CERELYN E.

DACULA, MD
Far Eastern University – Nicanor Reyes Medical Foundation
January 5, 2016 – REFORMATTED THE CASTILLO TRANS

TRIGGERING :

A. MIMICRY
 SLE – SYSTEMIC DISEASE  human cardiac myosin & group B streptococcal
 It affects kidney, spleen, liver, heart almost all M protein
parts of the body
 Self antibodies against self antigen M protein is seen in the heart. So if the group B strep
 They produce immune complex & when this produces infection normally heart will produce
immune complex lodge into the organs, that are antibodies on the myosin. So when the antibodies are
when they start a disease. recognized in the myosin within the heart. They will
 Normally, it must not have immune complex lodge there that’s when the time the patient will have
otherwise they will create for example, in the RHD.
kidneys, they will create sparring or produce or
form granulomas & it will lead to the B. IMMUNE MECHANISMS
dysfunction of the kidney.  TOLL LIKE RECEPTORS – DNA & RNA present
 The immune complex is lodged within the in endogenous complexes (such as apoptotic
organs & it will eventually lead to diseases. debris) may contribute to activating
autoreactive B & T cells by triggering TLR 7/8/9
pathways.

Example: systemic lupus in mouse model

TLR 7/8/9 is involved on the DNA receptors of the
pathogen
- CYTOKINES

 ANTI-IL 12 inhibits transfer of EAE by lymph

node cells activated in vitro by MBP plus CpG
oligo or bacterial DNA
 IL 12 modulation is potent inducer & remitter of
 HLA is deficient, body will produce antibodies relapsing autoimmune encephalomyelitis
against antigen.
 Ankylosing spondylitis – deficiency of HLA B27

SUSCEPTIBILITY- GENETIC FACTORS

THREE MAIN SET OF GENES ARE RELATED TO:

 Immunoglobulins
 T-cell Receptors
 Major Histocompatibility complex (MHC)

HLA DR2 HLA DR3 HLA DR4

strongly Strongly with Rheumatoid
correlated with Sjogren’s, arthritis, DM
SLE & MS & myasthenia Type 1,
negatively with gravis, SLE & pemphigous
DM Type 1 DM Type 1 vulgaris

Most notable MHC Class 1 correlation

HLA B27 – ankylosing spondylitis
CERELYN E. DACULA, MD
Far Eastern University – Nicanor Reyes Medical Foundation
January 5, 2016 – REFORMATTED THE CASTILLO TRANS