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− | ==Introduction==
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− | '''Autoimmune disease''' is defined as ''a disease state characterised by a specific antibody or cell mediated response against the body's own tissues ('self' antigens).
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− | The breakdown of [[Immune Tolerance - WikiBlood|tolerance]] to self antigens and the failure to regulate pathological immune responses are both responsible for autoimmune diseases. It has been shown in mice that thymectomy causes autoimmune disease, and plays a very important role in the recognition of 'self'.
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− | Particular individuals may be more susceptible to autoimmune diseases due to:
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− | ===Genetic factors===
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− | Many autoimmune diseases have a familiar component and the Human Leucocyte Antigen (HLA) haplotype is the predominant genetic factor, however having a particular HLA haplotype does not automatically result in the development of an autoimmune disease.
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− | * HLA-DR3/DR4 (MHC Class II):
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− | 1. Diabetes Mellitus
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− | 2. Rheumatoid Arthritis
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− | * HLA-B27 (MHC Class I):
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− | 1. Ankylosing spondylitis
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− | * TNF alpha
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− | * CTLA-4
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− | ===Hormonal factors===
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− | Testosterone is protective against Systemic Lupus Erythematosus (SLE) and thus it is not seen in males.
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− | ===Environmental factors===
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− | '''''Infection'''''
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− | 1. Molecular mimicry
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− | * Some bacteria and viruses have antigens that resemble host-cell components and the body can then also initiate an immune response against itself.
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− | 2. Polyclonal activation
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− | * T and B cells activation can occur as a result of an infection resulting in polyclonal activation. This can then cause autoreactive autoantibodies or mediate autoimmunity.
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− | 3. Inappropriate MHC expression
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− | * Autoreactive T cells are activated because infection stimulates APC and upregulates MHC class II.
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− | '''''Diet'''''
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− | '''''Stress'''''
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− | {| border="1" cellpadding="2"
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− | !width="150"|
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− | !width="150"|Antibody mediated
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− | !width="50"|Antibody mediated
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− | !width="200"|Cell mediated
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− | | '''Type of hypersensitivity''' || [[Type II Hypersensitivity - WikiBlood|Type II]] || [[Type III Hypersensitivity - WikiBlood|Type III]] || [[Type IV Hypersensitivity - WikiBlood|Type IV]]
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− | | '''Pathogenesis''' || Antibody to cell surface or matrix antigens || Antibody to soluble self antigens || T cell and macrophage activation to self antigens
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− | | '''Examples of diseases''' || Immune mediated haemolytic anaemia (IMHA) || Systemic Lupus Erythematosus (SLE) || Rheumatoid arthritis
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− | | || Immune mediated thrombocytopaenia (IMTP)|| || Diabetes Mellitus type 1
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− | | || Myasthenia gravis || || Hypothyroidism (lymphocytic throiditis)
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− | | || Pemphigus Vulgaris || || Hypoadrenocorticism (Addisons disease)
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− | | || Bullous pemphigoid || ||
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− | |}
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| ==Antibody mediated autoimmune diseases== | | ==Antibody mediated autoimmune diseases== |