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Semester 3 Microbiology & Immunology Autoimmunity and Transplantation

Semester 3 Microbiology & Immunology Autoimmunity and Transplantation. Basic Autoimmunity: Responses to Self Antigens and Self-Tolerance & Its Loss Nicholas R. Sinclair, MD PhD February 13, 2002 - 9:00am. Learning Objectives for Basic Autoimmunity.

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Semester 3 Microbiology & Immunology Autoimmunity and Transplantation

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  1. Semester 3Microbiology & ImmunologyAutoimmunity and Transplantation Basic Autoimmunity:Responses to Self Antigensand Self-Tolerance & Its Loss Nicholas R. Sinclair, MD PhD February 13, 2002 - 9:00am

  2. Learning Objectives forBasic Autoimmunity • Discuss autoimmune disease in terms of organ specificity • Relate clinical autoimmune disease to types of hypersensitivity states • Discuss immunopathogenesis of autoimmune disease • Discuss the genetic basis of clinical autoimmunity • Discuss the environmental triggers of clinical autoimmunity

  3. Three Types of Autoimmune DiseaseType IIType IIIType IV

  4. Type II Autoimmune Diseases **

  5. R&GCase 24AutoimmuneHemolyticAnemiaMycoplasma Pneumonia

  6. Case 24 Autoimmune HemolyticAnemia

  7. Case 24 Autoimmune HemolyticAnemia

  8. Case 24 Autoimmune HemolyticAnemia

  9. Case 24Autoimmune Hemolytic AnemiaPeripheral B Cell Tolerance

  10. Type II Autoimmune Diseases *

  11. Type II Autoimmune Diseases **

  12. Antibodies To Vascular Basement Membranes Cause Goodpasture’s Disease That Affects Renal Glomeruli and Lung Alveoli

  13. Type II Autoimmune Diseases **

  14. Case 27 Pemphigus Vulgaris

  15. Case 27 Pemphigus Vulgaris

  16. Case 27 Pemphigus Vulgaris

  17. Case 27 Pemphigus Vulgaris

  18. Case 27PemphigusVulgarisCyclophosphamide and Active Intermediate

  19. Type II Autoimmune Diseases *

  20. Type II Autoimmune DiseasesInclude Autoimmunity Against Cell Surface Receptors **

  21. Mechanism For Thyrotoxicosis (Graves’ Disease or Exophthalmic Goiter) Is Anti-TSH Antibody

  22. Autoimmune Thyroid Disease

  23. Normal Thyroid

  24. Normal Thyroid Histology

  25. Autoimmune Thyroid Disease *

  26. Atrophic Thyroid - Hashimoto’s

  27. Hashimoto’s Histology

  28. Hashimoto’s Histology

  29. Antimicrosomal Antibody Staining in thyroid epithelial cells No staining in follicle colloid Antigen is thyroid peroxidase Seen in Hashimoto’s thyroiditis

  30. Anti-thyroglobulin Antibody Staining in follicle colloid No staining in thyroid epithelial cells

  31. Autoimmune Thyroid Disease *

  32. Autoimmune Colloid Goitre (Euthyroid - ‘cold’ nodules)

  33. Euthyroid Nodular Goitre

  34. Euthyroid Nodular Goitre Inactive ‘cold’ nodule - flattened epithelial cells

  35. Autoimmune Thyroid Disease *

  36. Diffuse Hyperthyroid Picture Hyperactive thyroid tissue - infoldings of the hyperplastic epithelium Thyrotoxicosis - Grave’s Disease

  37. Diffuse Hyperthyroid Picture Hyperactive thyroid tissue - infoldings of the hyperplastic epithelium scalloping (arrow) Thyrotoxicosis - Grave’s Disease

  38. Evidence That A Circulating Antibody Can Cause Autoimmune Disease Involves Transfer Of Serum From Patient To An Animal

  39. Circulating IgG Autoantibodies Can Cross Placenta To Affect Fetus

  40. IgG Anti-TSH Antibodies Can Go From Mother To Fetus And Cause Graves’ Disease In Baby

  41. Type II Autoimmune DiseasesInclude Autoimmunity Against Cell Surface Receptors **

  42. In Myasthenia Gravis, Antibodies To The Acetylcholine Receptor Block Neuromuscular Transmission Needed Form Muscle Contraction

  43. Case 20MyastheniaGravisEye Muscle Weakness Seen When Moving Eyes to Each Side

  44. Case 20 Myasthenia GravisPlacental Transfer of Ab

  45. Both Antibodies & T Cells Induce Myasthenia Gravis

  46. Case 20MyastheniaGravisAzathioprine (Imuran)Is a Purine Analogue

  47. Case 20 - Myasthenia GravisRelapses after Infection

  48. Type II Autoimmune DiseasesInclude Autoimmunity Against Cell Surface Receptors * *

  49. Pernicious Anemia

  50. Types III/IV Autoimmune Diseases *

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