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DISORDERS OF IMMUNITY II: AUTOIMMUNE DISEASES

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

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  1. DISORDERS OF IMMUNITY II: AUTOIMMUNE DISEASES R. HUGO MARTÍNEZ LOZANO, M.D. Aug-12-2009.

  2. 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

  3. GENERAL FEATURES • FRECUENCY: • DISEASE VS NORMALITY (Pathologic vs physiologic autoimm.)

  4. CRITERIA FOR DX OF AUTOIMMUNE DISEASES • AUTOIMMUNE REACTION • NOT SECONDARY TO TISSUE DAMAGE • NO OTHER CAUSE

  5. 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)

  6. MECHANISMS OF AUTOIMMUNE DIS. ROLES: - GENETICS - INFECTION/INFLAMMATION MUTATIONS: -AIRE -CTLA-4 -ETC.

  7. ROLE OF INFECTIONS

  8. ROLE OF INFECTIONS C. EPITOPE EXPOSITION & SPREAD.

  9. SLE: GENERAL FEATURES • INCIDENCE: 1:700 • SEX: 9:1 • ETHNIC GROUP • AGE:

  10. CLINICAL CRITERIA:(TABLE 6-8. p. 228) • MALAR RASH • DISCOIDE RASH • PHOTOSENSITIVITY • ORAL ULCERS • ARTHRITIS • SEROSITIS • RENAL INVOLVEMENT • ANA • ETC.

  11. ANA • GENERIC • ANTI-DOBLE-STRANDED DNA • ANTI-SMITH (Sm) • ANTIHISTONE (DRUG-INDUCED LE) • SS-A & B (RNP) • ANTICENTROMERE (CREST)

  12. RISK FACTORS • GENETIC • ENVIRONMENTAL • IMMUNOLOGIC

  13. PATHOGENESIS: VASCULITIS (PHASES)

  14. Lupus erythematosus: skin.

  15. SKIN: ANTI-B.M. INJURY

  16. Idem.

  17. IDEM: (IMMUNEFLUORESCENCE)

  18. Malar rash

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