?????? ( Autoimmune Diseases )

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??????( Autoimmune Diseases )

• ?????? ??
• 95.05.09

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Historical development

• 1900. Ehrilichs (horror autotoxicus)
• 1900-1940. no general notion of autoimmune
• dieases existed and
  autoantibodies
• were arcane immunologic
  curiosities
• 1950. clinical observation
• 1.Antiglobulin test
• 2.LE cell
• 3.Rheumatoid factor
  

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Historical development

• 1970-1980. ??????
• T-cell B-cell MHC HLA APC
• 1980. Molecular biology

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What is Autoimmunity What is Autoimmune disease
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Etiology of autoimmunity

• 1.???estrogens
• 2.??HLA class ? DR DQ DP
• 3.????
• 4.agefrequently womengtman
• 5.????

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HLA- class ? association

• RA DR1DR4
• SLE DR3
• IDDM DR3DR4

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????

• 1.????autoimmune
• ??. ??. ????
• 2.?????autoimmune
• uv. chemicals. medical drugs.
  Silicone?

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???????????

• (1) ?????(organ-specific)
• ???????????????? ??????? ?
• (2)?????????(systemic autoimmune) ???????

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Organ specific diseas

• 1.Thyroid
• Hashimotos???????
• 2.Stomach
• pernicious anemia????
• 3.Adrenal
• (Addison's disease)?????
• 4.Pancreas IDDM???????

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Non-organ specific diseas (systemic autoimmune)

• 1.Muscle
• ?????????
• 2.Kidney
• SLE????
• 3.Skin
• scleroderma???
• 4.Joint
• RA??????

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???? ????

• 1 anti-Sm ?????
• 2 anti-SCL-70 ???
• 3 Jo-1 ?????????
• 4 Ro/SSA ???????????
• 5 La/SSB ????????????
• ?????????
• 6 CANCA(protinase3) ???????? ???
• 7 PANCA(MPO) ????????????.??

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???? ????

• 8 anti-Thyroglobulin ?????????
  
• 9 anti-Sm/RNP ?????????(MCTD)
• 10 anti-DsDNA ????
• 11 RF RA
• 12.anti-Ach receptor ?????
• 13.anti-platelet ab

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ANTI-ENA

• 1.Anti-ENA-Ro/La Ab
• 2.Anti-ENA-Sm/RNP Ab
• 3.Anti-ENA-Scl-70 Ab

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?????
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??????
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?????????

• ?? ???
• ???????
• ???
• ?????????
• ???
• ???Sjogren????

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?? ???

• 1.age10-50 ?gt?91
• 2.fever
• 3.skin??
• 4.?????
• 5.???
• 6.???16-35
• 7.HLA-DR3

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??????????????

• 1????????(????????)?
• 2??????(??????????)?
• 3??????(??????,???????)?
• 4??????(????,????)?
• 5????????????
• 6????????0.5????????
• 7?????????
• 8?????????(??????????)?
• 9???????????????????
• 10??????DNA?SM??(????),?????????????????(LE
  cell)???
• 11?????(ANA)???

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SLE??????

• ANA?
• C3.C4?
• ESR?
• Proteinuria?
• IgG?
• Anti-dsDNA
• ??

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????????????????????

• ???(Homogeneous)??????????????
• ?????(Speckle)???????????????
• ???(Nucleolar)????????
• ????(Centromere)????????

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??ANA????

• 1.???????????????
• 2.??????B????C????
• 3.??????
• 4???????
• 5??????????? .

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ANA???

• SLE gt95
• RA 20-30
• IDDM 20
• Sjogrens 50-60
• Normal lt5
• gt70?? 10
• ??? 60-70

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RA?????

• 1?ESR
• 2?CRP
• 3?RA
• 4?ANA
• 5?C3 C4
• 6?Anti-CCP??????????

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???????7(4) ?? ?

• 1????????????,
• 2?????????????????,
• 3??????,
• 4???????,
• 5??????,
• 6????????????,
• 7?X????????

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???????????

• ??????????????????????,??????????,????????????????
  ??????????????????????????????????????????,???????
  ,?????????????,????????,????????

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?????????????

• ???????????????????????????,????,?????????????,???
  ??????????????????????????,????,???????????,??????
  ?,?????????,????????????????

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?????????????????

• ???,???????????????,????????????,??????????,??????
  ???????,??????????????????????????,???????????????
  ??

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????????????

• ?????????????????X?????????,??????????????????????
  ??????????,?????????????????????

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END????