加州大學(xué)分校免疫學(xué)課程15(part1)_第1頁
加州大學(xué)分校免疫學(xué)課程15(part1)_第2頁
加州大學(xué)分校免疫學(xué)課程15(part1)_第3頁
加州大學(xué)分校免疫學(xué)課程15(part1)_第4頁
加州大學(xué)分校免疫學(xué)課程15(part1)_第5頁
已閱讀5頁,還剩22頁未讀 繼續(xù)免費(fèi)閱讀

下載本文檔

版權(quán)說明:本文檔由用戶提供并上傳,收益歸屬內(nèi)容提供方,若內(nèi)容存在侵權(quán),請進(jìn)行舉報(bào)或認(rèn)領(lǐng)

文檔簡介

Lecture15AutoimmunityAutoimmunityTypesofautoimmunityPossiblemechanismsDefectsinthymictolerance,AIREDefectsindownregulationofimmuneresponsesFasLCTLA4Roleofinflammation/adjuvants/costimulationSuppressor/regulatoryTcellsEnvironmentalfactorsCrossreactivityCrosslinkingRoleofMHC"horrorautoxicus"PaulEhrlichca.1890Ehrlich,whowasstudyingtheabilityofantibodiesandcomplementtodestroyxenogeneicredbloodcells,recognizedthatifantibodiestoselferythrocyteswereproduced,theresultswouldbedevastating.2-5%ofthepopulationsuffersfromautoimmunediseaseAutoimmunediseasesaretissueandantigenspecificTypeIjuvenileonset(insulin-dependent)diabetesTypeIdiabetesisaTcell-mediateddiseaseinwhichtheisletscellsofthepancreasareattackedandkilled.Theantigenrecognizedisnotknown,butthereisaverylargecorrelationwiththeexpressionoftheDR3/4HLAtypes.TheculpritappearstobeavariantofthelinkedDQ-betagenelackingachargedasparticacidatposition57.Diabeticautoimmunityischaracterizedbyself-reactiveBandTlymphocytesthattargetasetofproteinsexpressedinpancreaticcells.Proinsulin(PI),IA2,GAD65and67,andisletcellautoantigenof69kDa(ICA69)arethemajorexamples.Thesetargetself-Agsarenotisletcellspecific,andneitherisdiabeticautoimmunity;signsofceliacandthyroidautoimmunityarefairlycommoninpatients,anddiabetes-proneNODmicedevelopsignsofthyroidandSj?gren’sdisease.Occasionalislet-reactiveTcellsarefoundinalmost10%ofthegeneralpopulation,but<0.5%ofthesesubjectsarelikelytodevelopovertdiabetes.AlthoughitisuncertainwhatexpandsautoimmuneTcellpoolsandwhatdeterminestheirtissue-destructivepotential,accesstoislettargettissuehasbeensuggestedasacriticalelementindiabetes-pronehosts,despiteavailabilityofmostrelevantautoantigensinothertissues.Processiveinsulitisandisletcelldestructionindiabetes-proneNODstrainmiceHealthyisletsLymphocyteinfiltrateFigure13-34Someautoantibody-mediateddiseasesFigure11-2Figure11-14Figure11-5GravesdiseaseinvolvesantibodiestothyroidstimulatinghormonereceptorInsomecases,itisclearthatantibodiesarepathogenicFigure11-7part2of2SystemlupuserythematosisThediagnosisofSLEismadewhenotherillnesseshavebeenruledout,andwhenapersonhas4of11criteria.Thesecriteriainclude:discoidrash,malar(butterfly)rash,photosensitivity,mouthsores,arthritis,serositis(usuallyheartorlunginflammation),kidneydisorder,neurologicalproblems,bloodchanges,immunechanges,abnormaltitreofantinuclearantibody(ANA).Itisimportanttorememberthat4ormoreoftheaboveneedtobepresent.SometimesSLEissuspectedwithfewersymptomspresent.Forexample,ifapersonhasapositiveANA,thediagnosismaynotbeconfirmedunlessothersymptomsarepresent.Itcanbefrustratingtonotknowforsure.Theaveragetimefromtheonsetofsymptomsanddiagnosisisabout3years.SLEcontinuedSLEcandamagealmostanypartororganofthebody.ManypeopleareinitiallythoughttohavearthritisbecauseSLEhascausedinflammationofthejoints.Kidneysarefrequentlyaffected.IfSLEaffectsthebrain,forexample,apersonmightbeinitiallydiagnosedaspsychotic,epilepticorsufferingfromastroke.

TherespiratorysystemisoneofthemostfrequentlyinvolvedsystemsinSLE.Infectionspresentfrequentproblems.CertainmedicationsusedinSLEmaypredisposeapersontounusualkindsofinfections.Themoreseriousproblemsinvolvelungdiseaseincludinginterstitiallungdisease,pulmonaryhemorrhage.Treatable.TreatmentofSLEdependsontheseverityofthecase.Somepeoplerequireonlyanti-inflammatorymedicine(i.e.aspirin)tocontrolpainandswelling.Othersmayneedcorticosteroidsorcytotoxicmedicationsincludingazathioprineorcyclophosphamide.Insomecases,medicationsmaybeusedtosuppresstheimmunesystem.Antimalarialmedicationsarefrequentlyused.Figure11-9ProbablemodeofantinuclearantibodyproductioninSL

溫馨提示

  • 1. 本站所有資源如無特殊說明,都需要本地電腦安裝OFFICE2007和PDF閱讀器。圖紙軟件為CAD,CAXA,PROE,UG,SolidWorks等.壓縮文件請下載最新的WinRAR軟件解壓。
  • 2. 本站的文檔不包含任何第三方提供的附件圖紙等,如果需要附件,請聯(lián)系上傳者。文件的所有權(quán)益歸上傳用戶所有。
  • 3. 本站RAR壓縮包中若帶圖紙,網(wǎng)頁內(nèi)容里面會(huì)有圖紙預(yù)覽,若沒有圖紙預(yù)覽就沒有圖紙。
  • 4. 未經(jīng)權(quán)益所有人同意不得將文件中的內(nèi)容挪作商業(yè)或盈利用途。
  • 5. 人人文庫網(wǎng)僅提供信息存儲(chǔ)空間,僅對(duì)用戶上傳內(nèi)容的表現(xiàn)方式做保護(hù)處理,對(duì)用戶上傳分享的文檔內(nèi)容本身不做任何修改或編輯,并不能對(duì)任何下載內(nèi)容負(fù)責(zé)。
  • 6. 下載文件中如有侵權(quán)或不適當(dāng)內(nèi)容,請與我們聯(lián)系,我們立即糾正。
  • 7. 本站不保證下載資源的準(zhǔn)確性、安全性和完整性, 同時(shí)也不承擔(dān)用戶因使用這些下載資源對(duì)自己和他人造成任何形式的傷害或損失。

評(píng)論

0/150

提交評(píng)論