Immune response and RA

What are the 2 responses of the immune system ?

Acquired (T-cell and B-cell)

Innate (bloodbourne, physical barriers)

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Antibodies are immunoglobulins, they bind to antigens to destroy them
GAMED

IgG= most abundant antibody, for bacterial and viral infections, protection for unborn baby
IgA= protect from pathogens in mucous membranes
IgM= in blood and lymph fluid, fights new infections
IgE= for allergic reactions
IgD= least understood

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What is the immune system?

Finely tuned network to protect us from foreign antigens, pathogenic microorganisms. Immunity is the reaction of WBC to these pathogenic microorganisms.

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Sometimes network breakdowns, immune systems acts inappropriately, causing hypersensitivity which is an altered immune response to an antigen resulting in disease or damage to host.
Give examples of HYPERSENSITIVITY

1. Exaggerated against environmental antigens, allergy
2. Misdirected against host own cell, autoimmunity (self-antigens)
3. Directed against beneficial foreign tissue, transplant or transfusion (alloimmunity-other persons antigen)
Or
4. Deficiency in im

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What is immunity and antigen?

Immunity= protective response to antigens

Antigens= substance recognised by the body as foreign, causes immune system to produce antibodies against it

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Hypersensitivity reactions can be classified in 2 ways which are?

By its trigger (allergy, alloimmunity)

By the mechanism that causes disease

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An example of alloimmunuty in unborn baby?

FNAIT- Foetal/ Neonatal Alloimmune Thrombocytopenia, bleeding disorder antibodies destroy child’s platelets

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Mechanisms of hypersensitivity
4 types of hypersensitivity reactions to a target antigen.
ABCE

Type I= IgE Allergic Reaction
Type II= IgG antiBody, tissue specific, cytotoxic
Type III= IgG, IgM, Immune Complex
Type IV= Delayed, cell mediated takes time involves T-cells

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Immunodeficiency disorders
2 types
Primary immunodeficiency: hereditary, congenital
Secondary immunodeficiency: acquired deficiencies

Primary are at birth, secondary acquired after birth and not related to genetic defect but as a result of nutritional deficiencies. Also in secondary latrogenic/ drug therapy, trauma/ infection and stress causes.

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What is Rheumatoid arthritis?

Chronic systematic autoimmune disease, causing chronic inflammation of connective tissue in joints.

The surface area of ARTICULAR cartilage is damaged.

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Diagnostic factors of RA?

Symmetrical joint swelling
50-55 years
Female
Joint pain & swelling
May feel BOGGY

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Definitions of joint pain

Bilateral metacarpophalangeal- palm of hand to fingers
Proximal interphalangeal- between first and second phalange
Metatarsophalangeal- joints between metatarsal bones of foot and proximal bones of toes.

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Other signs and symptoms

Morning stiffness of joints
Osteoporosis
Rheumatoid nodules (subcutaneous nodules on arms, elbows and pressure points on feet and knee)
Dry eye and mouth (Sjogrens syndrome)
Carpal tunnel syndrome
Lymphoma

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Risk factors

Family history
Sex -women

Smoking
Environmental-asbestos
Obesity

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Later in the disease pain is caused by sclerosis of subchondral bone and new bone formation. What is this?

Sclerosis is stiffening on tissue, subchondral is the layer just below cartilage.

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RA can cause bursae, what is this?

Fluid filled sacs, when they rub area is called bursitis as inflamed.

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What are autoantibodies?

Antibodies that attach host tissues, self-antigens - termed as rheumatoid factors.

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Name for hardened arteries

Atherosclerosis, build up of fatty plaque

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Drugs used to treat RA = steroids which can cause?

More susceptible to infections long term,
‘Bone rubbers’- more likely to get osteoporosis

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What is a degenerative disease of joints?

Osteoarthritis

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An antigen with an antibody bound to it

Immune complex

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Artois be damage results in 3 processes which are ?

1. Neutrophils, T-cells in synovial fluid activated, degrading surface layer of articular cartilage
2. Cytokines cause chondrocytes (cartilage cell) to attack cartilage
3. Synovium digests cartilage, releasing inflammatory molecules.

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Phagocytes of inflammation?

Neutrophils and macrophages

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Meaning of occluded?

Blocked

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Immune response and RA

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