AUTOIMMUNITY TISSUES AND ORGANS INVOLVED

- Problem of recognizing self from non- self

- Occurrence of an immune response resulting in the production of either ORGAN - Autoimmune response are  BRAIN:
antibody and/or sensitized lymphoid cells capable of reacting with normal SPECIFIC directed against antigens - Multiple sclerosis
body constituents present only in particular  THYROID
- Breakdown of the immune system’s ability to discriminate between self organ - Hashimoto’s
and non- self - Autoantibodies bind to self - Thyroiditis
- PAUL EHRLICH: horror autotoxicosis antigen to organ cells and - Primary myxedema
lead to destruction of cells  STOMACH
AUTOIMMUNE DISORDERS - The autoantibodies bind to - Pernicious anemia
self- antigen on cells and leads  ADRENAL
- Varied group of chronic illnesses that involves almost every human organ to either over stimulation of - Addison’s disease
system the cell or suppression of the  PANCREAS
- Seen when demonstrable immunoglobulins of cytotoxic T cells display normal functioning cell - Insulin dependent
specificity for self-antigen - Damage is confined to the - Diabetes mellitus
organ against which the
FACTORS INFLUENCING AUTOIMMUNITY immune response is mounted
 Genetic factors & Infection and environmental exposure
NON – - Immune response against  MUSCLE
o Immune regulation ORGAN antigens which are not - Dermatomyositis
 Autoimmunity SPECIFIC associated with organ  KIDNEY
involved - SLE
DEVELOPMENT OF AUTOIMMUNE RESPONSE
 SKIN
- Antigen that do not normally circulate the blood - Scleroderma
- Altered antigens that arise because of chemical, physical or biological - SLE
process  JOINTS
- A foreign antigen that is shared with self-antigen and tissue component - Rheumatoid
- Mutation of immunocompetent cells arthritis
- Loss of immunoregulatory function of T lymphocyte subset

MECHANISM OF AUTOIMMUNITY AUTOIMMUNE HEMOLYTIC ANEMIA

- Autoantibodies to self- RBCs are formed

- The autoantibodies bind to antigens on RBCs and lead to the lysis of RBCs
- Maybe caused by drugs ( cephalosporin, dapsone) > act as haptens
- The drug – RBC antigen complex induces the immune system to produce
antibodies
- Lead to activation of complement cascade

MAJOR AUTOANTIBODIES

 ANTI – AchR Ab: myasthenia gravis

 ANTI- ADRENAL Ab: addison’s disease
  ANTICARDIOLIPIN Ab: SLE associated with arterial and venous thrombosis - Most common type of hemolytic anemia associated with cold- reactive
 ANTICENTRIOLE Ab: systemic sclerosis autoantibodies
 ANTICENTROMERE Ab: CREST syndrome - Acute: M.pneumoniae or lymphoma
 ANTI- DNA Ab: SLE - Chronic: seen in older patients, Reynaud’s phenomenon
 ANTI- GLOMERULAR BASEMENT MEMBRANE Ab: Goodpasture’s
PAROXYSMAL COLD HEMOGLOBINURIA
syndrome
 ANTI- IF Ab: pernicious anemia - IgG autoantibody (biphasic hemolysin)
 ANTI- ISLET CELL Ab: Type 1 DM - IgG autoantibody that reacts with RBCs in colder parts of the body
 ANTI- LKM Ab: hepatic disease - C3 and C4 bind irreversibly to the RBCs
 ANTI-MITOCHONDRIAL Ab: primary biliary cirrhosis
 ANTI-MYELIN Ab: Multiple sclerosis
 ANTI-MYOCARDIAL Ab: Dressler’s syndrome
 ANTI- PARIETAL CELL Ab: pernicious anemia/ atrophic gastritits
 ANTINEUTROPHIL Ab: Wegner’s granulomatosis
 ANTINUCLEAR Ab (ANA): 99% of patients with SLE
 ANTIPLATELET Ab: ITP
 ANTIRETICULIN Ab: dermatitis herpetiformis, adult gluten sensitive
enteropathy, chronic heroin addiction
 ANTI- Scl Ab: systemic sclerosis
 ANTISKIN Ab: dermal- epidermal: bullous pemphigoid
 ANTISKIN Ab: intraepithelial: pemphigus
 ANTI-Sm Ab: confirms the diagnosis of SLE
 ANTI-SMOOTH MUSCLE Ab: chronic active hepatitis
 ANTISPERM Ab: Antibodies to sperm cell

AIHA

WARM REACTIVE AUTOANTIBODIES

WAIHA

- Most common
- Associated with antibodies reactive at warm temperature (37)
- The RBCs are coated with both IgG and complement

CAIHA

- Aka as COLD HEMAGGLUTININ DISEASE

- Cold- reactive IgM autoantibody reacts with RBCs
- Acute or chronic