AUTOIMMUNITY – A REVIEW

Chaitanya Kiran PullelaB.Pharm

VJ’s College of pharmacy.

Introduction

• Immunity – It is the ability of the body to defend itself

against specific invading agents such as bacteria, toxins,

viruses etc.

Introduction

• COMPONENTS OF THE IMMUNE SYSTEM• B - Lymphocytes• T – Lymphocytes• CD4+ cells ( T helper cells)• CD8+ cells (Cytotoxic T cells)• Memory T cells

• The NKCs• Macrophages• Dendritic cells• The MHC antigens (HLA)• Cytokines

Introduction

• Innate immune response :• First line of defense• Non – specific• Examples : Physical – skin, mucosa

Biochemical – complement, Lysozyme, IFNs Cellular – NKCs, Neutrophils, Monocytes, Macrophages

• Adaptive immune response• Specific towards a particular antigen

Tolerance

• It refers to a state in which an individual is incapable of

developing an immune response against a specific antigen.

Self – tolerance refers to the lack of immune responsiveness

to one’s own tissue antigens.

• Self – tolerance mechanisms

• Central tolerance - deletion of self reactive T &B lymphocytes

during their maturation in central lymphoid organs

• Peripheral tolerance – Back up mechanisms

Autoimmunity

• Is the condition when the immune response takes place

against the normal endogenous proteins.

• The disease resulting from this phenomenon is called as an

“AUTOIMMUNE DISEASE”.

• Mainly seen in young adults.

• Females are at a higher risk of developing an autoimmune

response. But the reactions occurring in men are more

severe.

Classification of Autoimmune diseases

• SYSTEMIC (Not tissue specific)

• Systemic lupus erythematosus (SLE)

• Sjögren's syndrome

• Scleroderma

• LOCAL SYNDROMES (Tissue specific)

• Endocrinologic : IDDM, Hashimoto’s disease

• Gastrointestinal : Crohn’s disease

• Dermatologic : Vitiligo

• Hematologic : Idiopathic Thrombocytopenic purpura

• Neurologic : Myasthenia gravis

Pathogenesis

• Failure of Activation-Induced Cell Death

• Breakdown of T-Cell Anergy

• Molecular Mimicry

• Dendritic cell malfunctioning

• Cryptic self exposure

Triggers• GENES• INFECTIONS

• Viruses : Hepatitis C virus, Hepatitis D virus, Coxsackie B virus• Bacteria : Treponema pallidum , Streptococcus pyrogenes• Other: Trypanosoma cruzi, Ochocerca volvulus

• DIET• Cow’s milk• Gluten

• Chemicals• Mercury, Copper, Iron, Iodine

• DRUGS• Hydralazine and Procainamide• Quinidine

Diagnosis• INFLAMMATORY MARKERS

• ESR• CRP• Ferretin

• AUTOANTIBODIES AND IMMUNOLOGIC STUDIES• ELISA• Anti nuclear antibody• Anti neutrophil cytoplasmic antibody• Anti phospholipid antibody

• FLOW CYTOMETRY• CYTOKINE STUDIES• MHC

Treatment

• IMMUNOSUPPRESSANTS

• Corticosteroids• Prednisone• Prednisolone

• Immunophilin ligands• Cyclosporine• Tacrolimus• Sirolimus

• Mycophenolate mofetil (MMF)

• Thalidomide

Treatment• CYTOTOXIC AGENTS

• Azathioprine• Mercaptopurine• Cyclophosphamide• Leflunomide• Methotrexate• Vincristine

• IMMUNOSUPPRESSIVE ANTIBODIES• Immunoglobulin Intravenous• Adalimumab• Infliximab• Etanercept• Alefacept

Treatment• OTHER DRUGS

• Chlorambucil• Hydroxychloroquine• Gold compounds• Interleukin -1 antagonists• Sulfasalazine

THANK YOU