MALAR RASH • DISCOIDE RASH • PHOTOSENSITIVITY • ORAL ULCERS • ARTHRITIS • SEROSITIS • RENAL INVOLVEMENT • ANA • ETC.
ANA • GENERIC • ANTI-DOBLE-STRANDED DNA • ANTI-SMITH (Sm) • ANTIHISTONE (DRUG-INDUCED LE) • SS-A & B (RNP) • ANTICENTROMERE (CREST)
RISK FACTORS • GENETIC • ENVIRONMENTAL • IMMUNOLOGIC
PATHOGENESIS: VASCULITIS (PHASES)