Autoimmune and Hypersensitivity Disorders

TYPE 4 HYPERSENSITIVITY

Targets the CNS, antigens are myelin proteins (MBP, MOG, PLP, MAG, lipids) and the antibodies target the proteins

Multiple Sclerosis

TYPE 4 HYPERSENSITIVITY

Targets pancreatic beta-islets for the glutamate decarboxylase receptor, insulin receptor and insulin; infiltrates make their way into the islets.

Type 1 Diabetes

Targets the small and medium sized intrahepatic bile ducts for the mitochondrial antigens; produces AMAutoantibodies

Primary Biliary Cirrhosis

targets the liver; chromatin, ribonucleoproteins, asialoglycoprotein receptor, F-actin and CYP2D6 antigens

Autoimmune Hepatitis

Targets the bile ducts; Tubulin beta-5 antigens, antineutrophil, antiendothelial cell antibody; “onion-skin” lesions

Primary Sclerosing Cholangitis

Targets the GI tract; antigens are Tubulin beta-5 and desmin

Crohn’s Disease

TYPE 2 HYPERSENSITIVITY

Targets the thyroid receptors with anti-thyroid receptor antibodies

Grave’s Disease

Targets the colon by attacking desmin and Tubulin beta-5

Ulcerative Colitis

Targets the small intestine via tissue transglutaminase antigen; marked by IgA infiltrates

Celiac Disease

Targets the adrenal glands via 21-hydroxylase (CYP21)

Addison’s Disease

Targets several organs: lungs liver kidneys CNS but mainly salivary/lacrimal glands via La phosphoprotein

Sjogren’s Disease

TYPE 3 HYPERSENSITIVITY

Targets many organs via nucleic proteins with antinuclear antibodies. Picture is nephritis caused by this

SLE

TYPE 4 HYPERSENSITIVITY

Targets the synovium of joints via antigens such as collagen, ccp, fibronectin, keratin

Rheumatoid Arthritis

TYPE 1 HYPERSENSITIVITY

a Dermal edema and perivascular and interstitial inflammatory cell infiltration with minimal epidermal change

b Dilatation of small vessel and swelling of endothelium (arrows)

c Perivascular mixed cell infiltrate with lymphocytes, neutrophils, and eosinophils.

d Interstitial infiltration. Neutrophils are scattered among the collagen bundles

e Neutrophils are present inside the dilated small vessel. A neutrophil migrates into the vessel wall (arrow)

f Some eosinophils are attached to and emigrated from the vessel wall (arrow)

g Subcutaneous cellular infiltration

Urticaria

TYPE 2 HYPERSENSITIVITY

targets RBC membrane proteins (Rh, I antigen)

opsonizes and phagocytizes RBC’s

Autoimmune hemolytic anemia

TYPE 2 HYPERSENSITIVITY

antigens are desmogliens between epidermal cells; causes skin vesicles

Pemphigus Vulgaris

TYPE 2 HYPERSENSITIVITY

reaction caused by neutrophil degranulation

ANCA vasculitis

TYPE 2 HYPERSENSITIVITY

targets basement membranes of the kidneys and the lungs

complement and Fc-receptor mediated inflammation; nephritis and lung hemorrhage

Good Pasture Syndrome

TYPE 2 HYPERSENSITIVITY

streptococcal cell wall antigen will cross react with myocardial antigen, leading to myocarditis

Acute Rheumatic Fever

TYPE 2 HYPERSENSITIVITY

target the acetylcholine receptor and inhibits binding, causing paralysis and muscle weakness

Myasthenia Gravis

TYPE 3 HYPERSENSITIVITY

streptococcal cell wall antigen may plant itself into glomerular membrane

Poststreptococcal Glomerulonephritis

TYPE 3 HYERSENSITIVITY

causes systemic vasculitis, sometimes by hepB antigens

Polyarteritis Nodosa

TYPE 3 HYPERSENSITIVITY

Causes cutaneous vasculitis from various foreign antigens

Arthus Reaction

TYPE 4 HYPERSENSITIVITY

Inflammation of the intestines by TH1 and TH17 cytokines

Inflammatory Bowel Disease

TYPE 4 HYPERSENSITIVITY

inflammation is mediated by TH17 cytokines - causes destructive skin plaques

Psoriasis

TYPE 4 HYPERSENSITIVITY

causes epidermal necrosis and dermal inflammation by TH1 and potentially TH17 cytokines (think poison ivy)

Contact Sensitivity