BHD RMSK- Combined

characteristics of the immune system

innate v. adaptive immunity

systemic inflammatory response

acute phase reactants (APRs)

induction of acute phase reactants (*key point)

how do we measure inflammation?

laboratory measures of APRs (*)

laboratory measures of APRs- CRP

fever during infection

mechanism- fever during infection (*)

mechanism- fever during chronic inflammatory disease (*)

anemia of chronic inflammation (aka anemia of chronic disease)

hepcidin (*)

function of hepcidin (*)

hepcidin and anemia (*)

anemia of inflammation

cachexia- loss of muscle driven by chronic inflammation (*)

atherogenesis/thrombosis (*)

atherogenesis/thrombosis- chronic inflammation (*)

links between inflammation and thrombosis

auto-inflammation (*)

inflammasome

familial mediterranean fever (FMF)

adult onset still’s disease

adult onset still’s disease progression and treatment

systemic juvenile idiopathic arthritis (sJIA)

macrophage activation syndrome (*)

summary

potential targets of immunomodulators

glucocorticoids- background

glucocorticoids- mechanisms of genomic effects

glucocorticoids- non-genomic effects

glucocorticoids- side effects

“anti-metabolites”

-interfere with biochemical reactions necessary for DNA replication

-methotrexate, sulfasalazine, leflunomide

methotrexate- use and dose

methotrexate- pharmacology and cellular transport

methotrexate- mechanism

methotrexate- side effects

methotrexate- pregnancy

leflunomide- use

leflunomide- mechanism

leflunomide- mechanism with DHODH

leflunomide- side effects

sulfasalazine- use

sulfasalazine- mechanism

anti-malarials

-hydroxychloroquine

-chloroquine

-quinacrine

-others

hydroxychloroquine- use

hydroxychloroquine- mechanism

hydroxychloroquine- mechanism

hydroxychloroquine- side effects

cytotoxic agents

azathioprine

azathioprine- toxicities

cyclophosphamide- metabolism and uses

cyclophosphamide- mechanism

cyclophosphamide- side effects

mycophenolate- metabolism and use

mycophenolate- mechanism

mycophenolate- side effects

calcineurin inhibitors

calcineurin inhibitors- mechanism

targeted therapies

janus kinase (JAK) inhibitors

targeted therapies- monoclonal Abs and JAK inhibitors

IVIG- use

Sjogren’s

Sjogren’s pathogenesis

autoimmunity & tolerance

Sjogren’s symptoms

Sjogren’s skin symptoms

Sjogren’s musculoskeletal symptoms

pulmonary disease in Sjogren’s (*)

Sjogren’s with ILD (*)

genitourinary Sjogren’s symptoms

GI Sjogren’s symptoms

renal Sjogren’s symptoms

neurological Sjogren’s symptoms

other Sjogren’s symptoms

Sjogren’s diagnostic workup- labs

Sjogren’s diagnostic workup- histopathology

Sjogren’s ocular tests

Schirmer test

xerostomia- objective tests

sialometry

ACR-EULAR Sjogren’s classification criteria

general recommendations for Sjogren’s treatment

treating xerostomia

stimulating salivary flow

-sugarless candies/chewing gum

-secretagogues

pilocarpine

cevimeline

oral secretion replacement

xerophthalmia

tear replacement

minimizing tear loss

other medications for dry eye

immunomodulatory or immunosuppressive therapy

Ianalumab and Telitacicept

Sjogren’s take home points

anti-phospholipid antibody syndrome (APS)

types of APS